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Coast Hospital, Round Three

Think it is time for some clarification. I have seen this posted on Facebook and heard it so many times I started to believe it myself, that being that the election for the Board of Directors to represent the Mendocino Coast Health Care District (MCHCD) would take place as part of the June 2022 primary. It will not. That election occurs in November of this year, not June. A call to Mendocino County Clerk Katrina Bartolomie confirmed the November election for all special districts. County offices, like the Third and Fifth District Supervisors' seats, will be up for election in June, with runoffs (if necessary) taking place as part of the November election. BTW: Both Supervisors John Haschak and Ted Williams have completed the preliminaries for filing for re-election.

In the coast health care district, four of the five seats will be up for grabs. Jessica Grinberg, Amy McColley, and John Redding were all elected in November 2018 and took office in January 2019. Their seats all represent four year terms of office. Norman deVall's seat will become a two year term in the November election. As readers may recall, deVall, the former four term county supervisor was appointed to his seat in fall 2020.

In prior weeks this space described the agreement between MCHCD and Adventist Health that allows AH to run the day to day operations at the Fort Bragg hospital which is now called Adventist Health Mendocino Coast (AHMC). The thirty year lease at the heart of the affiliation agreement provides several opt-out scenarios for Adventist Health. AH can opt-out of the deal after three, five, ten, fifteen, twenty, and twenty-five years. The three year opt-out would occur on July 1, 2023. The potential opt out is contingent on economic reasons spelled out in Section 19.10 of the agreement. “Tenant [Adventist Health] may terminate this Lease if Tenant determines that the EBITDA [Earnings Before Interest, Taxes, Depreciation, and Amortization] from the Medical Business is less than five percent (5%) of the net revenue for the immediately preceding twelve (12) month period prior to the date of determination...”

In this scenario AH would have to give 270 days (nine months) notice to the healthcare district. But let's hold onto our seats. Adventist Health is not going to opt-out in the middle of 2023. AH is in the process of investing about thirteen million dollars on a new electronic medical records (EMR) system

at the coast hospital. A corporation or a non-profit or anyone is not going to pull out willy-nilly after a mere three years and leave that sort of investment behind. 

Implementing that EMR system has caused some problems in communication with the main hospital and at its clinic, including getting prescriptions filled in a timely manner this past fall. Corrections have been made, especially at the hospital's clinic. However, this is still an ongoing work in progress. Patients should remember that simple prescription refills can almost always be handled by contacting your pharmacy first. Always allow one week in advance. In other words, if you need a refill do the math and contact the pharmacy at least five days before you run out. Part of efficient healthcare means patients advocating for themselves or having someone who will.

In addition to improving an antiquated EMR system, AH has obtained a new group of radiologists for the coast hospital, according to AHMC President Judy Leach. She acknowledges the generosity of the Mendocino Coast Healthcare Foundation for assisting in the purchase of a new ultrasound machine and a new mammography unit that will be installed soon. Leach says AH is actively engaged in national searches to bring new doctors, including specialists to the coast facility. A husband and wife team, she a physician, he in behavioral health, have recently relocated to the coast.

AH is handling the crucial aspects of day to day during a pandemic that has stretched out to include their entire tenancy. Even if one discounts Covid patients, the daily census of patients has risen from less than five per day when AH took over in 2019 to regular census averages in the teens recently.

So, if AH is here to stay for the foreseeable future, the critical question left for coast residents is what kind of long term facility will we decide on. By 2030 all California hospitals are required to meet seismic retrofit standards or close their doors. The hospital facility in Fort Bragg is split into seven distinct buildings for seismic regulation purposes. Only one of those buildings meets the requirements needed to operate beyond January 1, 2030. The current seismic retrofit law would close the other six, including the main hospital building and all aspects of the emergency room (ER). To upgrade the coast hospital buildings to meet the legal standards set by the state of California could cost $25-30 million. That amount would be borne by the taxpayers of the Mendocino Coast Health Care District (MCHCD).

There is a possibility that the state legislature may act to push that deadline farther into the 2030s. Nevertheless the coast hospital is over fifty years old. AH may use it as is for several years, with help from the $2 million Improvement Fund that coast taxpayers agreed to pay each year as part of the affiliation agreement. In 2019 and 2020, it also appears that AH has benefited from funds from the Measure C parcel tax (passed in June 2018). That fund brings in about $1.6 million annually from property owners. At the October 2021 Oversight Committee (for the Measure C money) a question was asked as to whether the Measure C dollars could be spent for other healthcare needs, including recruiting and retaining providers independent of AH. One of the crucial paragraphs within Measure C states that its dollars are intended for “attracting and retaining high quality doctors and nurses... and providing essential healthcare to residents of Mendocino County.” 

It will be interesting to see if Measure C continues to be merely a supplementary money pot to the $2 million Improvement Fund accommodating only Adventist Health or if it is used in the manner suggested above and/or used as part of saving toward future facility construction which might benefit all of the above.

As for now, don't look for AH to make any definitive declarations about a new facility until at least this summer. It seems clear, that for the time being AH is tied to a basic tenet that there should be 100 beds available for each 100,000 in population. AH runs fifty beds at its Ukiah hospital, twenty-five in Willits, and the twenty-five available at AHMC. 

Clearly, during Covid surges like the Omicron variant AH is not going to drop the number of beds it wants and needs in a hospital. Whether that view changes as far as a longer term option remains a key question to be answered.

In the background to all this resides Assembly Bill 1400. On January 11th, this single-payer healthcare bill passed the Health Committee by a vote of 11-3. If it becomes law, all Californians would be part of the same health insurer. Paid for through taxes, every Californian would receive medical, dental, and vision care along with pharmaceuticals without co-pays or deductibles.

Our Assembly member, Jim Wood, is the chair of the Assembly Health Committee. He will be on hand at a zoom forum hosted by the Coast Democratic Club on February 3rd at 6 p.m. No doubt he will discuss AB 1400, but much of the get together will be focused on the future of healthcare on the coast and what direction to take regarding retrofitting the current hospital or building a new facility. Representatives from Adventist Health, the healthcare district, and county government will also be on hand. Zoom links and other pertinent information will be announced soon.

One Comment

  1. benjamin graham January 20, 2022

    Run for the Board, Malcolm. Buz

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