Coast Hospital Rifts Widen

There is a distinct rift within the Board of Directors of Mendocino Coast District Hospital (MCDH). The divide between new physician board members William Rohr and Peter Glusker and holdovers Tom Birdsell and Board Chair Sean Hogan was clearly in evidence at a August 27th meeting.

The event started fairly magnanimously with unanimous votes to further extend the negotiation period for Dr. Diane Harris through the end of the year (see earlier AVA articles for background on the uproar over Dr. Harris' contract). However, signs of disconnect were apparent from the first minutes when Chair Sean Hogan reported on matters from the closed session that preceded the public board meeting. Hogan stated that the employees union had concluded voting on a contract extension, but that he did not know the results of the vote. Apparently Hogan doesn't stoop to reading the AVA online or he would have known that more than 80% of the union voters approved the contract.

The crapola hit the fan during “New Business.” The item that sparked the fan was labeled “Determine MCDH negotiator for Dr. Diane Harris' contract.” Board member Tom Birdsell and MCDH's local attorney John Ruprecht made it clear that they did not want to set a precedent by having anyone other than CEO Bob Edwards negotiating contracts. Drs. Rohr and Glusker proved equally insistent in reminding the board and the audience (largely hospital staffers) that it had been Edwards' proposed contract offer to Harris that had stirred up so much consternation that a couple dozen of Harris' patients had shown up at a special board meeting ten days earlier to express their displeasure at the whole contract mess.

This particular item was eventually solved when Chair Hogan and Board member Kitty Bruning (who may not have spoken a dozen words in the entire three hour meeting) voted “aye” on a Glusker and Rohr motion to find something approaching middle ground (read as: a state mediator or arbitrator is likely to be the party bringing about the final contract agreement with representatives of Dr. Harris and the hospital, neither of whom will be Dr. Harris' spouse—Fort Bragg City Councilman Doug Hammerstrom— or new Coast Hospital CEO Bob Edwards).

But we weren't done with the issue of Dr. Harris or the contract proposed to her by CEO Edwards in July. Nor were we done with the displeasure of the old guard (Birdsell, Hogan, and attorney Ruprecht) over the emergency motion made by Glusker, and seconded by Rohr, at the August 17th special MCDH Board meeting to offer Dr. Harris an extension to her current contract for the purpose of negotiating a new one.

Chairman Hogan read forthwith from codes and regulations detailing the exact letter of the law regarding regular, special, and emergency board meetings. The upshot of Hogan's recitation proved that he (Hogan) did not believe the action taken in extending Harris had been played according to Hoyle. He didn't ask for a re-deal, but his recitation gave Birdsell and Ruprecht opportunity for self serving I-told-you-so remarks.

Dr. Rohr essentially responded with words that said he believed more in protecting the rights of Dr. Harris' patients than any code. Glusker echoed those sentiments and Rohr came within two or three syllables of saying that the detailed code could be shoved where the sun don't shine.

Game on. Not to mention hypocrisy volleyed into Chair Hogan's court. You see it was this same Sean Hogan, this stickler to the intended detail of state codes who had sat himself down in the audience of MCDH's Finance Committee meeting just a few days earlier. The same Sean Hogan who then proceeded to take an active part in discussion on agenda items of said same Finance Committee, thus violated California's Brown Act (see my previous article on MCDH for more on that Finance Committee meeting of August 25, 2015).

By the time the August 27th meeting got down to “Old Business” the rift split into a chasm. The item: MCDH Primary Care Physician Boilerplate Contract Discussion. After Dr. Glusker affirmed Dr. Rohr's belief that the so-called “boilerplate” contracts were only to be used as a tool in recruiting beginning physicians and not to be used in negotiating renewal contracts with long established coastal physicians, like Dr. Harris, Tom Birdsell said that he thought Glusker had gone along with the idea of using the “boilerplate” contracts for CEO Edwards to negotiate with Dr. Harris. Dr. Glusker flatly denied any such thing. Furthermore, both Glusker and Rohr adamantly stated that each of them would have refused to sign such a “boilerplate” contract as the one offered by CEO Edwards to Dr. Harris and at least two other North Coast Family Health Center physicians.

Rohr and Glusker counter punched the meeting to a close with charts and graphics concerning the hospital’s financial situation. This proved somewhat anticlimactic after the verbal body blows to the MCDH Board's holdover members. Rohr's financial presentation concluded with something of a refutation of the status quo with his visual statement that the proposed budget's projected $860,000 loss for fiscal year 2016 was “unacceptable.”

* * *

The Mendocino Coast District Hospital (MCDH) has reached agreement with its employees union. The union ratified the contract proposal, with approximately 85% of its voting members in favor. The contract thus agreed upon is a one year extension of the existing contract.

The idea to continue under the old contract for one more year came from the union. The bigger story lies in what the hospital administration had previously offered the employees union. According to a source familiar with the situation, initially MCDH offered a proposed contract that would have “trashed” the health insurance benefits of the employees, greatly increasing what employees would have to pay out of pocket for less coverage in order to maintain any health benefits whatsoever.

The union flatly refused that offer. Next, MCDH apparently attempted a divide and conquer strategy by offering the hospital's nurses, lab technicians, and X-ray techs a 10% raise. The flip side of that offer: every MCDH employee below the nurse and tech salary level would end up paying for their own insurance.

As an old teacher used to say, "there you have it," a hospital administration attempting to cut the health benefits of hospital employees, including caregivers. More math: the same hospital board of directors just hired (Spring 2015) a new CEO, Bob Edwards, for $320,000 annually plus a plum benefits package. The previous CEO, who was at times also performing the job of chief financial officer, received approximately $215,000 in annual salary. In addition, the hospital has just hired a new full time chief financial officer (CFO), Wade Sturgeon. What his salary will be is not known at this time.

The best guess is that the contract proposals to the employees union came directly from Mr. Edwards, considering that at least one member of MCDH's Board of Directors was not fully aware of the negotiation tactics as of the third week in August. Generally, a board of directors would not take any direct role in negotiations. However, it is the MCDH Board of Directors who are ultimately in charge, so these contract proffers to the employee union cannot be completely shunted aside as the responsibility of someone else.

At MCDH's August 25th Finance Committee meeting interim CFO Steve Miller detailed July, 2015 figures that showed the hospital with a net revenue loss of $36,872 for the month, a loss that was also $108,000 more than the projected budget. However, Miller spoke in optimistic terms about MCDH's long term potential to avoid a reversion to bankruptcy.

Speaking of that nasty term, bankruptcy. Everyone present at the August 25th Finance Committee meeting received a handout specifying MCDH's year by year schedule of payments through 2024. All of these numbers are subject to bankruptcy court approval, but here are the total annual payment obligations of MCDH.

2016: $1,370,473;

2017: $1,638,595;

2018: $1,547,177;

2019: $1,635,794;

2020: $1,420,742;

2021: $1,118,864;

2022: $1,113,921;

2023: $861,216;

2024: $857,654.

That adds up to $11,564,434. Readers should keep in mind that by law MCDH will be required to have a new hospital building in place by 2030.

Three members of MCDH's Board of Directors were newly elected last fall. Two of them, Drs. William Rohr and Peter Glusker are on the finance committee. Both seem intent on digging deep into the dollars that make up the MCDH budget as well as finding sensible ways to make prudent decisions on which departments need cuts and which need investment. However, these tough fiscal decisions will have to be made with two holdover board members still in the voting picture.

The two holdovers are Board Chair Sean Hogan and Tom Birdsell. These two require mention at this point in regard to the Brown Act. The Brown Act (1953) guarantees the public the right to attend civic meetings. Within the Brown Act are rules of law regarding the members of elected bodies such as the Mendocino Coast District Hospital's Board of Directors. One of those Brown Act provisions states: "The attendance of a majority of the members of a legislative body at an open and noticed meeting of a standing committee of that body, provided that the members of the legislative body who are not members of the standing committee attend only as observers." Thus, every member of an elected board, like MCDH's Board of Directors, could attend a committee meeting as long as they don't participate in that committee meeting.

The MCDH Board of Directors is made up of five members. The MCDH Finance Committee has two members of that Board on it. Dr. Rohr chairs the Finance Committee. At the August 25th Finance Committee, MCDH Board Chair Sean Hogan (a retired attorney) sat in the audience, but he did not remain a silent observer for long. He actively sought the attention of the committee, then proceeeded to give his opinion on agendized matters. If memory serves correct, Tom Birdsell was present at the May Finance Committee and also particpated in discussion with the committee during its meeting.

The MCDH Board of Directors appears to have grown accustomed to doing things without public scrutiny. The holdover members need to clean up their act in respect to not only dollars, but also common sense.