MCDH Board continues to struggle to attain balance and support
Mendocino TV has been recording Mendocino Coast District Hospital (MCDH) Board of Directors meetings often over the last 18 months or so. During this period there has been a great deal of emotions expressed in meetings, turmoil among various staff, Board and community members brought to light as well as changes in staff, finances and operations. Given all of these factors, the MCDH community has clearly worked hard to preserve and improve its operations, given the critical role the hospital has in building a healthy community.
Over the last 3 years or so, Mendocino County and its government entities and health care providers have struggled to provide quality medical and behavioral health services to all residents, regardless of their income and immigration status, while making massive changes with the advent of electronic health records, ”Obamacare”, the ageing of both the community and its health care work force, economic instability, rising costs and shrinking resources as well as the looming threat of an earthquake retrofit for the hospital are getting closer every day. These challenges are not unique to the Mendocino Coast, they are felt nationwide right now, especially in rural and isolated communities. This leaves the Mendocino Coast Healthcare District (MCHD), the hospital, local health care providers, government and the community in a quandary about the healthiest directions to take to reach the goals of building a healthy community.
The March MCHD/MCDH Board meeting reflected these factors as the Board and staff struggles to address its future. This meeting reflects some positive changes as Chair Birdsell tried to set clearer rules for discussion and input to rein in the chaos often evident in some prior meetings, although you can see in the video the need to temper his desire for order with a bit more latitude and common sense. While it is evident there are still deep divisions between board members, staff and the community, people appear to be trying to be more civil and rational in their disagreements. It is clear staff and the Board is working to resolve the enormous problems, especially the fiscal and service delivery issues, there is no consensus on how to specifically proceed and the tensions are evident.
The new potential course of action in this meeting is the concept of converting the hospital into a nonprofit organization with the potential of increasing certain reimbursements, which will take a vote of the people. Technically this Board is legally the Mendocino Coast Healthcare District (MCHD), doing business as MCDH, which is different from a standard nonprofit organization, most notably giving it the ability to tax and requires citizen voting for its Board of Directors. This is sometimes confusing to the community and may cause even more confusion if the Board chooses to pursue nonprofit status in the hopes of generating additional new income. The parcel tax plan is also still moving forward. Both of these potential solutions still need a great deal of research and especially community input in a relatively short timeline.
It appears to this observer that before genuine, stabilizing improvements can be made to save our health care resources there needs to be more conflict resolution and communications with all parties including the Board, staff and the community. The Board, management and the medical leadership appear to have begun a process and it needs to move forward quickly and have an impact at all levels of the organization. It appears new management has made some progress with staff relations and improved operations, this may not be universal. There must be an honest dialog with the district residents and a process to rebuild their trust. People generally only remember and share negative experiences and over the years many people have an unhappy story to tell. Additionally, many taxpayers are still feeling ripped off for supporting previous tax increases, most notably the funding for building the new registration area. It is critical that the Board and staff listen receptively to the community and actively address their issues. It will be a challenge to get people involved, to engage them and rebuild their trust. The district citizens, all of us, has a responsibility to participate because the consequences of ignoring our local healthcare issues will be grim.