MCDH Board of Directors struggles to define roles & relationships

MCDH Report March 2019

The Mendocino Coast District Hospital (MCDH) Board of Directors held their March 28, 2019 Board Meeting in the vast lobby where patients register, accommodating a growing number of community and MCDH staff attendees.  While this wing was built specifically for the purpose of large meetings, this is the first time in its history to happen.  While this leaves the board able to hold closed meetings in a different location from the board meeting, it also gives Mendocino TV enough time to set up our video equipment and microphones now. There are still audio issues we are contending with as we compete with a loud ventilation system.

During Public Comment there was a great deal of community input, generally focused around the idea of MCDH affiliation with another organization, which came out of the blue at the last meeting, surprising many, including some MCDH Board Members.  While opinions are developing on all sides of the issue, it was clarified that the new “Affiliation Ad Hoc Committee” will be looking at a variety of potential agreements with all available organizations. 

People also expressed concern that there appears to be a great deal of decisions being made outside of the public view, even when “transparency” was a rallying cry when candidates ran for this new MCDH Board.  Announcing new members of the Affiliation Ad Hoc Committee along with the apparent potential return of previous CFO/CEO Wayne Allen as a national search for a permanent CEO begins, illustrates transparency concerns.  These decisions had not been discussed openly or as a report out of Closed Sessions. People were stunned at Mr. Allen’s appearance at the last meeting, when the Board refused to answer the questions from the public about why he was there.

Another hot topic is that the American Civil Liberties Union (ACLU) has initiated potential threats of litigation because, while MCDH has Labor & Delivery, women are not able to obtain a medical abortion, which has been true throughout Mendocino County for a number of years. The issue is now being researched legally and will be discussed when that is complete.  Lack of access to medical abortions is also a reason some people objected to affiliation with the Adventist Healthcare system.

This is in addition to the concerns voters have because  a number of staff and committee members are already advocating again, the closure of Obstetrics.  The last two surveys have indicated a majority of people consider having Emergency Department and Obstetrics as the highest service need.  Lucresha Renteria, Executive Director of Mendocino Coast Clinics, announced that the average number of births have decreased only slightly.  She also announced that the OB/GYN candidate she was recruiting declined her offer, which is not surprising given the number of people who are openly advocating slashing OB services.  Killing OB will certainly negatively impact this aging population, as we struggle to keep younger people here to keep our community functioning!  A long time retired employee pointed out that when MCDH had the first Birthing Center in the County, people came here to have babies, rather than go to Ukiah, which was closed by the MCDH Board in 2003.

Dr. Bill Miller, who is now the Hospitalist Program Manager, had some interesting remarks and ideas about the need for MCDH to more actively engage the community to improve the hospital’s reputation.  His impressions, from being here for 1 ½ years, is certainly worth watching on the video.

The bulk of the meeting was a long and sometimes confusing discussion regarding the financial status of the hospital, actions some Board Members are engaging in and the need for more training and learning how to work effectively together. Much of this discussion was around Board & Committee roles and responsibilities, as well as the relationships with management, staff and the community.  The tremendous fiscal and planning needs of MCDH result in need for critical decisions to be made rapidly which impact the future of both MCDH and the Coastal Community. 

The looming deadline around the legal requirement to have the MCDH Earthquake retrofit complete by 2030, or the State will shut our doors, is part of what is driving these decisions.  While some think it can be delayed, apparently Representative Jim Woods has assured everyone that this is a drop dead deadline, which is illustrated by the recent closure of a hospital in Long Beach, who could not meet this goal.

As financial issues continue to drive everything, part of the Board disagreements are surrounding the need for planning and processes to address the MCDH quandaries.  While there is clearly some overlap and joint planning necessary between the Committees, the Board needs to have a retreat to improve their skills and figure out how to proceed. So, it does appear they are scheduling a retreat, open to the public, to handle these problems.

All of these new Board Members say they want more community engagement and participation.  The community is loudly telling them that there are very qualified volunteers ready and willing to participate, that are not being utilized.  A prime example are the volunteers tagged for the Ad Hoc Affiliation, which included people like Linda Ruffing, Linda Jo Stern and Dr. Jeff Berenson, in addition to MCDH staff. Yet none of the existing group of active volunteers or anyone from Mendocino Coast Clinics, the largest health clinic on the coast.  Lucresha Renteria, MCC Executive Director, did ask that she be included, which is critical to its success!

There is a understandable egocentric view of themselves in how MCDH sees their place in the healthcare community. At the same time we see how this leaves the other players in the field at a competitive disadvantage when they look for strategic relationships where all benefit. The needs of MCDH consume all rational discourse in the healthcare community. Until the conversation can be disengaged from what MCDH needs to feed it’s ever changing appetite and demands, we can’t have a discourse that reflects what the whole community wants from a hospital to serve the entire community’s health care concerns and needs. An example of that is how MCDH staff and volunteers see MCC as a resource to fill their needs, yet also as a competitor. This narrow viewpoint of the rest of the healthcare community, as subservient to their needs, is a major reason people go elsewhere for medical care.

The potential hiring of Wayne Allen as temporary CEO also needs some deep research and community input.  Although I was involved a little bit when he was handling MCDH the last time and have no concrete opinions, it appears many of the problems that have emerged over the last few years, including deferred capital expenses and kicking financial woes to the future, happened under his watch as CFO then returning as CEO/CFO.  So, given his experience closing many rural hospitals, what will he do now to put MCDH on solid financial footing now?

We are looking forward to rolling out Polls during our live broadcasts where you can express your opinions and vote on issues as they come up, live. This is the forerunner of a new form of electorate that is both engaged and participates in real time, all the while sitting at home preserving precious natural resources from polluting.

We thought most of the technical issues would be solved with the move to the lobby but there will be incremental improvements. We encountered a ventilating system that generated a prevalent hum on the audio track. We applaud the Board of Directors for taking the first step toward making their meetings more welcoming.

Please do watch this video, so you can see the total picture yourself and become engaged. The health of the hospital holds our community’s future in its hands.  Mendocino TV devotes a vast amount of our resources to bringing you MCDH meetings hoping to educate and motivate you. Watch from home and become active and educated.