The MCDH Planning Committee May 20 2019

The Mendocino Coast District Hospital (MCDH) Board of Directors Planning Committee will address the following issues:

Planning Committee Transparency

This was one of the most shocking public behaviors I have recorded. Amy McColley made accusations about lack of transparency to committee members John Allison and Carol White. Accusations of dishonesty and disingenuous motives while attending committees and in their public persona, about 2 year old emails, left the room taken aback. Insisting that John Allison must represent The Hospital Foundation, since he was the president of The Hospital Foundation seemed like something that should have been discussed at The Hospital Foundation Board of Directors.

Carole White handled her accusations with aplomb, explaining the very natural reasons for using certain terms and then said that this type of misunderstanding could have been easily handled with a few questions privately. By dropping these accusations in the manner Amy did, with the wild speculations accompanying them, was counterproductive, to say the least and did nothing towards building a committee with a common plan

Ambulance Service Plan

John Allison presented a plan in which the hospital sees more effective utilization of the ambulance as they leave the Coast by integrating it into the swing bed arrangement they recently entered into with Howard Memorial Hospital. By picking up patients while returning to the Coast they may pick up some additional revenue.

Parcel Tax funding for the ambulance district

Expanding ambulance coverage to outside of the district as explained in John Allison’s report may jeopardize the critical emergency response capability members of the coastal community have come to depend on. The community has responded to all surveys with ER and a responsive ambulance as their first choice of where the hospital should allocate resources with OB a close second choice.

Having witnessed three situations in the last three years where the air ambulance couldn’t land due to weather conditions and the evacuation was to be performed by the ambulance but the ambulance drivers and paramedics hadn’t had the required rest period before driving. In 2 of these conditions the patients were bleeding internally. Those two hours where there is nobody available to drive the ambulance are a serious time gap and are critical! During the last one FBFD was involved in getting the patient out of their bed and into the ambulance and Westport FD was backing up the existing ambulance.

I propose the committee overseeing the allocation of the parcel tax funds consider, since the Hospital is considering expanding their ambulance business, including more patient transfers for the swing bed program, I suggest we consider directing enough of the parcel tax to:

• Bring the ambulance district employees to full staffing levels so there is no down time because of mandated rest time.
• Buy the best ambulances and equipment looking ahead 20 years.
• Be prepared for treating and transporting multiple burn victims.
• Purchasing a hyperbaric chamber for decompression sickness.
• Discuss and integrate Mentally Ill transportation to Mental Health facilities and all that requires. (work with FBPD who is purchasing a prisoner transportation vehicle)
• Purchasing and supporting the proper navigation equipment and landing space for 24/7/365 air ambulance support.

Affiliation Update

Wayne Allen announced that they were in delicate negotiations with the Seventh Day Adventists. These were to be attended by the 2 board members on the Planning Committee and himself. These meetings are closed to the public and the press and will be reported on. Since this will be an ad hoc committee it will not be subject to the Brown Act.

Currently, only two of the 5 healthcare organizations that were sent Request For Proposals (RFP) by Interim CEO Wayne Allen have indicated interest in affiliating with Mendocino Coast District Hospital. (MCDH).

Adventist Health spent two days at MCDH assessing the hospital, its services and facilities.  American Advanced Medical Services (AAMS), a Private for Profit Corporation, organized and operated by a group of physicians in Modesto, came to the hospital for about two hours and then video conferenced into the Planning Committee meeting.  Two systems, Dignity Health and Sutter Health did not respond and Providence Health indicated they are not interested in affiliating with MCDH.

The information shared by AAMS, indicated to me that while they did realize that continuing to provide Obstetrics (OB) is vital to this community, they had not really done a deep dive into MCDH information easily accessed on the internet, particularly by all the videos recorded by Mendocino TV over the last 4 plus years available.  And, while using AAMS for several hospital closures facilitated by Wayne Allen, they have closed OB and not all the hospitals continued successfully. 

Other ideas they presented were regarding cosmetic renovations, better marketing, expanding clinic services including prenatal care and increasing local births, increasing swing bed rehabilitation and a strong hospitalist program, which MCDH has done already by hiring Dr. Miller as a Hospitalist Manager. A key to AAMS successes was building a cadre of local doctors to staff the Emergency Department (ED), as the MCDH previously did, as a key to their success because they work to keep patients at the local hospital rather than transferring them out of the area, to keep the patient population more robust. AAMS will do a presentation to the MCDH Board soon.

It does appear that the Adventist Healthcare system is the most likely to respond with a proposal that will best serve this community’s needs.  Clearly, the biggest stumbling block to overcome will be the Coastal Community’s insistence that women’s health, including abortions, be available.  Dr. Barbara Killion, representing MCDH medical staff, also wants to assure that services are available to everyone, including low income, older and the LGBQT communities accessible.

CEO Wayne Allen made a commitment to hold many community meetings to discuss the pros and cons of any proposals that are submitted by June 30.  As he said, the community wil make the final decisions, as it will require a positive vote from the people in this district, to make such a massive transition that will impact MCDH for potentially decades. Mr. Allen did indicate he may call the Ad Hoc Affiliation Committee together to consider proposals that may come before the June 30 deadline. 

Mendocino TV has concerns about the fact that this group only consists of Mr. Allen, who is only Interim staff with no accountability in the long run, Jessica Grinberg, who already has a fiscal relationship with the Adventists and Amy McColley, who often participates remotely from San Francisco.  So, building trust and convincing the public that affiliation is the best solution to its financial, operational and leadership issues are critical. People need to closely follow the MCDH issues as they are complex and will impact the community in many ways, keeping in mind that a viable Emergency Department and Obstetrics consistently rank at the top of voters’ priorities in the last two community surveys.

Women’s Health

Amy McColley played a slide show marketing presentation about her desire to hire a gynecologist specializing in certain procedures. This prompted an outburst at the end of the committee meeting when Lucresha Rentaria, MCC inc CEO, questioned the presentation as filling a need, when Lucresha’s organization, Mendocino Coast Clinics Inc., has been filling in for the hospital’s staffing coverage and has been directed to start actively recruiting someone to fill that OB/GYN position. This was in direct opposition to an agreement written by the previous board and management with MCC Inc and misdirects vital resources.