Keeping the city’s hospital healthy

People responsible for operating health care facilities live in very complicated times. Witness last year’s shuttering and bankruptcy of Sebastopol’s 73-year-old Palm Drive Hospital. The reality of soaring costs and dwindling revenue streams, coupled with economic uncertainties tied to ongoing national health care reform policies, make operating a hospital today an increasingly difficult proposition.

It is against this backdrop that the Petaluma Health Care District is preparing to formally evaluate who will operate our local hospital over the next two decades when its contract with St. Joseph Health System expires in just 16 months. The district’s options include renewing its contract with St. Joseph, seeking a new management partner to operate the hospital or managing the hospital itself, although the latter option appears unlikely.

The responsibility for ensuring that Petaluma’s hospital stays healthy rests with five publicly-elected members of the Petaluma Health Care District board of directors, together with its CEO, Ramona Faith.

Based on a number of focus groups and interviews held earlier this year, the district compiled a report to help it evaluate the kind of services desired at the 80-bed acute care hospital through 2037. The report showed a strong desire for a provider that could maintain emergency services, inpatient services and intensive care, while expanding services like those addressing Petaluma’s aging population, primary care for new patients and greater availability of pharmacy and radiology services.

Participants also expressed a strong desire for a provider that would maintain or even expand the maternity, obstetrics and gynecology programs at the hospital, services that have become less financially viable following cuts to reimbursement rates from Medi-Cal.

In June, the district requested and, according to one board member, has received “multiple” proposals from prospective hospital operators, including St. Joseph.

The district will soon evaluate the various proposals and is expected to make a recommendation on a long-term hospital operator that will need to be ratified by Petaluma voters during an election next year.

At this point, St. Joseph appears to be the front runner despite a sometimes rocky relationship that culminated in a tumultuous 2008 health care district board election in which three candidates critical of St. Joseph were elected to the board.

However, over the last seven years the relationship between the district, local physicians, and St. Joseph has improved markedly.

The problem of physician recruitment and retention, which was a major concern in the 2008 board election, has improved significantly, in part due to the work of the St. Joseph Foundation and the Annadel Medical Group, a physician group supported by St. Joseph. Another significant achievement has been the establishment of an agreement whereby physicians are being paid by St. Joseph to manage the hospital’s operating room, a move that has helped doctors financially.

St. Joseph has also invested several million dollars in information technology and other new, state-of-the-art equipment that has improved the quality of care.

As the district prepares to evaluate the various proposals for managing the hospital, it’s important to keep the public informed and engaged. To maximize public participation, the district should soon begin hosting forums explaining the selection process and alternatives so that people are able to weigh in on what they believe is the best course for the future of their hospital. Such dialogue and engaged decision-making is vital to ensure that high quality, affordable and convenient health-care services are preserved in the south county.

The process of selecting a hospital operator needs to be open and transparent, and the district must do a better job communicating with the public. A few weeks ago, when the board met to appoint someone to serve out the term of a departing publicly elected board member, they did so at 7:30 a.m., while giving the public a scant two-days’ notice to participate in the decision-making process. Important decisions, such as who will represent the public’s interests in selecting a major health care provider, should be made during meetings when more members of the public can attend and after the public has had adequate time to properly evaluate and comment upon the issue at hand.

Earlier this year, the Petaluma Health Care District was honored as the best among the state’s 78 health care districts, a recognition that its programs and services have yielded significant benefits for the health and well-being of its residents. Adding more transparency in important public decisions will make the health care district even better.