Urgency in Petaluma Valley Hospital process

The clock has begun to tick in a hasty process to find a suitable operator for Petaluma Valley Hospital, and the collective uncertainty over exactly how Petaluma’s long term health care needs will be met is, to say the least, disconcerting.

For the past two decades, St. Joseph Health has capably operated the city’s only acute care facility on a lease from the Petaluma Health Care District, the public entity that owns the hospital. That lease is set to expire in January. In an ideal situation, another contract would have been in place by now, ensuring either continuity with the current operator, or a smooth transition to a new operator.

That’s not what has happened. The heath care district, under the guidance of its publicly-elected board of directors, spent much of the last year pursuing a new contract with St. Joseph, only to see that process abruptly collapse in October.

Both parties cited three main issues preventing a new contract: financial terms regarding how much St. Joseph would pay the district to operate the hospital, a non-compete clause, and what officials said were “complexities related to the need to maintain all family birthing center services.” While the first two issues relate to money, which can usually be resolved through compromise, the third issue lingered as a key sticking point.

As it turned out, St. Joseph’s policy decision to discontinue tubal ligations, a female sterilization process, was the primary reason the two parties were unable to reach agreement. District officials, believing that Petaluma’s public hospital should provide a full range of women’s health services, found this unacceptable. St. Joseph, which is part of a Catholic ministry that now disallows contraception procedures, found itself unable to bend to the district’s demands.

St. Joseph has agreed to stay on and operate the hospital until September, or until a new operator is on board, which likely won’t be sooner than next summer since Petaluma voters must ratify the new contract at the ballot, and the earliest this can happen is June.

Now that St. Joseph has no place in the future of the hospital, district officials have set an accelerated time line to choose the new operator. This expedited “speed dating” of potential hospital operators, which will give the publicly elected board and community members precious little time to thoroughly evaluate their qualifications, is unfortunate and could probably have been avoided.

Shortly before it requested bids from prospective operators two years ago, the district conducted surveys and focus groups to help it evaluate the kind of services desired at the 80-bed acute care hospital. Results showed the community wanted a provider that could maintain emergency services, inpatient services and intensive care, while expanding primary care services 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. Women’s health services, including contraception, were an important priority.

Although the public was prevented from learning what was contained in the various proposals the district subsequently received from a variety of prospective operators, it’s logical to assume that the proposal from St. Joseph made clear its new policy prohibiting tubal ligations. Despite this, district officials rejected all other bids and continued talks with St. Joseph officials well past their expiration date as the two parties struggled in vain to come up with a solution in a third-party provider of the tubal ligation procedures. Only when that attempt failed did the parties finally walk away from the table, leaving district officials up against the clock to find an alternative hospital operator in just seven months.

From a negotiating standpoint, the district is now in a somewhat weakened position, simply because it has far less time to dicker over such matters. And with the pending departure of St. Joseph casting a dark cloud of uncertainty over who will be providing health care services one year from today, physician recruitment and retention could become a major problem.

People responsible for operating health care facilities, including Petaluma’s locally elected health care district officials, live in very complicated times. The reality of soaring medical costs and dwindling revenue streams, coupled with economic uncertainties tied to the recent implementation of national health care reform policies, make operating a hospital today an increasingly difficult proposition. The recent election of Donald Trump, who has vowed to work with the Republican-controlled Congress to dismantle the Affordable Care Act, will make those challenges even greater.

That said, Petaluma Valley Hospital has been and continues to be operated profitably, and the quality of care offered to its patients has, for the most part, been consistently outstanding. This should make it an attractive prospect for both for-profit and non-profit health care entities seeking to expand their footprint in the North Bay.

As the expedited process moves forward, we hope it will be more transparent by allowing community members an opportunity to review and weigh in on the various proposals received before a decision that will go before voters.

Response to?Confederate flag

EDITOR: When I was 11, I flew a Confederate flag on my bike. It was partly to defy my parents; the word rebel was appealing, evoking James Dean in the movie “Rebel Without a Cause.”

After a little education, I learned that the Confederate flag represents the southern states who fought for their property rights. Property rights? Who wouldn’t fight to defend their property, their farms, their homes. But we are not talking about fighting for land and homes. The “property” the Confederate states fought for was human beings. They fought to own, to buy and sell people. They wanted to continue to enrich themselves from the labors of these owned people.

Perhaps if those who flew the Confederate flag want to honor their Confederate ancestors, rather than flying a flag which symbolizes wanting to own human beings as property, they might consider honoring these ancestors with a donation to a good charity such as Free The Slaves.

I now see the “Pavlovian” revulsion to that flag which represents the evil of human beings owning other human beings as an honorable response.

Karen DeLue

Petaluma

Won’t miss St. Joseph

EDITOR: I want to express my gratitude to the Petaluma Health Care District regarding their decision to break off negotiations with St. Joseph Health due, in part, to the unwillingness of St. Joseph’s to continue providing tubal ligations for women. As Catholic entities increase their financial interests in running hospitals around the country, it is vital that we recognize the ramifications of religious organizations being in charge of our health.

Catholic facilities, whose health care policies are driven by church directives, typically refuse to provide full reproductive services for both men and women, including vasectomies, contraception, tubal ligations and abortions, even in emergency cases where a woman’s health is in jeopardy.

Upon entering a medical facility, both patients and medical personnel who work there deserve the right to assume that the moral convictions of the hospital facility will not preempt the availability of full reproductive care.

Thank you to the Petaluma Health Care District for holding to the standard of providing full medical reproductive health care as you return to your search for a new operator for Petaluma Valley Hospital.

Lisa Eldredge

Petaluma

No place for?Confederate flag

EDITOR: To Scott Young, who defended the presence of the Confederate flag in Petaluma, I’m sorry your feelings were hurt by our town’s horrified reaction to the unwelcome presence of the Confederate flag at our Veteran’s Day parade. You state that you see your ancestors who died for their cause in that flag and you want to honor them.

Unfortunately, your ancestors died for an unjust cause, a cause that defended the right to enslave others. That is what we see in that flag. Asking us to consider the Confederate flag as merely a representation of a pastoral past is a carefully constructed statement meant to divert us from noticing that your deceased ancestors fought so valiantly to preserve their states’ option for slavery, with its accompanying abuse and violence.

I imagine you have been called many bad names due to your ancestors’ defense of enslavement, but that’s because most people find slavery abhorrent. Perhaps you don’t accept or approve of slavery, and so perhaps you don’t deserve many of those names. But your ancestors did defend slavery, and for them I cannot find any pity or muster up much respect.

You may see your proud grandfather or granduncles in that flag. We see, with clenched guts and a sick headache, the lynched slaves and freemen hanging from the bars of that flag. The Confederate flag was not hijacked by racists - it was designed by racists and slave owners to represent a part of the country that wanted to continue the practice of slavery, a practice that is never acceptable.

You want to honor their lives peacefully, but the Confederate flag does not bring peace to the majority of the people who see it. I’m sorry, but to me, it symbolizes the fight for the right to continue slavery and that brings revulsion and, yes, disgust. I think you might want to find another way to honor your ancestors that does not at the same time remind the majority of Americans of the painful, devastating lifestyle they fought for.

I do not think the Confederate flag has any pride of place in Petaluma or, indeed, anywhere in public in America.

Lakin Willard Khan

Petaluma