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Guest Commentary: A foggy forecast for hospital

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Hospitals are critically important community institutions. The vital role played by the 80-bed Petaluma Valley Hospital is regularly illuminated by the lives that are saved there every week.

During the horrific wildfires of the last few years, the hospital was the only one in the county that consistently remained open to provide life-saving services, deliver babies and treat injuries. And although 62% of Petaluma residents are currently insured by Kaiser Permanente, which has facilities in Santa Rosa and San Rafael, if you suffer a serious health care crisis you are going to want to get to the PVH emergency room as soon as possible.

Yet the dramatic and often unpredictable changes in health care nationwide are causing hospitals to close, including one in Sebastopol that was recently shuttered and reopened as a long-term acute care facility. Keeping that from happening here is the primary responsibility of the Petaluma Health Care District, a public agency with five elected representatives and a small staff. Their job is to guarantee the continuance of the high-quality emergency and acute care services at the hospital which many of us wrongly take for granted.

Following the expiration of a 20-year lease management agreement with St. Joseph Health in 2017, negotiations aimed at having the Catholic healthcare provider continue operating the hospital broke down over financial terms and St. Joseph’s decision to discontinue providing women’s reproductive health services, which are at odds with the institution’s religious precepts.

The district subsequently launched a robust search for a new operator but that failed when no qualified applicants came forward. Hope was renewed last year when St. Joseph announced it was negotiating with Adventist Health to form a new joint operating company that would have solved the matter of how to offer women’s reproductive healthcare locally since Adventist lacked any religious opposition to providing such services.

But last October, Attorney General Xavier Becerra, for reasons entirely unclear, decided to quash the St. Joseph/Adventist merger, thus throwing the future of Petaluma’s hospital into further disarray. Ironically, Becerra issued a brief statement that the proposed deal would have limited “access and availability of health care services,” while it would, in fact, have had just the opposite effect.

While St. Joseph has continued to operate the hospital on an interim basis, the facility’s uncertain future has hampered physician recruitment, employee retention and capital investment. It’s also added increased complexity to the ongoing labor negotiations with nurses seeking a new contract for pay and benefits.

So, is there any good news here? Possibly. According to Ramona Faith, CEO of the PHCD, the district recently received a “letter of intent” from St. Joseph and its parent company, Providence Health, proposing that a Providence affiliate manage Petaluma’s hospital. That company, Western Health Connect, was described to PHCD as a Washington-based “organization that manages other-than-Catholic hospitals for Providence/St. Joseph Health and will create a California subsidiary that would manage and operate PVH.” The proposal assures that PVH would maintain all existing services and that “obligations of existing labor relationships will be honored and assumed.”

After doing a little research, I learned that Providence, also a Catholic hospital system, created Western Health Connect as a separate entity when it affiliated with Swedish Health Services, a secular hospital organization in Seattle providing women’s reproductive services, in 2012. It is located in the same building that houses the headquarters of Providence Health in Renton, Washington.

Faith told me this week that she is cautiously optimistic about the new proposal but needs more information. To get that, the district has hired a business and financial consultant familiar with the vagaries of health care systems to thoroughly research the opportunity and guide district negotiations towards a prospective new hospital management contract.

Ultimately, voters in and around Petaluma will need to weigh in on the matter of the hospital’s future since, by law, the local electorate must ratify whatever agreement is forged by their district representatives.

Next week, Faith said she and her board will meet to evaluate the offer. However, she is keeping “all other options” on the table, including the prospect of securing a management agreement with another operator. If history is any guide, the likelihood of that happening is not very promising, but the effort must be made.

The Providence/St. Joe’s proposal makes sense for a host of reasons, not the least of which is to finally resolve the nettlesome problem over how to provide women’s reproductive health services, primarily tubal ligations. The Western Heath Connect solution has enabled Catholic and non-Catholic hospitals to operate successfully in Washington for many years, so it certainly deserves serious consideration here in Petaluma.

This assumes, of course, that Attorney General Becerra doesn’t decide to screw it up again. In addition to derailing plans for the future of Petaluma’s hospital, the AG’s decision preventing the merger between Adventist and St. Joseph resulted in the closure last month of the maternity ward at the Adventist hospital in St. Helena, further disproving his theory that preventing such mergers enhances patient access to health services.

So, once again, there is hope for the future of Petaluma’s hospital which continues to provide exemplary health care services to residents here.

The people responsible for overseeing and operating health care facilities live in very complicated times. Soaring costs and dwindling revenue streams, coupled with economic uncertainties and ever-shifting national health care budgets make operating a hospital today an extraordinarily difficult proposition.

As such, we all owe a huge debt of gratitude to St. Joseph employees. We should also thank the PHCD board members, past and present, including board president Elece Hempel, who have dedicated seemingly endless volunteer hours ensuring that a full-service hospital continues to operate in Petaluma.

(John Burns is former publisher of the Petaluma Argus-Courier. He can be reached at john.burns@arguscourier.com.)

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