Hospital planning still critical

The Strategic Planning Committee of the Sonoma Valley Health Care District met for over two hours on Wednesday evening, outnumbering the members of the public in attendance by 8 to 1, not counting the press.
Outgoing committee chair Dick Fogg, who is continuing as a committee member, wanted it known that the focus of the whole hospital organization is on the quality of patient care, and that apparent disagreements among committee members were entirely in that context.
First up was district board member Dick Kirk, M.D., who is serving as president of the new Joint Powers Authority. This organization was formed is the first step in creating a “regional” entity (along hospitals with Sebastopol and Mendocino) to pool resources for greater efficiency, to present a larger client base for physicians, and to negotiate better reimbursement rates from insurers. The JPA is still in what Kirk called “formative stages,” and new committee chair Alden Brosseau suggested that the JPA effort is intended to “reincarnate HPR,” referring to the Health Plan of the Redwoods, a local HMO that failed in 2002.
Next was a review of the joint meeting a week earlier between the district board and the Sonoma City Council. Fogg suggested that the council members were “not on top of their game” with regard to the hospital and its several projects, while Gina Cuclis, who said she was a confidante of several council members, reported the impression that there was no clear agenda for the discussion and suggested that asking for more redevelopment money at the meeting was not well received.
Hospital CEO Carl Gerlach spoke next, describing his own efforts on behalf of the JPA, which he views as the most likely way to develop a network of doctors and facilities large enough to compete with Kaiser and to negotiate with the insurers. Committee member Joe Smith, M.D., worried that the efforts were “too little, too late,” a concern that Gerlach shared when he stated his opinion that independent district hospitals, like Sonoma Valley Hospital, could not survive another 3–5 years on their own. Affiliation into some larger organization would be required.
New committee member Bill Hutchinson asked if Gerlach were ready to sign Sonoma Valley Hospital up now as an arm of a regional enterprise, and the answer, after a pause, was that, “It would be a board decision.” Asked by the Sun what would happen in, say, 5 years if the JPA or some other affiliation had not been successfully attained, Gerlach replied that the district would have to “go back to the taxpayers for a decision and see how the community responds.”
Ellen Akre, Director of Physician Relations for the district, made a short presentation about recruitment and retention of primary care physicians, of which there are 16 presently in Sonoma: six family practitioners (two of whom are part-time), six internists (one part-time), and four pediatricians (two part-time). Kaiser was reported to have 25 percent of the health care market in Sonoma Valley, and 90 percent of the rest is served by those 16 primary care physicians.
The final presentation of the meeting was by Gerlach again and addressed the continued loss of market share to surgery centers out of the area in which doctors have a financial interest; state records for 2007 put that market share for Sonoma Valley Hospital at 25 percent, and Gerlach said it was lower now. Petaluma Valley Hospital, which is not a part of the new JPA, reportedly has an arrangement with 13 surgeons to manage its operating rooms, with financial incentives, and that has contributed to the loss of ambulatory surgery volume in Sonoma. Gerlach said that one of several options he’s considering is a similar management agreement.
Other members of the strategic planning committee are Patricia Talbot, Director of Sonoma Valley Community Health Clinic, and Clinton Lane, M.D., who were in attendance, and Tom Anderson and Peter Hohorst, who were absent. There is one vacancy on the committee, which meets again next on Wednesday, March 18.