Sonoma Valley Health Care Coalition

Final Recommendations Documents Available

2007-05-15T18:00:00.000-07:00

The final documents are ready and available. (pdf warning)

Executive Summary
Final Report
Statement of Purpose
Final Recommendations

Options & Survey Data Now Available

2007-04-30T23:10:00.000-07:00

Several new informational documents regarding the hospital community survey, and options presentation are available for viewing. (pdf. & ppt. warning. please don't try to download if you are using a dial up connection)

1. Options Presentation

2. Survey Powerpoint

3. Survey Raw Data

Another Monday Evening Meeting

2007-04-18T11:08:00.000-07:00

The Sonoma Valley Health Care Coalition will hold another in its series of Monday Night Coalition Meeting on Monday, April 23 at Andrews Hall in the Sonoma Community Center from 7:15 – 9 PM.

At this meeting Chuck Rund of the Charlton Group will present the findings of the recent phone survey sponsored by the SVHCC. The results from the medical staff and physicians survey and the mail-in public survey will also be shared as well as an update on the status of the major alternatives being considered and the decision making process that SVHCC is engaged in to make its recommendations to the Sonoma Valley Health Care District Board of Directors.

We encourage anyone who has attended the Monday night meetings to attend this update meeting and we also encourage anyone who has not attended but is interested in the issue, to come to the meeting.

Monday, April 23, 7:15 – 9 PM Andrews Hall at the Sonoma Community Center.

SATURDAY INFORMATION MEETINGS

2007-02-09T13:14:00.000-08:00

This coming Saturday, Feb 10, the Coalition is having two friendly meetings to give you the best thinking we've come up with and show you the options that are being evaluated.

We'll share our 8,100 hours of research and do our best to answer your questions and listen to your concerns as we move forward.

Please come to the one that suits your schedule to get the straight skinney, don't rely on gossip around the water cooler, or rumors on the grapevine. We'll give it to you straight. No secrets.

There will be refreshments, coffee and tea, of course, as well as a selection of Aug Sebastiani's wine, cheese from Gary Edwards' collection, other edibles from the valley and beyond. And, in the morning session, Shelley's Homemade Jams for your bagels and cream cheese from Homegrown Bagels.

Come for the food, stay for the presentation, or come for the information, stay for the food! Your choice!

TWO LOCATIONS -- TWO TIMES -- TO SUIT YOUR SCHEDULE -- RAIN OR SHINE
SATURDAY FEB 10

MORNING:
10-12 FAITH LUTHERAN CHURCH
19355 Arnold Drive at Petaluma Blvd
Goehring Hall

AFTERNOON:
2 - 4 FIRST CONGREGATIONAL CHURCH
252 W. Spain Street
Burlingame Hall

The Latest Documents Posted

2007-01-22T16:44:00.000-08:00

Today, we added the most recent documents for the IN TOWN OPTION and the SMALL HOSPTITAL to the blog.

The complete list of documents posted can be found on the right hand side bar. Scroll down to find the document you want to view, then click on it. It will open the Acrobat program and then open that document in Acrobat (the only way we can view PDF files in this system).

You can continue to open as many documents as you wish and print them, if you want to. Some of them take time to load, but take a few deep, relaxing breaths, and they will be on the screen before you know it.

Feel free to email me if you have questions about any of the documents, or are having trouble.

Shelley Arrowsmith
arrowfarms@vom.com

New Documents Posted

2006-12-19T12:57:00.000-08:00

Please see the new links to the documents for the Cirrus Proposal, Small Hospital Option, and Broadway Option in the sidebar. Please feel free to comment and ask questions. (documents also posted below) Thank you to VOM.com for hosting the documents for us.

Cirrus Documents
Original Proposal
John Thomas Revised Proposal
Timeline
Preliminary Site Plan
Site Plan w/Expansions
Supplement to Proposal
Square Footage Spreadsheet
Resumes of Key Personnel
Asset Management Market Study
Cirrus Response to Coalition Questions
Reconciliation of SVH & Cirrus FTEs
Program Diagram
Wayne Fairchild Resume
HFS Evaluation of Cirrus Proposal
Letter to Henry Grausz
Converted Use Estimate
Residential Land Estimate
SVH Discharges
Revised Sonoma Financial Proforma
Sonoma County Discharges
CA Heart & Surgical Hospital
Central CA Edoscopy Center
Financial Proposal
Fresno Surgical Hospital
Laguna Hills Surgery Center
Linden Crest Surgery Center
North Texas Hospital
Spring Creek Surgery Center
Surgery Center @ Craig Ranch
Thousand Oaks Surgical Hospital
Jim McSweeney Notes

Small Hospital Option
HFS Small Hospital Report
Small Hospital Description
Financial Model w/OB
Financial Model w/Out OB
OB Financial Analysis

Broadway Option
HFS Draft Evaluation
Pulic-Private Partnership
SVH $ Model- Broadway Business Plan
Ca Med Imaging Letter of Intent
SVH Construction Cost Estimate
Anshen & Allen 56 Bed Program
Amb. Svcs & J.V
Converted Use Estimate
Residential Land Estimate
Michael Roos Comments
Joint Venture Legal Structure
SVH Draft Project Timeline
Adjacencies
Construction Cost Contingency
Dr. Galanopoulos Letter to Henry Grausz
SVH OB Financial Analysis

Cirrus Health Proposal Evaluation Presented

2006-12-13T21:24:00.000-08:00

The Evaluation by HFS Consultants of the Cirrus Health proposal will be presented this Monday, 12/18 at 7Pm at the Vintage House, 264 First Streeet East, Sonoma.

This evening will be the first and only time that the HFS Evaluation of the Cirrus proposal will be presented to the public.

The evaluation, along with the Cirrus proposal and accompanying documents will be posted on the blog Friday morning.
The blog is being updated to reflect all proposals and evaluations so you will be able to view them all here, on the blog.

Hope to see you on Monday with your questions for Carl Gerlach from HFS Consultants.

Monday Coalition Meeting Replaced

2006-12-08T21:11:00.000-08:00

The regularly scheduled Coalition meeting will not occur Monday night as information regarding the next proposal to review is not, as yet, available.

Instead, a non-Coalition meeting will occur regarding the ideas about a Parcel Tax to keep the current hospital operational. Hopefully there will be as good a turnout as at Coalition meetings as this, too, is an important issue for the community to address.

The meeting will take place at Vintage House on Monday from 7 - 9PM. We urge you to attend.

Coalition Meeting Tonight

2006-11-27T17:24:00.000-08:00

Monday, November 27 at Vintage House at 7PM
We will be debuting the informational slide show that will be our "road show" tonight and will ask for your feedback.

We will also go through the schedule of activities and meetings leading up to our recommendation to the Board.

Thanks for your continued interest.
See you there.

IN-TOWN HOSPITAL PROPOSAL DEBUT

2006-11-17T10:47:00.000-08:00

IN-TOWN HOSPITAL PROPOSAL DEBUT

The Monday November 20 meeting of the Sonoma Valley Health Care Coalition will be held at Vintage House 264 1st St. East from 7 to 9 PM.

This meeting will be the debut presentation of the work of the “In-Town Hospital” sub-committee of the Options Committee. The Architects have been working hard with members of the sub-committee to evaluate how a replacement hospital would work on or near the present site. Tonight they will make their debut presentation to the Coalition.

Will they make it work, can it all fit in, have they left anything out? Come along on Monday night and find out.

While this is not an engraved and hand addressed invitation, anyone who reads this notice is encouraged to attend and bring your friends, associates, spousal equivalents, or even spouses!

This is the first time this presentation will be shared with the community. In order to speed up the future evaluation process, we have asked members of the Options Committee and the Steering Committee to be sure to attend so they will not need a separate presentation (which takes more precious time). No group decisions will be made at this time. This presentation will not be repeated. Information will be shared and questions will be answered.

Nov 13 Monday Coalition Meeting

2006-11-13T10:40:00.000-08:00

The subject of this Monday's meeting of the Sonoma Valley Health Care Coalition will be "OUR HEALTHCARE NETWORK - A HOSPITAL AND WHAT ELSE".

The committee has met a number of times and has refined the concept and has some further information to share. Your questions and input will be appreciated.

Also, there will be the usual Committee Reports and updates prior to the presentation

The meeting will be held at Vintage House, 264 1st St East from 7PM to 9PM.

Agenda - November 6, 2006 7 PM

2006-11-02T15:23:00.000-08:00

The next Monday Night Coalition meeting will be on November 6, at 7 PM at the Vintage House 264 1st St East, North of Spain Street.

We've all checked-in, we've checked-up and now it's time to talk about how we go forward. A panel discussion is planned with Steering Committee and Options Committee Leaders and you to go over the results of the Oct 23 break out group workshop. We're hoping to engage you in the conversation too.
· What Are The Most Important Things The Coalition Still Needs To Find Out?
· What Are The Most Important Things For The Coalition To Consider?
· How Do We Best Engage The Community Going Forward?
Working tonight toward the goal of taking our next steps in information sharing and engaging the community.

Y'all come! Check-In/Check-Up Workshop

2006-10-20T12:33:00.000-07:00

Sonoma Valley Health Care Coalition
MONDAY, October 23, 2006
7:00 PM – 9:00 PM Vintage House
264 First Street East
We will start on time we have a lot to accomplish!
Please come early to register and get a good seat!

1. Welcome and Committee Reports

2. “What Have We Learned” – A Check-in and Check-up Workshop
Facilitated by Jonathan Gottlieb and Cathy Webber, our community workshop consultants.

We’ve done enough education. Many of you have sat through those meetings, absorbed the information and even asked some questions. Now it’s time for YOUR FEEDBACK. We’re looking for dialog about our next hospital based on what we’ve all learned. Bring your friends even if they haven’t been involved in the past. A chance to get them up to speed and to get feedback from everyone who attends.

For a reminder of the meeting topics and speakers, see the list at the bottom of this notice, or go to the “all meeting notes” section of this Blog.

A Different Kind of Meeting Monday October 23!

2006-10-17T13:53:00.000-07:00

We need eyeballs!

No it’s not some Halloween prank. Sonoma Valley Health Care Coalition, YOUR volunteer group working to come to a solution about our next hospital needs you.

We need your eyeballs, your mind, your voice and your body for a check-in.
We’ve done the professional survey, we’re doing a mail in survey, but we want to check in with you, a little like a check-up, to see how we’re doing.

We need you to give us your thoughts and ideas about where we are, what we’ve all learned, and where we’re going on the road to our next hospital.

This will be a chance for you to express yourself and come to some concensus about where we are and where we are going.

We’ve learned a lot about what it takes to run an ER, about seismic rules and regulations, about eminent domain, about demographics, about ….. well, you name it, and if it relates to our hospital, we’ve had someone come to tell us about that subject.

Now it’s time to tell us what you’ve learned from all of this. Even if you haven’t been involved in the evening Coalition meetings on a regular basis, you have an opinion, a thought, a feeling about where we are and where we’re going.

Tell us. This is your chance. The first of a series of workshops to engage the community in dialog about our next hospital. Be a part of something big.

Vintage House, 264 First Street East
7PM – 9 PM Monday, October 23.

We’ll bring the cookies! You bring the eyeballs!

Sonoma Valley Health Care Coalition
working to find a 67% solution to our next hospital.

Monday 10/16/06 Coalition Meeting Topic

2006-10-14T18:55:00.000-07:00

The meeting topic for the usual Monday meeting of the Sonoma Valley Health Care Coalition will be Dr. Roger Richter, from the California Hospiatl Association talking about California Seismic Issues.

We are not alone in the seismic cunundrum we are in with our hospital. Dr. Richter will help us understand the seismic issues we face and why they are so important. The more we understand, the better we will be able to decide the best course of action for our next hospital.

Same time, Same place -- we promise!
Monday, October 16, 7PM to 9 PM
Vintage House, 264 First Street East,
Just North of the Plaza.

A View From Sonoma Sun

2006-10-03T12:38:00.000-07:00

In our hands

'“Whither the Hospital?” has been one of our recurring questions these last few years, and of course it was the question of concerned citizens in the Valley for many years before the Sun ever rose. Unfortunately, there is yet no answer to that question."

"We well remember when the hospital administration sat with the Sun’s editorial board last spring and said, in essence, “We can prove to you right now that the hospital will close in 8 months if Measure C doesn’t pass.”'

"Well, it didn’t pass, and it hasn’t closed. That’s thanks to continued good efforts by the administration, which we appreciate, but some credibility has been lost. That’s why we were so pleased to see the Plan B group form and step into the post-C vacuum. And why we’re so pleased the Health Care Coalition is active, though we wish Messrs. Pease and Edwards, the coalition’s designated leaders, could move its deliberations along a little faster."

"Nevertheless, the coalition’s process has been most interesting to follow, with a progression of largely disinterested speakers educating the community on sometimes complex aspects of hospital regulations, operations, financing, siting, and construction."

"Two weeks ago, the coalition heard a proposal, or more properly, a presentation, by Cirrus Health, a Texas firm that builds and runs private hospitals. If its due diligence pans out, Cirrus would build a new hospital at Eighth Street East and Napa Road, with NO taxpayer funds, and operate it in conformance with state laws requiring access by the entire community.
What’s not to like?"

"Well, as we learned at the coalition’s meeting this week, sewer and water. Those are the key problems that County Supervisor Valerie Brown and City Planner David Goodison identified for us. The county could, on its own authority, provide sewer service to the Eighth Street site, were Ms. Brown willing. And if the water problem could be solved, then the main regulatory hurdles would seem to be cleared, with no vote of the people required. That is, all the approvals could come by agency action – forget the daunting two-thirds majority of voters. No tax, and therefore no voters, would be needed! (Nor the cost of an election, nor the potential for another divisive contest.)"

"But how to solve the water problem? Wells? Really deep ones? Probably, water for the hospital is a higher priority than water for a golf course, but underground water levels reportedly have been dropping for years, in any case, and so water might need to be purchased, presumably from the Valley of the Moon Water District. And the district doesn’t serve that far east, UNLESS, of course, the land were to be within the Sonoma city limits."

"This fact ultimately puts the decision back in our hands, the hands of the voters, which is where it should be. Far better, that the citizens themselves vote to expand the Urban Growth Boundary to include the Eighth Street site, if it is to become home to our new hospital."

"A 4 percent increase in the UGB area would suffice, and the city could zone the connecting parcels as the county has them zoned now, so no immediate changes would result from the expansion of the UGB, other than to make possible a new hospital at the proposed site."

"So, fellow citizens, perhaps we’ll soon have the issue back in our hands. With rejuvenated leadership from the Hospital Board and support from the city council, this could work. Or not! We trust that the voters will make a good decision, as a community, once they have the opportunity."

"Other sites? Other proposals? Still not much from which to choose, and it may all be moot, if some measure isn’t put back before the voters, soon."

SVHCC Agenda 10-02-06

2006-10-01T14:09:00.000-07:00

Monday night’s Coalition Meeting will feature - “A Health Care System to Serve Sonoma Valley .”

Discussion will be led by Norman Gilroy who is putting together a panel of speakers with plans for breakout groups to review such matters as:

* A Network of Health and Wellness Centers
* The role of Sonoma Valley Community Health Center ,
* Integrative Medicine and the current program offered by the Hospital
* The Women’s Healthcare Initiative
* And much, much more ...

This promises to be a lively, informative session. A preliminary discussion of the subject at Thursday night’s Options’ Committee meeting elicited genuine enthusiasm for the topic and its ramifications.

You won’t want to miss this one.

Because Shelly Arrowsmith’s e-mail system is down and I do not have the complete list of Coalition attendees, would you please help pass the word along so that everyone who has interest will know what’s on tap for tomorrow night.

Thanks very much,

Steve Pease

Download Presentation Summary (pdf)

Health Care District Candidate Forum

2006-10-01T14:08:00.000-07:00

Sun to host health care district candidates’ forum
October 5th, 2006 from 7 p.m. to 9 p.m.

The five candidates running for the Sonoma Valley Health Care District board will participate in a forum on Thursday, Oct. 5, from 7 to 9 p.m. at the Sonoma Community Center.

Kathy Barnett, Lisa Hardy, Dick Kirk, Michael Norton and Arnold Riebli are campaigning for the two available seats on the board.Presented by the Sonoma Sun, the forum will be moderated by Sun publisher Bill Hammett and broadcast live on KSVY Sonoma at 91.3 FM.

Following introductory remarks from the candidates, members of the audience will be able to ask questions. All the candidates will have an opportunity to respond to all questions from the audience before making brief closing statements.

The event will be in Andrews Hall at the Sonoma Community Center, 276 E. Napa St., Sonoma.

Talking Out the Hospital Sites

2006-10-01T13:24:00.000-07:00

New hospital sites sized up (from Sonoma Valley Sun)
Officials explain permit requirements, pitfalls of potential properties

"How hard would Sonoma County fight if the Sonoma Valley Hospital tried to use eminent domain to build a new hospital at Maxwell Farms Regional Park?"

"That question was posed Monday night by Arnold Riebli, a candidate for the hospital board, to Valerie Brown, the Sonoma County Supervisor who represents Sonoma Valley. It turns out that initially, Brown was interested in building the hospital at Maxwell Park, which is located at Highway 12 and Verano Avenue."

'“I thought there was space available on Maxwell Park,” she told an audience of about 60 people who came to the Vintage House senior center for a meeting of the Sonoma Valley Health Care Coalition. It’s the ad hoc committee that’s trying to figure out how to keep a hospital in the Valley following the failure in the spring of Measure C, the ballot proposal to build a new, $148 million earthquake-safe facility replacing the existing Andrieux Street hospital, which the state may close in 2012 under current seismic safety standards."

"On Monday night, as part of an ongoing series of talks, the coalition invited Brown and other county and city officials to discuss some of the planning aspects associated with potential hospital sites.Brown said that about a year ago she invited people to sit down in her office to discuss the potential use of Maxwell Park as a hospital site."

"For years, hospital officials have eyed the park, which they consider to be ideally located to serve the hospital’s customers. Another advantage: The park is inside the city’s urban growth boundary, which means city water and sewer service is available."

'“Quite frankly, I thought it’d be nice to be somebody riding in on a white horse, doing something,” said Brown, describing her initial hopeful feeling about the park site. But it turned out that the county has taken grant money, including federal money, for the park on the condition that the land stay in recreational use."

“I honestly believe that land is sewed up,” Brown said. “I don’t even know if you can do an eminent domain on property that’s conditioned the way that is.”

"And so it went throughout the 90-minute meeting. Brown and the other officials indicated that all the proposed hospital sites were problematic."

'“I don’t envy any of you the challenge of finding the optimal site for the hospital. You’re going to have to figure out the least-worst option,” said Sonoma City Planner David Goodison. He kicked off the proceedings with an explanation of such things as the city’s urban growth boundary. It’s a line voted into place by Sonoma’s voters in 2000 that more or less matches Sonoma’s city limits."

"The only way the urban growth boundary can be expanded is by majority vote of the city’s voters. The urban growth boundary comes into play for two proposed hospital sites: a 22-acre site on the northwest corner of Eighth Street East and Napa Road and a 15 acre site on the southwest corner of Broadway and Napa Road."

"City sewer and water? It’s on the Eighth Street East site that the Dallas, Tex.-based Cirrus Health proposes building a privately funded hospital and medical office building alongside an upscale medical spa proposed by developer Henry Grause and architect Michael Ross."

"In order for the Eighth Street East site to get city sewer and water service, Sonoma residents would have to vote to expand the city’s urban growth boundary to include the 22-acre site along with about 50 acres of adjacent property. Supervisor Brown said that she met with Grause and Ross early on, when the two were simply proposing a spa on the property."

'“Quite candidly, I said to the two of them: You have huge hurdles with this property. You’ve got some huge problems attached to this particular parcel,” Brown told the audience."

“'The next time I hear about the Eighth Street East project, there’s a (proposed) hospital... alongside it.”'

"She suggested that a high-intensity use such as a hospital would be better inside city limits. Brown cited a Dec. 13, 2005 memorandum from the Sonoma LAFCO, or the Local Agency Formation Commission, that concluded that the spa would be more appropriate inside the City of Sonoma’s boundaries."

"LAFCO is a state agency created in 1963 to discourage urban sprawl. Each California county has a 7-member LAFCO comprised of local elected officials, and one member of the public who weigh in on annexations and other boundary issues."

"Steve Sharpe, executive officer of Sonoma LAFCO, told the audience of another hurdle facing any site to be annexed into the city, even if the city’s voters extend the urban growth boundary: If enough property owners inside an area that’s being annexed are opposed, the property owners can veto the annexation."

"Other potential issues that Supervisor Brown cited with the Eighth Street East site is that residents there already are upset about truck traffic, that the site floods and that she predicted wine warehouse tenants on Eighth Street East would clamor for the right to open tasting rooms, should the hospital get built."

"Or, well water and county sewer? Ross defended the Eighth Street East site during the question-and-answer period, saying the most emphasis should be placed on “which parcel has the most chance of delivering a hospital.”'

"Following the meeting, Grause said that a Eighth Street East hospital site could use well water. As for sewer service, the county has a moratorium on new hook-ups. But Ross provided The Sun with a copy of the 1998 resolution that established the Sonoma Valley Sanitation District’s urban service boundary."

"The resolution says that the county supervisors can provide sewer service from the Eighth Street East sewage plant if “a significant public... need is served.” Under that criterion, Ross thinks the supervisors could provide sewer service to a hospital on Eighth Street East, even if the property is outside the city limits."

"A proposed 15-acre hospital site on Broadway and Napa Road straddles the city’s urban growth boundary.“There has been talk about bifurcating the usage of the property,” Brown said, or possibly building the hospital inside city limits with its parking lot constructed as a separate project in the county."

"Mitch Mulas, a longtime Schellville dairy farmer, said at the meeting that there are sites with water and sewer service that could be used for a hospital, but aren’t getting attention.“I don’t think you’ve approached everybody,” said Mulas, who declined to name the sites."

What I Still Need to Know

2006-09-23T15:03:00.000-07:00

A lot of ground was covered in the Coalition Monday Meetings. But there’s a chance we didn’t cover something you need to know, or it wasn’t covered to the extent you need.

Let’s talk about WHAT YOU STILL NEED TO KNOW to make an informed decision when the time comes. Click the comment section below to begin the conversation.

You can review the handwritten meeting notes by clicking on the meeting notes section in the menu at the right.

What I learned from Coalition Mondays

2006-09-23T15:01:00.000-07:00

Almost every Monday evening for four months, the Coalition has put on educational meetings about issues relating to the Hospital. The intent was that you could gather information you need to know to make an informed decision about what our hospital should be.

This place on the blog is for you to tell us what you learned.

Did you learn something new, did you change your mind, do you feel different than you did before, or maybe it even confirmed what you already knew. Maybe there are others out there who agree with you, maybe they disagree.

You can find a link to the hand-written meeting notes to refresh your memory in the menu margin on the right.

Let’s talk!

Urban Growth Boundary Discussion

2006-09-23T12:37:00.000-07:00

UGB topic of talk

Sonoma Sun - News Briefs Sept. 21 2006

Sonoma’s urban growth boundary and the effect it has on siting a new Sonoma Valley Hospital will be discussed at 7 p.m. Monday at the meeting of the Sonoma Valley Health Care Coalition at the Vintage House senior center.

The speakers will Sonoma County Supervisor Valerie Brown who represents the Sonoma Valley and Sonoma City Planner David Goodison.

A potential new hospital site on Eighth Street East and Napa Road is completely outside the urban growth boundary while the potential site on Broadway and Napa Road is partially outside the boundary. A majority of city voters would have to agree to expand the urban growth boundary in order for city sewer and water service to reach the sites.

Topics will include whether the county would be able to extend sewer service to the sites even if Sonoma voters decided against expanding the urban growth boundary.

The health care coalition is an ad hoc group that’s been meeting regularly to work on plans for a new hospital following the failure in the spring of Measure C, a ballot proposal to sell $148 million in bonds to build a new hospital.

AGENDA Sept 24, 2006

2006-09-23T10:04:00.000-07:00

Sonoma Valley Health Care Coalition
MONDAY, September 25, 2006
7:00 PM – 9:00 PM Vintage House

Welcome and Opening Remarks – Co-Chairs (15 minutes)

• Options Committee Report
• Surveys update
• Communications – KSVY/Blog/Coalition Page
• Community Outreach Program

1. Site-related Issues: Urban Growth Boundary, Regulatory Requirements and Other Sticky Wickets (Valerie Brown, County Supervisor and David Goodison, City of Sonoma Planning Dept.)

2. Future Agendas

October 2 -- A Hospital, and What Else?: Other Healthcare System Possibilities – Norman Gilroy

October 9 -- Preliminary Voter Survey Results -- Chuck Rund, Charlton Research Company

‘Free’ Hospital Plan Gets Grilled

2006-09-14T13:05:00.000-07:00

Audience members pose tough questions at Monday forum

Sonoma Valley Sun

A proposal to build a free hospital in Sonoma didn’t get a free ride at a public forum Monday night.Audience members asked tough questions of the developers who want to build a privately funded hospital to replace the publicly owned Sonoma Valley Hospital, which faces potential closure in 2013 under state earthquake-safety laws.

And not all of them accepted the answers.At first blush, you might wonder what’s not to like about the private hospital, accompanying medical office building and luxury health spa that are proposed for the northwest corner of Eighth Street East and Napa Road.

The hospital wouldn’t cost taxpayers a dime. It would have a full-service emergency room open around the clock that would accept all patients. It would pay sales taxes and property taxes back to the community — unlike the public hospital, which pays no taxes.

Those were some highlights presented by John Thomas, president of the Dallas, Texas-based Cirrus Health, which proposes to build and operate the hospital, and architect Michael Ross, of the Boyes Hot Springs-based firm Ross Drulis Cusenbury, which would design the luxury spa.“The total public tax financing that’s being presented to you in this proposal tonight is... zero,” Ross said to an audience of about 80 people gathered at the Vintage House Senior Center for the Monday night meeting of the Sonoma Valley Health Care Coalition.

It’s an ad hoc group that’s trying to ensure that the Sonoma Valley maintains some sort of hospital following the failure in the spring of Measure C, a $148 million ballot proposal to replace the existing Andrieux Street facility. Thomas and Ross said that the privately funded hospital would make its money by drawing customers from the greater Bay Area — and the entire nation — for specialty treatments such as bariatric, or weight-loss surgery, joint replacements and “executive physicals,” 5-day stays at which wealthy patients with cardiac problems or other illnesses would dwell in one of 60 cabins at a luxury health spa that’s proposed on the property next to the hospital by Sonoma developer Henry Grause, who also took the microphone and spoke at Monday’s meeting.

The spa’s guests would learn exercise habits in the spa’s pool and other facilities and healthful cooking skills at such places as Ramekins Culinary School.Services guaranteed?Audience members didn’t pull any punches, once the presentation ended and the question-and-answer period began.

The current hospital’s administrators have said all along that some hospital operations, such as the emergency room, are money-losers.The first audience question came from coalition spokesman Bob Edwards, who wanted to know if Cirrus Health was willing to sign “legally binding” documents promising to provide the services that the public hospital now offers.

And Steve Page, general manager of Infineon Raceway and a leader in the pro-Measure C campaign, sought assurances that the private hospital would provide basic services to the community, even if such services weren’t profitable.

Page framed the private hospital proposal as a trade: Sonoma voters would have to approve an expansion of the urban growth boundary to allow public utilities, mainly water and sewer service, to reach the Eighth Street East site, which currently is outside the city limits.

That would allow the developers to open their medical spa, with the hospital and medical office building thrown in to sweeten the deal for the public. But Page said that if the hospital’s earnings took a nosedive, its investors would apply pressure to cut unprofitable services — as would happen in any business.

“Fifteen, 20, years from now... how do we assure that the memory of that deal doesn’t fade?” Page asked. In response, Thomas offered to sit down with attorneys to work out a solution.

Thomas also addressed the larger issue of private hospitals versus public hospitals.

Communities have concerns when private firms take over, he said.But Thomas said that private hospitals are successful, including in his home state of Texas where more than half of the hospitals are privately owned.

Enough customers? Robert Kowal, the Sonoma Valley Hospital’s chief executive officer, questioned Cirrus Health’s business model, saying that Cirrus planned on having 90 percent of its income come through surgery. Kowal said that, now, surgery only makes up a small percentage of the Sonoma Valley Hospital’s business.

Currently, 83 percent of the hospital’s clientele are medical patients, such as people in their 80s who need non-surgical treatment for such things as congestive heart failure, he said.“This isn’t razzle-dazzle medicine. It doesn’t pay well. I don’t see how your model can work,” Kowal said. “Our facility is just the exact opposite of what you’re talking about.”

Thomas responded by saying the proposed Cirrus Health facility would attract surgical business. At one point during his presentation, Thomas showed a satellite map of all the other hospitals, doctors and health facilities within a 30-mile radius of the Sonoma Valley — a market that he said could be tapped by the Cirrus Health facility and associated medical spa.

“This is $1.5 billion in hospital revenue, (some) of which could be brought to this community,” Thomas said.Thomas predicted that the new hospital would cost $50 million to $60 million. The capital for that would come from Cirrus Group, the real estate development sister company of Cirrus Health.

Cirrus Health is hoping to find at least 50 physicians who would each invest $200,000 in the hospital, or a total of $10 million.The physicians would own the hospital business and rent space in the building.John MacConaghy, a Sonoma attorney and elected member of the current hospital’s governing board, questioned whether the hospital would be able to attract enough business to produce the $6 million to $8 million in annual revenue that McConaghy estimated would be needed to cover the capital costs of the hospital’s construction.

Thomas said, “We believe the market’s out there to do that.” He said that Cirrus Health is working on an in-depth feasibility analysis that should be done by the end of October.Thomas said that Cirrus Health invited two dozen doctors to a dinner two weeks ago and the physicians had “high interest” in the proposed private hospital.

Throughout the evening, Thomas defended the idea of physician-owned hospitals, saying that federal studies have shown that such facilities provide superior medical care.Cirrus Health currently operates specialty surgical centers. Kowal said those only work if a full-service hospital is nearby. One woman in the audience suggested that “Sonoma will be an experiment” for Cirrus Health, because the proposed hospital here would be its first full-service facility.

Thomas responded, “We’re going to invest $50 million. It won’t be an experiment.” An audience member asked what would happen if the proposed Cirrus hospital failed. Grause said, in that case, the community could buy the hospital from Cirrus.“This community is going to buy one hell of a hospital really cheap,” Grause told the audience.If the community supports the Cirrus hospital proposal and amends the urban growth boundary to incorporate the site into city limits, Thomas predicted the new hospital could be built by March, 2011.

“In California, that’s a very quick (construction) for a hospital,” he said.Architect Michael Ross said that the Cirrus hospital proposal calls for freezing the existing zoning in place on the land that would be added to the city of Sonoma.“Therefore, it will not be sprawl-inducing or growth-inducing,” Ross said.

The Sonoma Valley Health Care Coalition won’t meet again until Monday, Sept. 25, when David Goodison, Sonoma’s city planner, and Valerie Brown, the Sonoma County Supervisor who represents the Valley, will speak about the urban growth boundary and other hospital siting issues at 7 p.m. at the Vintage House senior center.

Hospitals Struggle with Costs vs. Quality Service

2006-09-12T12:56:00.000-07:00

This Press Democrat article was reference by one of the commenters here. Please feel free to comment and discuss.

"Sonoma County doctors and hospitals are in the midst of a difficult balancing act."

"Doctors are struggling to improve the quality of health care in an environment where government and private health plans pay them less than doctors in other parts of the Bay Area.Hospitals, meanwhile, have undertaken $800 million in new construction projects at a time when the skyrocketing cost of providing unreimbursed medical care to the poor and uninsured is gnawing away at their bottom line."

"Total operating revenue for all seven hospitals in Sonoma County was up 14 percent in 2005, but operating expenses were up 18 percent, according to the county Economic Development Board."

"It's an ominous signal in a state where 70 hospitals have closed their doors in the past 10 years, said Jan Emerson, a spokeswoman for the California Hospital Association, a trade group based in Sacramento."We're very concerned about access to care," Emerson said."

"Hospitals can't continue running with a deficit situation over the long term. You can't continue to lose buckets and buckets of money and keep your doors open."

"High operating expenses are due in part to the rapidly increasing cost of providing care to the one out of four Sonoma County residents who is either uninsured or on Medi-Cal, a state low-income health plan that does not fully cover the cost of services."

"People who lack adequate health insurance delay getting health care and often end up in emergency rooms when they do get sick. Federal law requires hospitals to treat the people who show up, regardless of their ability to pay."

"Sonoma County hospitals saw the cost of providing charity care double last year, according to Moody's Economy.com, a West Chester, Pa., research firm.Sonoma County hospitals spent more than $2 million on what is known as charity care in the second quarter of 2005, up from $900,000 in the same period a year earlier."

"The figure jumped to $3.7 million in the first quarter of 2006."It's quite a significant problem in Sonoma County, and a problem for hospitals across the country," said Rakesh Shankar, an analyst with Moody's Economy.com."

"Another big expense is capital improvements.More than $800 million in construction projects are planned or under way at local hospitals. All seven in Sonoma County face a deadline of 2013 to bring their facilities up to state seismic safety standards."

"Some are replacing or retrofitting aging structures, while others are expanding their facilities to improve patient care.Sutter Medical Center, Sonoma Valley Hospital and Petaluma Valley Hospital expect to build new hospitals."

"Santa Rosa Memorial Hospital is building a new cardiac center and Kaiser Permanente is expanding both its hospital and its medical office buildings. Healdsburg and Palm Drive hospitals will be retrofitting existing structures."

"The cost of installing electronic medical records also is weighing heavily on hospitals' bottom lines. Startup costs for these systems are high, even though they may eventually save money because of better coordination of patient care."

"With such a system, doctors can access a patient's complete medical record online, together with the results of lab tests and the images made by X-rays, MRIs and and CT scans. A doctor in an emergency room who had never seen the patient would instantly be able to tell what medications the patient was taking and any drug allergies."

"Sutter Medical Center of Santa Rosa plans to implement a comprehensive electronic medical record system within two years, at a cost of $4 million to $5 million.By the end of 2007, all 20 physicians in the Sutter Medical Group will be using electronic medical records and the hospital is expected to be online in 2008, said Mitch Proaps, a Sutter spokesman."

"The system, which will be integrated with other Sutter Health providers, is expected to be the most comprehensive in the western United States, Proaps said. Santa Rosa Memorial Hospital expects to roll out its system in spring 2007 and be fully operational in 2008, at a cost of $5 million to $10 million."

"To eliminate medication errors, Kaiser plans to have a bar code system for patients. Drugs will be given a bar code when they leave the pharmacy and must be matched against a code on a patient's wristband before they are administered."

"Like hospitals, physicians are under pressure to invest in costly, but potentially life-saving, electronic medical records systems. Unlike hospitals, however, reimbursements to doctors are remaining flat. Partly because of the grim reimbursement picture, doctors are moving more slowly than hospitals to install electronic medical records systems."

"The initial cost for a physician's office is typically between $100,000 and $150,000, and most doctors' offices in Sonoma County are small.Most physicians will probably wait until there is a national standard that guarantees the system a doctor buys will be able to talk to every other relevant system, said Brad Drexler, a Healdsburg physician and a director of the Sonoma County Medical Association."

"The biggest stress cited by many physicians is wrangling payments from health plans, which peg their reimbursements to Medicare, the federal health plan for the elderly. And, Medicare pays Sonoma County physicians about 8percent less than doctors in the rest of the Bay Area, putting the county in the same basket as rural counties where the cost of living is much lower."

"In addition, doctors say the formula for annual increases does not keep pace with the skyrocketing cost of providing care."This remains the major issue for Sonoma County and the reason for the physician shortage," Drexler said.

"Unless both the formula for yearly growth and the (payment) inequities are fixed, the ability to attract and keep physicians in Sonoma County practices will continue to erode."

"The Sonoma County Medical Association, working with the California Medical Association, appealed to Medicare last year to change the ranking, without success."

"This year, the two associations will press for legislation instead. The California Medical Association is building a coalition with other states whose counties also have fallen behind, said Peter Warren, a spokesman for the California Medical Association."

Private or Public? Let's Talk

2006-09-12T08:38:00.000-07:00

We heard a presentation from Cirrus Corporation, Dr. Grausz and Michael Ross on Monday, September 11, 2006 that was quite enticing. A free hospital, a spa, a medical office building, all built and operated by Cirrus.

But there are trade-offs. We have to give something to get something. That's, basically, an Urban Growth Boundary extention. This is a quick synopsis, there are many many issues to be discussed and thought about.

In a few days you'll be able to view the powerpoint presentation given by the Cirrus Team and the notes of the meeting, taken by yours truly, including questions and answers.

But in the meantime.... as Joan Rivers said "LET"S TALK"! How did the presentation strike you, how does the concept feel. PRIVATE OR PUBLIC, it's a good question.

SVHCC Agenda- September 11th, 2006

2006-09-07T21:51:00.000-07:00

MONDAY, September 11, 2006
7:00 PM – 9:00 PM Vintage House

A Private Hospital
Dr. Henry Grausz
Michael Ross
Cirrus Health
Presenting theier revised plan for a private hospital on Napa Road at 8th Street East.

If They Unbuild it, What Will Come?

2006-09-07T13:12:00.000-07:00

If hospital is knocked down, site could become housing, park

Sonoma Valley Sun

If a new Sonoma Valley Hospital gets built on the outskirts of town, what happens to the existing hospital on Andrieux Street? That likely will be influenced by covenants, codes and restrictions, or CCRs, written years ago when the Sebastiani family donated the land on Andrieux Street on which the existing hospital building sits.

The hospital site is part of the Sebastiani subdivision, which was established in 1948. And the CCRs in the deeds of 120 nearby residents say that the current hospital site can only be used for a hospital, or for single-family homes.During the Measure C campaign, the hospital’s failed bond proposal to build a new, $148 million facility, officials proposed selling the Andrieux Street property to be developed as single-family housing.

But the land’s future use has a little more flexibility than what’s spelled out in the neighbors’ deeds.That’s according to Mary McEachron, an attorney with the legal firm Hanson Bridgett, who does work for the hospital. McEachron discussed potential uses for the current hospital site at the Aug. 21 meeting of the Sonoma Valley Health Care Coalition, an ad hoc group that hopes to get a new earthquake-ready hospital built to replace the current building, which the state may close in 2013 because it doesn’t meet seismic safety standards.

Eminent domain, or the power of government agencies to buy land at market rate from unwilling sellers, was one of McEachron’s topics. Eminent domain was used in the spring as an epithet by opponents of Measure C when the hospital proposed building the new facility on a picturesque Fifth Street West hayfield owned by the Leveroni family, an unwilling seller.But — strange as it may sound — eminent domain might be necessary if the existing hospital was razed and the Andrieux Street site was turned into a city park.

If a park were built, neighbors opposed to it could sue, McEachron said, and a jury would have to decide how much the neighbors’ property values would diminish due to the CCRs being broken to allow a park’s construction.But in that case, the neighbors probably wouldn’t get a dime, she said.“Most juries would say, you are (crazy) to pay the (neighbors),” McEachron said.If the hospital wanted to convert the use of the existing facility to, say, a medical office building, it would be up to a judge to determine whether that fits the CCRs, McEachron said.

But a judge might be inclined to see a medical office building as allowable, she said.“A hospital’s going to be whatever a judge decides it’s going to be,” she said on Aug. 21 to the audience of about 70 people at the health care coalition’s meeting at the Vintage House senior center.

Richard Kirk, M.D., a candidate for the hospital board, on Aug. 21 cautioned people about the old CCRs at the Sebastiani subdivision: While the circa-1948 CCRs forbade uses other than a hospital or single-family homes, the restrictions also — as was common practice in those days — prohibited non-whites from living there, unless they were servants living with the white homeowner or tenant.And McEachron shared a cautionary tale about government bodies taking a hard line against the use of eminent domain.

She said the Rancho Sante Fe School District in Southern California has been trying for nine years to buy land for a new school, but hamstrung itself by vowing not to use eminent domain.“It made it impossible to acquire land,” McEachron said.

The school district encompasses almost 11 square miles of land in which it couldn’t find a site to build a new school, she said.At one point, the school district was poised to pay more than market value for a site, until the State Court of Appeals shot that down, deeming it to be a “gift of public funds,” McEachron said.“I think the moral of the Rancho Santa Fe School District... is in a logical, coherent, well-planned community, there are times when you use eminent domain,” McEachron told the Sun.

SVHCC Agenda- August 28th, 2006

2006-08-27T23:40:00.000-07:00

Sonoma Valley Health Care Coalition
MONDAY, August 28, 2006
7:00 PM – 9:00 PM Vintage House

Welcome and Opening Remarks – Co-Chairs (15 minutes)

· Options Committee Report
· Communications – KSVY/Blog/Coalition Page
· Volunteers – Community Outreach Program

1. A Doctor/Hospital Proposal – Bob Kowal

2. Future Agendas

· September 11 -- A Private Hospital Alternative – (Dr. Henry Grause and Michael Ross

Doctors Proposal to be Presented

2006-08-27T23:38:00.000-07:00

At 7 PM on Monday, August 28, the Coalition will receive a presentation by Robert Kowal and a group of doctors at the Sonoma Hospital for a locally based public/private approach to a new hospital in the Sonoma Valley.

Note that the meeting will be at the Vintage House on Second Street East in Sonoma, not Ramekins.

There will be no Coalition meeting on Labor Day but on the following Monday, September 11
Dr. Henry Grause, architect Michael Ross, and a representative of the Cirrus Group will present their revised plan for a private hospital on Napa Road at 8th Street East.

Heard It Through The Grapevine

2006-08-26T23:50:00.000-07:00

This is the place to share your thoughts or ask questions and discuss the latest information, regarding the plan to build a new hospital in Sonoma.

What's on your mind?

Five Seek Two Seats on Hospital Board

2006-08-24T13:48:00.000-07:00

Sonoma Valley Sun

Following are ballot statements from candidates seeking two available hospital board seats. Lisa Hardy did not file a ballot statement, so The Sun interviewed her for this article.

Kathy (Whelan) Barnett
Age: 55
Occupation: Financial Consultant

I am running for a seat on the Sonoma Valley Health Care District Board because nothing is more important to our Valley than saving our hospital.If elected, I will be a voice of the community on the board.

As a financial consultant, the fiscal health and sustainability of our hospital will be my highest priority. I will continue to listen to every perspective and make commonsense decisions with the best interests of our community in mind.

As Treasurer of the No on C Committee, I worked hard to defeat a measure which was too expensive and which used eminent domain. I refused to listen to doomsday scenarios and knew there was another solution. Going forward, it is important for all of us to come together, regardless of where we stood on Measure C, and find a proposal our community can support.From the very beginning, a local hospital and the services it provides are important to me. I was born in a hospital which is now Bartholomew Park Winery.

Both my children were delivered at Sonoma Valley Hospital. Simply, our hospital is a vital part of our community’s fabric that must be preserved. With you vote, I’ll make sure that happens.

Dick Kirk
Age: 63
Occupation: Psychiatrist, pediatrician, family doctor, business consultant

I am a physician and member of the Health Care District Board, who grew up in Sonoma Valley valuing the land, people and beautiful environment. My education, from Dunbar School and Sonoma High, through becoming a Psychiatrist, Pediatrician, Family Physician, and a Master’s in Health Planning taught me to help heal.

I heal individuals, families and family businesses from illnesses and conflicts. The common sense I learned from our Valley combined with the technical sense of medical education helps me keep both in balance.I have focused on bringing the Board and community together, respecting all viewpoints and people.

The community is struggling to save our existing resources and build a new hospital. The hospital is a vital part of our community and must be preserved. I joined the “Plan B” process to develop alternatives to the hospital’s Measure C, and am now part of the new Coalition, working with integrity to find a quality solution, at reasonable cost, in an acceptable location.

I am working to increase community involvement to balance professional recommendations. I will bring the community together to heal this conflict. Please support me for another term on your District Board.

Michael A. Norton
Age: 57
Hospital Pharmacist

Healthcare in Sonoma Valley is at a crossroads. Timing is critical, if we are to preserve the services provided by our local hospital in a way that is sustainable. I am proud to have worked as a hospital pharmacist, both at a staff level and managerial capacity for 21 years. It’s been a pleasure to work with many dedicated hospital employees and I have enjoyed a collegial relationship with all our local physicians.

It is through the energies of devoted healthcare providers and support staff as well as the creativity of many different administrators and managers that the hospital has been able to survive and even thrive.

My wife and I moved to Sonoma in 1985. We are proud to be Sonomans and plan to live here long into retirement. Continuation of a local hospital is an important part of our vision for Sonoma’s future as it is for many longtime residents and recent arrivals. I hope to use my knowledge of hospital operations to help create a facility that is operationally efficient, capable of attracting quality physicians and other healthcare professionals, affordable and sustainable for years to come. If you share this vision, I would appreciate your vote.

Arnold J. “Arnie” Riebli
Age: 63
Occupation: Farmer-Businessman

I am running for the SVH Board. I am running for the good of my community, my neighbors and my grandchildren.I am a fourth generation, 52-year resident of Sonoma Valley, married to Joan, and I have four adult children, two of whom still reside in Sonoma with four of my grandchildren. I was formerly a volunteer fireman serving in the Valley for over 28 years.

I have worked in Agribusiness in Sonoma County for over 40 years. I reside on six boards. I feel my qualifications as a farmer, businessman and past public servant make me a solid candidate for the board. I am practical, possess integrity and I look forward to working with others to reach positive solutions. As a longstanding member of the community, I believe that I have a sound understanding of a major cross section of the local community.

If given the public confidence, I will represent the people with fiscal responsibility, compassion for my fellow neighbor and willingness to work toward compromise for the common good.With my experience, respect for community and your support, I feel that together, we can collectively make SVHCD the best that it can be.

Lisa Hardy
Occupation: Property Management

Glen Ellen resident Lisa Hardy didn’t file a campaign statement because, she explained Tuesday, doing so cost several hundred dollars and “I’m low-budget campaigning.”“I threw my hat into the the race because I felt like the hospital board has been dragging its feet, kind of in a rut,” said Hardy, who said she hopes to bring “new energy” and a “fresh voice” to the board.

Hardy feels it’s taking too long to get a new hospital built.“We should have been taking care of this sooner,” she said.Hardy said she was opposed to Measure C, the failed ballot proposal to build a new $148 million hospital on Fifth Street West because she was opposed to eminent domain required to take the Leveroni family’s hayfield there as a building site.

Hardy said she’s open-minded about a variety of sites for the hospital, but feels building a new facility on Eighth Street East and Napa Road might be too far away from Glen Ellen. Hardy worked for more than 18 years at Hanna Boys Center, starting as a child care worker and moving up to supervisor. Currently, she and her husband, Michael Hardy, run their own property management business.

Latinos Financial Impact

2006-08-24T13:46:00.000-07:00

Sonoma Valley Sun

People complain, sometimes, to Sonoma Valley Hospital officials about non-citizens coming in as patients because they assume that non-citizens drain the hospital’s finances. That assumption is wrong, hospital officials say.

“We are better off with that community here than if we didn’t have them,” said Jim McSweeney, the hospital’s chief financial officer. If the Valley’s non-citizen population disappeared, “There’s no question in my mind that the hospital would be worse off, financially,” he said.

Hospital finance is a “confusing, arcane” subject, but McSweeney explained it this way:About half of the births that take place every year at the Sonoma Valley Hospital are paid for by Medi-Cal, a state and federal program for the poor that is often used in the Valley by Latina mothers.

“You can get on it if you’re a mother, even if you’re not a citizen,” McSweeney said.Medi-Cal accounts for about 10 percent of the hospital’s total income. Another 40 percent of the hospital’s income comes from Medicare, the federal program for those over age 65.

But Medicare kicks in more funding as the hospital serves more Medi-Cal patients.The Sonoma Valley Hospital gets an extra $500,000 a year from Medicare because of all the Medi-Cal patients that it serves.For comparison’s sake, that $500,000 is about one quarter of the $2 million in revenue that the hospital gets annually through the parcel tax paid by the Valley’s property owners.

Financially speaking, the more patients the hospital gets, the better off it is. Additional patients help offset the fixed costs that the hospital incurs by being open and staffed around the clock.“One, or two or 10 more births, aren’t going to add a dime to our costs,” McSweeney said.

Could Latino Vote Help Build Sonoma Hospital?

2006-08-24T13:17:00.000-07:00

Only 7 percent of Latinos registered, but what about letting non-citizens vote?

Sonoma Valley Sun

Want a new hospital? Get the Latino community involved.Consultant Kathy Yarbrough offered that advice on Aug. 7 when she spoke to the Sonoma Valley Health Care Coalition, the ad hoc group that meets every Monday night to help craft a bond proposal for a new Sonoma Valley Hospital that will capture the required two-thirds voters’ support.

Yarbrough, the executive director for a coalition of rural hospitals, said that Tehachapi, a city east of Bakersfield, tried to get a hospital built only to have voters reject it by a 3-to-1 margin.But the second time around, Tehachapi voters approved a new, $21 million hospital — a success that Yarbrough attributed to Latino support.

“We really worked on getting with the Hispanic community,” she said. Tehachapi hospital supporters set up booths in front of Mexican restaurants, they included Latinos in focus groups and surveys, and they held meetings at the homes of Latino community leaders, Yarbrough said.Would such a campaign make a difference here?

One thing is obvious: Few, if any, Latinos have been involved at the Monday night hospital coalition meetings. Latinos also were noticeably absent at the three town hall meetings held prior to the hospital board’s decision to introduce Measure C, the failed proposal to build a $148 million hospital on Fifth Street West. And Latinos are underrepresented as voters in the Valley.

Latinos account for about 21 percent of Sonoma County’s population. Yet they only make up an estimated 7 percent of the registered voters in the Sonoma Valley Health Care District, according to the Sun’s analysis of computerized voter registration records. (Geographically, the hospital district includes all of Sonoma Valley up to Kenwood.)

The hospital district currently has 20,029 registered voters. The Sun estimated that 1,373 of those — or 7 percent — were Latino voters, based on their last names.Of course, many of the Sonoma Valley’s Latino residents aren’t citizens and can’t vote. The Valley was home to 3,985 non-citizens, according to year 2000 U.S. Census tract data.

If all those non-citizens were old enough to vote, they could boost voter participation by 20 percent in the hospital district.But non-citizens can’t vote, right?Wrong.It’s a little-known fact that the U.S. Constitution allows non-citizens to vote.

Non-citizen voting?“Philosophically, I’d have to say I’m opposed to it,” said hospital board member John MacConaghy, invoking a common sentiment. Although I’m very pro-immigration and pro-inclusion of our immigrant community, to me, my whole definition of a voter is a citizen.” But, surprising as it may sound, some communities have increased Latino participation by allowing non-citizens to vote in local elections.

For example, Chicago allows non-citizens to vote in school board elections. And in 2004, a referendum in San Francisco that would have let non-citizens vote for school board seats failed narrowly, by 51 percent to 49 percent.Hospital board member Mike Smith was intrigued by the idea.“It sounds like a good idea, if you could get people organized,” Smith said. “It certainly would change the dynamics of a lot of stuff.”

Non-citizen voting used to be widespread. For the first 150 years of U.S. history, from 1776 to 1926, 22 states and federal territories allowed non-citizens to vote in local, state and even federal elections. But the rights were gradually repealed, due to such things as anti-immigrant sentiment, southern states’ resentment of immigrants’ opposition to slavery, and the Red Scare after World War I.That’s according to Ron Hayduk, a political science professor at the Borough of Manhattan Community College, who’s written articles and a book about the subject titled “Democracy for All: Restoring Immigrant Voting Rights in the United States.”

Hayduk’s point is that the United States has an estimated 12 million legal permanent residents who may work, pay taxes, send their children to school and participate in the military — yet aren’t allowed to vote.He got interested in the subject while working for New York City’s Voter Assistance Commission, which encourages and helps people to register to vote.Hayduk looked at U.S. Census data and found there was a huge non-citizen population that wasn’t eligible to vote.

Around the same time, he heard news of an effort to register non-citizens in Tacoma Park, Md.His reaction to the Maryland campaign was, “Oh wow, really? You can do this? It’s legal?” Hayduk recalled.“I think it’s fascinating that this history has been effectively erased from our national (memory),” Hayduk told the Sun.

Most people know about poll taxes, literacy tests and other methods that the segregated South used to prevent blacks and poor whites from voting prior to the Voting Rights Act of 1965, Hayduk said, but few people realize non-citizens can vote.

Arguments pro and conThe most common objection to non-citizen voting is that immigrants should be citizens first, said an article co-written by Hayduk and Michele Wucker, of the World Policy Institute.But their argument against that is that the naturalization process has become cumbersome and slow and can take years, especially after Sept. 11, 2001.Their article said that opponents also question loyalty of immigrants.“Yet most immigrants are already members of their communities and assume all the other responsibilities of local citizenship.

They already have an inherent interest in safe, clean streets and services the community need to survive,” Hayduk and Wucker responded.They also note that non-citizens are not a homogenous group.“Some evidence from research on ... non-citizen voting in Europe suggests only modest shifts in the political balance of power, if any, would occur,” the article said.

Matt Gonzalez is the San Francisco city supervisor who introduced Proposition F, the 2004 ballot proposition that would have let non-citizens to vote in school board elections in the city.“There’s talk about doing it again, because we got so close,” Gonzales told the Sun.

Roughly one-third of San Francisco’s students have immigrant parents.Interestingly, Gonzales said voters turned down Proposition F in some of the traditionally more progressive neighborhoods, such as Haight-Ashbury, and approved it in more conservative – yet immigrant-heavy – neighborhoods, such as the Excelsior District.

Proposition F’s opponents said the measure would require an amendment to California’s constitution, but supporters believed that wasn’t necessary and that the measure could stave off any court challenges.

Meeting Summary (8-14-06)

2006-08-21T20:48:00.000-07:00

Affiliation with St. Joseph Memorial Not in the Cards for SVH

Addressing the Sonoma Valley Health Care Coalition at its regular Monday meeting at Vintage House, George Perez, CEO of St. Joseph Memorial Hospital in Santa Rosa, extinguished any hope that Memorial would entertain a financial or operating affiliation with Sonoma Valley Hospital as a solution to the Valley’s need for a new viable hospital facility.

Perez, along with Mark Knight, St. Joseph’s Vice President of Strategic Services, was invited to address the Coalition, which is exploring a variety of options for a new healthcare system in the wake of the defeat of Measure C.

Bob Edwards, Co-Chair of the Coalition with Steve Pease, explained that numerous Coalition participants had asked whether taxpayer burden for a new facility might be reduced, and operating margins for the hospital improved, if the hospital entered into a joint relationship with Memorial, as has Petaluma Hospital and Queen of the Valley hospital in Napa. With interest in the subject high, the Coalition wanted to hear Perez discuss that possibility directly.

“I think we got the answer tonight,” said Edwards, who observed that “Though it wasn’t what we might have liked, at least we have laid that possibility to rest and the Coalition can focus on other Options. It’s part of what we are trying to do – working through information and options to see what will work best -- financially, operationally and for the voters. Part of learning what will work includes learning what will not.”

Perez distinguished Sonoma Valley’s situation from that of Petaluma and Napa hospitals, noting that the latter do not have the extensive seismic issues facing Sonoma Valley Hospital, with its implication of greater construction costs. He also said that the 80-bed Petaluma Hospital, like Napa’s and unlike Sonoma Valley, serves a far larger population (about 100,000 in its service area) and draws revenue from a greater pool of patients. Napa, he noted, also depends heavily on a very generous philanthropic income of some $12 million a year.

Pressed by several members of the audience seeking his opinion as to the threshold size of hospital which would be financially viable in Sonoma, Perez and Knight declined to speculate, noting there were many variables. Both said that in the current and anticipated health care environment, it will be difficult for small general hospitals to survive without taxpayer support of some kind. Small private for-profit hospitals are more likely to be successful, he noted, because they typically focus on high-margin or niche business and do not attempt to serve the medical needs of the general community.

Perez made it clear that constantly increasing costs and continually shrinking payor reimbursements, Memorial is not looking for additional relationships with other small hospitals, for financial reasons. “Though Sonoma has a high wealth base and is better off than many small hospitals, things are tough for small hospitals everywhere, and they have a very hard job,” he said. Noting that Petaluma lost $700,000 last month he said that small hospitals do not enjoy the benefits of high volume to stabilize ups and downs in patient load and revenue, and high fixed overheard costs can’t be reliably covered each month. He did not see that changing, given the on-going reductions in reimbursements from Medi-cal, Medicare and private insurers.

Like all speakers who have addressed the Coalition on a variety of topics since its inception on May, Perez and Knight devoted ample time to take numerous questions from the floor.

At the Coalitions August 21st meeting, attorney Mary McEachron will provide information and answer questions on eminent domain and restrictions pertaining to the use of the current hospital property. Also on the program will be an explanation of seismic code requirements by Michael Van Pelt, Principal, Van Pelt Construction Services, Suisun City, and Bill Dasher, S.E., Principal, DASSE Design, Oakland

On August 28, the Coalition will hear a presentation of a new hospital Option put together by the hospital and staff physicians. After a Labor Day break, Dr. Henry Grause and architect Michael Ross will return on September 11 to present the Coalition a two-pronged Option, including a newly developed proposal for a privately financed and operated hospital.

***

SVHCC Meeting Double Header

2006-08-20T20:44:00.000-07:00

REMEMBER -- AND PASS THE WORD.

The Sonoma Valley Health Care Coalition is meeting at Vintage House on Monday, Aug 21, and 28 at 7PM.

Tomorrows meeting, August 21, is a double header!

Two hot topics. Seismic Mandate in California and Eminent Domain.

Michael Van Pelt and Bill Dasher will talk to us about the California Seismic Mandate and its effect on us and other hospitals. They will also talk about our situation with the West Wing of our hospital, the Central Core and the East Wing, Skilled Nursing Facility.

Mary McEachron will then cover eminent domain. She will talk about how eminent domain works in California as well as the specific issues surrounding the Carnelli and Cuneo properties. So there are two key topics on tap for one session.

HOPE TO SEE YOU THERE -- AND PASS THE WORD.

No Sugar Daddy

2006-08-17T14:08:00.000-07:00

St. Joseph no ‘sugar daddy’ Owns area hospitals but no capital to build one in Sonoma, official says

Sonoma Valley Sun

Will a “sugar daddy” step forward and pay for a new Sonoma Valley Hospital so that taxpayers don’t have to?If that happens, the St. Joseph Health System, which operates hospitals in Santa Rosa, Napa and Petaluma, won’t be Mr. Moneybags.

At the Monday night meeting of the Sonoma Valley Healthcare Coalition, George Perez, the CEO of St. Joseph, said it doesn’t have the money to build a new facility here.“We just wouldn’t be able to do that,” said Perez. “We just don’t have the capital.“These are very expensive, very difficult times for people in healthcare right now.”

Perez went on to describe — with help from his vice president Mark Knight — how things work at St. Joseph as a crowd of about 60 people peppered him with questions at the Vintage House senior center.St. Joseph owns Queen of the Valley Hospital in Napa and Santa Rosa Memorial Hospital, and both of those are doing well, Perez said.

One thing that helps Queen of the Valley is the high level of donations that it receives, he said.“Napa’s consistently done much better than Santa Rosa” when it comes to philanthropy, he said, noting that about $11 million in donations have been made towards the heart institute there with $15 million expected by years’ end. But the real advantage that the two hospitals have over Petaluma’s publicly owned hospital (which St. Joseph’s operates) is size.“Economy of scale is a large part of it,” he said.

As an example, Perez said that a $450,000 piece of medical equipment costs as much for a small hospital as it does for a large one — but the large hospital will recover its expense sooner because the equipment gets more use.“It’s going to cost you $450,000 if you’re a 25-bed hospital or a 350-bed hospital,” Perez said.

All of St. Joseph’s hospitals, including some small ones along the California coast in the Eureka area, have to support themselves. The system’s big hospitals don’t subsidize the small ones, he said.Taxpayers in Petaluma will have to pass a bond to pay for facility improvements there; Petaluma’s hospital — though growing — doesn’t earn enough to make the improvements without taxpayers’ help, he said.A subsidy of some sort or donations generally are needed to keep a smaller hospital afloat, Knight said.“When you get below 100 beds, you’re in a tough situation no matter where you are,” he said.

• Want to stay abreast of the Sonoma Valley Healthcare Coalition’s doings? Check out the ad hoc committee’s blog at http://www.svhcc.blogspot.com

SVHCC Agenda - August 14th, 2006

2006-08-14T12:46:00.000-07:00

Sonoma Valley Health Care Coalition
MONDAY, August 14, 2006
7:00 PM – 9:00 PM Vintage House

Welcome and Opening Remarks – Co-Chairs (15 minutes)

· Voter Survey Status Report

· Staff Survey Status Report

· Communications – KSVY/Blog/Coaltion Page

1. George Perez, CEO, Memorial Hospital, Santa Rosa, and Mark Knight, Vice President – Strategic Services, S. Joe/Memorial

2. Future Agendas

· August 21 – Eminent Domain & CC & R’s - Mary McEachron, Esq.; Seismic code requirements - Michael Van Pelt, Principal, Van Pelt Construction Services, Suisun City, & Bill Dasher, S.E., Principal, DASSE Design, Oakland

· August 28 -- ??

· September 11 -- ??

· September 18 -- ??

· September 25 -- ??

Adjourn: 9:00 PM

SVHCC Planned Meeting Speakers & Major Topics

2006-08-14T12:42:00.000-07:00

Sonoma Valley Healthcare Coalition

Major Topics/Planned Meeting Speakers to Date

June 5, 2006: Review and Approval of The Statement of Purpose of the Coalition and Status Reports of Committees and Game Plan Going Forward

June 12, 2006: Drs. David Nidorf, Robert Cohen and Jim McSweeney – Emergency Rooms in California and the Sonoma Valley Hospital ER

June 19, 2006: Steve Marler – Sonoma Valley FireMed Ambulance Service

June 26, 2006: Preparation of Questions for the Plan B Experts[1]

July 3, 2006 – No meeting

July 6, 2006: Return of the Plan B Experts – Jim Diaz and Wanda Jones

July 10, 2006: Patricia Talbot – Sonoma Valley Community Health Center

July 17, 2006: David Hitchcock and David Yarborough – Outlook for Component (or Modular) Construction of California Hospital

July 24, 2006: Dr. Henry Grausz & Michael Ross – Another Option for Sonoma

July 31, 2006: J. Michael Watt – Future Market Demand for Sonoma Valley’s Hospital

August 7, 2006: Kathy Yarborough – The Outlook for Rural Hospitals in California

August 14, 2006: George Perez and Mark Knight – Memorial Hospital and its Relationship with Sonoma Valley Hospital

August 21, 2006: Mary McEachron – Eminent Domain and Mike Van Pelt, Van Pelt Construction Service & Bill Dasher, DASSE Design - Seismic Issues at Sonoma Valley Hospital

August 28, 2006: The Marin IPA/Doctors and Hospital Proposal
[1] On June 26th, the Options Committee meeting which preceded the Coalition Meeting had a presentation from representatives of Healdsburg Hospital to discuss their situation

SVHCC Agenda- July 31st, 2006

2006-07-31T17:11:00.000-07:00

Sonoma Valley Health Care Coalition
MONDAY, JULY 31, 2006
7:00 PM – 9:00 PM Ramekins

Welcome and Opening Remarks – Co-Chairs (15 minutes)

· Solicitation of Other Options & Options Timetable

· Voter Survey Status Report

· Staff Survey Status Report

· Appeal to Candidates: Protecting the Coalition from Politics

· Disclosure of Conflicts

1. J. Michael Watt: Demographics and Forcasting Future Demand for a Sonoma Valley Hospital

2. Future Agendas

· August 7 – Kathy Yarborough – Project Director, Rural Health Design Network

· August 14 – George Perez, CEO, Memorial Hospital, Santa Rosa, and Mark Knight, Vice President – Strategic Services of St. Joe/Memorial

Adjourn: 9:00 PM

SVHCC Agenda- July 24th, 2006

2006-07-23T22:33:00.000-07:00

Sonoma Valley Health Care Coalition
MONDAY, JULY 24, 2006
7:00 PM – 9:00 PM Ramekins

Welcome and Opening Remarks – Co-Chairs (5 minutes)

1. July 24 – “A Seventh Option” - Dr. Henry Grausz, MD, Sonoma

· Presentation by Dr. Grausz

· Questions and answers

2. Future Agendas

· July 31 – J. Michael Watt – Forcasting Future Demand for a Sonoma Valley Hospital

· August 7 – George Perez – Memorial Hospital, Santa Rosa (tentative)

· August 14 (tentative) – Kathy Yarborough – Project Director, Rural Health Design Network

Adjourn: 9:00 PM

Request for Proposal

2006-07-20T22:26:00.000-07:00

Request for Proposal

Overview

Following is a call to qualified professionals in the fields of hospital facilities planning, operations, finance and risk analysis for proposals to:

a) provide assistance in the on-going planning process for a health care system for the Sonoma Valley Health Care District; and

b) prepare a comparative evaluation of the projected capital costs and future operating results for alternative health care delivery systems (the “Options”) for Sonoma Valley.

Background

Like other hospitals in California, Sonoma Valley Hospital (“SVH”) is , under the SB 1953 mandate to update its hospital to current seismic standards. Measure C, a bond issue that would have provided $148 million in financing for that purpose, was defeated by the voters in April 2006. A search is now under way for a solution that will receive the 67% vote needed to pass it in a future election. During the last weeks of the Measure C campaign, several community leaders, under the banner of the Plan B Committee, assembled a small group of health care experts who reviewed the District’s business plan which was represented by Measure C, took community testimony and issued a report now known as the “Plan B Report”, a copy of which is attached. To facilitate that search, leadership from both sides of the Measure C issue has now come together to form the Sonoma Valley Health Care Coalition (“SVHCC”), a citizens group concerned with the future of the hospital in our community.

SVHCC has established an Options Committee (the “Committee”) which is charged with identifying, evaluating and prioritizing alternative development plans, assessing their implications under potential future scenarios, and recommending the economically viable Option(s) most likely to receive majority support in preparation for another bond issue election, probably in June 2007. The Board of the Sonoma Valley Health Care District (the “District”) has pledged its support and assistance to SVHCC and the Committee, and will cooperate in the activities and the funding for the studies requested in this RFP. It is anticipated that SVH will be the contracting party with the successful candidate. All direction under the engagement, however, will be directed by the Committee on behalf of SVHCC.

Objective Of The RFP

In order to make its evaluations in a timely and informed manner, the SVHCC Committee is in need of the services of an experienced consultant with extensive hands-on knowledge of the workings of small hospitals in California - hence this Request for Proposals.

The consultant selected will be expected to work with the Committee as it formulates, evaluates and compares the Options and provides the financial projections and risk analyses necessary to arrive at a Business Plan for a facility and health care system that will be sustainable over at least the life of the financing bonds – 30 years from 2008 – and beyond.

Tools And Assets Available

The successful candidate will be given access to all of the books, records, research, plans, projections and other information generated by SVH during the several years the District has been studying the issue of replacement or retrofitting of the existing hospital.

The successful candidate will also be given access to, and, unless the consultant has an in-house analytical tool that it prefers to use, will be expected to utilize, as appropriate, SVH’s business planning model (the “Planning Model”). Financial projections developed by the client will be delivered in the Business Model. A copy of the Planning Model and a brief overview is attached.

Options For Evaluation

In the process of identifying potentially viable options to be evaluated, the Committee has utilized the matrix format on pages 6 and 7 of the Plan B Report to define and evaluate alternative health care delivery systems for the Sonoma Valley. Out of the six options presented in the Plan B Report, for purposes of your proposal you should assume a base case of four Options to analyze. In making its selections, the Committee has established three “gates” through which each proposed health care system will be required to pass to be further considered as an Option. The gates are:

a. Financial sustainability

Reasonably projected operating cash flow will be sufficient to maintain the system into the foreseeable future;

b. Quality health care

The health care system\ will delivery a high standard of care, at least equal to the status quo; and

c. Basic emergency

The Committee has decided that, to be acceptable, any Option must include a Basic Emergency Room as defined under California law.

The health care systems alternatives described on Exhibit A attached, should be considered examples of Options that pass gates b. and c, although they have NOT been accepted or rejected by the Committee. It will be the consultant’s job to determine if an Option passes gate a. - the financial sustainability requirement.

It is possible that the Committee will produce two or more additional sub-sets for Option D. Including the incorporation of one or more public/private partnerships for certain medical services. If such proposals are considered potentially viable components of a health care system for Sonoma Valley, they will be incorporated in a separate Option to be evaluated and the consultant will be so notified.

Scope Of Work

The first task will be to develop an analytical framework to evaluate the various proposals. The objective of this task is to ensure that a common ‘measuring stick’ is used in evaluating the various proposals. Questions to be resolved in this task include:

· How should (or should) differences in projected operating results be considered in the evaluation. For example, if two Options have similar capital costs, but dissimilar operating results, how should these differences be reconciled be taken into account?

· If options provide solutions that are viable over different time frames, how should that be taken into account? For example, if one Option must be abandoned at 2030 and another Option is viable beyond 2030, how should that difference be taken in account?

· If there are substantial differences in uncertainty afforded by the various Options, how should they be evaluated?

The consultant is required to complete the following tasks:

Using the broad space plans and gross building square footages provided by the Committee for the major clinical and administrative areas in each Option, prepare a capital budget for each Option;

Examine the Business Model provided by SVH sufficiently to:

i. accept it as the primary analytical tool for evaluating the Options and modify the Business Model and develop satellite models as necessary to meet analytical needs not met by the existing Business Model; or consultant’s tools or

ii. elect to use a proprietary tool under the control of the consultant, provide client with a description of such tool and explanation of why you prefer to utilize it.

Work with the Committee to identify the time frames or milestones within which to evaluate the financial viability of Options;

With respect to material business risks, work with the Committee to identify specific risk scenarios based on likely trends in payment schedules, market fluctuations over time and other potentially material exogenous variables and perform risk analyses with respect for each Option.

For any Option that is projected to generate cash flow in excess of that required to assure sustainability of the District and its hospital, identify and evaluate potential capital assets that might be owned by the private sector and leased to the District.

Use the Business Model and the agreed criteria, for each Option produce;

i. A capital budget;

ii. A first year, ramp-up and milestone(s) pro forma;

iii. A risk-adjusted pro forma;

iv. An analysis of the likely costs to the tax payer or property owner; and

v. Comparative analyses of the Options with supporting commentary;

Present findings in a written report and Power Point presentation suitable for presentation at public meetings; and

Participate in meetings of the Committee, the Steering Committee, SVHCC and the District Board as required to present and discuss the study.

Form Of Proposal Required

In addition to the necessary statement of the consultant’s qualifications and ability to do the work described in this RFP, the consultant’s proposal shall identify the following;

a. a lump-sum fee for the work included in items a. through g. in the Scope of Work (with respect to four Options such as those identified in Exhibit A);

b. payment timetable;

c. methodology and rates for item h. in the Scope of Work; and

d. a list of references.

Ownership Of Work Product

SVH and/or the District will own the work product, design and progress documentation and associated planning and design documents, whether complete or in progress. Consultant recognizes that it is not authorized to use this work product on other projects.

Qualifications Required Of The Consultant

The successful consultant will demonstrate current experience in the following areas of small hospital design and management in California:

accounting & finance;

risk analysis;

developing and evaluating small hospital business plans;

developing new capital budgets for hospital and health care systems; and

financial modeling for small hospitals.

The successful consultant will also demonstrate to the satisfaction of the Committee its ability to serve as an objective, independent advisor to the process without ties or other allegiances to SVH or any group or individual in the Sonoma Valley or its region.

Timing Objectives

Following are the anticipated timing objectives are:

July 18 - Issue RFP

Aug 7 - Proposals due

August 18 - Successful candidate notified

August 24 - Successful candidate to participate in Committee meeting in Sonoma

August 28 - Finalized list of Options to consultant

August 19 – October 27 - Work period

October 27 – Report due

August 24 - January 15 - Consultant to participate in meetings with SVH staff, Committee, SVHCC and BOD as requested

Date, Time And Place For Submission Of Proposals

Proposals in response to this RFP shall be delivered, via e-mail or courier, on or before 5 PM on August 7, 2006. Proposals should be delivered to:

Gary Nelson Bill Boerum
PO BOX 1378 320 Davila Court
Glen Ellen, CA 95442-1378 Sonoma, CA 95476-7652
e-mail: theothergarynelson@sbcglobal.net e-mail: bill@vom.com
Home: (707) 938-1776 Home: (707) 935-9304
Office: (707) 935-6576 Cell: (707) 996-7005
Cell: (707) 318-3974

Peter Haywood
18000 Gehricke Road
Sonoma, CA 95476
e-mail: haywood@vom.com
Home: (707) 938-5386
Office: (707) 996-4298

Notification Of Award

It is anticipated that the successful bidder will be notified on or before close of business on August 4, 2006. Documentation necessary to the study will be available to the successful consultant immediately upon execution of the engagement letter.

Exhibit A

Options For Inclusion In The Study.

o Option A. Smallest Operationally-Sensible Hospital - Basic ER, under 20 acute nursing beds, 4 ICU beds, surgery. Future addition likely for services to aging population. Appropriately-sized medical office building privately financed.

o Option B. Adequate For Current Volumes - Basic ER. 4 to 6 operating rooms, 3-4 LDRs, 6 ICU beds, 25-25 SNF beds (SNF could be omitted). Appropriately-sized medical office building privately financed.

o Option C. Healthcare System - Basic ER, 6 – 8 Ors, ICU, 34 beds, night clinic for pediatrics, chronic disease-capable. Off-site Birthing Center. Network of community clinics. Private SNF. “Membership” system to facilitate long-term support of patients with chronic conditions and/or acute illnesses. Appropriately-sized group practice medical office building privately financed.

o Option D. Reuse of, and additions to, existing on-site buildings. Basic ER, 4 – 6 operating rooms, 3-4 LDRs, 6 ICU beds, 25-35 acute beds, 20-25 SNF beds. New hospital wing on West End of property to accommodate ORs, LDRs, SNF and inpatient services. New central plant. Route utilities from new central plant to new hospital building. New entrance and lobby for East & West wings and acute care. Adjacent, appropriately-sized, medical & group practice building. Off-site Birthing Center (if so, delete LDRs above). Network of strategically located community clinics (2).

July 20, 2006 Agenda (Options Committee)

2006-07-19T22:08:00.000-07:00

AGENDA

Sonoma Valley Health Care Coalition
Options Committee

5:00 p.m., Thursday, July 20, 2006

Firehouse – 630 Second Street West

1. Method for Evaluation of the Proposed Health Care Options

2. Timeline for Options Committee Activities

3. Timeline for Consultant Report

RFP timeline as provided to candidate consultants is:

a. July 18 - Issue RFP

b. Aug 7 - Proposals due

c. August 21 - Successful candidate notified

d. August 24 - Successful candidate to participate in Committee meeting in Sonoma

e. August 28 - Finalized list of Options to consultant

f. August 21 – October 27 - Work period

g. October 27 – Report due

h. August 24 - January 15 - Consultant to participate in meetings with SVH staff, Committee, SVHCC and BOD as requested

Heard It On The GrapeVine

2006-06-15T19:18:00.000-07:00

Tells us your thoughts, what are you hearing, what's on your mind?

SVHCC Meetings Begin- Public Invited

2006-06-05T11:37:00.000-07:00

More than 70 people from all sides of the recent Measure C controversy met on Monday night, June 5, at Ramekins to begin the work of the newly formed Sonoma Valley Healthcare Coalition (SVHCC).

By the end of the meeting, over 60% of those attending had volunteered to serve on the committees through which the Coalition will do its work in the coming months.

“We are here to tell you that the disagreement over Measure C is formally, and finally, over” said Bob Edwards, a co-Chair of the Coalition and a leader of the former “No” campaign on Measure C. “There is no “Yes” and there is no “No” on the hospital any more. Our job now is to bring the community together around a search for the 67% solution – a plan for a health care system that provides quality care and will receive the super-majority support needed to pass it."

Coalition co-chair Steve Pease introduced a Statement of Purpose for the Coalition that, after some debate, received unanimous support. It reads “To recommend to the Sonoma Valley Health Care District Board of Directors the scope, size and setting of an economically viable Health Care Proposal most likely to achieve at least 67% voter approval for any ballot measure required to implement it and, if the Proposal is accepted and adopted by the Board, to undertake a positive information program to encourage voter approval."

The meeting was also attended by a number of the doctors and medical personnel from the Sonoma Valley Hospital who shared their concerns regarding the uncertainty and low morale there now in the wake of Measure C. Some expressed fears that key practitioners will decide to leave if not reassured that the community is serious about having a new hospital in the Sonoma Valley that meets State earthquake standards and delivers quality health care.

When asked by Co-Chair Edwards “How many people here want to see a new hospital here in town”, all 70 attendees voted “Yes”. Leaders of the Coalition invited hospital doctors and staff to join them in their efforts and to lend their expertise to the decision making process to come.

“However, we need to be clear that the only thing the voters are being asked to do is to pay for something” said Edwards. “We need to understand the dynamic of that, and to work toward a solution that will receive the needed support, even from the percentage of voters whose health plans take them elsewhere for general care and who may only use our hospital in a life threatening emergency”.

In support of that, committees were formed to conduct and fund an opinion survey to determine “what the voters want and what they are willing to pay for”, to review of the range of facility options provided by Plan B’s expert panel and by the community or other private groups; and to raise funding to support the SVHCC’s work.

In an intensive effort to get its work done in a timely manner, the Sonoma Valley Healthcare Coalition will meet at Ramekins from 7 to 9 every Monday night (except holidays) “until its work is done”.

It is expected that one of the up-coming Monday night meetings will feature a return visit by key members of the Plan B Expert Panel to review their recommendations and to answer questions from the public and from the Coalition as their work proceeds. Members of the public with an interest in working toward a positive outcome to the search for a sustainable health care system in the Sonoma Valley are invited to attend.

Expert Panel Report Now Available

2006-05-31T00:41:00.000-07:00

OPTIONS FOR
HEALTH CARE
IN THE
SONOMA VALLEY

A REPORT TO THE PLAN B COMMITTEE BY THE EXPERT PANEL
Based on the proceedings of an Intensive Evaluation Workshop held at Ramekins in the City of Sonoma on April 20 and 21, 2006

Panel Members:
Jim Diaz, Principal, KMD Architects, San Francisco
Wanda Jones, President, New Century Healthcare Institute, S.F.
Craig Acosta, Principal, KSA Health Care Planning, San Bruno

Presented here is the Final Report submitted to the community in the Sonoma Valley by the Expert Panel that was commissioned by the Plan B Committee to evaluate previous assumptions, examine publicly unexamined alternatives, and suggest new concepts for a new hospital and health care system to serve the Sonoma Valley.

Download the Report (pdf)

The report is based on the information presented to the Expert Panel at an Intensive Evaluation Workshop sponsored and organized by the Plan B Committee and held at Ramekins in the City of Sonoma on April 20 & 21, 2006.

Plan B is not a plan but a process.
In the days when the Plan B Committee was being formed, the name seemed appropriate in view of the fact that Plan A (Measure C) was clearly on a course toward failure, and a “Plan B” of some kind was the next logical destination for our community. Additionally the name always gets a smile (a rare thing in the Measure C debate), and its intention is always immediately understood.

Plan B’s activities: Our activities have been, and will continue to be, geared toward a process rather than a plan, and this report is just one part of the process. Running parallel are efforts to form a coalition of leaders from both sides of the Measure C debate to enable our newly informed and awakened community to regroup and provide positive input into the decisions that need to be made soon; to reassure the doctors, nurses and staff at the hospital and invite them to work toward a positive outcome in the effort to find consensus on health care in the Sonoma Valley; and to work to involve the leadership of the Latino community in the next steps of the process.

The role of the Expert Panel has been to gather information, listen to the presentations and review the documentation presented at the Workshop, then provide the benefit of their experience in hospital design, construction and programming to develop the report presented here.

Four panelists participated in the Intensive Evaluation Workshop at Ramekins: Jim Diaz, Principal with KMD Architects, San Francisco; Wanda Jones, President, New Century Healthcare Institute in San Francisco; Craig Acosta, KSA Health Care Planning, San Bruno; and Siga Weber, Principal in Weber & Company in Glen Ellen.

Unfortunately, due to the responsibilities surrounding the death of a close family member that occurred soon after the Workshop at Ramekins, Siga had to drop out of the Panel. We regret her absence, wish her well, and thank her for her participation in the two days of the Workshop at Ramekins.

The role of the Plan B Committee has been to invite and sponsor the Panel of Experts, facilitate the Workshop, and deliver the report by the Expert Panel to the community in the Sonoma Valley and to the Board and administration of the Sonoma Valley Health Care District. The Plan B Committee wishes to make it clear from the outset that this is the Expert Panel’s report, not the Plan B Committee’s report.

The opinions expressed here are those of the Panel members and, like the public and the hospital administration, the members of the Plan B Committee may have differing opinions about their content any findings they make. The Plan B Committee looks forward to working with the community and the administration of the hospital to arrive at a course of action that is appropriate to the future of health care in the Sonoma Valley.

DISTRIBUTION
The Plan B Committee has made the following arrangements for distribution of the Expert Panel’s report:

Summary: the summary will be printed in English and included for distribution in the two local newspapers that serve the Sonoma Valley – the Sonoma Index-Tribune and the Sonoma Valley Sun. The Sun has agreed to also make an additional 1000 copies of the Summary available for further distribution.

The Summary also will be translated into Spanish for distribution to the Latino community in the Sonoma Valley through El Sol de Sonoma, the Spanish language newspaper published by the Sun.

Download The Report (PDF)