On April 3, Hazel Hawkins Memorial Hospital’s board of directors moved to renew the current contract with ACE Anesthesia Group for three years at $1.62 million for the first year, but left the price negotiable for the following two years. An agreement is expected to be presented to ACE in an open meeting in May, and the group will have 10 days to accept or reject the offer.
Before the gavel sounded to begin the meeting, hospital board member and ACE anesthesiologist Ariel Hurtado tried to convince hospital counsel Gary Ray that even though he recused himself from board discussion of the contract, he should be able to remain in the room and seated in the audience. Hurtado presented a thick binder containing the California Health and Safety Code District 23 that he believed supported his position.
Ray, however, said he believed Hurtado misinterpreted the law. He said he couldn’t tell Hurtado to leave, but cautioned Hurtado that if he stayed, he might jeopardize negotiations for ACE. Hurtado packed up his bags and left the meeting.
Then Chief Financial Officer Mark Robinson gave his report on the weeks-long, back-and-forth negotiations with ACE, which bid $1.8 million, and two competing anesthesiology groups. One was Elite Anesthesia Medical Group of Gilroy, which bid $1.7 million. The second was Vituity in Emeryville with a bid of $2.4 million, which put it out of the race, according to Robinson.
Board member Mary Casillas supported ACE, even though its bid was $100,000 more than Elite, with the rationale that ACE accounted for fewer cancellations. She said each cancellation potentially costs the hospital from $2,000 to $6,000 because staff have prepared for the case. She said even if the figure were $3,000 it would only take 33 cases to make up the $100,000.
“So, putting in the right group of anesthesiologists is super important,” she said, “so we can decrease those cancelled cases. Putting in the wrong group can increase those cases. This is the right thing to do for the patients.”
Without further comment from other board members and before the public was allowed to comment, board member Jeri Hernandez read a typed motion, prepared before the meeting in which she moved to cancel the RFP and renew the ACE contract, effective July 1. She also proposed to reduce the contract period from three years to two.
Also within the motion was a warning for Hurtado in which she used the same language of “disruptive behavior” that pulmonologist Joseph Ezer used at the March 28 meeting. He had accused Hurtado of breaking medical staff bylaws with “hurtful and painful” opinions of fellow doctors appearing on social media.
“All members of ACE Anesthesiology Group Inc. shall fully acknowledge and fully comply with hospital medical staff bylaws, rules and regulations pertaining to disruptive physician behavior,” Hernandez said (see PDF below). She didn’t say, however, what would happen if Hurtado or any other member of ACE should continue to speak out publicly.
Anesthesiologist and president of ACE Amitabh Mathur told the board that the new agreement Hernandez proposed at the meeting conflicted with what he had agreed to in the RFP, particularly that she reduced the contract period to two years. He told BenitoLink after the meeting that comments about “disruptive behavior” shouldn’t be in a contract agreement.
Casillas also expressed concerns over Hernandez’s changes to the agreement. She insisted the agreement be for three years and that it should be renegotiated the second and third year. She also asked CFO Robinson to go over the numbers from the bids once more. Then she asked Hernandez to read the motion again to better understand what it included.
“We asked for an RFP and I just struggle. It’s what we wanted to do, go out to bid,” Casillas said. “If we just wanted to redo their contract, we should have just done it.”
Casillas’ comments were interrupted by loud applause.
“It is my opinion they should stay with us,” Hernandez, said, referring to ACE. “I made the decision and you have to decide what you want to do.”
The board voted 4-0 (with Hurtado absent) to approve the agreement for three years, as the original RFP indicated. Hospital counsel Ray told BenitoLink on April 4 that there was nothing improper about the Hernandez motion being written before the meeting. As for her reference to disruptive behavior, he said there was a provision in the medical staff bylaws (see PDF below) that addresses disruptive physicians and that contract agreements require compliance with these bylaws. The specific provision spells out the type of possible behaviors that could be classified as disruptive, such as “degrading or demeaning comments regarding patients, patients’ family members, physicians, nurses, other Hospital personnel, or the Hospital which may have an impact on the efficient and collegial conduct of patient care.”
If a physician were to be accused of such behavior, Ray said, “That would be a determination made by the medical staff, based on the requirements within the bylaws.” Asked if the issue was a matter of free speech, he said, “The government can’t limit free speech and I don’t know how that’s extended to a medical staff that’s not a government entity.”
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