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OPINION: To do or not to do, that is the question

The fate of Hazel Hawkins Hospital should be in the hands of the owners - the people of San Benito County. 

This article was contributed by Dr. Parveen Sharma, MD.

Hazel Hawkins Hospital administration, which is seeking partnership with a nearby district hospital, announced that a community vote is not mandatory. The hospital did hold a few community meetings; however the attendees were comprised by mostly hospital staff, members of the Hazel Hawkins Foundation, hospital nurses, and couple of hospital-based physicians. Local community members were sadly missing from these meetings!

Strategically, the hospital administration seems to believe that this effort on their part, to educate the residents of San Benito County, is sufficient reason to negotiate a partnership with an outside agency. They would like the public to believe that this is the only avenue for the survival of the hospital in San Benito County. Although Kaiser has 7,000 members in our county, there are 40,000 community members in the county who are questioning why a partnership has become necessary.

The big question that begs to be asked is - Why now? What administrative policies and decisions brought the hospital to this end? It has been repeatedly stated that the cause is the declining government reimbursement, lower rates of insurance contracts, and outflow of patients to neighboring hospitals. Although this rationale has some merit, it is important to look deeper into past years for those factors that have brought the hospital to the point of needing a partner to survive. As someone who has had experience at many hospitals around the world and has personally witnessed a flourishing hospital as a trustee for 12 years- until recently, it is my opinion that the following requirements are the keys to the success of a community hospital:

  • Transparent management that respects the community it serves by openly sharing the status of the hospital finances on an ongoing basis.
  • Competent decision-makers who value and look for talent and skills among those physicians who live within their own community.
  • Fiscally responsible leadership that ensures objective contracting and recruitment of qualified healthcare providers and employees.
  • Un-biased and objective administrators who not only communicate their successes to the community, but also their failures when dealing with financial decisions that impact hospital operations.
  • Administrators who are actively involved in the community, developing trust and respect for those they serve.
  • Qualified leadership that demonstrates the ability to think strategically with the goal of achieving financial stability and patient satisfaction.

It behooves the Hollister city and county managers to review these requirements and evaluate how San Benito County and community members will be accurately and fairly represented in the proposed partnership. The community deserves answers to the following questions:

  • What does the partner gain from this consolidation/ partnership?
  • Will the partners be actively committed to investing in our hospital? And how?
  • Can we be assured that the uninsured and underinsured members of the county will continue to get the needed health services within their own community or will have to travel miles for care?
  • Will the partner strategically commit to enhance healthcare services within our community?
  • Will all healthcare providers and staff who support our hospital be treated and represented fairly?
  • Will this partnership ensure financial stability and success for our hospital and healthcare services?
  • Are we to believe that by bringing on a partner, federal and state reimbursements will increase?
  • Will this partnership commit to providing reputable leadership that will demonstrate accountability, competency, and transparency?
  • Will there be enough representation of the community on a Joint Board of Partners?
  • Would each member of the board commit to an open review of the affiliation or partnership agreement with the community, prior to making a decision?
  • Will there be any pay off to administration if they are not required to continue working for the partnership?

It is my sincere hope that the current and future San Benito County healthcare leadership openly identify and acknowledge the issues that need to be addressed in an open public forum with the residents who elected them as Trustees. 

Disclosure: I served as Trustee on the Board of Directors of the San Benito County Health Care District for 3 terms:  2002-2006 and 2008-2016. 

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Comments

Submitted by (Jason) on

Thank you for this very accurate and well presented description of what needs to happen....from a current HHH employee.

While no one can argue that the attributes pointed out by Dr. Sharma are essential; however, I detect that this written more as a critique of the current hospital administration than a general commentary.  That too is fine with me, provided Dr. Sharma would supply specifics, not generalities.

As trustee for for three terms, 2002-2006 and 2008-2016, she can certainly identify the specific policies that she believes were a problem.  What were they, what should they have been - finally, how would that have helped?

The hospital financials are public records because it is a public district and they are audited.  From 2005-2006 to 2016-20017, 11 years, the operating margins were in the red every single year, so it could not have been a surprise that they were going to run into financial difficulties.

It is not logical that the trustees, administration, and medical professionals from doctors down through the nurses, did not know the hospital's financial condition during those 11 years.  What did they do about it is a fair question.

I expect we'll hear a lot of, "It's not my job."

Marty Richman

Submitted by (Mohammad Al Hasan MD) on

Dr Sharma did the community a favor by bringing up the general problems of the Hospital. Until the community comes to the hospital and asks questions, they will never know the specifics. People see where the money goes, where the waste is and where improvements are needed, but they don't "blow the whistle" because of fear of retaliation. There are people in positions that make a lot of money for very little work. There are too many "Chiefs" for the number of "Indians". There are physicians brought in, and their income is supplemented by the hospital, that don't do anything different than a primary care doctor was doing. The Hospitalist program ran fine by local doctors but Administration brought in physicians making $100+ an hour to see the few patients admitted. There are Departments staffed for a large urban community Hospital, not a hospital with an average of 14 patients per day and many times as low as 5 patients per day. The nurses were able to negotiate very high wages to get 12 hour shifts, the techs often work for overtime pay, and much of the hospital is overstaffed. This is where the problems exist. If anyone thinks they will have better care by merging with another hospital, think again! The only reason another hospital would come in would be financial. If Salinas valley wanted to welcome San Benito residents, they would not be so difficult in receiving transfers from the ER now. Any Hospital that merges with us will be looking for services that make them money. Profitable surgery, Interventional Cardiology, Labor and Delivery, weekend MRI/CT test, and any other service that pays well will not be available here. San Benito County residents will be at the mercy of the other hospital as they take care of their local residents first. We will be left with a se

Doctor Hasan, I thank you for your willingness to address these issues in some detail as you see them.  I hope that your comment will encourage others - especially the management and professional staff - to voice their opinions on the specific subjects whether they agree with you or not.

It's no secret that other hospitals are not breaking down the doors to partner with Hazel Hawkins which means that we may not be an attractive partner.  I assure you that if there is a significant reduction in local capability or if the hospital district has to close, those who are saying nothing now will be screaming their heads off.

The only criticism I have of your comment is that the community is never going to go to the hospital to ask those questions, they need to be presented the information by those who know the system and they need to hear from all sides.

Marty Richman 

Submitted by (Barb Taddeo) on

How about not scheduling the public meeting when another major community meeting is going on the same night? I had to choose between this meeting and the election meeting. Also list what will be discussed at the meeting ahead of time. They would have gotten more of the public there. The hospital and the local doctors have to wake up and consider an HMO. I worked out of the county for years and was forced to to use out of county doctors and hospitals, even though my taxes paid for the hospital.
Please schedule another meeting and list what will be discussed. Don't just consider a hospital in Salinas but one in Santa Clara county if you do merge with another hospital. The majority of commuters commute north instead of south.
Barb

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