Supervisors to open public hearings on Sutter

Public comment on Sutter Health's plan to transfer publicly guaranteed health programs to Santa Rosa Memorial Hospital likely will get off to a difficult start Tuesday when Sonoma County supervisors open hearings on Sutter's plan to shut its hospital.

Sutter officials say continuing negotiations with Memorial's parent company, St. Joseph Health System, will prevent them from giving many details at the hearing.

Mike Cohill, Sutter's chief executive officer, said anti-trust regulations will limit him to providing bare-bones information until a transfer agreement is signed, something unlikely until early April.

Unions, doctors, nurses, patients, activists, and neighborhood groups concerned about everything from helicopter noise to parking garages are galvanizing members to turn out in big numbers.

The hearing also will be difficult because, unlike last week's tightly focused fact-finding sessions by the county Department of Health Services, the public hearing process is less certain.

The process is unprecedented in the county and is only partly comparable to the tumultuous 1994-1995 period when county supervisors debated giving Sutter the contract in the first place.

In abandoning operation of the public Community Hospital by signing a 1996 contract with Sutter, the county government relinquished administrative control over many publicly funded programs.

The county essentially gave the Sacramento-based health corporation a license to use its hospital building, its equipment and its workers in exchange for operating a defined list of public programs and funding them from what Sutter could generate from virtually free use of the hospital.

Other than lease payments that so far have amounted to only about $500,000, little money actually changes hands through the Health Care Access Agreement.

"The biggest misconception is that there is a big pot of money to play with," said Eli Hall, a former Santa Cruz County health official retained by the county as a consultant on the transfer. "The county does not pay Sutter to do anything."

Sutter gets money from Sonoma County through the County Medical Services Program, which pays for care of indigent patients who don't qualify for the state's Medi-Cal program for low-income residents. Sonoma County spends about $15million on this program, which also funds patient treatment at the other six hospitals.

In fact, a health department review of patient data found the county program pays for almost twice as many patient days at Memorial as it does at Sutter.

In 2005, the county program paid for 6,164 patient days at Memorial, 3,542 at Sutter and 1,321 at Petaluma Valley Hospital, which St. Joseph operates.

Reviewing those numbers at a discussion last week on indigent care, Memorial's Dr. Tucker Bierbaum observed: "It looks like Memorial is already taking care of the indigent cases."

In addition to considering indigent care, supervisors will hear from a host of other constituencies affected by other programs that the current agreement calls for Sutter to provide. They include sexual assault services, inpatient care for jail inmates, quarantine of public health threats, HIV and AIDS clinics, inpatient alcoholism treatment and a family practice residency program that educates new doctors.

Supervisors have said other public hearings are likely, but they aren't ready to schedule them until Sutter and Memorial reach terms of an agreement.