Persistance and Tenacity, requires a new chapter, a new beginning....

Thursday, October 30, 2008

Town Hall Meetin' And Cheatin'

The public confusion about the troubles with the Kern Valley Health Care District was apparent, last Monday evening, Oct. 27, at the Senior Center in Lake Isabella, at the "Town Hall Meeting," when candidates for the KVHD board of trustees were asked questions which seemed out of touch with the real problems going on at the district.

The meeting began with each candidate giving short biographies as to their backgrounds and the reason why they are running for the board.

Bob Knight, who said he has more than 40 years experience in the health care industry, relayed a startling message to the 50 or 60 people in the audience, that Chet Beedle, the Chief Financial Officer for the district, told the board that the hospital may have to consider some serious options as they have no assets left.

No further questions were asked and none of the candidates commented after Knight revealed the depth of financial trouble the district is currently in.

Knight was joined by all the other candidates, incumbents, Bob Jamison and Barbara Casas; Hospital dietician and educator, Victoria Alwin; write-in candidate, William Van Lente (pronounced Lentee) who owns a management consulting firm; and Dr. Robert Gross, local physician and hospitalist. And from Canada, on the set of a movie he is producing, John Blythe, made the forum via telephone. (there were technical problems as he could not here questions or answers from the other candidates).

Currently, there are three members of the board whose seats are up for grabs. Jamison, Casas, and Knight all attended what could be considered an eye opener of a meeting.

Incumbent, Jamison, explained a story that at the last board meeting in Oct., he had to deal with a disgruntled customer whose wife's CT scans were priced questionably. He said it cost what it should and they even gave him a sliding scale price.

When I arrived at that last, official board meeting, Jamison and the unknown customer were yelling so loudly their voices carried down the hall and straight into the dining room where the SNF residents were having dinner.

But it was not until late in the event, after almost two hours, that members of the audience were allowed to ask their own questions. One person in the audience had a lot to say, when given the chance, and none of it flattering to the hospital.

Diane Jones was obviously upset by some of the answers she heard from the current board members about the problems they percieve at the hospital. She implied that the hospital would have more money and customers if it could get the billing straight and end the collection problem.

Though many of the questions by the moderators were tally type questions to see who believes in issues such as term limits, dress code, top problems, etc., when the audience was allowed it's brief time to speak, issues of a pointed nature were brought up. One gentleman asked if there would be a conflict of interest if Dr. Robert Gross as the hospitalist was elected.

Though Gross answered the question that he would obviously not be able to vote on any actions regarding his "subcontract" with the hospital, the questioner persisted. In the Local Health Care District Law booklet for the state of California (which can be downloaded on line), it deliniates that in fact it would not be a conflict of interest.

Here's one of the entries regarding the topic on page 19:

1. The officer abstains from participation in the making of the contract.

2.The officer's relationship to the contract is disclosed to the body or board and noted in the official records.

3. if the requirements of paragraphs 1 and 2 are satisfied, the body or board does both of the following, without any participation by the officer: finds the contract is fair to the district and in it's best interest. Authorizes the contract in good faith.

Another question involved term limits which most of the candidates agreed on. In the Local health Care District law booklet, there is no mention of term limits, except to say single terms are of a four year duration.

Victoria Alwin, outspoken, refusing to use a microphone, transmitted her message to the audience with certainty in her voice, said she has been in the middle of all the investigations in the SNF, and has experienced first hand what it's like to deal with the Department of Health Services.

She went on to say that after working at the hospital on and off for 18 years, she has seen a lot of things happen.

Alwin did not let the issue of the investigations drop even after, Jamison, tried to refute her claim that the state is watching vigilantly because the hospital has not passed the standards in the SNF even after spending close to a million in fines and having to hire a management company.

One audience member mentioned, JCAHO, the Joint Commission, an accredidation organization hospitals pay to make sure they operate in good stead and avoid costly situations such as the one's that have occurred at the hospital.

Alwin agreed and Jamison disagreed that using JCAHO would be a possible money saver. The fees for the service are minor in comparison to the fines the hospital has had to pay.

"The Joint Commission of Accredidation of Healthcare Organizations is a non-profit organization that rates hospitals and other health care facilities. JCAHO accredidation is a prerequisite for hospitals to be reimbursed when treating federally subsidized Medicare patients.

Mission: The mission of the Joint Commission is to continuously improve the safety and quality of care provided to the public through the provision of health care accredidation and related services that support performance improvement in health care organizations.

JCAHO website: http://www.jointcommission.org/

Another subject, a sore one, was brought up regarding measure M, a general obligation bond, which failed in 2006 by a short margain. However, the CEO at the time said that the 12.5 million dollar bond to meet state seismic buiding requirements, would not have covered all the expenses because the plans were flawed.

In a previous article in 2007, it said that along with discovering that septic tanks with leech lines exist under the planned site for the new acute care building, the CEO said the original money would not cover the project which would have to be changed.

"We do have some problems with the project shrinking in that it has reduced space that we previously had considered essential working areas. So, we may end up having to say we can't live with less square footage; that we need to look at a higher bond in the end."

What if we had given the bond to the hospital in 2006; paid the higher property taxes, and then found out they didn't have the right figures or plans, and they had to come back to the community for more money? Would we trust them again?

A question was asked about the Senate Bill 1953, regarding the seismic retrofitting or rebuilding of the hospital. The 2006 bond was supposed to cover all costs associated with the upgrade of the facility. According to Jamison the district sent a letter to the state asking for extra time, possibly through 2030, to fix the problems. He said there are no guarantees they will get the time and he said this could cause the hospital to close down.

However, if the hospital had the money, it could potentially bring the acute unit up one level of code, SPC1 to SPC 2, which would guarantee the hospital has the time to carefully investigate costs, prepare realistic architectural plans, and truthfully involve the community. There is a document I can post that says the very same thing. It was done when Knight was CEO.

Although, John Blythe, was on the phone dealing with glitches, he managed to tell the audience that the debt from the first project, in the late 1980's, which included adding the SNF, OR, and cafeteria, is "killing the hospital."

He referred to figures at around 22 million. Research proves the hospital originally was given a performance bond to build twice as many rooms for the SNF. This was originally 13 million dollars. Contractors have been blamed; lack of oversight was blamed; but all in all, the state of California, division of Cal Mortgage, insured the hospital to borrow all the way up to 22 million.

Even with the extra monies, the board was unable to finish building the extra rooms for the SNF; which had it been done, the project would have paid for itself and there would be no debt.

Blythe focused on the debt because the hospital is not supplying all the staff it needs or all the medical equipment it requires.

With the whole country being bailed out of debt, it would be prudent to look at what the debt has done to the hospital, and how it even could obtain that much money when the property itself was worth less than 5 million at the time.

WEBSITE for the Office of Statewide Health Planning and Development, which includes Cal Mortgage and seismic information. http://www.oshpd.cahwnet.gov/

One of the more interesting quotes comes from incumbent, Casas, who told the audience about her platform or "stand." What makes it so odd is the fact that she is the one who wrote the email I entered into this blog, under "Brown Act" violations. The email clearly tells of three board members who will even cancel a meeting to make sure they have quorum.

Casas also went on to say there were no board members having meetings prior to the actual board meetings, she said that was nonsense.

According to the Brown Act, which has regulations for local board meetings, contact between a quorum of board members, whether through email, intermediaries, telephone or personal contact, to discuss or debate action to be taken is strictly prohibited.

Asked about how the acute care unit is doing, Casas blamed insurance companies for not paying the district it's price and having to send patients to Bakersfield. She also said that the hospital is short staffed and that happens sometimes.

Write-in candidate, William Van Lente, (which must be spelled correctly if the vote is to count) was moderate with his responses and said his background in organizational development, which helps businesses transcend their difficulties, is part of the reason he decided to run for the KVHD board.

Asked why he was not a registered candidate, Van Lente said he was considering a position out of state during the time frame to register, and he didn't want to run for office until he knew what would happen with the job. He said former CEO, Robert Duncan, was the one who thought his skills would be valuable on this board.

One of the more contentious questions involved the right for a husband and wife to be on the same board. A few of the candidates said they think it is improper, but the Kern County Elections office has a different view.

"They're elected, not appointed or hired, it's the people's choice, that's who they're serving," said Sandy Brockman with the county election's office. "I don't see it as improper. There's nothing in the code that says they cannot."

Brockman said she had heard of a father and daughter on a board and that everything worked fine until someone in the public didn't like the way they voted. "Then they made an issue about it," she said.

The meeting was moderated and questions were asked through Cathy Perfect of the Kern Valley Sun Newspaper, a representitive of the Squirrel Valley Homeowners Association, and Joan Amos with the Hospital Foundation which raises money for things such as mammogram machines.

There are more video clips available for veiwing on YouTube, go to http://www.youtube.com/profile?user=OrderBipolarDisorder&view=videos We've had our own technical difficulties with the video, so if you have a problem with sound or quality, please let us know. Thanks.

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