KVHD Oct. Board meeting: Public can't see Plan B

Kern Valley Healthcare District Board meeting: interesting as usual

(Kathryn Knight, pictured above, tells board and the audience we need a plan "b" or maybe C and D too.)

The first question from the public at the October Kern Valley Healthcare District board meeting was what will the hospital do if the property tax increase, Measure G, doesn't pass?

That was not the first time the question was asked it has been going on for months, with no response from the administrators or the board.

With a 22.7 million dollar property tax supported, general obligation bond, on the ballot for voters to decide whether they want to invest their money into a financially faltering hospital or wait for another alternative, the managers and board had another chance to answer questions from the public.

Former interim board member, Wayne Ottison, headed to the podium and directly asked for an answer as to whether the hospital will survive without the bond.

The answer, from CEO, Tim McGlew, was "yes."

So, they will survive

A second concern voiced in the community is the participation of the public in the oversight if the bond is passed or even in the conception of a plan to deal with the future of the district.

Ron Benoit, known for his service in the community and a member of the Lake Isabella/Bodfish Homeowners association, questioned the board as to why they are not paying off the "old debt" with this bond money.

Benoit suggested had that been paid off, he said he felt there would be more public support.

No, they are going to juggle three bonds

• The "old debt" you hear some people talking about has existed since 1988, when this hospital went after it's first bail out from a mishandled construction project. This project produced less than half of what it originally had been planned, but cost twice as much as "normal" costs would have been. That was from 1986 and we have now paid more than 60 million to carry a debt that would not go away. This bond will not be paid off for another decade, meaning the community is paying double...for now.
• If the community were to band together and obtain this bond, Measure G, the money could actually be lost in many places such as lawsuits, potential construction costs not foreseen as there are in fact no construction plans, or a whole slew of pitfalls which could catch hold of the new found cash. Those taxes will come due annually to property owners who will have no choice but to pay for the next 30 years.
• There are no current threats of closure due to seismic upgrades on the hospital. Not until 2030. So, since Measure G will not be paid off, or capable of upgrading or building, another bond will need to be sold to the community, and at some point we could be paying for three bonds.

Not much of a plan to say the least, but we have to consider the whole picture, the needs today and the trends toward the future.

I'm positive this community would be willing to share in the responsibility of a bond measure they were included in creating.

There has been surveys done for years now and the same issues arise each time: Cataract surgery, dialysis, chemotherapy, urgent care and mammography.

The waste

KVHD has bought two cataract surgery PHACO units and continues to be unable to provide this service.

However, McGlew announced that they are doing "lap band" surgeries for the obese people in the valley. As this is the hospital surgeon's speciality, Dr. Kent Skoegerson, who made a career from these procedures, it has been announced there have been four successful lap band surgeries performed already.

Lap band surgery never came up on any surveys, but since we have the technology why not use it.

They had mammography at one short point, but now after all these promises, it's a matter of actually materializing the needs of the community.

No more empty promises KVHD

Their campaign slogan is "you owe us a GOB," as they are sore as a boil over there that we the tax payer aren't paying enough.

Let them not forget the whole project called KVHD came from the government with our money. The point: to care for the needs of rural health. This hospital was built with government money to serve the underserved, it is actually a "cash cow."

Yes, there are diamonds in this mine of medicare and medical monies, as well as ER services as opposed to urgent care.

It costs more to enter an ER and is generally expected that one goes to an emergency room for things a regular doctor cannot handle.

Urgent care is basically a clinic full of coughing children or stitches, this keeps the ER from overloading with patients who can wait or be treated more efficiently in a different setting.

One woman at the September meeting complained that her husband had come to the ER for a catheter and left with a CT scan, new prescriptions, and a bill. Their regular doctor stopped the prescriptions and basically went back to where they started which was a catheter.

She called it fraud.

Another patient who is uninsured was using the sliding scale available to qualified individuals as the hospital IS reimbursed for much of these patients care. Don't let them fool you, there is a difference between a bad debt and a lack of proper billing practices.

Bad debt does not mean charity care. A bad debt could mean an unpaid co-pay for the ER let's say.

But if I decided to allow a debt to get out three years or more, it's tough to collect. People move, people die, and people lose jobs and have no homes, welcome to the "depression."

KVHD doesn't know others need money too

Having a CEO take a raise on the very night the district asks tax payers to put 22.7 million dollars into the hands of the some of the same people involved in the understaffing disaster which lead to the use of psychotropics on nursing home patients is devoid of any common sense.

I remember the night of the fire in Kernville, I leaned against my car filming the glow in the evening sky. Then I had a thought, what does the hospital do when a fast moving fire hits it's constituents.

Much to my dismay, some employees didn't know there was a fire, one was only concerned that it was across the lake (this time), and no administrators.

I said, if I were your CEO, I would be sleeping in my office tonight until I knew all were safe in the smoldering community. Just an opinion, but you can't pay someone to care, they generally only care if they are paid.

Meeting summary

Here's what you may want to watch for at KVHD:

The board voted in a new contract for telehealth. It costs $3000 a month, with consultation at $200 per hour by psychiatrists, cardiologists, and other specialites. The service is available 24 hours a day, seven days a week.

The hospital will not own the equipment, and actually doesn't have a doctor willing to consult in the skilled nursing center.

According the Chet Beedle, that is because the SNF, nursing facility, does not have electronic records to go with the telemedicine. The doctors don't want to only see a patient on TV, they want access to their records as well.

Beedle explained that the nursing facility has needed a psychiatrist consultant in conjunction with the use of psychotropic drugs for the patients for many years. But apparently that will still be delayed unless, of course, it is being enforced by the Department of Public Health...

Only RHC will have the ability to use it initially, when it gets there. Though McGlew said there were also "four" patients at rural health using the psychTV. The answers were confusing.

The televised consultations come to the hospital via Southern Sierra Telehealth.

http://sierratelehealth.org/

Next, we found out we have a potential new partner in strategic planning called Focus and execute. Actually, there was description by the CEO that the company has some great software that makes sure that goals are met. Mcglew said he had just recieved a proposal for the consultants right before he walked in the door to the meeting.

Chairwoman, Victoria Alwin, reminded him the board would need "three" summaries from different companies.

http://focusandexecute.com/index.php

What about Chet Beedle?

According to the resume of Chet Beedle he provided me back in 2007, he's a specialist in rural health strategic planning.

So, why are we not using his skills? Why are we considering paying others when we pay 133,000 to our CFO? Many small hospitals can't afford CFO's like Beedle, they have their CEO doing the financials which is often time the job description of the executive officer.

We can't have Plan B...yet

Finally, board member, Kathryn Knight, had the board pull the minutes from the September Finance committee meeting, indicating there was a discussion regarding a "plan b," to be implemented in the event the GOB doesn't pass.

I asked what this plan was about, and if I could have a copy, and I was turned down. I, of course, told them if it had been discussed at a public meeting it now became a public record.

Scott Nave, counsel for the board, was asked by me if I could have the document and he said I could not because it was a "draft."

Again, I responded, if the public had attended the finance meeting then we would know what this plan, option, or draft had been, and it would have been public.

All members refused to allow the public access to the plan or the discussion surrounding the plan, even though it went through a public meeting and not a closed session.

Had I attended or anyone else we would not have to go begging for information rightly due the public.

Somewhere out there is a plan of action or reaction ordered by Cal Mtg. in case the community wakes up and begins to demand proof and doesn't rubber stamp Measure G.

Do we even know what Measure G is about?

Even though I will pursue the plan B, also known as the "turn around' plan, and written by Tim Mcglew and Chet Beedle, both admitted, I still don't understand plan A, the bond.

With a promise of a new ER and a retrofit of the current ER into an radiology center, and a partial payment off the "old debt," a two million dollar loan to close the gap on the bond sales, I don't understand how this could be called, "a head start" by the CEO.

The hospital is now 40 years old, and to add a new structure with the old which will need to be replaced in the next twenty years, has no vision for the future.

If you could choose now how that money is spent how would you want to spend it? New ER, or maybe a new urgent care, or a medical center, or outpatient surgery, or the many opportunities time and research could provide where do you want it to go?

Four years ago, we told the public that we needed a new acute care unit, for 12 million, only to find ot the architectural plans were not feasible and were slated to sit atop the septic system.

What would have happened had we voted in Measure M in 2006?

Answer: we would still be coming after this second bond and then a third bond, while continuing to pay the original debt where decisions were not carefully planned, but big money was invited in.

We would be paying the extra taxes on the former measure, then pushed into another bond, and then knowing a final bond would be necessary.

As an opinion piece I put up from the Tehachapi newspaper regarding their GOB they voted in after much ado, a woman said, she didn't expect to live to see the hospital built, but she does have to pay her annual "GOB" taxes regardless of whether or not the money was spent on the "potentially" new hospital.