Saving DMC is the myth that keeps on giving. When will it all end, and who do you believe? I’m getting weary of being scapegoated, along with Rogers and Myrick, for not saving Doctors Medical Center.
First of all, the three of us are a minority on the Richmond City Council. Regardless of what we did, the other four council members could have voted to extract any amount of money from Chevron for DMC, whether it would be effective or not.
No matter how you slice and dice it, Chevron was unwilling to offer to provide the upfront money needed right now to keep the hospital open. That was a Chevron decision, not a Butt, Rogers and Myrick decision.
The best chance for saving DMC was Measure C;  the City Council endorsed it, and I voted for it, but it missed the needed 2/3 vote after the Contra Costa Times bashed it and editorialized against it multiple times:
Initially, the CCT published an editorial that advocated a "no" vote on Measure C. It stated that it was time for the hospital to give up and finally admit that it was not financially feasible
In 2011, we urged district officials to work quickly to find a permanent solution before this year, when projections showed the district would run out of money.
That day has come. There has been no progress in 2 1/2 years. District officials are still talking about the savior hospital with which it can merge. Meanwhile, it's hemorrhaging money and going deeper into debt.

The hospital now loses roughly $20 million a year, even with the two current tax measures. Worse, to keep the hospital afloat since 2011, the district borrowed $40 million. The money's gone, but the loan won't be paid off until 2042.

It's time for district residents to cut their losses. Even if the district finds a partner, it would have to go back to voters again for another tax to fund construction of a new hospital because the current one is not earthquake safe.

Most of the hospital's services can be provided elsewhere. The concern -- and it's a big one -- is the loss of the emergency room. Without it, residents will be forced to drive farther when they need lifesaving help.
On April 26, 2014, the Contra Costa Times editorialized against it again:
West Contra Costa Health Care District -- No on Measure C. This huge tax would purportedly keep Doctors Medical Center in San Pablo financially afloat. But, actually, it won't be enough to save the hospital.

Measure C would more than triple the current charge for the typical homeowner, bringing the total for a 1,500-square-foot home to $309 a year. It would be a permanent tax that would remain in effect even if the facility is acquired by another health care system, and would end only if the hospital and emergency room close.
We all agree that the closure of DMC will likely set off a health care crises in West County, or maybe not. I received a copy of an interesting email from a former hospital administrator in Milwaukee who went through a similar crisis. He wrote:
Dear Mr. Zell

I was CEO of a 120 bed inner city acute care general hospital in Milwaukee, WI that was forced to close its door due to our reimbursement mix of primarily government payers.

We declared Chapter 11 bankrupcy and, ironically, after liquidating our hard assets and collecting our receivable ended up paying our creditors $1.05 for each dollar we owed them.

Before we closed, I spent most of my time and energy working with my nursing staff to convince them to hang on and stay with us and my board to move forward with our plans to get out of the secondary acute care business.

Unfortunately, the cash flow clock ran out on us and, for the sake of quality care, we had to pull the plug.

DMC does not need to face that eventuality if you move quickly and aggressively to secure the loyalty of your employees by keeping them minutely up to date on hospital plans; immediately begin negotiations with area hospitals to accept your secondary and tertiary care patients by ambulance or flight for life; and put together a model of primary care for the Richmond community that meets our needs.

I would argue that a neighborhood health center approach with branches out in our community, similar to how other services i.e.. fire and police operate, will address 99.9% of our health care and social needs.

My experience when we closed with a census of 89 patients to be transferred to other hospitals was positive. My peer CEOs, to a person, did not view my patients as a drag on finances. On the margin, they could cover some of their overhead in caring for these folks. Almost everyone has some type of coverage.

If you should have any questions feel free to contact me.

Regards and good luck.

Jim Zahradka
510.620.1830
311 Seacliff Way
94801 
Hospital, health care officials say money from Chevron would have benefitted Doctors Medical Center
By Robert Rogers
Contra Costa Times
Posted:   08/06/2014 04:43:19 PM PDT0 Comments | Updated:   26 min. ago

RICHMOND -- A number of hospital and other health care officials this week challenged the notion that a share of Chevron's promised $90 million community benefits package would have been too little, too late to make a difference in the survival of beleaguered Doctors Medical Center, contradicting two City Council members who excluded the hospital when negotiating the pact.
Officials grappling for a plan to preserve services at West Contra Costa's largest hospital and emergency room -- which will stop receiving ambulances Thursday morning -- point out that multiple scenarios are still being explored for DMC, including a radical downsize or free-standing emergency department. Any funding commitment, either now or in the future, would have been valuable, they say.
"What happened with the negotiations was incompetence and failure of imagination," said Dr. Sharon Drager, a DMC physician and member of the San Pablo hospital's governing board. "Smaller amounts of money over different time periods could have been used to leverage with other potential investments, but the council members obviously had pet projects that meant more to them."
Councilmen Tom Butt and Jim Rogers defended their decision to bypass funding for the hospital when they negotiated the benefits package with Chevron as a condition of its refinery modernization project, instead earmarking millions for green transportation programs and a solar farm, among other projects. They said they were told a large amount was needed immediately, and that was a deal breaker.
Rogers added this week that he thought including the hospital in the package could have dissuaded other potential funders.
Councilman Jael Myrick, who also took part in the negotiations, said he offered to take half the money from the student scholarship program he championed and divert it to the hospital, but the idea was rejected during the talks with Chevron representatives because of the timing in making the money available.
Participants said Chevron was only willing to commit the funding once it received final legal approval to begin construction on its modernization, which could still be a year or two away.
Both Dr. William Walker, director of Contra Costa County Health Services, and county Supervisor John Gioia, of Richmond, who sits on the hospital's governing board, also suggested this week that money at a later time would have helped the effort to preserve hospital services to some degree.
"It would have had to be a substantial amount of funds soon to preserve the current model, but any amount of money would have helped as we transition (to a smaller hospital)," Walker said.
Said Gioia in an email: "The council could have proposed any funding amount (e.g. $1 million, $5 million, $10 million, $27 million or whatever)."
Meanwhile, the war of words heated up between those who negotiated the package during private meetings ahead of last week's City Council vote, with Butt accusing Chevron in a Facebook post of promising to "take the bullet" for excluding DMC in the package and now "trying to weasel out and blame others."
Chevron spokeswoman Melissa Ritchie declined to address Butt's accusation, saying the company stands by its original statement that "Chevron did not decide the categories of funding. This was done by the city and the City Council members ..."
Chevron, which regularly touts the millions it gives to the community annually in philanthropy, said it has no plans to provide voluntary funding to DMC.
"Chevron cannot financially support the hospital beyond our existing taxes, which last year included $175,000 earmarked for DMC," she said.
While Butt accused Chevron of pinning the blame on him and fellow council members Rogers and Myrick, the Chevron lobbyist and DMC official who negotiated the package said it was the other way around. Eric Zell, board chairman of the West Contra Costa Healthcare District, which runs the hospital, met with the three council members and a Chevron public affairs specialist in area restaurants and his Point Richmond offices to hammer out the deal,
Zell maintains that he wanted money for the hospital, but the council members opted not to and now want him to take the political heat for their decisions.
"Unfortunate that council members looking for cover at my expense," Zell wrote in an email this week. "They could have spent a vast majority on DMC. Chevron was not opposed, and I certainly wasn't."
In the days leading up to the council vote, the three council members convinced Chevron to increase the community funding from $60 million to $90 million over the next decade.
The hospital, which holds 25 of the area's 40 emergency room beds and has been a primary source of medical care after past fires at Chevron's refinery, is on life support, running an $18 million annual deficit and losing workers in droves as they resign because of the grim outlook. Voters rejected a parcel tax measure earlier this year, and the county, despite pressure from hospital unions, has shown no willingness to provide funds to save it or to float a new sales tax.
"The easy answer is we don't have any money to provide to DMC," county Administrator David Twa said.
Butt insisted on his website last week that the only scenarios in which the city could have forced Chevron to help save, or postpone the closure, of DMC had "fatal flaws," including the inability to access the money immediately.
Rogers, who secured millions for green transportation projects that he has championed in the past, said he gave up his efforts to get money for DMC because there was no guarantee the money would have saved some form of the hospital, and that future dollars earmarked for the hospital might be a signal for other potential funders to pull back rather than chip in. Rogers also noted that his favored transit-oriented programs satisfied greenhouse gas mitigation requirements linked to the project's approval.
"If there was money up front that actually had gotten the hospital to stay open, we would have gone for it," Rogers said. "But taking from some other programs to give money to some unknown operation two or three years from now, which may do no good because other funders may cut their contributions? No, that's not as high a priority."
Gioia pointed out that in 2008, when a larger Chevron project was envisioned -- but was later halted in court -- and the council agreed on a community benefits package, it also did not include money for DMC. It did earmark $6 million for a nonprofit health clinic, he said.
A health care district board meeting to update the public on DMC's future was canceled this week, and doctors and county political and health officials met with state leaders in Sacramento on Monday to plea for more funding. Gioia said state health officials were noncommittal because in part of their own budget problems.
Meanwhile, DMC's crisis deepens, and officials say they need to make a decision this month on how to restructure the hospital to avoid closure.
Contact Robert Rogers at 510-262-2726. Follow him at Twitter.com/sfbaynewsrogers.

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