Barry's take on the Palm Drive Board Election

After all is said (and written) and done, the vote on the Palm Drive Health Care District board members comes down to:

Do you want to give Dan Smith and company one last try at re-opening Palm Drive Hospital?

If so, vote for Richard E. Powers and Dennis E. Colhurst. If you are skeptical if it can be reopened then vote for Jim Horn, and if you like, one of the other guys.

Dr. Powers and Dennis Colhurst are going to support the Palm Drive Foundation plan no matter what, whereas Jim Horn is going to wait to see the full plan along with financial projections (which have yet to be submitted) and vote as he sees fit.

There's no real data available to say if the plan is viable or not, and even if there was we are not sophisticated enough in the twisted world of medical economics to evaluate it, nor would reality end up matching the plan.

So it comes down to if you want to give Dan Smith's team a go at it, or do you want to give up and get some form of urgent care that provides significantly less service than an emergency room but is hopefully financially viable.

Correct me if I'm wrong, but Dan & co. haven't had a full chance to put their plan into place yet over the years. There's been high drama at board level for many years (which I haven't followed). So I'm inclined to give them one more chance and I hope the other board members also let them have a good faith try.

I also think it won't work. Between the financial realities and the politics and personalities involved my guess it will fail again. But the win for the community of having viable emergency room is big enough to give it a try.

I'd really like to see the emergency room re-open, especially since my house is virtually around the corner from it! And given how small Sebastopol is, the same applies to pretty much anybody who lives in the city limits. And I can understand that the people on the coast and river feel like that don't see much value from their $155 tax bill.

So if we really want to have a hospital in town, I think the City of Sebastopol should add a new real estate tax, in addition to the $155, and donate that money to the district. I don't know the math (or legality) involved, but I could easily support anything up to $200 per year.

Barry,

Thanks for the endorsement but you are giving me way too much credit! The plan that has been developed is much more from the medical community, especially Jim Gude and Terry Newmyer than from me. I am doing a LOT of work to put it together and bringing the business side to it, but without the physicians and nurses, there is no hospital and truth be known, I don't know much about medical care, I understand business. All of the work I am doing is under the guidance of the physicians.

I know it is hard for some people to believe that we can have a sustainable (profitable) hospital after such calamity but that part is not as hard as one might think. When we tried to keep the hospital open in April, we were not acting our of passion as some thought but out of an understanding of the finances that gave us confidence that with a $3M cash infusion and some business changes, we could get it to cash flow. Now, it will take much more to restart.

We are not proposing any new taxes because they are not needed and my personal feeling is we have already asked enough from the broad community. The district has adequate tax revenue to maintain and upgrade the building and major medical equipment and we can make the operations profitable so there is no reason to have more tax.

We are already a good way into raising the capital to start up, (estimated to be $10-12 million) and are being very warmly received by major donors throughout the area. This is going much better than even I imagined! Not all of the money will come from donors, there will need to be a package of capital sources that will likely include some debt (not for the district), factoring receivables, and other capital sources.

There are no guarantees in life or reopening hospitals so we can't say 100% as some would like that we will be successful over a period of many years but we can say we are ready to solve the issues that closed the hospital before we open the doors, not after. And even if we only last 5 years, we will save a lot of lives and likely create a transition to another operator if it is needed.

While I decry the hospital's closing, it does create an opportunity to start from scratch in areas like billing and collection that were chronic problems at Palm Drive. We can also refurbish the lab and ER, which could not be done when the hospital was operational.

If urgent care would provide what our physicians say we need and it could be financially viable, I would be all for it. But Sebastopol will not support urgent care financially nor would it handle the real community need, which requires a full Emergency Room with lab, imaging and surgery.

I think you are off about the coast and west county. This is where support is the highest because it is a LONG trip to Santa Rosa in an emergency. With Sutter moving to north Santa Rosa, the River support has softened, but lots of River people still get medical services here in Sebastopol so it seems split at this point.

You did hit one point very well. There were some things like billing that never really got fixed after 2007. This was improved for a while, but still not where it needed to be. And governance has also been an issue for every district hospital in the state. The concept of trying to run a complex, highly regulated and competitive business with five elected officials simply does not work. If you realize that a hospital is very different from a school district, a sewer district or even a city in the sense that is has to compete for doctors and patients with neighboring hospitals, you can understand why district hospitals fail so often.

We need a bigger board of business and health leaders. Unfortunately, state law does not allow more than 5 on a district board and people are business leaders do not like to be in politics of any kind.

We do need to get beyond personal politics, which you identified correctly as an obstacle. Someone close to the issues said 'so how are your enemies doing' to which I replied, 'we have no enemies, just friends and people who have not yet decided to be friends.' I have matured some over the last 10 years and now realize we have to keep an open door for everyone to be at the table, friend or not yet friend.

I appreciate that there has been a very lively dialogue on WACCO about the hospital. I think this is very healthy for the community and that many people now have a better understanding of the issues.

Farmer Dan aka Dan Smith

Thanks, Barry.

I accept your view that I will "wait to see the full plan along with financial projections (which have yet to be submitted) and vote as he sees fit." I think that's my job as a board member: to do my homework, ask questions, talk to experts, listen to the community, and then use my best judgment to do the best we can for everyone in the Palm Drive District.

If that's what you want from your elected board members, then I would appreciate your vote next Tuesday. Thank you.

Jim Horn

Quote:

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Posted in reply to the post by Barry:

...There's no real data available to say if the plan is viable or not, and even if there, was we are not sophisticated enough in the twisted world of medical economics to evaluate it, nor would reality end up matching the plan.

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Barry, unlike you, I have studied the new plan, and the underlying business assumptions, and the financial history of the hospital and what went wrong.

My forecast is that the new plan will indeed succeed.

And that the only way we will not get an emergency room back is if Jim Horn is elected; for reasons I wrote about here.

I think you have bought into a projection that Palm Drive will fail financially because it failed during these past four years.

Yet four years ago, the current Board majority disbanded the hospital's financial advisory board. Lax oversight and financial mismanagement followed.

Plenty of small hospitals succeed and thrive. They do so with competitive business models and by providing strong financial management. The old Palm Drive had neither of these. The new plan will have both.

This election will be about whether we reopen our hospital or not.

It is between the political establishment of our city: every member of the City Council, all but one on the District Board, and all of Sebastopol Tomorrow, against every doctor in the area, and a wide majority of the people.

I agree with your conclusion, Barry. There is no rationale for not allowing the Foundation to try to reopen the hospital. Yet it is clear the the existing Board majority is invested in its past failure, and will not believe any plan that is set before them. I have written and marketed many business plans. They are, by their nature, hypothetical. One can never prove a hypothetical.

Why not let the Foundation group try? They are not requesting any increase in taxes. We will pay that parcel tax whether the hospital reopens or not.

Urgent care will not save lives. Hundreds of people are already suffering by longer waits, and less personal care, at the overcrowded Santa Rosa hospitals. Should an earthquake hit without Plam Drive open, as a recent headline suggested was imminent, we are all screwed.

In a recent post, John Eder demonstrated how far removed he is from representing or even hearing the people of our community.he is joined in this shocking refusal to practice responsive government by a small circle of politically loyal friends and relatives who have, walking in lockstep, managed to deny our community its hospital. Council Member Eder wrote that the "worst thing" that could possibly happen to Palm Drive was that in three to five years, we would be here on the Wacco Board talking about how the new Sonoma West Medical Center, after years of trying, was bankrupt again.

This is the world view of Council Member Eder, apparently along with, to the dismay of many, like me, who helped elect him, Mayor Robert Jacob, and my opponents in this race, Council Members Gurney, Glass and Slayter. All endorse Jim Horn As well as the members of Sebastopol Tomorrow, and the existing Board majority.

Their edict: DO NOT TRY to reopen a hospital because IT MAY FAIL.

I would like the voting public to think of this from a different perspective, one that I think reflects the sentiment of more than 95% of the hundreds of residents I have spoken with these past months during my campaign.

The worst thing that can happen is that during the next three years, when I or my neighbor may have a heart attack, the emergency room at Pam Drive remains closed, as it is now. And we die because the District Board decided it was "not worth" allowing the Foundation to try reopening it.

The worst thing is not trying and perhaps failing-or perhaps succeeding where the current District Board has so tragically, and consequentially, failed.

The worst thing is not having an emergency room in our community for the first time in 70 years.
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The worst thing is the suffering from the fear, and inconvenience, of having to go to a big city hospital after a lifetime of personal, local, and humane care

The worst thing is that people will die during the next few years because our hospital is closed.

If we can delay the worst thing from happening for three or five or fifty years, is that not worth trying?

Is this not at the very core of what we elect our representatives to do for us?