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HomeMy WebLinkAboutMINUTES - 09271994 - 1.85 1 .85 THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA DATE: September 27, 1994 MATTER OF RECORD ------------------------------------------------------------------------------ ------------------------------------------------------------------------------ LETTER from A. B. McNabney,commenting on the need for rebuilding the County Hospital in Martinez. THIS IS A MATTER FOR RECORD PURPOSE ONLY NO BOARD ACTION TAKEN RE 1161 Leisure Lane No. 7 t,EIVE® Walnuyt Creek, CA 94585 10 September 1994 SEP Honorable Tom Powers, Chair & jcLERK B'UA OF S 1S0RS CONTMembers-Board of Supervisors Greetings:RE:County hospital et al It is distressing to see the convaluted situation that is evolving around the reconstruction of the so called County Hospital in Martinez. I believe the Board has made the correct decisions i.e. that funding should be sought (it wass found), that the present hosptial be razed and a new facility be constructed in Martinez. I also understand it will be the purpose of the Board and Health Services Department to provide outpatient servcies in local communities, such as Richmond, Bay Point, Pittsburg etc. I also understand the Board and Health Services department contemplate the making available important emergency services in local areas, with elective care (surgery et al) being made avilable (except for some highly specialized conditions at a new facility in Martinez. For such situations (highly specialized conditions) care will be provdided at an institution that has the qualified staff, equipment and ability to carry out such in a competant, cost effective manner. Such specialzied care will be (usually( carried out in an institution with which the County (Health Services) has a meaningful contract. As I understand the current situation: an issue has been raised in the courts wherein the allegation is made that the proposed replacement of the County's hospital will discriminate against "some" individuals in "some" communities and minority groups, where such individuals have to look to the County System for care and health servcies. As I understand it, there is an injunction which prevents (at least for the time being) contiuned movement on the Hospital Plan the county has developed. Developed after long, arduous hearings at which (I presume) thk was substantial public input. Also involved are existing and/or former hospitals in the area that have (or have had) low occupancy rates, financial difficulties or both. Such institutions and some individuals (some from the staff of one or more of these institutions) argue the County should (must) use these institutions to provide care, rather than spend money rebuilding the County Hospital in Martinez. Pressure is exerted by the media, individivals and some groups to estop the building of a new hospital in Martinez. Noted too is a call by one Supervisor for creation of a Committee of some sort to further review the entire matter (with I presume the thought there will be NO new hosptial in Martinez). I suggest and argue there has been enough review, consideration discussion. Other than meeting the court challenge, the Board should proceddhe Plan already worked out. The Board "might" take into account some of the suggestions, infra. -1- I respectfully suggest the argument that indivdivals in some communities are being discriminated against because the proposed rebuilding of the present hosptial does not take into account all of the facts, circumstances and conditions. It is my view there is only so much money avilable to provide for care and treatment of individuals who look to the County and County Health Services for health care services. Current and anticipated in-hospital care will and does require less and less in-hospital time than used to be the case. As a result, hospitals all over the United States are finding it impossible to continue service, ergo they close. Other institutions find their facility with many empty beds, which means the average cost per hospital day is rising (dramatically) ergo they seek county paid for patients to enhance the institution's income. As I un erstand it other hosptials, while interested in having the patients (and income) have been unwilling (or unable) to enter into contracts that would give County Health Service personnel i.e. doctors the "right" to manage county patients under Health Service rules etc. In short, placement of patients in hospitals other than the County facility would mean the County Health Services would not be in a position to control costs. There could even be a question as to control of quality, although such "may" not be an issue in this county. If the above(somewhat) accurately sumarizes the present situation, I offer the following for your consideration: 1. As to violation of an individuals civil rights: If the County Health Services arrange for adequate emergency and outpatient care that is of high quality, is reasonbaly available in the local areas around the County, most health care services should be so reasonably available there could be no effective charge of discrimination. Such care and service can be developed in any "decent" setting. County medical staff (professional and lay) would be employed and available during necessary hours. Emergency services will have to be worked out, depending on need, availabilty of staff and cost. Some emergency service should be provided in a local institution with participation of County Health Services in the decision making processes. Some emergency service will quite likely have to be provided "IN" the Martinez Hospital. In such circumstance ambulance and/or adequate transport has to be made avilable or must be provided under a County Health Service arrangement. 2. Routine, in-hospital service would be provided at the Martinez Instition, patients in the Martinez hospital will have available to them, essentially ALL services. The possible exception, highly specialized care i.e. open heart surgey and post operative care. The patients at the Martinez facility will have available to them doctors and staff who have an arrangement with County Health Services, including laboratory, x-ray, other diagnostic services and facilities essential to providing high quality care in a cost effective manner. -2- I f 1• There can be NO "effective" charge of.discrimination if such conditions are available. However, there will be the issue and/or question of family visits, transport of non-critical patients to and from their homes and/or to and from the Martinez Hospital. Comparing the cost of a hospital day in most hospitals, with costs involved in providing "some" reasonable form of transport for patients and families will quickly show a lot of transport can be made available at a cost far below outside, hospital costs. The overall cost of such will be well below costs of a hospital day in most hospitals. I suggest it is in the interests of everyone, the taxpayers, (overall costs under the suggestions here advanced, should be well below costs that will be created if the County has to hospitalize patients in any and/or all hospitals in the various areas, rather than use a system as suggested). Such a system should (would) be in the interest of the patients and/or those who look to the County Health Services Dept., for health/hospital care and attention. A very high quality of care can be provided, at reasonable costs to the system, by doctors and staff who "care". Distances are mitigated by the providing of transport i.e. emergency and routine for patients and families. Such a system would be of benefit to the County. The current and anticipated financial situation requires close scrutiny and control of ALL costs. Increases in taxes to cover health care costs will be difficult, if not impossible to come by. The system suggested will give the County and County Health Services a way to contiue to provide high quality health care services in a cost effective way, thereby not forcing decisions that will further cut services to those who must look the County for health care service. Re ec A. B. c abne