Candidate for
Director; Marin Healthcare District

Lori Wood-Philosophy

• Former District Secretary dedicated to making our hospital and especially labor and delivery rooms earthquake-safe as soon as possible.

• Committed to fiscal responsibility and competent management of District and hospital finances.

• Advocate for open government, respecting the public's rights and maintaining voter control (rather than private control) of our publicly-owned assets like the hospital.

Some members of the public doubt that the soon-to-be-elected Marin Healthcare District Board's can transition Marin General into a viable, financially strong hospital without Sutter or another private healthcare system at the helm.

Some believe that the publicly-elected board and Marin General (without a private partner like Sutter) will end up in a "boondoggle" costly to taxpayers if hospital finances and earthquake repair bonds, are not managed carefully. Some think a privatized model of operation would make Marin General more secure but how can we be sure?

History reflects a very poor track record with the "private" model in Marin. What the private model has produced over the past 10 years is: hospital profits taken out of our county rather than reinvested into Marin General, lease terms ignored, lawsuits, and Sutter only negotiating when the elected board agrees to meet behind closed doors.

Members of the public, even healthcare professionals, who oppose Sutter get labeled as "troublemakers"--a label that recycles through the press (like propoganda) to Sutter's advantage. Those who enjoy the way things are with Sutter currently in charge are the first to criticize the "activists." Instead of debating the issues in public and answering the "activists" concerns, Sutter has a cameraman recording each meeting.

Since 1996, Sutter has taken over $100M in profits out of Marin General, while refusing to spend a dime on State mandated earthquake repairs. With recent profits averaging $15M-$20M per year, Sutter proposed another 30 year lease at Marin General in exchange for doing the seismic upgrades--with one condition--no public/district oversight during those 30 years.

The problem with giving up voter/district control of Marin General is that it would overturn the charter for the healthcare district established in 1946. With that charter, past community members gave future generations a gift--public ownership and voter-control of the hospital through an elected board. Giving that power away would be shortsighted and counter to our democratic system of local government.

The word "demokratia" translates from Ancient Greek as "people rule." We should treasure our democratic ability to elect those who will safeguard our basic human needs like healthcare, water, sanitation, transportation, fire and emergency services, etc. In less democratic countries (or even the U.K.), we see disastrous results when public services are privatized for profit.

The district could not agree to the 30-year "no oversight" deal that Sutter was proposing and in fact, believed Sutter's lease required them to do the repairs. To try to resolve the matter, in June of 2005, Sutter proposed a so-called "consensus building effort" to study seismic repair options, but in the middle of the process Sutter abruptly sued the district. Then Sutter proposed "settlement talks" if the board agreed to closed door meetings and confidentiality agreements.

Directors Severinghaus, Jackson and Coxhead agreed to the secrecy. These three board members form a majority and vote as a bloc on virtually every action, but the two elected anti-Sutter neurosurgeons on the board (Dr. Arnstein & Dr. Ramirez) strongly objected. The neurosurgeons were ultimately left out of the discussions and forced to be silent by confidentiality rules put into place.

For many months, there was no word re: the negotiations. What was happening was the attorneys were working out a 300+ page settlement agreement with new lease terms strongly favorable to Sutter. Once the terms were released, "public discussion" meetings were held, a perfunctory gesture since the attorneys stated the terms were already fixed.

I was surprised to find myself as the only candidate currently running for the board who opposed the settlement agreement/new lease terms and the way the process was handled in secret. It seemed to me like no one else had read all 300 pages of the agreement and during the September meetings, the pro-Sutter voices kept saying, "move beyond the past...we need to go forward, we need to move on."

I didn't agree that moving on was a wise move. I think the deal is designed to weaken the district and hospital while strengthening Sutter's plans to compete with Marin General in 4 years. The terms also leave the district in an uncertain position because there is no way of knowing when Sutter will actually choose to leave--sometime between January, 2009 and July, 2010.

I also could not condone an agreement which was negotiated in violation of California's open government laws. The Brown Act allows for closed session lease negotiations (which these discussions were) only when 1) the public is informed of the actual names of the persons negotiating (all of the people behind the closed doors); and 2) the board only discusses business which it has advised the public it will discuss (no other business is to be discussed). Both of these Brown Act requirements (54957.7 and 54656.8) were disregarded by the district's attorneys.

The closed door discussions improperly covered subjects way beyond the seismic litigation questions and made future promises obligating future boards to all sorts of actions. The attorneys even went so far as to negotiate a blanket release of Sutter from all past claims by the district including unresolved improper transfer of district assets and property to Sutter (i.e. the improper transfer of the district's home health services agency, Marin Home Care, to Sutter VNA in 2004).

I believe the residents of Marin must avoid partnerhips with groups like Sutter who operate as I have described, trying to wiggle out of their agreements using secrecy and costly litigation as leverage. The public needs to maintain voter/district-control of their hospital. If it is possible to partner with a "healthcare system" that would agree to real accountability and strict oversight by the district then a partnership might be able to exist that would be mutually beneficial.

But a district-run community hospital can also work well if the right leadership is put into place to manage hospital functions that (for the past 10 years) have been performed by Sutter. Leadership and financial expertise are both key to a successful, district-operated, community hospital and some, well-defined partnerships can be advantageous.

While I may have strong opinions about how to make Marin General profitable and secure for the future, right now, I am keeping an open mind when formulating future plans because what the board can do depends upon who the public elects and what all five board members (or at least a majority) will be able to agree on.

In the coming months, the new board will need to see if Sutter or Cirrus or other private investors like them are able to go forward with plans to compete with Marin General in Sausalito/Marin City. The board will also be expected to follow a strict timeline to put the new "settlement" agreement/lease terms into place and meet many obligations leading up to Sutter's departure.

Board members will also need to educate themselves and hire experts to advise the board about financial issues, and the hospital's staffing, infrastructure and facility needs. Finally, the board must develop plans to make the hospital and especially labor and delivery rooms earthquake-safe as soon as possible.

I am not as convinced about the soundness of proceeding with a bond measure for a new wing (to meet the earthquake safety laws) like all the other candidates. The plan to build a new wing is based on facility/construction/architectural data collected and reviewed in 2003-2004 by Sutter's analysts. I think the new board and public (who will fund the work) deserve the chance to review more current facility/construction cost data and timelines. Before acting on the old plans for a new wing, I think the board needs to have a new analysis using the latest computer software and technology designed to find solutions to seismic problems at hospitals.

An earthquake "compliance plan" is due at the Office of Statewide Health Planning and Development (OSHPD) in January. Although the board was aware of the January 2007 deadline for years, only this month did they ask Thistlethwaite Architects to prepare something to submit. With no time for any new architectural or structural review, the board now has to use the old 2003-2004 plan that Sutter developed so something can be prepared quickly, but the intention is that the new board will have to submit an amended or different plan later on.

The 2003-2004 plan recommending a new wing was estimated to take over 4 years to complete. With the 3-4 year wait to begin seismic work required by the settlement terms, a new, seismically safe labor and delivery department is therefore actually 7-8 years away.

In the interest of public safety, we cannot wait 7-8 years to put earthquake safety measures of some kind into place. The new board needs to find a way to compel Sutter to agree to move some departments to other buildings so labor and delivery rooms can be relocated to a safer area in the hospital. Perhaps it would be possible to find a way to brace the unbraced piping in the ceilings of the labor and delivery rooms (identified as dangers during an earthquake by two structural engineers). The hospital should have an overall "earthquake safety plan" developed with help from other local government agencies including the Office of Emergency Services.

If bringing Marin General into seismic compliance in its current location turns out to be a difficult proposition once the new board determines the costs and hears new input re: structural solutions, the district can explore the idea of building a new hospital at a new location which could be ready to open in just 4-5 years.

A profitable and successful future is possible for Marin General if the public elects competent board members and if the community supports Marin General by passing bonds for the repair work and discouraging competition that would weaken our hospital's ability to survive.

Thank you for considering voting for me as a candidate for the Marin Healthcare Board and call me if you have any questions or comments at 479-5621 or email: lorisanrafael@yahoo.com.

Lori Wood