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Affiliation First

The most significant news out of the Mendocino Coast District Hospital (MCDH) Board of Directors meeting on August 29 was the suspension of a contract with Meditech for a new electronic health record (EHR) system. Interim Chief Executive Officer (CEO) Wayne Allen estimates suspending the contract now will save the hospital at least $600,000. It could be more when the cost of lost employee time due to extended training hours is factored in.

The new Meditech system had been scheduled to be operational on July 1, but that deadline came and went. At the time of the contract suspension, the earliest Meditech's new EHR could go fully online was projected as February, 2020. MCDH already poured $700,000 into this EHR, all of it funded by Measure C parcel tax money.

At the end of May, 2019, MCDH's hospitalist, Dr. William Miller, noted that so many errors riddled the new EHR system, “I think we'd be better off staying with our current software.” This in light of Dr. Miller describing the current EHR at MCDH as really bad, “It's horrible.”

The likely long term reality: MCDH will affiliate with Adventist Health and the Adventists will pour several million dollars into aligning the coast hospital with their EHR, run by Cerner Corporation. 

Readers should recall that the Meditech financial hole was voted in by the previous Board of Directors, of whom there is only one carry over member still serving.

Meanwhile, while yours truly vacated the premises for much of late July through mid-August on backpacking and hiking trips, I returned to some of the same old same old at Mendocino Coast District Hospital (MCDH). Rumors ran amok concerning internal MCDH Board of Directors strife, but what has transpired in mid to late August derived first from an anonymous letter sent to the California Fair Political Practices Commission (FPPC). That letter was then passed along to the MCDH Board President on August 13. 

The crucial parts of the original complaint to the FPPC stated, “Ms. McCullough is a deposed witness for the plaintiff in an ongoing lawsuit (Hardind vs Coast Hospital)a MCDH. She has failed to recuse herself, despite being asked, from meetings where MCDH (defense) has been discussing it defense stragedies. As a witness for the plaintiff, this appears to be a very clear conflict of interest.

“Ms. McCullough has made legal (via deposition in Hardin vs Coast hospital) and public statements regarding not residing in the Mendocino Coast Hospital District. She has stated in various forms that she lives full time in San Francisco, work full time in San Francisco, has both her children enrolled in full time public schools in San Francisco. This is in direct conflict with Article III of the Boards Bylaws.”

Despite the numerous misspellings (much more than normal typographical errors), the complainant asked a question that has swirled since Amy McColley, a one time MCDH employee of more than a dozen years, was elected as one of four new MCDH Board members in November, 2018. McColley responded to the allegation on August 21: “I have not recused myself from any closed session items [at] the direction of the Health Care District Counsel, BBK [Best Best & Krieger]. I am using them as guidance, at this current time I have not identified myself to have ANY conflict with the Hardin Case.

“I provided a deposition on June 14, 2019; there [have] been no issues with the role I may have.”

Her response to the FPPC included a voicemail from one of the BB&K attorneys from January. It seems to communicate that the lawyer did not find a conflict of interest in regard to Ms. McColley's being a witness in the case of a former human resources officer at MCDH suing the hospital, its former chief executive officer (CEO), Bob Edwards, former chief financial officer (CFO), Wade Sturgeon, and then President of the MCDH Board of Directors, Steve Lund, as well as the hospital itself. The case is still ongoing in federal court in the Northern District of California.

The ill-prepared and clumsily executed letter also referenced Ms. McColley's work in San Francisco and questioned her residency within the Mendocino Coast Healthcare District. The same question also arose in a letter from a long time hospital observer. That letter was addressed directly to MCDH Board President Karen Arnold in mid-August. It contains virtually no spelling or grammatical errors, but it did again question how Ms. McColley can work for Sutter Health in San Francisco most weekdays and have at least two of her children enrolled full time in San Francisco schools while claiming residence on the Mendocino Coast.

This second letter of complaint cites the San Francisco Unified School District's application form for student enrollment, quoting its residency requirement: “In order to be enrolled in SFUSD, the student's parent/legal guardian must continually reside in San Francisco at the time of application and for the entire period of enrollment in SFUSD.”

The letter writer stated, “Ms. McColley cannot claim to be a resident of the Mendocino Healthcare District for the purpose of serving as a member of its Board, and claim to be a resident of San Francisco for the purpose of enrolling her children in San Francisco public schools.”

The letter cited the California Attorney General's ruling in a prior case in which the term “residence,” for voting purposes, was defined as a person's domicile, the place in which a person's habitation is fixed, wherein that person has the intention of remaining, and to which, whenever he or she is absent, the person has the intention of returning. This definition by the Attorney General concluded, “At any given time, a person may have only one domicile.”

Ms. McColley responded to this allegation citing San Francisco Unified's Administrative Regulation 5111.1 on special residency situations. It states, “A student shall be deemed to have complied with district residency requirements for enrollment in a district school if he/she meets any of the following criteria: The student's parent/guardian resides outside district boundaries but is employed within district boundaries and lives with the student at the place of employment for a minimum of three days during the school week.”

McColley also referenced further language in California Elections Code 349, omitted by the complaining letter writer: “The residence of a person is that place in which the person’s habitation is fixed for some period of time, but wherein he or she does not have the intention of remaining. At a given time, a person may have more than one residence.”

In her own words, McColley added, “I am temporarily residing in San Francisco for work purposes and for purposes of attending the local schools but my permanent residence [her emphasis] is in Mendocino Health Care District. It would be different if I had rented out my healthcare district house to someone else and didn't regularly sleep there, etc., but that is not the case.”

On August 28, the FPPC found insufficient evidence to pursue the matter addressed in the first letter. The following day the MCDH Board of Directors voted 4-0, with one abstention, to reject the complaint of the second letter.

This is not intended, by any means, to be an all out defense of Ms. McColley. This particular hospital board has seen its share of messiness; some self-imposed, some painted by outsiders who'd sooner see particular board members sullied than work toward saving the hospital from financial ruin. 

This is a time of great change at MCDH. Change is often accompanied by a good deal of messy slop. There are other important matters on the horizon, like dealing with the required seismic retrofit of the hospital and finding a long term solution relating to labor and delivery services, but in the near future almost all this Board of Directors need do is negotiate the most favorable affiliation deal possible then step out of the way with as little mud-splatter on their reputations as possible.

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