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Looking Back

Let us start by more or less repeating the opening of last week's piece: The most important item approved by the Mendocino Coast District Hospital (MCDH) Board of Directors at their August 29th meeting was the suspension of a contract with Meditech for a new electronic health record (EHR) system. Interim Chief Executive Officer (CEO) Wayne Allen estimated that suspending the contract will save the hospital at least $600,000.

The new Meditech system had been scheduled to “go live” on July 1st, but that day came and went. In reality, the earliest Meditech's new EHR could go fully operational is 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, citing many of the errors riddling the new EHR system, said, “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.

Before we get to that Director, let's retreat a month for some background. At the late July MCDH Board of Directors meeting, with all five members in attendance, the first agenda item of “New Business” proved to be something more akin to business delayed. Shin Green of Eastshore Consulting stepped to the podium to speak on the Measure C parcel tax. For those with memories beyond the instant gratification level, Mr. Green's name may sound familiar. At the first meeting of the new MCDH Board of Directors in January, Mr. Green made a presentation on Measure C. The AVA reported then about that convoluted agenda item entitled, “Parcel tax and specific action recommended by legal counsel on the treatment of the subject lumber harvest property owners.”

Again, using the language of the January AVA report on Shin Green's presentation, “What this boils down to is information the voters weren't given in the run-up to the election on the parcel tax. The hospital, through the CFO and/or the CEO, has been negotiating with large timberland owners like Mendocino Redwood Company (MRC) to 'consolidate' their numerous pieces of property into much smaller geographically connected parcels. Other than the government, MRC is the largest landowner in the county. Within the coastal hospital district it possesses about 600 (possibly more) parcels, as noted in the assessor's books. Six hundred or so parcels would roughly equal a $90,000 annual tax payment to MCDH. Through consolidation MRC hopes to reduce the number of parcels counted against it to around seventy, thus lowering their yearly hospital tax to about $10,000.

“This concept of consolidation for MRC and other large landowners was presented to the new MCDH Board in the softest of smooth talking sells by a consultant (from Eastshore Consulting) initially hired by the hospital in conjunction with the endeavor to pass the parcel tax measure. However, with comments from the audience, including yours truly, addressing the complexities of the consolidation efforts and its potential for inequity when compared to the single parcel taxpayer, the new board refused to go along with a swift passage of the consolidation plan that would largely benefit only corporate landowners.”

That was then. Seven and a half months later, Mr. Green gave much the same “snow job,” soft sell to the board for nearly fifty minutes in July, and, though the agenda item was listed as “Action/Information,” no action up or down was taken. What is apparent is that the hospital district is going to go along with the large timberland owners (mostly corporations) consolidating their parcels. This will result in a loss of more than $150,000 in parcel tax revenue to the district, approximately 8.5% of the total.

The consolidation process may well be legal under California's “Map Act,” within California Government Code 53087.4 and Section 66410 of Title 7. 

However, if one looks back at the text of Measure C as presented to voters in the spring of 2018, you won't find consolidation mentioned, nor the Map Act. What was presented to voters was the concept that each parcel of land in the district would be charged $144 in order to help shore up the finances of the coast healthcare district. At that time, while the measure was before the voters, Eastshore Consulting made no mention of the consolidation process that would allow corporate timber companies a way out of full taxation. That leaves things in a bit of a pickle in which there are only two ways out: 1. Eastshore Consulting was unaware of the vagaries of California's Map Act (Govt. Code 53087.4), in which case why did the previous board of directors hire a firm that didn't know the laws applicable to the very measure they were to provide advice for? 2. Eastshore Consulting was aware of the Map Act and Govt. Code 53087.4 and deliberately chose not to inform the MCDH Board and just as importantly chose to omit this information, prior to the election, from public scrutiny.

Neither choice paints a pretty picture.

That one holdover MCDH Board member is Steve Lund. He was President of the board at the time Measure C came before it to be approved for placement on the ballot. As committee chair, Lund ramrodded the parcel tax through the hospital's Planning Committee in February, 2018, so that it could be approved by the full board in the last days of the month in time to qualify for the June, 2018 election with scarcely three months time for the voting public to consider the ramifications.

Well before February, 2018, Lund was aware of the complications implicit in a healthcare district whose dominant parcel owners are corporate timber companies, not to mention the inequities inherent in an area where single parcels of prime real estate are worth millions (think homes overlooking the ocean) vs. the modest value of a single family dwelling in the middle of Fort Bragg.

How do I know Lund was aware of these things. I told him, more than once, at committee meetings and right after meetings in detailed private conversation. I explained the messiness of trying to collect a “parcel is a parcel” tax in a timber company region. The quote marks are there for a reason. Lund used that phrase more than once in responding to questions about a potential tax like Measure C. And yet, as we can clearly see when the Map Act and Govt. Code 53087.4 are applied, not all parcels are taxed equally.

In general, Mr. Lund is an amiable fellow. With two board members recused, Lund is likely the coolest head among the board members left to serve on the affiliation committee. He's a loyal San Francisco Giants fan, which should give one a bit of dispensation. However, short-sighted MCDH Board watchers who are lacking in basic Civics skills have more or less fawned over Lund while calling for the immediate replacement of recused board members (the name Robert Becker comes immediately to mind as fawner-in-chief).

Lund has largely skated free of public critique despite the fact that he is a defendant in a federal lawsuit and that he, as board president, spearheaded an effort to extend the contract of former MCDH CEO Bob Edwards for multiple years. That 2018 extension hamstrung the new board when they fired Edwards in January, 2019, forcing them to pay Edwards about $400,000 to go away. Edwards is also a defendant in that ongoing federal lawsuit filed by a past human resources director at MCDH.

So to wrap it up: The old MCDH Board of Directors, with Steve Lund as president, approved the contract for the Meditech EHR system. The same board hired Eastshore Consulting to guide the healthcare district through a parcel tax measure. The consulting firm either lacked knowledge concerning corporate timber exemptions from said tax or deliberately chose not to inform the general public about that issue until more than a year after the fact. Lund was a driving force in getting the Measure C parcel tax on the ballot. $700,000 of that parcel tax (more than 40% of the first year's funds) went down the drain because the new Meditech EHR was a flop.

By the way, the hospital's so-called Oversight Committee, which authorized dumping $700,000 of public tax money into the failed Meditech EHR is stocked full with, as you might expect, cheerleaders for Measure C from its three month period of public evaluation. The committee's vice-chair is one Robert Becker, who is fond of preambling comments at MCDH get-togethers by telling all those listening that he authored part of Measure C. Becker has also let it be known that he'd just as soon be rid of all the current MCDH Board members, save for Finance Committee Chair John Redding and Steve Lund.

Looking for good news out of MCDH? At the August board meeting, medical staff services director Will Lee announced that for the first time in a long while the hospital will provide 24/7 orthopedic services to patients. The around the clock coverage is guaranteed, according to Lee, who doubles as Fort Bragg's mayor, into February and is made possible by the recent addition of multiple orthopedic surgeons. 

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