SVHCC Statement of Purpose: “To recommend to the Sonoma Valley Health Care District Board of Directors the scope, size and setting of an economically viable Health Care Proposal most likely to achieve at least 67% voter approval for any ballot measure required to implement it and, if the Proposal is accepted and adopted by the Board, to undertake a positive information program to encourage voter approval."
This is the place to share your thoughts or ask questions and discuss the latest information, regarding the plan to build a new hospital in Sonoma.
posted by tduccini @ 11:50 PM
20 comments
20 Comments:
Along with all the work that is being done to find a solution for health care in Sonoma Valley with the committees, coalition, public meetings and airing all the upcoming options, we now have a blog site.
Haleluliah.
To everybody out there........ get involved!
Hi, finally found you. thanks to all who have taken the volunteer time to do this.
So far there are no interesting comments? We need Bob Kowel's and the doctors proposal allso the 8th st. proposal. Or are they on the blog and I cannot find them? Does it show what day the comments are made the time is of little interest.
dear anonymous, Re: Kowal proposal. The hospital powerpoint presentation is on the hospitla website. You can access it from the sidebar of the main page of this blog. Then go to "publi information" and find the doctors proposal. Also the handwritten notes from the meeting were published to our usual "holding place" website and announced via email. Are you on the email list, and did you get those notes?
I, too, would like to see a DATE and a TIME of the posting. I don't know if Google(the provider of the blog system) makes that available. Tina will know and will give us the answer.
Shelley
dear anonymous, Re: Kowal proposal. The hospital powerpoint presentation is on the hospitla website. You can access it from the sidebar of the main page of this blog. Then go to "publi information" and find the doctors proposal. Also the handwritten notes from the meeting were published to our usual "holding place" website and announced via email. Are you on the email list, and did you get those notes?
I, too, would like to see a DATE and a TIME of the posting. I don't know if Google(the provider of the blog system) makes that available. Tina will know and will give us the answer.
Shelley
dear anonymous,
You asked where to find the 8th St East proposal. There is NO proposal at this time. Cirrus made a presentation to Coalition Options Committee in 8/24 describing the kind of business plan that they are considering for the Valley. The president and CEO made it clear that they were just beginning the due diligence process, that ist, gathering essential information to be able to assess the viability of operating a private hospital in the Valley.
I heard, through the grapevine, from a customer at the Farmer's Market, that they thought the Leveroni property on 5th St. West was for sale and asked me "what's up with that?"
Well, I looked closely at the sign on the corner of the Leveroni property and it's advertising a mobile home in the Mobile Home Park acros the street -- that's what is for sale, NOT THE LEVERONI PROPERTY!
MYTH -- BUSTED!
Haven't heard anything more about using components for lowering costs for the new hospital.
If the Press-Democrat article of yesterday is correct it is disturbing that coalition process is being corrupted in such a manner. Tonight we are supposed to hear about a free hospital on donated land but apparently the outcome is a forgone conclusion if the Press-Democrat is to be believed. I would like to know how such a message was given to the reporter.
Posted By Shelley Arrowsmith on previous post:
At 4:45 PM, Shelley Arrowsmith said...
comment by Dick Senn.
I know it is the 14th hour but, nonetheless, want to share my thoughts with all.
We are pulling together as a community because we all know that we need, must have a hospital in Sonoma. The hospital must meet the needs of our community whether the patients be medicare, medical, private pay or just patients who don't have a dime to their name. The hospital that we create will be the only hospital in Sonoma Valley.
It is my assumption that most if not all for profit hospitals are among other hospitals rather than the only one that the community depends on. That being the case, if Sonoma were to have a for profit hospital, how would that hospital deal with a situation where admitting certain classes of patients would be extremely unprofitable. Would they refuse them and if so who would then care for them? If a community based not for profit hospital were faced with the same situation, they would treat this class of patients and if it made the hospital unprofitable in the long run, then contributions from the community or a parcel tax would make up the difference. A for profit hospital does not have these sources of funds available. Mr Cirrus, how do you deal with this situation?????.
Dennis, We discussed it in our Steering Committee this noon and it seems that no one in an official capacity talked to the reporter. That's why everyone needs to come to the meetings and see for themselves. They are open and transparent. We aren't proceeding with any 'foregone conclustions". See you tonight!
The consumer of healthcare and the providers of the services of healthcare have different goals. One part of what’s been handed into the public dicussion about our healthcare district’s goal for a new hospital is the lack of forthright clarity about that.
The business of healthcare, messy as it is, is a straightfoward for-profit enterprise that does all the things any large enterprise will do to achieve it’s commercial purpose. It’s goals are business goals. In this case it’s a service rather than a manufactured product so it seeks to give satisfactory service as it’s product and it naturally seeks to expand it’s market. It’s competitive and will seek to sell it’s product to anyone that can be convinced to buy it.
The consumer of health services usually is in need of healing and for the most part has utterly different goals than the above-mentioned provider.
For a long time now in Sonoma Valley we’ve been hearing a steady stream of business plans, different locations etc. Our citizens have attended endless meetings, poured over reams of newsprint and public discussion when virtually the only topic has been money, or things related to money, and the business needs of the Healthcare District and it’s staff of professionals and other workers.
The consumer has been asked repeatedly to get into the business bubble mind-set, threatened with loss of life-saving capacity (emergency room) and reminded they needed to worry about this whole affair.
So far this hasn’t been very successful and the professional purveyors of these stories..the hospital enterprise itself, the newspapers etc. keep up their creations of more business plans as if the local consumer will finally find one they will at least formally agree to and pay taxes for.
The orphan in this story is the consumer in need of healing comfort and service. The religions of modern medicine and business process, so woven into their default assumption that they are the solution to the consumers need, apparently see little need to reexamine what the actual healing needs and wishes for service the consumers have. Even from a purely business point of view this is life-threatening assumption. Much of our Valley has already wandered off seeking care elsewhere in response to that assumption in part. No wonder many voters will not agree to taxation for huge expenses for a service center they don’t presume they themselves will much use.
Earnest citizens have come foward to form the Plan B committee. They have reached broadly into the community to review the situation. Insofar as I’ve seen or heard they haven’t yet asked some of the central questions. What is healthcare? What are the healing needs of our community? What is the future of healthcare as a social service not merely as a business process? Besides the default conventional services our Healthcare District provides what would and does today’s consumer choose to employ in their care and search for increased well being? How will any choices we make today integrate into a Single Payer world should one be passed in California?
Plan B folks are largely from our business community and they are naturally drawn to this issue as pretty much a business issue as well and so these will unlikely be questions they feel inclined to even encounter much less give real consideration to. I hope they might choose to go beyond that reluctance and really explore what the orphan in this story needs. After all they’re the ones who likely will pay most of the bills.
Ned Hoke
Ned's comments and concerns go to the very heart of what the Coalition has been about from the very beginning -- trying to marry the health care needs and wants of the voter/consumers with the very real and unavoidably practical aspects of paying for it all & making it all work for the residents of the Valley.
In addition to studying all the "business" aspects, we are taking the first of three surveys this month to find out more about what the "consumers" in the Valley want.
Unfortunately --or maybe not-- the Coalition can't solve ALL the world's health care problems, or by itself change the way health care is delivered, bought and paid for in this country. As private citizens, we can only do our best to work with what we have.
That requires the Coalition -- which is composed of the full spectrum of people who once bitterly argued over Measure C -- to look at things from a business standpoint as well as a consumer standpoint.
There is a simple reason for that: In 21st cnetury America, good health care does not come out of compassion or good intentions but from cold, hard cash. Cash to pay for hospitals, technology, doctors. nurses and medicines, etc.
That cash in turn comes from insurers and other payors, both government and private, and out of our own pockets.
Like it or not, insurers and the government -- the "Big Gorillas" -- make the rules and the Coaltion has little choice but to play by them.
So the ultimate question is very much a business matter: how much cash do we in Sonoma Valley want to put into our health care system, and for what kind of system and what do we expect out of it? (Neither the insurance companies, the state, federal or county government is going to build us a hospital)
A big part of the Coaltion's job is not just to assemble a health care wish list (which is very, very easy to do) but to create that "Fairy Godmother" -- a real world local hospital and health care system and financial plan -- that will make those wishes come true and at the lowest possible cost to us -- the voters and taxpayers.
Ned closes by asking "How will any choices we make today integrate into a Single Payer world should one be passed in California?"
It's a good question but not immediately relevant or helpful to the work we need to do now.
The operative phrase is "should one be passed." I for one favor a single payer system but the here-and-now reality the Coalition has to deal with (in the time before seismic laws shut down our existing hospital) is that there will likely be no single Payer system in California, much as we may wish otherwise.
But even if there were to be one, if we don't get a financially viable hospital built(and that frankly requires business sense as well as compassion) we will have no place in the Valley to buy the health care services that system would supposedly pay for.
So I encourage Ned and anyone else to continue to help with the Coaltition's very difficult job of building or finding that "fairy godmother." It is a job that will not get done without a steely-eyed business perspective that will protect and benefit the taxpayers AND the consumers. After all, in a community health care system, those people are one and the same group -- they are us!
Bob Edwards..in response to an earlier post by me came back to what everyone seems to feel is the central question..where is the money and how do we get it and get what we want also..I disagree again..I work everyday with people and healthcare expenses which includes insurances. Yes one needs to pay attention to those money questions but not first in line..at least that's my view and experience..that is if you want a healthcare experience that is about health care rather than money..
To : The Sonoma Valley Healthcare Coalition
From: Ned Hoke
I propose to make a few brief impertinent-sounding remarks in an effort to alert and awaken the process of healthcare reorganization in the Valley
Axiomatic in these assertions are conceptions of appropiate and necessary citizen and consumer authority, to my ears and eyes, largely unspoken thus far.
The world of important, useful and effective healthcare is considerably greater and more varied than what is commonly offered on the plates from conventional modern industrial healthcare represented by our current hospital and it’s enviroments.
Industrial, largely chemical, medical intervention is a proud product of our age. The giant effects of these biologic management tools absolutely dwarf any previous system of intervention. In any horse race for power and speed these guys are the winners.
But with all that power and authority the industrial system is strikingly incomplete also. Part of the incompleteness occurs, as a social service, simply because it is so enormously expensive and built within highly excessive for-profit intentions.
But the incompleteness shows itself in endless other ways as well. Chronic care, where the race isn’t to the swift but to the biologically and emotionally/spiritually appropiate industrial medicine pushes its chemicals as the cost-effective solution forgetting the actual healing needs of the patient very often.
Incompleteness occurs profoundly in diagnosis when the salient meticulous unwrapping of human health problems are scripted out of the consideration and symptom management is the default objective of the exercise. The patient is therefrom systematically disempowered from many genuine understandings of his or her true, and biologically discoverable, needs. The power of the potion, the surgical fix is hurridly given and the patient is dismissed maybe even with a pat on the back and a smile. But with this, as many of us well know, the needs are functionally unmet.
These are large and complex subjects and no overview pretends to be complete in itself. But I propose to this body as it “stands up” to the challenges of finding a publically agreeable framework for a new hospital and healthcare district that it not accept mindless domination by the established system gathered in the current hospital administration and its colleagues.
Looking in both the present and the future what’s actually happening in the healthcare marketplace today is a larger and more ecumenical reality. Rightly there is a huge place for modern chemical industrial healthcare but it in no way should be permitted the right and/or granted the authority to try to own our local healthcare enviroment supported with public funds. Public funds for healthcare need to be spent overtly and consciously in support of general public benefit where all can actually feel the benefit when needed. Bearing that in mind I have to hope Sonoma Valley Healthcare district, as a public entity, can thrive refreshed with many new tools and perspectives in the support of the real mission of human healthcare which is service rather than merely as a commercial for-profit process.
If the Coalition believes it’s principal job is to make and keep happy the current administration and find a way to sell the public a new ordinary hospital of the type previously offered my suggestions will have no place or value in the main. If however the Coalition sees an opportunity to create a new public/private partnership where the real world of the larger needs and desires of the Valley are included a new day for healthcare could be begun for us all.
My thanks for your kind attention
Ned has again touched on exactly what the Coalition's work is all about. He wrote:
"If the Coalition believes it’s principal job is to make and keep happy the current administration and find a way to sell the public a new ordinary hospital of the type previously offered my suggestions will have no place or value in the main. If however the Coalition sees an opportunity to create a new public/private partnership where the real world of the larger needs and desires of the Valley are included a new day for healthcare could be begun for us all."
Ned's ideas DO have a value and a place in the Coaltion. But as one of many former No on C advocates now participating in the work of the Coalition, let me assure those who may share Ned's concerns and objectives that keeping the current hospital adminstration happy is NOWHERE on our list of goals!
Those from both sides of the old Measure C argument understand and agree that we are in search of new solutions that work for the residents of the Valley. In an upcoming session, we will be examining the total healthcare system in the Valley, which includes -- or should -- far more than 'just' a hospital.
And we are in fact actively purusing a public/private partnership for the provision of healthcare in the Valley which Ned suggests. Such a proposal was formally made to the Coaltion at its September 11 public meeting, by the Cirrus Health Corporation and local Sonoma Valley partners. It is one of several we are exploring. Other entitites have also expressed an interest in such an arrangement, but are still in the "inquiry" stage.
Whether such a partnership could work, however, will depend not on the Coalition sharing Ned's goals of a broad, quality healthcare system for the Valley (we set those goals in our early meetings) but on whether it can deliver what we want AND work financially, for both the private AND the public side of such an equation. If it doesn't, then it is simply not going to happen; we are investingating that now.
Perhaps the best summary of the central challenge of our work is that we ARE trying to merge the "sociology" and the "math" of healthcare and come up with a workable solution and a new day. For many (myself included), math always seems to be the more stubborn and unpleasant subject, but we have no choice but to deal with both; any solution must be financially viable. If we fail, the 'sociology' of healthcare in the valley will always remain just another "nice idea" that no one is able or willing pay for.
Ironically, and for what it is worth, that's exactly what the "current (hospital)adminstration" worries about, too!
The Coalition may find itself needing to articulate different functions. If finance is really the only committee, the building committee and the healthcare services committee, and the community outreach center committee will be mere servants awaiting orders. Everyone knows alot of money is needed but for that not to be the point and the command center the Coalition may need to establish specific task areas. To bludgeon the public with constant withering reports from the finance committee is simply poor business process
I am not certain what the writer means when she/he says:
"The Coalition may find itself needing to articulate different functions. If finance is really the only committee, the building committee and the healthcare services committee, and the community outreach center committee will be mere servants awaiting orders. Everyone knows alot of money is needed but for that not to be the point and the command center the Coalition may need to establish specific task areas. To bludgeon the public with constant withering reports from the finance committee is simply poor business process"
The Finance Committee is actually set up to raise funds and monitor expenditures for the Coalition functions and issues reports only to the Steering Committee, not the public. Perhaps a quick outline of the exisiting Coalition committees may help clarify the work that is being done:
The Coalition committees as of now are:
The Steering Committee, which oversees, monitors and guides the various activities of the Coalition and its other committees in order to maximize the effectiveness of what is a totally volunteer organization of citizens trying to find the best solution for a hospital and healthcare in the valley. The Steering Committee "herds the cats," or tries to!
The Options Committee, a large body whose task is to develop methods for evaluating various hospital and healthcare Options that are being proposed by individuals, groups and public and private organziations, and to arrange for their presntation to the Coalition and independent analysis of each from a financial viability standpoint.
The Fundraising/finance committee - focused on raising money to fund the Coalition's activities (e.g., meeting room expenses, etc); as a volunteer body, the Coalition has no other source of revenue. The committee has pursuaded the hospital district to provide funding for the Coalition to the extent legally possible, since the work of the Coalition is, in the end, designed to assist the Board in deciding what to do about a hospital.
The Communications Committee, which oversees and coordinates news releases and other publicity about the activities of the Coalition, including this volunteer "free" blogsite.
The Budget Committee, which keeps track of funds and their expenditure.
The Myth-Busting Committee, which has the task of investigating rumors, claims and alleged "facts" about the hospital, healthcare in the Valley and/or the Coalition circulating in the public domain to find out the truth and set the record straight, so citizens have the "real story."
The Survey Committee, a varying group working with private survey firms to oversee the development of voter, resident and medical staff surveys to better find out what the voters and residents want and need in the way of a hospital and healthcare services,
The very important "Outreach Committee" (not its real name since it really doesn't have one yet) which is attempting to set up community outreach meetings to better allow key constituents in the Valley to bring in yet more ideas and needs that the general Coaltion may be totally unaware of and which formal surveys may not detect.
A small "Out-of-the-Box" committee which attempts to gather and think of new hospital/healthcare ideas and solutions, total or partial, that can get overlooked in the vast amount of work that is required.
The Coalition has tried to get out important infomration to the public and is constantly seeking better ways to do that. There is a lot of information that various indiviudals or groups are interested in knowing. If anything, those of us active in the Coalition worry we are not getting enough information to the public and we constantly strive to provide more of both what the public WANTS to know and what it NEEDS to know to make a good decision at the polls for Sonoma Valley health care.
The Monday meeting, Oct 2, gave us a well considered dream-scape of a functional healthcare process that was designed for the benefit of the user/patient. In the real world the provider(s) tries as much as possible to hold the cards and create profit, and when possible, dominance for themselves. To ignore this and talk pretty is to be functionally irrelevant. British National Healthcare, in conception, might have once said things as does Mr. Gilroy..and then actually tried to deliver. In Sonoma I fear things will be said and modest window dressing actions will occur and the old mafia doctor-dominated enviroment will sustain. Trying to sell a new hospital to reluctant voters is proving to be difficult.It seem if citizens can see something real in benefit for themselves and family there may be a sale. If however we are sung to with songs of extreme beauty and glorious plans the public likely will smell the emptiness of reality and the whole show will collide into further bankruptcy. Mr. Gilroy and others will need to show much more relevance in the finance area to really capture the publics attention..thankyou
Nice imagery auddubbatto.
Is this where your hat comes from?
Iai Do & Batto Do = Single motion drawing/cutting with a sword while kneeling or standing.
Iai Do & Batto Do practitioners are Students of the way. Strive for betterment of the whole instead of personal ego building.
Core values: Learning, Manners and Decorum. Being Open-minded, non-political and helpful.
If this is the real meaning behind your name... I like it. Very appropriate. :-D
When your site goes live, email me. tduccini@yahoo.com
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