The Health Commission last night unanimously determined that California Pacific Medical Center’s plan to transfer two clinics to the Mission Neighborhood Health Center will not have a detrimental impact on health care services in the community.
But not all were happy with the decision: About seven callers voiced concerns during the public comment period that Sutter was again pulling the rug out from under the Mission Bernal Campus and abdicating its responsibility to care for the Mission community.
“The clinic serves undocumented immigrants and people who are uninsured, and CPMC is trying to buy its way out,” said Dr. Teresa Palmer, who was an attending physician at St. Luke’s, the predecessor to the Mission Bernal Campus.
The Health Commission did not have any authority to compel Sutter to change its course of action — but had it found that Sutter’s move would produce a detrimental effect, it could have signaled to other city boards that the plan was worth a second look or additional oversight. As it stands, Sutter will close the two clinics on Thursday, April 1, and the health center will reopen them on the following Monday in the same location.
Part of the commission’s decision to vote “not detrimental” stemmed from the limited scope of what is known as a “Proposition Q” hearing designed to address the question of whether the proposed action will have a detrimental impact on a community’s health care service.
The broader question of whether Sutter is upholding its obligation to the community — codified in the city’s Development Agreement with the medical center — is not one for the committee to decide on, explained Commissioner Edward Chow. That was a sentiment the other commissioners seemed to agree with.
Based on the terms of the agreement between the medical group and the neighborhood nonprofit, commissioners and the Department of Public Health, which weighed in on the matter via a memorandum, determined that the deal would minimize patient and staff impact — thus, the “not detrimental” vote.
California Pacific and Mission Neighborhood Health Center first announced the planned ownership changes on Dec. 10. Combined, the two clinics served nearly 7,000 patients in 2019, the majority of whom were not privately insured.
Sutter indicated at the committee’s March 2 meeting that it primarily delivers secondary and tertiary care — usually specialized care and care requiring hospitalization — making Mission Bernal’s adult and pediatric primary care clinics an anomaly and a better fit for the work of Mission Neighborhood Health Center.
Sutter has also proposed to financially support the health center for five years, which includes upfront funding to support the center until it can obtain a cost-effective insurance reimbursement plan with the federal government and conduct facility upgrades.
Both the commissioners and public comment period callers praised the work of Mission Neighborhood Health Center and expressed confidence the organization would be able to successfully absorb the two clinics.
Commissioner Susan Christian did press California Pacific representatives for a commitment that if a five-year funding plan was insufficient or something unexpected happened that the organization would step in to financially support the local nonprofit.
“We have seen over time a disinvestment in public health from private entities,” she said. “And I’m concerned that this might possibly become another example of that.”
Emily Webb, the director of Community Health Programs for California Pacific, said that Sutter would not be able to commit to financially supporting Mission Neighborhood Health Center past five years, but added that Sutter plans to provide support to make sure the endeavor becomes sustainable.
Christian ultimately voted that the plan was “not detrimental,” agreeing with Chow that under Prop. Q, the existing plan was sufficient enough to vote as such.
But the point she made about private entities disinvesting in public health was something callers drilled down on.
Sutter attempted in 2010 to shut down St. Luke’s hospital, despite concerns that such a move further burden San Francisco General Hospital with uninsured patients. Critics of Sutter’s present proposal remembered this well, and brought it up last night.
Sutter drew further public ire in 2017 when it decided to close a skilled nursing facility at St. Luke’s, home to a medically fragile group of sub-acute patients.
“It was a death by a thousand cuts,” recalled Jane Sandoval, a nurse who has worked at St. Luke’s and the Mission Bernal campus for nearly four decades. “All these hearings, through all these years, the repeating theme is the erosion of services and preserving the mission of healthcare for the marginalized and underserved.”
Kung Feng, the executive director of the nonprofit Jobs with Justice, said the important question is not whether Mission Neighborhood Health Center will survive the transition — community health centers are fighters and know how to survive on limited resources. What matters is whether or not Sutter is fulfilling its responsibility to the community.
“People we know were born there, walk past there and see that campus as still a community hospital,” he said. “Sutter has an obligation to continue that.”