Tuesday, July 18, 2017

An Open Letter to the Future Mayor of Bremerton:






The single most critical issue facing your tenure will be improving access to healthcare for the population of Bremerton.  On May 1, 2017, the state Department of Health granted Catholic Health Initiatives (CHI) a long awaited Certificate of Need to transfer all of the available hospital beds outside of the city and complete a $600 million dollar hospital expansion project in Silverdale, at the expense of healthcare access. 

Recently, I attended a town hall meeting where neighbors came to brainstorm how to best advocate for themselves and hospital staff, who are struggling under the cost-cutting measures being implemented to prop up revenue.  We learned  a great deal about the experience of Piece County residents after CHI merged with Franciscan three years ago. 

St. Joseph Hospital in Tacoma sent $21 million in profit to headquarters in Denver rather than reinvesting it locally, quality ratings have fallen to an F grade, and the population lives 7 years less than the state average while paying $1000 more to reach that substandard milestone. 

On February 13, 1965, Harrison Hospital opened a new facility, the one in which I was born almost 10 years later.  At its inception, Harrison was a source of pride for our community.  Originally, the ER was staffed by community physicians of all specialties, including my father, who volunteered for monthly 12-hour shifts.  As a non-profit organization, Harrison was exempted from paying property taxes in exchange for providing charity care to citizens when necessary.  For decades, Harrison Memorial remained true to its mission, contributing a great deal to the health and wellness of our residents. 

Much has changed since Harrison Hospital was acquired by CHI in 2013. Over the last that time, spending on charity care has decreased from $27 million to $5 million annually, a reduction of 81%.  The number of patients receiving financial assistance for medical bills has been cut in half, from 10,685 to 5,040 individuals.  Some decrease is in part due to Medicaid expansion under the ACA; however, 11% of the population remains uninsured. 

CHI is in significant debt.  Our local hospital, one of many owned and operated by CHI across the country, is one of the few profitable locations.  As a result, revenue is sent elsewhere to prop up ailing locations.  This revenue should be reinvested in OUR community, not sent out-of-state to support others.  Over the last three years, there have been significant cuts to staffing and availability of necessary medical supplies resulting in a detriment to the health and safety of patients and a decline in quality ratings. 

CHI is a non-profit organization and as a result, currently enjoys a property tax exemption in the City of Bremerton of almost $950,000 annually.  This number does not include exemptions such as federal taxes, payroll taxes, and sales tax to which they are additionally authorized.  Over the next five years, CHI will leave an aging Bremerton facility with no plans for repair.  Re-evaluating the property tax exemption in the City of Bremerton is an issue worth some of your time and energy. 

CHI proposes building a brand new facility offering primary care and urgent care.  This structure will house the Family Practice residency program, training physicians who will hopefully join our community once completing their education.  As part of a non-profit organization, this “new” clinic will reap the benefits from requisite property tax exemptions; money the City of Bremerton will absorb in exchange for having access to charity care for those in the community in need. 

Instead of accepting leftover crumbs from CHI because we are starving for access to care, the City of Bremerton needs a comprehensive plan of their own. Please go back to the drawing board and find suitable alternatives rather than kowtowing to a corporation which is destroying the morale of staff, physicians, and our community.  Do not let CHI do to Kitsap County what it has already done to the Louisville, Kentucky community. 

CHI has demonstrated in the past how they cut costs:  by laying off employees, pruning supply budgets and shrinking employee benefits.  Through social media, countless CHI employees throughout the country have contacted me, including those in Kentucky, Nebraska, and Tennessee.  “Employee morale and retention are at an all-time low.”  The have shared difficulties faced working in an environment which is constantly in upheaval.  In a typical day, senior management changes tactics, outsources more services (like telemetry), and eliminates resources necessary to do our job.” 

They share their experience being pushed to the limits by administrative requirements.  “Profit drives decision making now, patients are no longer the top priority.” High acuity areas are reportedly short-staffed requiring employees to do overtime.  High standards of care are difficult to maintain as staff are being asked to do “training” on downtime during shifts.

In closing, the best predictor of future behavior is past behavior.  Once elected, please consider innovative solutions for solving the issue of reduced healthcare access in the City of Bremerton.  The lives and livelihoods of your constituents depend on it. 

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