Gary’s Blog

Celebrating National Hospital Week & National Nurses Week

2008-05-17T00:06:00.000-07:00

Sutter Delta Medical Center has just ended its two weeklong celebrations of National Hospital Week and National Nurses Week. It has been a fun filled two weeks, and a delight to see the smiling faces of our employees who participated in the various events planned throughout the weeks.

Some of you maybe asking yourself---what is National Hospital and Nurses Week, and why do we celebrate it?

Established on May 12, 1921 National Hospital Week (expanded from National Hospital Day) began as a way to gain the trust of local communities after a sever flu epidemic swept the nation. The celebration was initially held on Florence Nightingales’ birthday in order to pay homage to the woman who exemplified the same kind of innovative thinking that Sutter Delta Medical Center is now known for. It was Nightingales’ forward thinking and aptitude for problem solving that led to modern advancements in hospital sanitation and modern nursing.

National Hospital Week was and still is a commemorative celebration with a focus on uniting hospitals, healthcare workers, and communities. It is also a time when hospitals can present to the community the medical breakthroughs and new technologies that improve our quality of care. We also believe it is important to highlight all of the employees who demonstrate continued dedication and exemplary care for our patients in East Contra Costa County---as the men and women who make up our doctors, nurses, and hospital staff here at Sutter Delta are also our neighbors and friends.

Also coinciding with Florence Nightingale’s birthday, National Nurses Week commemorates nurses for their steadfast commitment to patients, their unwavering dedication to medicine, their excellence in quality care to our community, and their responsiveness to patients and their families in time of need. Celebrated nationally, National Nurses Week began in 1954, on the 100th anniversary of Florence Nightingale’s mission to Crimea. National Nurses Week promotes a positive and practical representation of nurses while honoring their courage and heroism, as well as sacrifices that they make. Several nurses wore their traditional nurses’ cap in honor of Florence Nightingale.

One of the largest employers in East Contra Costa County, Sutter Delta Medical Center thanks all of those who have helped provide such excellent care to the patients that trust us most. I have attached the newspaper ads we placed for Sutter Delta commemorating National Hospital Week and National Nurses Week. You will see from the long list of published names we released that we believe it is important to highlight all of our employees during this observance in order to recognize the difference they make every day.

Please email rapaportg@sutterhealth.org for comments or suggestion regarding this post.

Pittsburg City Council Resolution

2008-03-11T14:24:00.000-07:00

I am pleased to report that the Pittsburg City Council passed a resolution asking the Contra Costa Board of Supervisors to address the crisis in access to healthcare by the underinsured in East Contra Costa County. A copy of the resolution will be posted on the Sutter Delta website at www.sutterdelta.org

Last night the Los Medanos Healthcare District approved a collaborative effort to improve access to health care by their Healthcare District’s residents by funding up to $20,000 for the care of their District residents who utilize SDMC’s after hours urgent care service where appropriate, in lieu of the emergency department. They also agreed to fund a part-time volunteer coordinator to help enroll clinic patients in available health plans. Finally, they will partner this year to support the First Aide Booth at Pittsburg’s famous Seafood Festival this summer. We are looking forward to our partnership with the Los Medanos Healthcare District. For more information on the District, visit their website at www.lmchd.org.

Finally, I am disappointed to report the California Nurses Association has called its third strike against Sutter Delta Medical Center and other Bay Area Sutter Health affiliates. We believe that C.N.A. is calling for these strikes to further their efforts to unionize more nurses without having to earn the rights through traditional time-tested election process. We also are very concerned about the financial impacts of these strikes on our nurses, the hospital and the affordability of health care. Healthcare is simply not affordable and costly strikes further drive up the costs. The California Small Business Association had this to say about the upcoming strike:

California Small Business Association Condemns California Nurses Association's Decision to Call Prolonged Strike at Hospitals Throughout Northern California

State's Small Business Owners Will Pay Higher Healthcare Costs Because of Strikes and Union's Unrealistic Contract Demands S

ACRAMENTO, Calif., March 11 /PRNewswire-USNewswire/ -- the California Nurses Association announced their intention to hold prolonged strikes at hospitals throughout Northern California beginning March 21. The CNA strikes were called against hospitals affiliated with the Fremont-Rideout Health Group in Marysville and Yuba City, the Contra Costa Regional Medical Center (a county facility in Martinez) and six Bay Area hospitals affiliated with Sutter Health. Betty Jo Toccoli, president of the California Small Business Association, representing more than 200,000 small business owners in California, issued the following statement today in response to the latest round of strikes called by the California Nurses Association.

"On behalf of small business owners in Northern California and throughout the state, the California Small Business Association is deeply troubled by the California Nurses Association's (CNA) decision to conduct strikes against hospitals throughout Northern California for as long as 10 days.

"Clearly, the union's decision to bring thousands of nurses out on a prolonged strike will only serve to increase healthcare costs for all of us. The cost of these strikes and the union's unrealistic contract demands will hit small business owners especially hard.

"According to press accounts, a previous nurse strike at just two Northern California hospitals this past summer cost $1 million per day. Multiply that by nine hospitals over as many as ten-days, and it's clear that the CNA's strike will cost these hospitals -- and ultimately consumers -- tens of millions of dollars. That's tens of millions of dollars in unnecessary costs that could better be used to lower healthcare costs or expand technology, services or staff.

"CSBA is also troubled by what seem to be unrealistic and costly demands from CNA leadership at the bargaining table. Everyone agrees that nurses deserve to be well compensated. And, by all accounts, they are. According to the Hospital Association of Southern California, the average annual salary for a Bay Area Registered Nurse is $106,120.56 per year, before factoring benefits and overtime. That's more than many of California's small business owners earn.

"According to CNA statements and press accounts, the union is demanding tens of millions of dollars in increased costs for pension and retirement health care contributions, even though it's well documented that these nurses receive benefits far in excess of what employees from other industry sectors receive.

"Every healthcare consumer in this region has a vested interest in the outcome of these negotiations. Small business owners and their employees, in particular, cannot afford the continuing skyrocketing costs of healthcare. Employers will be forced to pass higher costs on to employees or worse, drop coverage altogether.

"Healthcare providers have a fiduciary responsibility to hold the line on costs for consumers. That means balancing their need to pay employees well, while also ensuring that compensation packages are reasonable so as not to unnecessarily burden healthcare consumers with even more costs.

"Lastly, it appears that CNA's motivation for conducting these strikes is questionable. According to press reports, as a condition of settlement the union is seeking to force many of these hospitals to accept easier union organizing rights, which would be a boon for the union but bad for employees. CSBA believes that employees should have a right to choose for themselves whether or not to join a union, and we oppose these union 'neutrality' agreements that strip employees of this fundamental right.

"We are hopeful the parties will get back to the bargaining table and avoid these unnecessary and costly strikes. All the while, hospitals must do what they can to protect consumers from unreasonable cost increases."

Betty Jo Tocolli is president of the California Small Business Association, representing more than 200,000 small business owners in California.

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Auxiliary’s First Crab Feed Fundraiser at the Antioch Veteran Memorial Building

2008-02-26T23:08:00.000-08:00

On Saturday, February 16th I attended our Auxiliary’s First (of what we hope to be an annual event) Crab Feed Fundraiser at the Antioch Veteran Memorial Building. We were all excited by the turnout to support the purchase of a new Stereo tactic Breast Biopsy unit. Dr. Mary Cardoza, General Surgeon spoke to the attendees on the importance of Mammography screening. She went on to explain how this new equipment will allow patients in need of a biopsy to undergo a minimally invasive fine needle biopsy. The alternative to this minimally invasive Stereo tactic biopsy is a trip to the operating room. For more information on this new service, please click to play the video below

A big thank you to Charlene Lujan and Erna Yap-Chiongco who chaired the event and together with their committee sold 150 tickets to the event, raising an estimated $ 5,000. Tim Bouslog, Foundation Trustee and Director of Materials Management at SDMC was the MC for the evening. SDMC is very grateful to the Auxiliary for all the wonderful services they provide for visitors, patients and staff, including the gift shop. The junior volunteers assisted with the Crab Feed with the same enthusiasm they serve along side the auxiliary in service to SDMC.

If you are interesting in supporting the auxiliary in raising funds for the Stereo tactic Breast Biopsy equipment or volunteering at SDMC, please call the auxiliary at 925-779-3000

Click below to see images from the Crab feed.

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Antioch City Counsel Passes Resolution in Support of Access to Health Care

2008-02-16T16:53:00.001-08:00

I am pleased to report that the Antioch City Counsel on February 13th approved a resolution (see below) in support of Sutter Delta Medical Center's (SDMC) efforts to raise awareness around the care for the under insured in East County and the deleterious effects it will have on SDMC and East County residents if solutions can not be found soon. The City Counsel in response to my presentation to East County Mayor's in January has helped to raise the consciousness on this matter. We applaud them for taking this action. If you agree, please make a call or send your own email to the council or directly to the Board of Supervisors to encourage their continued efforts to address this community health problem. A list of City Counsel members and our local Supervisors including phone and email addresses is below.

Gary Rapaport

RESOLUTION NO. 2008/**

RESOLUTION OF THE CITY COUNCIL OF THE CITY OF ANTIOCH

supporting Sutter Delta Medical Center and Urging

Contra Costa County to Enhance Medical Services

in East Contra Costa County

Whereas, Sutter Delta Medical Center is an integral part of the health care system in Antioch and all of East County; and

Whereas, Sutter Delta Medical Center Emergency Department had 53,000 visits in 2007; and

Whereas, Sutter Delta Medical Center Urgent Care (free) clinic had 6,280 visits in 2007; and

Whereas, in Contra Costa County 15% of the population is uninsured; and

Whereas, during 2007, Sutter Delta Medical Center provided over $9 million dollars in the cost of care to the uninsured; and

Whereas, the City of Antioch recognizes that the health of our community rests with the viability of our health care providers;

We the City Council of the City of Antioch do hereby resolve:

That Contra Costa County should strengthen its clinic system by adding urgent care services and after hour services or pay providers to fill in this gap in East Contra Costa County;

That Contra Costa County provides eligibility workers in East Contra Costa County Hospitals to enroll qualified patients in Basic Adult Care Services' as is provided in the County Hospital;

That Contra Costa County recognize the growth in East County and thereby distribute its available health care resources more proportionately to where its resident reside; and

That all hospitals within East Contra Costa County work together to share the cost of providing service to its uninsured residents.

* * * * * * * * * *

RESOLUTION NO. 2008/**

Page 2

I HEREBY CERTIFY that the foregoing resolution was passed and adopted by the City Council of the City of Antioch at a regular meeting thereof, held on the 13th day of February 2008, by the following vote:

AYES:

NOES:

ABSENT:

________________________________

L. JOLENE MARTIN, CITY CLERK

Mayor Donald P. Freitas

P.O. Box 5007
Antioch, CA 94531-5007

Tel (925) 778-1161

dpfreitas@comcast.net

Elected November 2004
Term expires November 2008

Mayor Pro Tem James D. Davis

Tel (925) 757-2020
Fax (925) 939-4617

jd4antioch@aol.com

Elected November 2006
Term expires November 2010

Council Member Brian Kalinowski

P.O. Box 5007
Antioch, CA 94531-5007

Tel (925) 777-1712

bkski1@comcast.net

Elected November 2004
Term expires November 2008

Council Member Arne Simonsen

P.O. Box 5007
Antioch, CA 94531-5007

Tel (925) 779-0905

asimonsen4@comcast.net

Elected November 2004
Term expires November 2008

Council Member Reginald L. Moore

P.O. Box 5007
Antioch, CA 94531-5007

Tel (925) 706-7040

reggiemoore35@msn.com

Elected November 2006
Term expires November 2010

Mary Piepho, Supervisor

Contact Our Offices

Danville Brentwood
309 Diablo Road

Danville, CA 94526

1200 Central Blvd., Suite B

Brentwood, CA 94513

Telephone: (925) 820-8683

Fax: (925) 820-6627

Telephone: (925) 240-7260

Fax: (925) 240-7261

Office Hours

Monday - Friday

8:00am to 5:00pm

email: dist3@bos.cccounty.us

Federal Glover, Supervisor

Dist5@bos.cccounty.us

315 E. Leland Road, Pittsburg 94565 | Ph: (925) 427-8138 | Fax: (925) 427-8142 |

Toll Free for East County Residents: (925) 634-5915

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In yesterday’s brentwood press, the article below was published.

2008-02-09T18:23:00.000-08:00

I would like to hear your thoughts.

----
Sutter Delta CEO warns of coming health care crisis

Published 02/08/2008 - 8:00 a.m.

AUTHOR
Dave Roberts

Gary Rapaport, CEO at Sutter Delta Medical Center, is sounding alarm bells that health care in East County is headed for a crisis unless actions are taken to head it off. He places much of the blame on the county and Kaiser Permanente for not doing more to deal with the problem before it becomes a crisis.

County officials acknowledge that there might be tough times ahead for health care due to expected state budget cutbacks at the same time East County’s population continues to grow. But county and Kaiser officials say they are doing their part, and everyone needs to work together to find solutions.

Rapaport, who took the helm at Sutter Delta two years ago, made his case recently at the Delta 6 meeting, a consortium made up of the leaders of the four East County cities and two county supervisors.

In a report, he outlined “the challenges we face in the growing provision of care to our East County residents. We look forward to bringing you into the loop in the hope that you can assist us in elevating the discussion, and more importantly the solutions, before we reach a crisis. We ask that the East County mayors’ group recognize the importance of our community’s health rests also with the health of its providers.”

Specifically, regarding the county, Rapaport says that Sutter Delta:

• Has asked the county to strengthen its clinic system by adding urgent-care and after-hour services or pay providers to fill in the gap in coverage.

• Has asked the county to provide eligibility workers in East County who will come to the hospital to enroll qualified patients in the county’s Basic Adult Care Services program. Currently, the county will not allow Sutter patients to register for the program until they are discharged from Sutter, which is not the case with the Contra Costa Regional Medical Center in Martinez.

• Would like the county to direct the ambulance system to transport patients more equally to both Sutter and Kaiser emergency rooms.

• Is asking the county to distribute more care resources to East County, where most of the county’s growth has occurred in the past decade.

• Is frustrated that other local health care providers, including the county, have not engaged with the same effort as Sutter in working to provide a clinic in Oakley, resulting in not much progress being made.

The financial situation at Sutter has worsened since the opening of the Kaiser hospital in November. Kaiser used to reimburse Sutter for treating Kaiser patients in Sutter’s emergency department. Now those patients are going to Kaiser, resulting in a significant loss of revenue for Sutter.

Several other factors are adding to the fiscal strain, according to Rapaport. Sutter’s Urgent Care clinic had 6,280 visits last year, treating the uninsured for free. In the county, 15 percent of the population is uninsured. About 16 percent of people treated at Sutter’s emergency room are uninsured. In 2007, Sutter provided more than $9 million in care to the uninsured.

His report to Delta 6 states that Sutter has asked Kaiser to share in the cost of caring for the uninsured, alleging that Kaiser officials have declined to share information or seek a system that would balance out the cost of health care between the two hospitals.

Rapaport also charged that Kaiser has refused to have the county-run ambulance system more equally distribute patients between the two hospitals’ emergency rooms.

Jim Caroompas, a Kaiser spokesman, disputes several of Rapaport’s contentions. Via e-mail, he stated:

“Kaiser Permanente’s Emergency Departments are open to all, regardless of a patient’s ability to pay. This is both our legal responsibility and an essential part of our mission to improve the health of the communities we serve.

“In addition, we provide low-cost Kaiser Permanente coverage to people in need, and offer comprehensive health insurance to low-income families through publicly funded programs such as Medi-Cal and Healthy Families.

“Kaiser Permanente has been instrumental in the formation of an East County Health Access Group, along with the other hospital CEOs and Dr. William Walker, director of Contra Costa County Health Services. We are sharing our data openly with this group.

“We follow all regulations and protocols for Contra Costa County (ambulance service).

“Kaiser Permanente provides significant funding, in the form of grants, to nonprofit groups in East Contra Costa County. Our local 2007 community benefit grants that serve East County total $306,000.”

Walker, in a phone interview, said the county has been doing what it can within its budget to get more health care services to East County.

“Obviously, it’s the fastest-growing area of the county,” he said. “The county has been trying to keep up by putting more clinics and staff out there. We have clinics in Pittsburg, Antioch and Brentwood. We are working to increase the capacity and putting more providers in Antioch and Brentwood. We are also recruiting physicians to work out there.

“Beyond that, the county can’t fix the problem by itself. We have to have partners. John Muir does a mobile van. La Clinica has a presence in Pittsburg, and is looking at the possibility of opening an extension of their clinic in Oakley or some other site that would expand further east.”

Regarding Rapaport’s request to more evenly divide the emergency room destination for ambulance patients between Sutter and Kaiser, Walker said there are rules in place based on the best interest of the patient.

Those suffering from trauma are taken to John Muir Medical Center in Walnut Creek. If the emergency is not due to trauma but is life-threatening (such as a heart attack), the ambulance driver must take the patient to the nearest hospital. If it’s neither of those, the patient chooses the hospital.

“Gary Rapaport’s concern is now that Kaiser has opened up, more of Kaiser’s patients go to Kaiser,” said Walker. “This is a revenue issue for him. There’s not an easy solution to that without having a system in place that (overrides) patients’ choice.

“We know right now there aren’t sufficient funds to do everything we want to do. It’s probably going to get worse. Not only with the county’s budget but the governor’s budget. Making people ineligible for Medi-Cal would impact us at the county level.

“Hopefully, we get through this by working together as partners. That’s my hope. I understand that Gary is anxious and concerned for an immediate solution. There’s probably not an easy solution.”

County Supervisor Mary Piepho said in a phone interview, “Sutter Delta’s been a great provider to East County, and I certainly recognize their long-standing relationship. But there is a competitive environment that is developing.”

She said a meeting is scheduled in the coming weeks with East County leaders and health care providers to bring “the stakeholders to the table to talk it through. So they hear all of the information at once, as opposed to (just) Gary’s concerns from the Sutter Delta perspective. It’s important that we keep the dialogue going and understand each party’s interests and concerns.

“We are all concerned. The cities are concerned. I am concerned because I need to make sure we (in county government) are doing our best to serve the public. Gary is raising the flag (on these) problems. We want to address them early on rather than later.”

Gary Rapaport

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Huddle To Improve Care

2008-02-02T15:24:00.000-08:00

We often think of a huddle as a way to plan for the next play on the football field or for a group in the wilderness looking to find warmth. At Sutter Delta Medical Center, we have a huddle every morning to review the care of our patients. At 9:30 each morning, our charge nurses from each nursing unit including the Emergency Department, meet with our case managers, social work staff and Hospitalist's (Internal Medicine Physicians who specialize in the care of hospitalized patients) to review the care needs of each patient for the day. The group is focused on ensuring that each patient will receive the best practice care according to published national guidelines.

Along side our care givers, Hospital leaders routinely attend the huddle to learn about opportunities to improve patient care and service and to assist care givers to break down barriers that are getting in the way of delivering best practice care.

It is my hope that SDMC will exceed the expectations of our patients and their family and visitors as we strive to deliver the best care to every patient every day.

Gary Rapaport

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Delta 6 East County Mayor's Group Meeting

2008-01-27T17:24:00.000-08:00

Don Giacomini, Board Chair, Mary Erbez, Trustee and I attended the most recent meeting of the six East Contra Costa Mayor's and our East County Supervisors, Supervisor Glover and Supervisor Piepho.

We asked to speak to this group about problems with access to health care for the uninsured in East County. Despite the recent opening of a second Hospital, Kaiser Antioch, the uninsured continue to utilize the Sutter Delta Emergency Department in record numbers, rather than accessing the Counties clinics in Antioch, Pittsburg and Brentwood, or even the new Kaiser Antioch Emergency Department. For the month of December (the first full month Kaiser Antioch was open for business) AMR transported 55 uninsured patients to the SDMC ED while only 5 were delivered to the Kaiser Antioch ED!

Inappropriate use of our ER leads to longer wait times for the seriously ill and this disproportionate use of SDMC by the uninsured challenges the financial health of SDMC. We were pleased to present to the Delta 6 a number of recommendations to improve access to pre hospital and post hospital care by the underinsured as well as opportunities to improve the access to health insurance. We encouraged the Delta 6 group to act now. We can not afford to sit back and wait for a crisis to develop. Let's learn from the situation that led to the Bankruptcy of Doctors Medical Center in West Contra Costa County and not allow the same to occur in East Contra Costa County.

While we have discussed all of our recommendations previously with the County staff and with the leadership at Kaiser Antioch, we have been disappointed by the response to date. We were pleased with the committment of Delta 6 to organize a committee of healthcare leaders with a charge to find workable solutions to the health care access needs for East County residents.

For a copy of our presentation, please respond with your full name and email address.

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What's going on

2008-01-22T09:34:00.000-08:00

We are pleased to welcome Board Certified General Surgeon , Dr. Ditmars who will be starting practice with East Bay Surgical Associates in February.
Dr. Darmawan, Pediatrician joined Dr. Garcia's practice in Brentwood last month (December 2007).
Dr. Mary Tao, Radiation Oncologist began her practice with East Bay Oncology in January and hopes to be providing Radiation Therapy in their new Cancer Center in March.
We hope to welcome later in 2008, a new Internist to Brentwood, a new Family Practitioner to Antioch, a new Thoracic and Vascular Surgeon, and new Pain Management Specialists.

Gary

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2007-12-25T11:20:00.000-08:00

Happy Holidays! I will be posting many things here soon. Please check back.

Gary