El Camino Hospital's board is set to expand

Majority of public comments opposed expansion, lessening of community control over hospital

Despite public opposition, the El Camino Healthcare District's board of directors agreed Monday night to expand the nonprofit hospital's governance board from nine members to 11 members. The decision would add health care experts to guide the hospital's major decisions and $800 million annual budget, but dilutes the influence local residents have over the hospital's operations by having five appointees and five elected board members.

Last month, the El Camino Healthcare District -- a special tax district encompassing Mountain View and several neighboring cities -- announced it was considering a governance shake-up for El Camino Hospital. The argument, according to hospital staff, is that the hospital is struggling to survive as an independent community hospital in a changing health care environment. Not only is competition fierce in the South Bay and the Peninsula, but changes in health care laws could threaten how much money El Camino Hospital receives from insurance companies and the federal government for services.

The remedy, according to hospital staff and the firm Nygren Consulting, is to add more people to the hospital's board of directors who have a strong background in health care -- whether it be the insurance industry, finance or clinical experience -- who can guide the hospital through uncertain times.

Though the hospital paints a bleak picture of its economic future, financial reports show the hospital's operating income through early 2017 was $33.5 million more than budgeted, and budgets going back to 2014 show the hospital has been able to stow away tens of millions of dollars in profits each year.

The El Camino Healthcare District is a separate entity from El Camino Hospital, and was created in the 1950s to finance the hospital's construction. Voters elect five members to the district's board of directors, who continue to wield significant sway over the hospital's operations because they also serve as members of the El Camino Hospital board.

The health care district's board wields the power to decide the hospital's board structure, and oversees the district, which owns the land under the hospital's Mountain View campus and leases it to the hospital.

Since the board was expanded in 2012, the hospital has been run by nine board members. All five of the El Camino Healthcare District board members serve on the hospital's governance board, as well as three appointed members and El Camino Hospital's CEO. One proposal Monday night suggested simply appointing two more health care experts to the hospital board, while another suggested leaving the board at nine members but swapping out two district board members for appointed directors.

'Slow-motion giveaway'

The majority of the public speakers, and most of the 115 public comments received over the last month, opposed stripping away voter-elected membership from the hospital's board, seeing it as a loss of public control over a community hospital that district residents helped finance with their taxes over the last 60 years. Changing the composition of the board to allow subject-area experts to overrule elected members as a voting bloc amounts to a "slow-motion giveaway" of the hospital, argued Los Altos resident Bill James, who previously ran for a seat on the health care district's board.

"This hospital and everything about it is owned by the people, and that's what's wonderful about it," James said. "In both these (proposed) models, the (hospital) board could override a unanimous vote from the district board."

Some speakers compared the proposed changes to a decision by the El Camino Healthcare District in 1992 that separated the district from the hospital entirely, ceding complete control of El Camino to another nonprofit entity. Sometimes referred to as the "privatization experiment," the district board voted three years later to file a lawsuit in order to claw back control of El Camino Hospital. The health care district regained oversight of the hospital in 1997.

Los Altos Hills resident Jim Abraham said the suggested changes to the board stink of an attempt to steal the hospital away from the people who continue to pay taxes to support it.

"The idea that you can pack the board with people who don't live in the area and are not elected just absolutely blows me away. It's just so wrong," Abraham said. "Take this turkey, bury it and don't come back to it. We've been here before -- let's not do it again."

Kary Lynch, a 40-year hospital employee working in the behavioral health department, wondered whether appointed health care experts would make decisions in the best interest of the public or the best interest from the perspective of the hospital's financial health. The existing board agreed to invest in a new behavioral health building, but plenty of private hospitals have sought to slash money-losing services in the name of economic solvency.

Failure to communicate?

Despite the public's pleas to leave the hospital board alone, three of the five board members remained unfazed. Board member David Reeder said his work in the local tech industry pales in comparison to the complex, challenging world of the health care market. To depend on five democratically elected board members to manage the hospital with so many changes and challenges on the horizon, he argued, would not bode well for the hospital's future. That's why so few independent local hospitals are left in the Bay Area.

"The board of directors that are elected by the people aren't always qualified to operate the hospital," Reeder said.

Board member John Zoglin, who voted against retaining the status quo, said residents shouldn't be alarmed over the prospect that appointed members will take over the hospital's operations, if only because he couldn't recall a single vote that pitted all five district board members against the three appointed members. What's more, the El Camino Healthcare District reserves the right to remove any appointed member from the board, giving the district ultimate power over what happens at the hospital.

Board member Dennis Chiu and Julia Miller voted in favor of leaving the hospital's board as-is, but the vote failed 2-3 with board members Peter Fung, Zoglin and Reeder opposed. Reeder then made a motion for "Option C," which called for swapping out district board members for appointed members, but it also went down in a 2-3 vote. Miller said she was "disappointed" that her colleagues were even considering Option C, given the public support to retain the power of elected officials over the hospital.

Reeder, responding to Miller's comments, said that he has to represent the entire community and not just those who weighed in through public comment. One public speaker questioned why the health care district asked for public comment, if board members were going to disregard it as a narrow band of broader public opinion.

Fung said that the opposition may stem from a misunderstanding, and that the public failed to understand that the El Camino Healthcare District board still maintains its power to appoint and remove hospital directors.

"Have we not done a good enough job?" Fung asked. "I think we did the best we could to explain to the public, both in the PowerPoint and the publication, that the district board still has reserved powers."

Board members eventually gave a reluctant but unanimous vote on a compromise that would add two appointed directors to the hospital's board but retain all five district board members, expanding the board to a total of 11 members. In an amendment proposed by Miller, district board members also agreed to strip the voting power of the CEO, leaving 10 voting board members. The amendment ensured that non-elected members would not have a majority vote over hospital decisions.

The de facto tie-breaking vote was Zoglin, who voted against both Option C and the existing board structure, and prompted the vote for the board expansion. He explained that he was proud of the existing governance structure and what it's accomplished so far, but acknowledged that the hospital was going to need more experienced leadership in order to remain a "jewel of an institution" and avoid "selling out to change" like Sutter Health.

"It's not, 'If it's working now, don't fix it,' but what do we need to do to make sure it's fixed in five years," he said.


10 people like this
Posted by Ridiculous
a resident of Old Mountain View
on May 18, 2017 at 11:39 am

Dr. Fung's comments were especially baffling. At one point he argued that the 5 board members were very qualified to oversee the operations and then he said that they needed help from others.

The majority thinks that the help they need requires voting rights on the hospital board rather than having experts serve as advisors to the elected board.

7 people like this
Posted by Voter
a resident of St. Francis Acres
on May 18, 2017 at 1:13 pm

Who represents Mountain View on this board? Reeder? He's out.

2 people like this
Posted by Old Mountain Viewan
a resident of North Whisman
on May 18, 2017 at 2:32 pm

I think it's so sad, that the entire health care system, is no longer about patients but about PROFIT!! The insurance industry is the biggest culprit with their big paying lobbyists, and they do their jobs, pay less, get MORE money. I have grown up and still live in Mountain View and have always loved it, to ruin this wonderful hospital is not right.

14 people like this
Posted by Alex M
a resident of Willowgate
on May 18, 2017 at 2:47 pm

Alex M is a registered user.

It's very simple. If the hospital is to be controlled by appointees who aren't beholden to the taxpayers, let's amend the tax structure so that the hospital is no longer supported by taxpayers. It's a no-brainer. The El Camino Health Care District needs to know they can't have their cake and eat it too. Either take the hospital private and pay for it yourself, or take taxpayer money and leave the control with the taxpayers.

6 people like this
Posted by Bruce Karney
a resident of Old Mountain View
on May 18, 2017 at 5:20 pm

This is a sad day for the voters and taxpayers of Mountain View and surrounding cities. The three El Camino Hospital directors who voted for this change should be voted out of office.

6 people like this
Posted by Rodger
a resident of Sylvan Park
on May 18, 2017 at 5:31 pm

The hospital district is out of control and is soaking the tax payers. No voting member should be unelected, the salaries of the operating managers should be reduced, the out of district hospitals should be sold. Serious reform and house cleaning to restore control to the taxpayers. We need a measure on the ballot in the next election to make this happen, the highly paid administration will scheme against this action but let's get started now!

1 person likes this
Posted by the_punnisher
a resident of North Whisman
on May 18, 2017 at 8:43 pm

the_punnisher is a registered user.

The only thing I got to remember this hospital by is a dose of c-dif that took 3 weeks to get rid of...
Oh, and a screw up of my pain meds, resulting in a " hot shot " that the nurses had to watch to make sure I was breathing for 6 hours..

Since this is a NON-PROFIT hospital, the VOTERS should have control of the Board of Directors. If not, the voters need to take title of the land this hospital sits on and FORCE the Board of Directors OUT and have formal Elections for the Board of Directors that will be responsible to the local communities. This is how the RTD ( VTA ) problem got fixed. Your ( non-working ) City Attorney should be applying this remedy NOW.

6 people like this
Posted by Disgusted
a resident of Waverly Park
on May 19, 2017 at 12:21 am

Mountain View taxpayers have supported this hospital for 60 years, and the Board should be responsive to the TAXPAYERS in the DISTRICT - not outsiders. Yes, let there be some "experts" on the Board, but there should be no chance AT ALL that they can outvote the locals. This is vital, looking at the history of the hospital. How did the taxpayers in THIS district ever end up supporting an OUT of district hospital in Los Gatos? That is a stellar example of misuse of our taxes.

It is pretty clear that we need an entirely NEW Board - one that spends our tax money on OUR district, and puts the taxpayer first. I agree with another poster here (Alex M) that if they want to vote outside our best interests, then they should not have access to our taxes.

Reeder doesn't stand a chance at reelection after his ignorant and arrogant attitude in dealing with OUR funds.

2 people like this
Posted by Pause & Consider
a resident of Cuesta Park
on May 21, 2017 at 11:00 am

Healthcare used to be much simpler, like every other business. District elected boards effectively made decisions because the equations were not as complex -- a service was provided, a bill was paid, the books balanced. Older people with failing organs died and younger people survived with the right treatments. MDs came over at lunch to see the patients they followed from their office. People stayed for weeks if needed. There were a lot more hospital beds in an area not nearly as populated. It is a completely different world today. The complexities are hard even for experienced administrators to grapple with for every sub-set of an issue. Consultants roll in and out as needed. The independent hospital is a wonder these days, because the expenses of administering these new complexities (take I.T. -- used to be a couple of geeks, now probably over 100 -- HR might have been Hilda who also did payroll == probably 40 now) is paid for through a smaller revenue base than a consolidated system. Dave Reader is 100% correct and a brave acknowledgement. No one cares more about the quality of care or has been more supportive of the kindness that ECH has been known for. The community knows we have a "Gem" in El Camino, who provides services other hospitals do not and does them well. The District retains FULL ownership. But the elected officials do not have the expertise to make key operational decisions. What they must have is the expertise to ensure the people they select have that expertise, as well as qualities such as Moral Courage, Compassion, Quality First, all the things that represent the residents of this community. I salute Dave for being honest at the risk of being targeted. I salute those who are angry at the board as well for caring enough to get angry -- gotta love Democracy.

Posted by Name hidden
a resident of Castro City

on Sep 17, 2017 at 10:16 am

Due to repeated violations of our Terms of Use, comments from this poster are automatically removed. Why?

Sorry, but further commenting on this topic has been closed.

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