Hospital Expansion Proposal Opens Old Wounds

County leaders would be “spitting on the face of voters” if they approve a $28.7-million hospital project today and ignore Community Memorial Hospital’s bid to take over health care for the poor, an attorney for the private hospital said Monday.

“For elected officials to intentionally and systematically ignore and violate the will of the electorate represents a cynical breach of public trust,” said Steven Merksamer, a Sacramento lobbyist who is Community Memorial’s lead negotiator on health-care matters with the county.

Merksamer argued that instead of following through with a project the voters have essentially rejected, the county should turn to the private, nonprofit hospital down the street to handle all indigent care, or at least the current outpatient load. That could lead to shutting down the 75-year-old Ventura County Medical Center.

But county health care chief Pierre Durand said Community Memorial’s offer did not include taking care of the county’s “entire safety net,” which he said includes $20 million worth of annual care to the indigent, the working poor and the uninsured.

“This issue is not about buildings,” he said. “This to us is an issue about care to the people that need it, and about providing health care in a responsible way.”

The issue arises as the Board of Supervisors is considering a proposal for construction of a new, two-story building to replace the county hospital’s kitchen and medical laboratory. The project also includes a three-story parking garage and relocation of utilities.

A majority of county supervisors said that the new building is needed to replace structurally unsound facilities that otherwise would threaten the hospital’s state license. They said the project is vastly different from the proposed $56-million project rejected by voters in March because it does not include walk-in clinics.

But Merksamer, one-time chief of staff to former Gov. George Deukmejian, said the four components of the new project are exactly the same size as what was originally proposed and therefore “is a deliberate disregard for the will of the voters.”

“The kitchen is the size of the kitchen at the Luxor Hotel in Las Vegas,” he said. “I mean give me a break. This is no scaled-down facility.”

But county officials said the kitchen and lab are larger because the hospital’s current facilities are outdated and cramped--and have been cited as substandard by state inspectors.

“I have a responsibility as a supervisor in this county to provide a hospital that we’re charged to run and make sure it’s accredited,” Board Chairman Frank Schillo said. “This is nowhere near what the other proposal was before. They’re lying.”

But Merksamer said that Community Memorial had learned that the county is negotiating to either purchase or rent a 35,000-square-foot building now occupied by Foundation Health near the public hospital for use as a future walk-in clinic.

“I have reason to believe that they’re just going to move over to the Foundation Health building and then they get exactly what the taxpayers of this county told them in overwhelming numbers what they couldn’t have,” he said.

Durand, director of the county Health Care Agency, acknowledged that the county is looking “for space to rent” to consolidate its specialty clinics in the future. But Durand said that the final decisions would be made by the Board of Supervisors.

“We’re not going out and building a medical clinic,” he said. “We’re renting. The question is do we rent 50 places at 1,200 square feet each or do we rent one of 30,000 square feet.”

Meanwhile, Merksamer said Community Memorial has been in negotiations with county officials over the past six months over whether the private hospital should take over the county’s indigent caseload.

He said the county rejected that offer outright, and a proposal to merge Community Memorial with the county’s eight satellite clinics was also turned down.

Merksamer said that the hospital’s purpose was simply to eliminate duplication of services.

“We went to them with our hand out and all that happened in the end was we got our hand slapped,” he said.

Schillo said that he and Supervisor Judy Mikels had met several times with members of Community Memorial’s board of directors to discuss possibly merging services provided by the two hospitals. But Schillo said that the county wanted to replace its kitchen and lab facilities before moving forward with a formal plan.

“We need this because of our accreditation problems,” he said. “But they don’t want to hear the truth.”

The two hospitals have been fighting for years. Tensions peaked last March when Community Memorial spent more than $1.6 million on a voter referendum to defeat the county hospital’s plans to build a new, five-story outpatient center.

Community Memorial officials charged that the financing plan for the $56-million project, which relied heavily on state and federal grants, was risky and that county voters could wind up paying the entire bill.

Roughly $17 million of the new $28.7-million project would be paid for with state and federal grants, with the balance to come out of the medical center’s own budget as well as the county’s general fund over a 15-year period.

If the project is approved, bond-like certificates would be sold within the next 30 to 60 days to finance the new building and parking garage, officials said.

Merksamer declined to say what Community Memorial would do if the supervisors approve the new project today.

“We have a limited number of options,” he said. “I think it’s obvious what they are.”