24/7 or Bust!
A community forum was held Wednesday, June 4, 2014, at 3 PM at the Downieville School Gym. The purpose was to discuss the reasons the Western Sierra Medical Clinic’s (WSMC) CEO, Scott McFarland, and members of the Board of Directors regarding a decision by WSMC Board of Directors to substantially reduce the medical services in Downieville and to request a cooperative effort to find solutions to ensure health and emergency care continues at levels acceptable to the community.
Over 100 concerned citizens of Western Sierra County attended.
A letter from Robert Eshleman of Sierra City was read as the “community statement”. Eshleman’s plea for service hours to be maintained at the present level (5 days/week office and 24/7 care) is passionate and convincing. In brief, he articulately states the need for “round-the-clock” care because “car accidents, mountain bike accidents, motor cycle accidents, rattlesnake bites, heart attacks and other internal medical crises” don’t “happen on schedule”.
Scott McFarland, CEO of WSMC then informed the audience of the Board’s decision to reduce the Downieville Clinic’s hours to 3 days, with nurses on staff using telemedicine for the other 2 days. For after-hours 24/7 care, EMS staff will be required to call a medical provider in Grass Valley. The 24/7 hands on medical care that has serviced residents and visitors alike for over 38 years will be a thing of the past. McFarland justified these measures based upon changes in what he calls the “health care landscape”, which includes the increasing costs of health care including wages and employee benefits. He claimed that the Board did not make a “snap decision”.
McFarland then proceeded to respond to 10 questions that had been previously submitted to him. They were a composite of questions submitted by concerned residents to what is now the “Downieville Clinic Advisory Committee”. This Committee has been formed to continue dialogue with WSMC for reaching an agreeable solution.
The community wanted to know why it was not engaged in the process. Why the secrecy? What about transparency? The process should be open. If McFarland and the Board did not previously know that it is all about community, they certainly should by now.
We are concerned about the status of recruiting a new provider to take FNP Sarah Cantrell’s position after she leaves on August 4th. We asked for the recruiting status and got answers that did not make sense. Mr. McFarland did state, at the end of the meeting, that there was an applicant from Florida that was interested in the position.
The community was aghast to discover that the Clinic Building in Downieville is now encumbered as collateral for the financing of the $5 million Miner’s Clinic Building in Grass Valley presently under construction.
Information regarding the 2013 Downieville Budget was not available but Mr. McFarland promised to provide it to the Committee the next day. The audience challenged McFarland’s statistics regarding the Downieville clinic. One long time resident said they were “skewed”.
Suggestions were offered, including cutting wages at the top. One of our EMS responders passionately stated that the “whole concept of telemedicine will not work for us”. Emotions grew. One resident said “maybe you, Mr. McFarland, are not the right leader for us.”
The following question was asked twice: “If we decided to separate from Miner’s Clinic, would you cooperate?” That question remains unanswered.
Bette Jo Lang read a letter from her son, Frank Lang, Jr. MD, who served as the Chief Medical Officer of WSMC for many years. Dr. Lang urged that various real life emergency and urgent care case scenarios be examined in order to reach workable solutions.
Downieville High School graduating senior, Savannah Burr, asked if McFarland and the Board members would be OK telling their kids who had broken a bone in a sports injury that they must travel over an hour for medical help.
Statements were made regarding the fact that 24/7 care has been part of the Mission Statement of WSMC since its inception, and the fact that the continuation of 24/7 care in Downieville was of utmost concern by the Board in approving the merger with Miner’s Clinic. McFarland and the current Board were also reminded that they used the Downieville 24/7 model in their most recent renewal application for the Federal Grant.
The Articles of Incorporation of WSMC were quoted. The primary purposes of the corporation are “to obtain health care services as needed and desired, for the general area of Western Sierra County…” and to provide, organize, and promote, in western Sierra County, a comprehensive health care program for medical services” and “to do all things necessary, expedient, or appropriate to the accomplishment of any of the objects and purposes for which this corporation is formed”. A plea for the needed and desired 24/7 services was made over and over again by members of the audience.
In conclusion, the Downieville Clinic Advisory Committee (DCAC) asked for an “immediate commitment…for continuing the medical services at the Downieville site 5 days per week and 24/7 care during the ongoing dialogue.” The date of August 5 was mentioned as a critical deadline to have a plan in place as FNP Cantrell’s last day is August 4th. Family Nurse Practioner Frank Lang said while the search for a permanent 24/7/ provider continued that he, Dr. Scott Kellerman and NP Lora Lee Grutkowski would be available for interim coverage.
Mr. McFarland appeared to acknowledge that he would delay the implementation of the Clinic cutbacks pending further discussion with the Clinic Staff, the Clinic Board of Directors and the Downieville Clinic Advisory Committee that would develop a more community based solution which would maintain the availability of 24/7 care in western Sierra County.
The DCAC pledged transparency and openness in the process to continue in assuring the availability of preventative and emergency healthcare for western Sierra County. A “core group” meeting will be held at the Downieville Community Hall on June 16 at 4 pm and another community meeting where critical administrators and interested parties will be invited to attend on June 23 at the Community Hall. If you have ideas or information contact email@example.com or firstname.lastname@example.org