1975/03/10 City Council MinutesROHNERT PARK CITY COUNCIL MI14UTES
March. 10, 1975
The Council of the City of Rohnert Park met this date in
adjourned regular session in the City Offices, 6750
Commerce Boulevard, Rohnert Park, with Mayor Beary pre -
siding.
Call to Order
Mayor Beary called the adjourned regular session to order
at approximately 7:35 p.m.
Roll Call
Present: (5) Councilmen Eck, Flores, Hopkins, Smith,
and Beary
Absent: (0) None
Staff present: City Manager Callinan
Other officials presents Petaluma Hospital District Board
members Frederick Groverman, Herbert
Newburger, Carole Barlas, Francis M.
Crinella, Brand Johnson, District
Administrator Charles Cowen, and Legal
Counsel Joseph Sheeks
Mayors' and Council-
City Manager Callinan reminded the Council members of the
men's Association
March 13th meeting of the Sonoma Co�?nty Mayors' and
Councilmen's Association for which Rohnert Park is host
and which will be held at the Washoe House.
Hospital Discussion
Mayor Beary initiated the scheduled joint discussion
between the City Council and the Petaluma Hospital
.
District Board of Directors by starting a self- introduc-
Lion.of all those present, including the members of the
audience.
Hospital Board President Fred Groverman made a presen-
tation as did District Administrator Cowen and Legal
Counsel Sheeks. Copies of the material received from
the Hospital District prior to the meeting are attached
to and made a part of these minutes.
A wide ranging discussion followed with all members of
the Board, City Council, staff members and some members
of the audience participating, concerning the planned new
hospital on the proposed'Troudy Lane site in Petaluma,
the advisability of the City of Rohnert Park staying in
or leaving the district, the different levels of services
provided by the different types of hospitals, the level
of services provided by district hospitals vs. proprietary
hospitals, tax rates, elections, and so forth.
Upon conclusion of the discussion, Mayor Beary indicated
that the City Council would be taking up the matter of
de-- annexing or not from the district at its next regular
meeting.
Page 2. March 10, 1975
Spivock Open Space Mayor Beary reported on the March 7th meeting which he
attended in the Santa Rosa City Offices concerning preser-
vation of the Spivock land north of the golf course as
open space. He indicated that in attendance at that
meeting were Supervisor Kortum, County Director of Public
Works Head, Santa Rosa City Manager Blackman,, Councilman
David Eck, City Manager Callinan, and Jimmie Rogers rep-
resenting the Spivocks. He indicated that he would recom-
mend that the city participate 10% in the cost of acqui-
sition and leave the negotiation of the actual acquisition
price to the county. Councilman Eck reported on his
feelings of the results of the Friday meeting. It was
reported that Supervisor Kortum was supposed to contact
the other members of the Board of Supervisors to determine
their interest in possibly pursuing the acquisition of
the property with the county picking up most of the cost.
It was further reported that the appraisals for the land
prepared by the county, in cooperation with the City of
Santa Rosa, came in with a value of $6,500 per acre. Dis-
cussion was held concerning how to make an appropriate
offer to the Spivocks and the possibility of the city
down zoning the land. The discussion was wide ranging
and no consensus was reached other than to agree that the
matter would be scheduled for discussion againlat` the regu-
lar City Council meeting on March 17th.
Comprehensive Health - Mayor Beary indicated that unless the Council members had
Planning some objections, he would send a letter to Comprehensive
Health Facilities Planning requesting a study of health
services and facilities needs for Rohnert Park. A brief
discussion followed.
Adjournment The meeting was adjourned at approximately 10:20 p.m.
J
City Clerk
APPROVED:
Mayor
HILLCREST HOSPITAL
PETAL17PJ\, CALIFORNIA
PROPOSED PRESENTATION TO
THE ROHNERT PARK CITY COUNCIL
MARCH 10, 1975
I. Dr. Groverman:
A. District's Responsibility to Rohnert Park
B. Long -Range Plan for the Petaluma Hospital
District
C. Proposed Site for New Hospital
II. Mr. Sheeks:
Advantages of District Hospitals
ITT, Mr. Cowen:
Alternatives Available to Rohnert Park regarding
Hospital Services
IV. Discussion
HILLCREST HOSPITAL
PETALUMA, CALIFORNIA
March 1975
MEMO TO: The Rohnert Park City Council
FROM:- Charles E. Cowen, Administrator
The assessed valuation of the Petaluma Hospital District is
approximately $160 million. Rohnert Park's assessed valua-
tion is about $23 million, or 170 of the total district. A
127 -bed full - service hospital with OB., Pediatrics, ICU /CCU,
etc., as well as a 24 -hour physician staffed Emergency Room
is being planned for the district at an estimated cost of
$12 million (efforts are being made to reduce this figure).
This $12 million figure translates into a tax of 78� per
$100 assessed valuation for the property owners within the
District, or 58� per $100 over -ride from the 20� tax the
district is now empowered to levy, but does not at this time
do so.
it would appear that Rohnert Park has four options regarding
hospital care for its citizens:
1.) Remain in the Petaluma Hospital District and help
finance a new 127 -bed full= service hospital to be
;located on Troudy Lane, off Petaluma Blvd. worth,
8 -10 minutes from Rohnert Park. This would cost
the property tax pavers of Rohnert Park, as well
as the rest of the district, 78� or less per $100
assessed valuation.
it is our opinion that a new hospital centrally
located within the district would bring new physi-
cians to Rohnert Park. and Petaluma who would use
the new facility for their inpatient care.
2.) Detach from the district and use hospitals in Santa
Rosa as well as Hillcrest. From a purely tax savings
perspective for the citizens of Rohnert Park, this
option appears attractive. This option, however,
will not attract new physicians to the area, nor will.
it quite possibly allow Hillcrest to move to a more
geographically central site within the district.
This would be unfortunate because Rohnert Park would
still be in Hillcrest's Service Area (403A) which
means that we would still be responsible for provid-
ing the inpatient facilities for the population of
Rohnert Park. This situation could be remedied if
the State Hospital Advisory Council was convinced
that including Rohnert Park's population in the Santa
Rosa planning area was appropriate. As you may be
aware, gaining state approval for service area changes
is extremely difficult and time- consuming. Further,
Memo to the Rohnert Park City Council
Dated March 1975
Page two
this option would not provide-Rohnert Park with a
hospital facility with which to identify, nor would
it afford Rohnert Park the opportunity to partici-
pate in the management of a hospital.
3.) Detach from the District and form a Rohnert Park
Hospital District which in turn would build a
hospital in Rohnert Park. 'It will be some years
before Rohnert Park's population will justify a
hospital facility of its own and then the cost of
the new facility to a district of limited assessed
valuation would be staggering.
4.) Detach from the District and entice a proprietary
hospital to build in Rohnert Park wh,`-_i the popula-
tion justifies a hospital. In addifJon to the fact
that proprietary hospitals ordinarily do not provide
comprehensive services, e.g., 24 -hour physician
staffed Emergency Room, Maternity, Pediatrics, etc.,
they are significantly more costly to patients than
are district hospitals {See attachment . Hillcrest
operates at $34.00 per day and $234.00 per stay less
expensively than does the average proprietary hosp-
ital within the area. This cost differential should
be borne in mind when deciding the future health care
alternatives for the residents of Rohnert Park. A
new 127 -bed, full - service Hillcrest Hospital located
more centrally within the district, will cost a home-
owner of a $40,000 house $78 per year. This amount
will decrease annually as the assessed valuation of
the district increases. Comparing this cost to the
significantly higher charges incurred by a patient in
a proprietary hospital, leads one to question the
merits of option 44. .
Rohnert Park has the opportunity to participate in the planning
of a top quality hospital facility which has a proven record of
efficient operations and high quality patient care. This facil-
ity, centrally located within the district, would attract new
physicians to Rohnert Park, Cotati as well as Petaluma. A new
facility which is anxious to accommodate new physicians in the
area is very attractive to physicians finishing their training.
The larger tax base of the Petaluma Hospital District will allow
for a more comprehensive hospital, both initially and in the
future. Comparing this alternative to the other three options
available will lead the residents of Rohnert Park, I believe, to
choose to stay in the existing District and to help direct the
future of Hillcrest.
Memo to the Rohnert Park City Council
Dated March 1975
Attachment A
In a confidential cost survey, compiled by Blue Cross for
the Redwood Empire Hospital Conference area for the period
July - December 1974, the following was revealed:
In a letter dated February 20, 1975, from the California Depart-
ment of Health regarding the Medi -Cal Program, Hillcrest Hospital
again was shown to have the lowest cost of all hospitals studied
in the Redwood Empire(See attachment B).
AVERAGE MEDI -CAL PAYMENT
PER HOSPITAL ADMISSION
Chronic
All Normal Heart
Admissions Delivery T & A Disease
HILLCREST HOSPITAL $ 389.00 $ 215.00 $ 184.00 $664.00
REDWOOD EMPIRE -
AVERAGE 652.00 328.00 275.00 861.00
HILLCREST AS
EMPIRE AVERAGE: (263.00) (113.00) (91.00) (197.00)
Total Cost
Total Cost
Per Dad *
Per Claim
HILLCREST HOSPITAL
$ 134.83
$ 576.22
REDWOOD EMPIRE HOSPITAL
CONFERENCE AVERAGE
(16 Hospitals)
161.06
795.05
PROPRIETARY HOSPITALS
AVERAGE (5 Hospitals)
168.86
810.52
* All Services Included
HILLCREST AS COMPARED TO:
REDWOOD EMPIRE HOSPITAL
CONFERENCE AVERAGE
$ (26.23)
$
PROPRIETARY HOSPITALS
AVERAGE
(34.03)
(234.30')
In a letter dated February 20, 1975, from the California Depart-
ment of Health regarding the Medi -Cal Program, Hillcrest Hospital
again was shown to have the lowest cost of all hospitals studied
in the Redwood Empire(See attachment B).
AVERAGE MEDI -CAL PAYMENT
PER HOSPITAL ADMISSION
Chronic
All Normal Heart
Admissions Delivery T & A Disease
HILLCREST HOSPITAL $ 389.00 $ 215.00 $ 184.00 $664.00
REDWOOD EMPIRE -
AVERAGE 652.00 328.00 275.00 861.00
HILLCREST AS
EMPIRE AVERAGE: (263.00) (113.00) (91.00) (197.00)
ATTACHMENT B
EDMUND G. BROWN JR., Governor
TATE OF CALIFORNIA - HEALTH AND WELFARE AGENCY `
)EPARTMENT OF HEALTH
• •'In 4 e
4 -744 P STREET '
ZRAMENTO, CALIFORNIA 95814
February 20, 1975
Dear Doctor:
As part of our continuing review of the Medi -Cal program, we have been
conducting an analysis of payments to hospitals for the ten diagnoses
which currently comprise the bulk, of hospital inpatient expenditures.
Not surprisingly, costs for the same service vary considerably among
different hospitals. A significant finding of this study was that many
practitioners are not fully aware of the hospitals' charges that their
patients incur. For this reason we feel that information on average
Medi -Cal payments to hospitals in your area may be of interest to you.
Naturally, there is no effective way to use cost of care as an indicator
of quality, nor should cost ever be the deciding factor in determining
proper treatment for patients. The figures on the attached sheet are
drawn from payment files over the 12- month period from November 1973 to
October 1974 for services rendered during that period and indicate only
an average of the payments to the individual hospitals for each type of
admission. No inferences regarding quality of care or appropriateness
of charges should be drawn from these figures. Individual hospitals
compute their charges based on the range of services offered and the
overhead costs for that particular institution.
As more and more of the state budget is absorbed in the steadily in-
creasing costs of Medi -Cal, it behooves all of us in health services
to know how these public funds are being expended. As I become aware
of other significant economic indicators in Medi -Cal, such as these
hospital payment statistics, I would like to share them -with you.
Hopefully, in this manner, we can all become more knowledgeable of the
entire scope of publicly financed health care, and can thus participate
more meaningfully in policy discussions regarding that care.
Sincerely,
1
ROBERT L. GNAIZDA
Director
- *' • 9' -''a' "R t- 'O "P1iAL AD�71SSt0`� g./ _
I/ Average payments. are computed from Medi -Cal expenditures for covered inpatient hospitalization. Payments exclude other coverage and patient liability.
2/ These ten diagnoses were selected as being the most costly to the Medi -Cal Program of total acute hospital inpatient care during the report period (listed in descending order of cost).
These diagnoses are:
ICDA 650 Delivery without complications ICDA 250 Diabetes mellitus
ICDA 640 Abortion induced for medical indications ICDA 009 Diarrhea! disease
ICDA 500 Hypertrophy of tonsils and adenoids ICDA 626 Disorder of menstruation
ICDA 412 Chronic ischemic -heart disease - ICDA 427 Symptomatic heart disease
ICDA 486 Pneumonia, unspecified ICDA 466 Acute bronchitis and bronchiolitis
QVERAGc tr1ED0 -,SAL PAirT. rG► �
roc �
FOR SELECTED DIAGNOSES
Soso. .�
Count
Rovem, -r 1973 through Ootowr 1974
V
,DIAGNOSIS
(ICDA CODE) ?
ALL
HOSPITAL
ADMISSIONS
650
640
500
412
483
250
009
620
427
466
C 1tan i ty F`os') 3 to 1 �
Sonta ROsa F;c.:.or is l Rospi to l
$ 855
$ • 370
$1,031
$
310
$ 0
$ 0
$1,099
$
335
$ 150
$ 255
$ 0
San;a Cosa General haspital
743
0
0
315
1,375
0
0
0
0
0
2,055
1,626
0
397
0
0
Heoldsburg General Rospital
554
491
392
335
.0
0
300
2G9
0
0
0
0
0
0
1,C05
0
0
k,'arrack fledicol Center
Scnc.:a ila i l e / District Kosp i to l
557
389
287
193
821
0
0
0
63?
326
0
Poln Drive r'aspital
657
39-9
0
215
0
390
0
18j4
583
6 4
0
-M4
533
503
0
0
0
235
0
0
0
0
Hi l lcrest i;aspital
Peto1um-3 General K-- spital
6147
0
0
0
0
1,030
0
0
0
0
0
Drc:. -kwcsd vcspital of Pacific
705
0
0
0
0
0
0
0
0
0
0
Cc-�.jnity haspital AveraSe
$ 652
$ 323
$ 511
$
275
$ 851
$ 855
$ 633
$
335
$1,100
$ 303
$ 0
County Ensr71tcl
C . "Unity Rospitol of'S =cm
$ 777
$ 512
$ 300
$
0
$ -0
$ 917
$3,1C9
$
0
:;i 862
4 €319
$ 0
I/ Average payments. are computed from Medi -Cal expenditures for covered inpatient hospitalization. Payments exclude other coverage and patient liability.
2/ These ten diagnoses were selected as being the most costly to the Medi -Cal Program of total acute hospital inpatient care during the report period (listed in descending order of cost).
These diagnoses are:
ICDA 650 Delivery without complications ICDA 250 Diabetes mellitus
ICDA 640 Abortion induced for medical indications ICDA 009 Diarrhea! disease
ICDA 500 Hypertrophy of tonsils and adenoids ICDA 626 Disorder of menstruation
ICDA 412 Chronic ischemic -heart disease - ICDA 427 Symptomatic heart disease
ICDA 486 Pneumonia, unspecified ICDA 466 Acute bronchitis and bronchiolitis
TOTAL PATIENT DISCHARGES, BY ACUTE GENERAL HOS. -AL, BY GEOGRAPHIC RESIDENCE OF PATIENT
-ONOMA COUNTY, CALIFORNIA, NOVEMBER, 1974
Z.
RESULTS OF OUESTIONN?1IRT nEGA_RD "r N(= FOS"ITT.L EXPA'N'SION
SEN`j' TO FESIDEl'TS OF ROHNFT'T PAR.K & COTATI
The following paragraphs prefaced the questionnaire:
The Petaluma Ilosp ital District (dba Ilillc _ est Nospit a.l) includin<° Rohnert
Park, Cotati, and East & West Petal'=a, is pl anninc for expansion, either
on its existing site, or on another site more geoaraPhically central within
the District. Comprehensive Health Manning of Sonoma County is seeking a
single hospital to serve southwestern Sonoma Count.7, rather than several
smaller ones. It is their feeling that one larger hospital can operate
more efficiently, provide more complete services, save consid.er,�Ible money
in construction costs and provide hia-her nuali t-7 c,-re than woul(" be tre
case if two or more smaller hospitals were built and operated. They have
also estimated that Rohnert Park's population coulei not support a hospital
of its own until at least 1990.
In light of the above, the Board of Directors of Hillcrest is very interested
in knowing if the residents of Rohnert Park and Co' --ati would use an enlarged
H.illcrest Hospital in the future. In this regard, please answer the follow-
ing questions.
(Wording approved by the Board of Directors of Hillcrest Hospital at:.
a Special Meeting held October 17, 1.974)
f SENT TO RESIDENTS OF R-,41;IERT PARK
& COTATI
RSHNERT PRRK RESULTS
3971 Sent, 737 Returned (18.55% Return)
YES
No
Number Percent
Number Percent
1)
If Hillcrest enlarged and modernized on its present
site, would you use the hospital facility?
247
360
438 640
2)
If Hillcrest relocated to a more geographically central
location with easy freeway access and built a modern
100+ bed hospital, would you use the facility?
442
690
198 310
3)
If property tax moneys were necessary in order to build
a hospital within the District, would you support a bond
election if:
a) Hillcrest remained on its present site?
119
220
418 780
b) Hillcrest relocated to a more central location?
434
670
210 330
4)
Do you now have a physician?
678
920
- -- - --
If yes, where is he located?
Number Percent
Petaluma 84 120
Rohnert Park 165 24%
Cotati 105 15%
Santa Rosa 167 25%
Other 158* 23% *(It should
be noted that
of
this number, 89
were Kaiser subscribers.)
5)
If you have been hospitalized within the last
five years or so, where did you go for your care?
Number Percent
Petaluma 113 21%
Santa Rosa 235 43%
Other 195 36%