Coastal
Post Online
January
2002
Making MGH Earthquake Safe
By Norman Carrigg, MD
What with the media absent, a special open
December 6 meeting at Marin General Hospital (MGH) of the Marin Healthcare
district board was not reported. MGH, like all California hospitals, has to
comply with the seismic upgrade requirements of SB 1953.
A modest amount of retrofitting by
2008 will be required by law for the East and Central hospital wings. Some has
already been done. This could suffice to 2030. Stephen Mayer, the District
board's financial consultant, using historical data as a basis, indicated that
funding retrofitting should not be a problem for the future.
Where we go now is more complicated
than the simplistic approach that I described to make the hospital earthquake
safer.
Margaret Sabin, the CEO of the two
Sutter Health Marin County hospital operations, wants the lease of MGH to Sutter
Health extended ten years to 2025. It expires in 2015. Sabin, in addition,
wants to build a new acute-care wing. If acute care is transferred to a new
wing, much retrofitting would not be required.
Sabin is adamant that MGH remain part
of Sutter's "obligated group." As a member of Sutter's obligated
group, Sutter has the right to siphon out any hospital excess cash. What is
excess cash? Cash in excess of that needed for 14 days operation. Sutter, not
MGH, decides. In addition, MGH now is one of many hospital guarantors of
Sutter's aggregate debt. This is even more scary than excess cash transfer. MGH
is a winner but some Sutter hospitals are losers.
At this moment in Sacramento, there
is a lawsuit by the Healthcare Board to void the hospital lease and return MGH
to community control. Currently the suit is sidetracked by a statute of
limitations question being heard at the appellate level. The Healthcare board
alleges that the 30 year lease of 1985 is illegal.
There are some realities to consider.
There are no free lunches. Patient revenue will upgrade the hospital or build a
new wing in order to avoid a certain amount of retrofitting.
Suppose only seismic upgrade is done
which will carry the hospital to 2030? Money saved could be diverted to such
uses as a bonafide stroke center, for example, or other quality improvements.
The Sutter Health Marin County Chief Financial Officer, Svend Ryge, pointed out
that a decision about building a new wing could be delayed until 2003.
Certainly the elected board and its constituents (all of Marin except Novato)
will need to know a great deal more than they do now about retrofitting and/or
rebuilding.