Health care district moves forward with Dignity Health

Mark Twain Health Care District board members vote to renew its relationship with Dignity Health Wednesday.

The Mark Twain Health Care District voted on Wednesday to continue its partnership with Dignity Health, but on substantially different terms. About 30 members of the public attended the meeting where that vote was taken.

The board voted 4-0 on the first agenda resolution to approve the terms and provisions that have been debated and negotiated over the past few years. Board Secretary Ann Radford abstained; she currently works as a family nurse practitioner at Mark Twain Medical Center in San Andreas.

The board then voted 4-0 to put a measure on the June 5 ballot that will ask voters to approve or disapprove of the board’s decision. The result will be determined by a simple majority. Radford abstained from that vote as well.

The principle terms of the new agreement, previously covered in general by the Enterprise and available on the district’s website, include a termination of the old lease, the creation of a new lease, amended terms and bylaws and a transfer of a 49 percent interest in the hospital to Dignity Health.

Health care district board President Lin Reed provided some historical perspective for the decision.

“Almost four years ago, we were working through the sixth amendment of the lease,” Reed said. “We were hoping it would be a template, and we thought we were about done with the process by June 2016. But over the preceding 60 days, we had a lot of public attendance and a lot of people questioning whether there was a better deal out there or whether we could just run the hospital ourselves. So we knew we needed to do some due diligence. It’s your money and we needed to listen to the taxpayers. We had a request for proposal process. We needed to re-engage in a fair-market valuation because the previous one was (completed) too long ago and not specific enough. As for the overall template, the pillars of the term sheet that have been discussed are still in place, but the money amounts have changed. Everyone involved was dedicated to making the deadlines and I’m happy with it.”

“I think maybe members of the board don’t have a lot of comments because they’ve been living this for the last three years,” said Dr. Randy Smart, executive director of the health care district. “They’ve probably memorized these resolutions by now.”

“Institutional memory is critical,” said Marti Crane of Valley Springs. “We can see a lack of that in a lot of other places, but we have that here, so I just wanted to say thank you.”

“This decision captures the essence of what we’re trying to achieve, which is providing quality health care to residents of Calaveras County,” said Nicki Stevens, marketing and business manager at the hospital. “I don’t think we could achieve those terms if we didn’t continue our agreement with Dignity Health.”

Much of the public comment echoed that sentiment, with several attendees thanking the board for their decision.

“When this board formed in 1946, it had one mission,” said Smart. “That was to form and maintain a hospital in Calaveras County. In 1989, it was in trouble. In partnership with Dignity Health, it worked its way out of financial trouble. The hospital provides a huge economic benefit to this county. It has a huge payroll of about $35 million. If you multiply that by 30, that’s equal to about $1 billion. This decision gives the board the financial capacity to build clinics, create mobile clinics and improve children’s health.”

“But we’re not done,” Smart continued. “The voters have to ratify it with a simple majority. I intend to go out and educate the public. Legally, we’re not allowed to tell people how to vote, but I intend to be robust. If we go out and educate the public, June 5 could be a great day for the county.”

Smart also addressed the possibility that the board’s recommendation might not be approved by noting that it would be difficult for the district to be successful if it tried to operate the hospital on its own.


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