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Health care board sets its course for future

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Posted: Friday, March 8, 2013 8:51 am | Updated: 8:33 am, Tue Mar 12, 2013.

Newly elected Mark Twain Health Care District board member Randy Smart said the district is moving forward in a positive direction and hopes to tackle a number of important issues over the coming months.

The Mark Twain Health Care District, a public agency, was formed by a vote of the people of Calaveras County in a special election held Aug. 27, 1946. The political boundaries of the Mark Twain Health Care District comprised all of Calaveras County.

In 1989, the district partnered with St. Joseph’s Hospital in Stockton and that partnership affiliated with Catholic Healthcare West.

Mark Twain Health District retains 50 percent ownership in all of the facility assets while the day-to-day operations of the hospital are the responsibility of the Mark Twain Medical Center’s Dignity Health Corporation. The operational lease agreement with the corporation expires Dec. 31, 2019. The board appointed an ad hoc Lease Review Committee to determine the best process to use as it moves forward in evaluating an extension or renewal of the current agreement.

The district receives a property tax allocation each year from Calaveras County, which has been more than $1 million at times, and provides funding to provide direct support and education for the health care needs of the communities served by the district.

The agreement between the district and Dignity Health is perhaps the only one like it in the state, according to district CEO Daymon Doss. Robert Campana was largely responsible for negotiating the agreement, and one of the most interesting clauses written into the contract was the district would receive a portion of whatever profits the corporation earned during the lease.

“Whatever the profits over the history of the lease, the district is entitled to 50 percent of those profits,” Doss said. “To date, our share is $17 million.”

Smart said such an arrangement is “extremely unusual.”

“I don’t know exactly where the money is, or how accessible it is. My understanding is it’s being kept in the coffers of Dignity Health,” he said.

Smart said the energy level and “dynamic” is completely different this year.

“When a group has a new member or new composition, it develops a new personality and a new kind of energy,” Smart said. “I think that’s really exciting.”

It was only two years ago, when the hospital was going through a number of difficult changes, that Smart said the board on which he now serves was failing the community.

“Our recent healthcare problems are not the fault of CHW (now Dignity Health); it was our own board members who failed us,” he wrote, in a letter to the editor.

Smart said there was a primary care crisis in the county – a crisis that had been allowed to take place by the District Health Care Board and Corporate Board, which team up to run the hospital.

In an attempt to correct the problems he identified, Smart sought election to the district board and won in a landslide last fall. During the campaign, Smart said one of his top priorities would be to attract and retain more physicians. This goal has been achieved in part, although Mark Twain Medical Center continues to seek quality doctors.

Other goals the district board is pursuing include: a telehealth study; long-term contract with Dignity Health; offering scholarships for high school students; and establishing a new healthcare clinic in Angels Camp.

“We’re spearheading an outpatient telehealth study to look at the feasibility of providing remote specialty care to our patients who can’t otherwise get the care,” Smart wrote. “There is great momentum on this project and it’s very promising we’ll have services in place this year in our Family Medical Centers.”

The board is in discussions with medical centers across the state to learn more about the possibilities.

Doss said a full audit of the district’s books was performed, adding the financials for the past three years can be viewed on the district’s website.

Talks with Dignity Health regarding the district’s long-term contract for management of Mark Twain Medical Center are in progress, Smart said.

“That contract expires in 2019,” he wrote. While we (the board) own the land and the building, we lease it to a corporation (Dignity Health) for operations and services. We pay utilities,” which run about $70,000 monthly.

Doss said a lease review committee was formed, made up of Dr. Peter Oliver and District Board President Lin Reed.

“Their goal is to review the current lease and perhaps suggest amendments to that lease prior to it expiring,” Doss said.

Last year, the district came under fire when the Calaveras County Grand Jury released a report that contained some criticism. The district promised to make a number of changes in the wake of the report, and Doss said he is planning to make a presentation to the Grand Jury on March 6 to update it on the district’s progress.

“Grand Jury members have been attending many of our meetings,” Doss said. “It’s great to have them there.”

Another important goal the district commits it to is offering scholarships to high school graduates who have an interest in health care professions. The board is reviewing applications from all the local high schools and it will award scholarships after worthy students are chosen, based on their merits.

One long-term project the board is pushing is to partner with Mark Twain Medical Center Foundation and the hospital to build a multi-service healthcare clinic in Angels Camp.

“Important discussions are already occurring,” Smart said.

Doss said the district is eager to reach out to the community to share, “what the district is, and what the district is not,” with a commitment to transparency.

The board’s next meeting, which is open to the public, is at 7:30 a.m. Wednesday, March 27, in Classroom 3 at the hospital.

More information about the district can be found on its website at

© 2015 Calaveras Enterprise. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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