Reasons you should support the North County Healthcare Coalition (NCHC)

Recently, North County Healthcare Coalition, a new citizen group, has sprung up in North County. Go to the website at www.NCHealthcareCoalition.org to find out more. Its purpose is to provide a voice for residents in the Palomar Pomerado Health (PPH) district and to allow input regarding the direction our district is going. Together we can urge the district to adjust its vision for Hospital construction in North County and more wisely spend Proposition BB funds.

The recommendations promoted by NCHC call for the upgrading of Palomar Medical Center (PMC) in Escondido and the construction of a new hospital in San Marcos. This is a compelling alternative approach and deserves careful consideration in light of the latest information available.

Supporters of NCHC are stepping forward with a broad range of motivations. Here are some of the many reasons that have been clearly articulated for supporting the NCHC goals:

PPH has not provided a reasonable explanation for abandoning Palomar Medical Center (PMC) Initially we were told that it was prohibitively expensive to retrofit PMC. However, just recently reports were released which show that it would require less than $7 million to bring the existing non-seismic compliant portion of the hospital up to 2030 earthquake standards. We have also been told that PMC is 50 years old and much too small. Again, recently extracted information shows that over half of the facility is seismically compliant and that the hospital space is 31% larger than officially admitted. Over half of the facility is less than 20 years old and in fine shape. Decommissioning the hospital and downgrading it to other uses is a huge misuse of resources and seems to be primarily motivated by a desire to help private developers lure professionals from the downtown.

The plan to build in the ERTC is flawed. The ERTC mega hospital proposal is not what we were told it would be. Instead of a spacious healing campus, the actual plan calls for a beehive of government and private enterprise. Most of this will likely be exempt from building fees, property taxes and infrastructure improvement costs. Specifically, the hospital is shown to be nine stories high and topped by a heliport. It will take up about half of the site demanded, with the remainder of the site scheduled for up to 300,000 square feet of medical office space. Moving the location of community hospitals does not generate jobs. The only result will be siphoning these jobs out of the downtown area. All indications are that this project is uneconomic, inaccessible and unwelcome. Developers will be the winners. The citizens of North County will be the losers.

Although generally not understood, the small print in Proposition BB allows funds to be used for virtually any capital improvement PPH lays out in its FMP. Changing the FMP can change any and all promises relating to the downtown site or even the new hospital and can be done by a simple vote of the PPH board.

Proposition BB funds are not adequate to do all that was initially promised. In creating its budget, costs were expected to go up by only 5% a year. Actual costs have gone up about 30% in the first year and are still ballooning. Because the project is way behind schedule and costs are so far above original estimates, something will need to give. The district is claiming that additional revenue bonds and contributions will make up the shortfall, but it is not at all clear that this is possible. There is already talk about phasing in certain portion of the ERTC project. Expected shortfalls will force the FMP to be adjusted and certain projects curtailed or eliminated. Delays and overruns are a direct result of PPH failure to hit the deck with plans in place. A constantly updated FMP including all projects and adjusted to current costs is needed as decisions are being made. This is the only way to assure that Prop BB funds are spent wisely.

The promised conversion of PMC into a first class center after acute services have been removed is becoming unlikely. Initially we were promised that PPH administration offices would move downtown. This is unlikely for both operational and functional reasons. The obtained plans reveal an excessive amount of new office space in the new hospital and related development. Recently we were shown elaborate drawings for other conversion ideas. However, nothing binds PPH to the promises made about the downtown, especially not for the long-term. In fact, there likely will be little if any money left to make any improvements to the PMC site. A recent public statement has already claimed that the original $73 million dollars promised for this is looking more like $40 million now, and the PMC site has lowest priority.

The goal of having up to date medical centers in each of the three major communities is compelling. It is also a practical, effective use for Prop BB funds. It would make acute healthcare accessible and manageable without pitting San Marcos against Escondido in a “winner takes all” battle. It would also spare Escondido from making unsavory land use and zoning decisions. Less confrontation and more enthusiasm across the board will inevitably result from such a “win, win” strategy.

Four of seven PPH board members are up for election in November 2006. We hope citizen activism will serve as a motivation to provoke adjustment on these important issues. This board or one made up of new members should abandon the mega hospital strategy. A “three hospital” solution is optimum and most cost effective. Since they are authorized to make this change, why not decide this right now?

Decisions made now will have a deep permanent affect on North County. We must proceed with all due speed in creating additional facilities. However, we must make sure that the right decisions are made. Key decisions concerning hospital locations, size and function, should be based on the public interest, not for private profit.