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Hospital officials – who called the decision “extremely difficult” – said the layoffs go into effect Jan. 15.
Siri Nelson, who joined the hospital last year as its newest chief administrative officer, said no direct patient caregiver positions were eliminated.
“All were support and administrative in nature,” she said.
The jobs affected included six managerial positions and 13 others across all areas of the hospital, including union and exempt positions, Nelson explained.
Nelson said the staffers who were laid off will be offered the chance to take open jobs in the Sutter system or be placed on a hiring list that would give them hiring preference.
SEIU United Healthcare Workers-West, which represents some of the workers at Sutter Lakeside, did not have a response on the situation this week.
Jan Emerson, spokesperson for the California Hospital Association, said they're seeing hospitals across the state having to lay off employees, halt wage increases, implement hiring freezes and even shut down programs because of the current economy.
“It's not uncommon,” she said. “It's been happening across the state in large hospitals and small hospitals as a result of the economy.”
Nelson and Tammi Silva, director of the hospital's marketing department as well as the Sutter Lakeside Foundation, explained that the hospital has had significant decreases in patient volumes, which they attribute to a mix of factors – population trends, patient mix, decreased insured patient market and duplication of services by providers in the area.
Early in 2008 the hospital was granted Critical Access Hospital designation, which capped the hospital's number of beds at 25. Although at one point they had as many as 69 beds, the hospital reported that it had never been close to that high number.
Nelson said that critical access designation didn't affect the current situation. Sutter Lakeside, she said, made sure patients had the right level of care, whether it was at the hospital, at home or in other care facilities.
She added that the designation actually helped Sutter Lakeside's financial situation, because it provided significant reimbursement for services provided for some patients.
Across the lake, at St. Helena Hospital Clearlake – also a Critical Access Hospital – the situation regarding patient population looks better.
Jeff Davis, spokesman for the St. Helena Hospital Clearlake, said they had an increase in patient census during the last half of 2009.
“Based on our volumes continuing to rise, we have no plans for staffing reductions at this time,” Davis said this week.
Sutter Lakeside's inpatient numbers trending down
The issue of patient numbers isn't new, and Sutter Lakeside's patient population hasn't kept pace with the growth in the county's population, Nelson said.
“This has been a challenge for Lakeside for the last couple of years,” she said. “Our volume has continued to decline.”
Based on a historical review, Nelson said the current hospital patient population is the same as it was in the 1970s, when Lake County's population was half of the current estimate of close to 65,000.
Sutter Lakeside's goal for 2009 was that the average census would level out at 23, but during the past year the average hospital census was 19.6 patients, which was 9.2 percent less than the hospital's budget estimated, according to Silva.
She explained that the 2009 budget already showed a 23.1-percent decrease to account for the 2008 census drop.
Overall, the hospital census was down in 2009 by 28.1 percent from its 2007 levels, said Silva. That is a change of approximately 9,937 patient days in 2007 to 7,144 patient days in 2009.
That put the employee-to-patient ratio at a higher number than budgeted. Sutter Lakeside reported that its number of full-time employees per patient was 7.13 in 2009, higher than budget of 6.51. For 2010, they've budgeted 6.2.
Still, based on the drop on patients, the hospital's latest benchmarking report showed that they were 38 full-time employees higher than their compare group, and were using considerably more staff hours than most hospitals to do similar volumes of work, which resulted in added costs.
So far, they've reduced staff by attrition – leaving positions unfilled after people resign or retire – and recently implemented a voluntary layoff option. However, more staff cuts were needed, especially in departments that didn't flex to adjust with patient loads, Nelsons aid.
Silva said the overarching message is that the reduction wasn't the fault of hospital staff members. “There are forces outside of their control that led to this.”
Another factor affecting patient numbers is technology, which has resulted in procedures that once required hospitalization becoming outpatient procedures, and also has raised the standard of care but at a higher cost. Where, in the 1970s, an x-ray was the standard, today it's CT scans, MRIs and PET Scans, which require multimillion-dollar machines, Nelsons aid.
The hospital no longer offers some services, like dialysis, which Nelson said isn't a core hospital competency and which is offered by other local health service providers.
As for emergency room numbers, both Sutter Lakeside and St. Helena Hospital Clearlake show increases between 2000 and 2008, according to data provided to Lake County News by the Office of Statewide Health Planning and Development.
Between 2008 and 2008, Sutter Lakeside grew from 1,002 to 1,411, while St. Helena Hospital Clearlake rose from 565 in 1000 to 778 in 2008, with a peak of 1,019 in 2002, according to the data.
Economic factors become more exacerbated
The economy and the local jobless rate – edging toward 18 percent – also are believed to have an impact on who is, and isn't, seeking care, Nelson said.
Anecdotally, she's hearing of people putting off procedures because they don't have insurance or simply can't afford it. That includes not only major surgery but preventive services, like mammograms and colonoscopies.
The hospital's nonprofit mission guarantees care. “We take anybody, regardless of their ability to pay,” she said.
They also have hard evidence of economic impacts on patients.
This past November, the hospital's dollar amount for uninsured care doubled from the average that had been established during the year's previous 10 months, Nelson said. In other words, twice the number of people were paying for their own services out of pocket in November.
“That's significant,” said Nelson.
Nelson added, “I don't know if that's going to be a trend.”
They said they believe that hospitals around the state and the country are facing similar challenges because of the economy and the growing number of uninsured.
Emerson said a study conducted last spring showed that hospitals across the state have been affected by the economic downturn in several ways.
“We've seen a substantial increase in uninsured patients,” Emerson said, with many of those people turning to emergency rooms.
They're also seeing a decline in elective procedures, said Emerson, which often are the money making procedures for hospitals, helping to offset the costs incurred in emergency rooms.
Lake County Health Officer Dr. Karen Tait said her office attempts to track the complex issues of utilization of the local health care system.
“Public Health has a general, overall interest in access to care issues but we don't really have a method of systematically tracking or analyzing all of the different angles to it,” she said.
The California Department of Public Health also told Lake County News this week that they also don't track the impact of the economy on health care access.
Tait said a local collaborative process is getting under way to do a countywide health needs assessment. A request for proposals has just been put out to seek a consultant.
“That process is the way that we in public health as well as others will be able to get a handle on what is impacting local people here,” said Tait.
She added, “The economy has to be a big factor,” regarding the kinds of trends Sutter Lakeside is seeing.
Tait said the information about Sutter Lakeside's patient trends is the kind of information that would go into the needs assessment.
“It really needs to be looked at systemically,” Tait said.
“Now is a really interesting time to do a needs assessment due to the changing conditions,” she continued. “It's sort of a moving target.”
Nelson and Silva said they didn't know yet if further staffing reductions would have to be made. Silva said they have to be good stewards of resources in order to preserve health care for the community.
Nelson said they have to always staff for patient volume.
“It's a conversation we have every day,” she said. “Our hope is to not have to do a reduction in force but we need to be very diligent to staff every day to every patient that we have.”
She added, “Sutter Lakeside is not alone in this conversation.”
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Reginald Bruce Mills, 21, and Brandon Scott Saulter, 19, both of Lakeport, were arrested Monday on charges of burglary, and possession of stolen property and burglary tools after breaking into Visions of Avatar, as Lake County News has reported.
On Thursday, Lt. Brad Rasmussen of the Lakeport Police Department said the agency's continuing investigation into several burglaries that occurred around the city in December had yielded evidence that linked Mills to at least one of those crimes.
On Wednesday Lakeport Police officers conducted a parole search at Mills' Armstrong Street residence, where they found numerous pieces of jewelry that they suspected were stolen from The Healing Earth on Main Street on Dec. 24, Rasmussen said.
Rasmussen said seven of the items were positively identified by the business owner on Thursday.
He said Lakeport Police will seek criminal charges for additional counts of possession of stolen property and burglary against Mills, who remains in custody at the Lake County Jail.
Lakeport officers are continuing their investigation of all of the recent Lakeport burglaries, Rasmussen said. They're evaluating other evidence recovered during the investigations in an effort to identify additional suspects and solve other cases.
Several of those other burglaries involved smashed windows as the suspects broke in and stole petty cash and other items, police reported.
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Lake County Health Services expects local vaccinators to receive more than 10,000 doses of vaccine over the next couple of months, which should about double the amount of vaccine that has arrived in the county to date, according to county Health Officer Dr. Tait.
Tait said the expected doses will be sufficient to immunize approximately one in five Lake County residents. Children under 10 years of age require two doses of the vaccine.
Although additional supplies of vaccine may follow, details are still pending and most of the planned vaccination efforts for the 2009-10 influenza season are likely to be completed by March, she reported.
“The interest has waned a little bit but the need is still there,” Tait said of H1N1 vaccinations.
Although those people who are at increased risk for complications from influenza are still most strongly urged to get vaccinated, anyone over age 6 months of age can now receive the vaccine. This includes people over 65 years of age, who had previously been asked to delay vaccination in order to make scarce supplies available to most susceptible groups.
Lake County Health Services currently offers H1N1 vaccine at no cost on a walk-in basis at its location at 922 Bevins Court in Lakeport on Tuesdays between 3 p.m. and 4 p.m. For those members of the public who cannot come at that time, scheduled appointments are available by calling 707-263-1090.
Tait reported that Public Health plans to schedule one or more mass vaccination clinics in January, starting at the south end of the lake. Information about specific dates and times will be advertised in the near future.
Many local doctors’ offices, clinics, and some local pharmacies also provide the vaccine. A small vaccine administration fee may be charged, but can be billed to health insurance companies.
Although the amount of influenza illness in the community appears to be declining, there are still good reasons to get vaccinated, according to local health officials.
The amount of influenza activity remains higher than usual for this time of year and the possibility of another wave of Pandemic 2009 (H1N1) in the months to come still exists. The vast majority of current influenza is attributable to the pandemic strain.
Tait said the community can also expect to see the H1N1 strain again as part of the annual seasonal influenza cycle.
She said certain individuals are at risk for severe illness from H1N1 influenza, including infants and young children, pregnant women and people of any age with chronic health conditions.
Updated information resources include the following:
– Revised fact sheet for people 65 and older to reflect the fact that supplies of the vaccine to protect against the 2009 H1N1 virus are increasing and many places have opened up vaccination to anyone who wants it. CDC is now encouraging those who have been patiently waiting to receive the 2009 H1N1 vaccine, including people 65 and older, to get vaccinated depending on local supply.
www.cdc.gov/h1n1flu/65andolder.htm
– About 2009 H1N1 flu: Describes 2009 H1N1 flu and five steps to take if you get 2009 H1N1 flu or seasonal flu. www.cdc.gov/h1n1flu/abouth1n1.htm
– 2009 H1N1 flu may be more serious for some: Describes people at high risk for developing flu-related complications. www.cdc.gov/h1n1flu/risks.htm
– Know the symptoms of flu: Describes symptoms that people who have the flu often feel and how long people with the flu should stay at home. www.cdc.gov/h1n1flu/symptoms.htm
– Know the emergency warning signs: Describes "emergency warning signs" in adults and children that should signal anyone to seek medical care urgently. www.cdc.gov/h1n1flu/warningsigns.htm
– Flu germs are spread from person to person: Describes how the flu is spread and how to keep yourself and others healthy during flu season. www.cdc.gov/h1n1flu/germs.htm
– When to get medical help for fluid loss: Describes when to get help for fluid loss. www.cdc.gov/h1n1flu/fluidlosshelp.htm
– Information on how to treat dry cough. www.cdc.gov/h1n1flu/treatdrycough.htm
– Treat other flu symptoms, such as sore throat, chills, aches, pains, congestion and stomach problems.
www.cdc.gov/h1n1flu/treatsymptoms.htm
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Brandon Scott Saulter, 19, and Reginald Bruce Mills, 21, both of Lakeport, were arrested shortly before midnight on Monday, according to Lt. Brad Rasmussen of the Lakeport Police Department.
They are alleged to have burglarized Visions of Avatar, a medical marijuana dispensary just outside the city limits, according to Rasmussen.
Lakeport Police Officer Jake Steely was on patrol that night and saw the two men in the 2700 block of S. Main near Rotten Robbie's gas station. Rasmussen said Steely made a consensual contact with the two and found them in possession of marijuana.
Rasmussen said Steely recognized Mills as being on parole for a burglary charge, and Saulter had a misdemeanor arrest warrant out for him.
While doing a parole search of Mills, Steely found not just marijuana but t-shirts from the store and other property alleged to have come from the establishment. Rasmussen said Saulter allegedly was carrying a bag containing marijuana, marijuana pipes, a scale and other paraphernalia.
Steely determined they had just burglarized the dispensary and arrested the men for possession of stolen property and burglary tools, said Rasmussen. The Lake County Sheriff's Office added a burglary charge.
After arresting the men, Steely contacted the sheriff's office, which sent deputies to investigate the burglary.
Capt. James Bauman of the Lake County Sheriff's Office said one of the suspects allegedly told deputies that they went to the dispensary with the intent to burglarize it.
He said deputies found that a hole had been pried in the building's tin siding in order to enter it. Smoking pipes and rolling papers were taken, and the suspects allegedly found and pried open a lock box containing an unknown amount of marijuana.
Bauman said investigators still aren't sure of exactly what was taken. “We're still waiting for an itemized list of items stolen from the business owners.”
Both Saulter and Mills remained in the Lake County Jail on Wednesday, according to jail records.
Lakeport has been hit by a rash of commercial burglaries over the past month, including a theft of about 20 firearms from a commercial storage locker earlier this week, as Lake County News has reported.
Rasmussen said police are investigating whether Saulter and Mills might have had anything to do with those earlier burglaries. “We don't know at this point for sure,” he said.
Bauman said he's been checking with sheriff's office sergeants about burglaries in other parts of the county.
So far he's heard back from Sgt. Gary Hall, stationed in Lucerne, who is reporting a spike in residential burglaries in that area. However, he said he doesn't currently have statistics on the crimes.
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The fire, reported just after 2 p.m., occurred in a home on Rosemont Drive, according to Northshore Fire Battalion Chief Jamie Crabtree.
The cause, said Crabtree, appeared to be a malfunctioning water heater.
“The homeowner noticed something wrong, came out and actually got the gas turned off,” said Crabtree.
Using a garden hose, the homeowner was able to control the fire, but by then it already had gotten into the attic space. Crabtree said Northshore Fire crews got there and opened up the attic to extinguish the fire.
Eight firefighters and four engines responded, Crabtree said. It took firefighters just over an hour to get the fire out and mop up the scene.
Crabtree estimated damage at between $5,000 and $10,000.
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The facsimile device was found by a Caltrans crew picking up trash along Highway 20 east of Highway 16 shortly before 10 a.m. Wednesday, according to California Highway Patrol Officer John Waggoner of the Williams CHP office.
Waggoner said the 8-inch-long object – found a short way off the roadway inside the Colusa County line – was constructed of PVC pipe, was a few inches in diameter and had caps on each end.
He said Caltrans immediately notified CHP, which in turn contacted the Butte County Sheriff's Office's explosives unit.
Waggoner said the bomb squad arrived at around 1 p.m., at which time the CHP completely closed down the highway.
He said Caltrans shut down traffic at Williams and CHP officers from the Clear Lake office diverted Highway 20 traffic onto Highway 16.
The bomb squad used a robot to help deal with the device, which they hit with a type of cannon that blew one side of it off, Waggoner said.
“They were able to see inside and saw that it was nothing,” said Waggoner, noting there were no explosives inside and no electronic device.
CHP's Ukiah Dispatch reported that the highway reopened shortly after 2 p.m.
Waggoner said such bomb scares aren't common occurrences.
“When we come across something like this we will take every precaution and make sure that it isn't an explosive device,” Waggoner said.
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