Sit-ins and candlelight vigils this past February got the attention of the SF Chronicle as it brought into focus the critical fact that St. Luke’s one of the city’s oldest and most vital hospitals faces a possible shut-down as a Blue Ribbon Committee gathers to determine its fate on March 20.

Kevin McCormack Media Rep for California Pacific Medical Center one of the two corporate entities in control of St. Luke’s, sees the forming of a committee as a positive step.

McCormack was enthusiastic when he talked to the Mission Dispatch about the forming of a Blue Ribbon Committee as he admitted he was biased about the idea.

"I think having a committee is a great idea. It brings together all the experts that have lots of credibility. Their experience and knowledge will have a much deeper and wider scope of understanding."

And with that, I am hoping they working all together as a committee will help turn St. Luke's around giving it the direction and help it needs," said McCormack

Currently, there are over 20 people who have agreed to participate. It reads like a “who’s who” of the medical and business community; including some non-profits like The SF Foundation. Described as leaders in their given fields of expertise/experience. The list continues to grow until the series of meetings officially convene.

Yet, activists and community leaders like Jane Martin of the Bernal Heights Community Center have reservations. “CPMC & Sutter Health has not been fully disclosing exactly what their plans are,” she said. This is why we have reservations about the Blue Ribbon Committee,” said Martin.

Some fear that the committee will have more participants aligning with CPMC/Sutter than it will on the side of St. Luke’s. With many broad and sweeping points of view on the committee, would the needs of patients be swept way?

The 138-year-old St. Luke’s serves a significant portion of the city’s population. Yet it is situated in the Mission, Bernal Heights and surrounding areas. These parts of the city consist of working class families, immigrants and low-income people.

Activists and community leaders believe that CPMC/Sutter wants to close it down because it is not economically stable. Basically said, it costs money and does not have the financial return CPMC/Sutter expects.

“Most of the patients are MediCal, MediCare or simply uninsured,” said Dr. Benita Ann Palmer, MD who feels very connected to St. Luke’s. “The doctors and staff here are committed, they know that if they work here, they are not out to make money but to serve the community, especially the under-served,” she said.

Which brings to light the question, what is St. Luke’s losing money on? Exactly, what costs are causing a concern for CPMC/Sutter? St. Luke’s is a non-profit hospital originally founded by the Episcopalian Diocese of SF in 1871. Its mission is to serve the poor.

Kim Curtis, communications rep for United Healthcare Workers – SEIU, noted
“One of our researchers took a look at the St. Luke’s financial data. The most significant expenses were the following: Physician Professional Fees, Other Professional Fees, Purchased Services and Employee Benefits.”

The Fairness Foundation noted in its study posted at hospitalvictims.com that St. Luke’s charges more than Johns Hopkins Hospital — ranked as one of the finest hospitals in the nation. St. Luke’s “hospital mark-up costs are at 352 percent whereas Johns Hopkins is 122 percent.”

Nora Johnson of Medical Billing Advocates of America, reviews expense reports and invoices on behalf of patients and employers. She explained, “Mark-up refers to items that hospitals purchase. Then those items are provided for and billed to patients.”

“Such items can vary, from item to item,” Johnson said. “For instance, hospitals will bill for IV solutions as much as $70.00 per bag. But purchased in bulk, hospitals actually pay about 0.10 cents per bag. That is a mark-up,” said Johnson.

In addition, Administrative Service expenses have increased pretty significantly at the hospital, Curtis also noted.

Johnson agreed as she said, “Paperwork has increased all over the place (in all hospitals). It is the cost of doing business,” Johnson said.

Looking at St. Luke’s situation, “when there is a 300 to 500 percent mark-up, the cost of paper work is no big deal,” she said. “Most business in general are considered successful if they have a 5 to 6 percent profit,” Johnson said.

In January, the SF Chronicle reported that CPMC received close to $70 million in tax breaks but only spent $5 million on charity care. In that article it was noted that St. Luke’s received less from CPMC over other CPMC hospitals, in that $70 million tax-break.

Palmer got more involved with the situation at St. Luke’s this past April. “I was an activist in my college days, so I used those skills to get the doctors aware of the situation and helped them to provide public testimony,” she said.

She is confident that Dr. Kenneth Barnes, MD will be a good representative of the doctors at St. Luke’s for the committee. He accepted the invite to join the committee.

“I see myself, particularly in terms of the Blue Ribbon Committee, as representing the needs of the community,” said Barnes who has been at St. Luke’s most of his medial career.

Palmer knows the Mission District area well for over 32 years, and like Dr. Ken Barnes, has been at St. Luke’s a long time.

She contributes to the daily blog online at the Save St. Luke’s web site.
She confided that being an activist and a doctor is “like having two full-time jobs,” said Palmer. To have to struggle with all the administrative issues with CMPC/Sutter is a real obstacle to practicing medicine,” she said.

“This hospital needs to stay open,” said Jane Sandoval, RN who has been at St. Luke’s for over two decades. “During the past three years,” said Sandoval, “CPMC/Sutter has been systematically closing St. Luke’s by shutting down or transferring out essential care units,” she said.

“The out-patient psychiatric unit was shut down, then the Worker’s Comp clinic was moved to the UC Davies Medical campus,” said Sandoval.

She continued, “Neonatal Care, three nursing stations, all our therapy departments, both physical therapy and occupational therapy, all taken away in the last three years,” said Sandoval.

“This past October, a surgical unit was shut down,” added Sandoval to the litany of units and services closed or moved out of the hospital. She fears that CMPC/Sutter’s “master plan” is to shut St. Luke’s down.

Palmer agreed as she said, “it is a very ambitious master plan.” As word in the medical circles goes round, “St. Luke’s is not able to attract new recruits from medical school if the place is closing,” she said. The hospital is short-staffed but the needs keep growing.

“Homeless patients are often transferred to us from other areas of the city because St. Luke’s manages the complex needs of the community,” said Sandoval.

“We have been fighting an on-going battle.We struggle daily and that is a stress to doctors,” she said. Palmer also mentioned the closing of the 10th Floor surgical ward and is puzzled as to why? “It was just remodeled,” she noted.

Palmer and Barnes like so many dedicated doctors and staff only wants to provide the best in medical care to a population desperately in need of it. Palmer hopes the committee which has been guided by the efforts of SF Supervisor Michela Alioto-Pier and SF Dept. of Health Director Mitch Katz, MD, will listen to the doctors of St. Luke’s.

Interestingly, Katz as director oversees one of the city’s largest departments. According to the March issue of the Sunset Beacon, it has an annual budget of over $1 billion.

Katz proposes to cut about $54 million, affecting thousands of people who rely on city outreach services to meet their medical needs.

Curtis said that the union has not received an invitation to the committee. Neither has the California Nurses Association, according to spokesperson, Shaum Preston. “We used to have a cordial relationship with CPMC/Sutter,” said Sandoval. “But it’s not warm and fuzzy, now, it is very impersonal and distant,” she said.

McCormack confirmed that invitations have been sent out to the California Nurses Association and the labor unions. "Invites were sent out, no response from them as of yet," he said.

“The current make up of the committee seems to be a little too heavy on Hospital executives,” said SF Supervisor Tom Ammiano. He serves the Mission District.

“But I'm hoping there will be a sincere effort to ensure balance in this process," he said. Ammiano stated he would do all that he can to save St. Luke’s.

Ironically, so far, as of Feb. 28, at a public hearing, the SF Board of Supervisors voted to save number of landmark trees. On that list is the old fig tree outside of St Luke’s. Hopefully, the Board of Supervisor’s and many others can do more than just save the old tree sitting outside of St. Luke’s, but save the hospital itself.

“If St. Luke’s were to close,” said Dr. Barnes, “where will all the people go? It is not fair to ask them to go elsewhere,” he said. Barnes who considers it a privilege to serve the under-served hopes it the committee will have a positive outcome. “I will do my best to convey to the committee and to CPMC/Sutter that to close St. Luke’s would be a disastrous mistake,” Barnes said.

To learn more about the struggle and to help the hospital visit: http://www.savestlukes.org/


Page 1 of 1