A packed house turned out for a hearing Friday morning as the state Attorney General’s office considers a historic partnership between the health care networks that operate Queen of the Valley Medical Center in Napa and Adventist Health St. Helena.

The hearing at Napa City Hall gave proponents and opponents a voice about the intended joint operating company. This is the second such local meeting this summer. An earlier hearing was held in early July in Calistoga.

The plan to form the new group was first announced in April 2018. Under the agreement the two Napa Valley hospitals would be part of a joint operations agreement (JOC) that will tie together regional facilities of St. Joseph Health and Adventist Health and their medical staffs in unprecedented ways. The Queen is a member of St. Joseph Health.

The agreement would integrate clinical activities and services from the two health care groups through a new organization called ST Network LLC.

Deputy Attorney General Scott Chan, who hosted the hearing, invited members from the Queen and Adventist Health to speak first. The AG’s office can approve the Master Formation Agreement, reject it or approve it with conditions.

Elaine St. John, CEO of the Queen of the Valley Foundation, spoke in support of the partnership. The health care landscape is ever-changing, she said. “The proposed company will unite our two hospitals and enhance our ability” to improve patient health outcomes.

The partnership will also help recruit physicians, especially much-needed primary care physicians, to the Napa Valley, she added.

“Change can be challenging,” she said, but “we believe the JOC will offer solutions to the many challenges we face today.”

St. Helena Hospital CEO and President Steve Herber pointed out that the partnership “will make us integrate and coordinate our care for the community,” something that’s been needed for a long time. “We need to provide our care smarter, and I believe we’ll do that together.”

“This is about focusing on what’s best for our community,” Herber said. “We’ll bring together the best of each organization,” he said. “By working together, we can transform the health of our community.”

Joanne Hatch, nutritional services director at Adventist Health St. Helena, said the partnership will help us expand our footprint in Napa Valley” and “help strengthen health services in our community.”

“This is an opportunity to bring both systems together” for many reasons including improved patient care, said Jan Marie Roberts, a nurse practitioner at St. Helena Hospital. “It’s a win for all of us” and “in the best interests of our patients and colleagues.”

Elba Gonzalez-Mares, executive director of Napa’s Community Health Initiative, and Alicia Hardy, CEO at OLE Health also spoke in favor of the agreement. “The more we can do to pool our resources, rather than duplicate,” the better, said Hardy.

George Porter, past chair of the Queen of Valley the Foundation, spoke of creating efficiencies of scale and greater buying power of a joint company. “This is simply good common sense,” he said.

Healthcare consultant Rick Mace spoke in favor of the agreement. “Keep care local,” said Mace.

According to Mace, St. Helena and the Queen account for less than 55 percent of the hospital discharges for residents of Napa County. That means that almost every other inpatient is leaving the county. Kaiser makes up for 30 percent of the total discharges, without even having a hospital in Napa County, he said.

The combined services of the Queen and St. Helena hospital “should be able to meet the needs of much more than half of the counties total inpatients,” he said.

Not everyone agreed.

Retired Napa physician Jeff Reichel said he was concerned “about the growing power of hospital groups dictating” patient care including for both women and those with gender dysphoria.

Lisa Seran, representing Indivisible Napa, a progressive grassroots organization, asked the Attorney General’s office to consider several conditions for the agreement including eliminating religious restrictions on reproductive health care, assuring that transgender patients will not be denied health care and requiring charity care levels be maintained for the next 20 years.

“We want to make sure care is extended to all members of the community, regardless of situation,” said Seran.

“This merger would make two hospital chains even more profitable at the expense of Napa Valley residents,” said Paula Reimers, a Queen of the Valley respiratory care practitioner, in a statement from the National Union of Healthcare Workers. “We’re already understaffed at Queen of the Valley. If this merger goes through, we’ll be getting more patients without the staffing we need to care for them.”

The union has yet to secure a contract with the Queen, despite employees having voted to join the union in November 2016.

“I’m concerned about access to women’s’ health care,” said Mary Lou Bahn, a longtime Queen nurse. “We cannot have an organization that does not allow all women reproductive rights,” she said.

Under this affiliation, the names of the Queen and St. Helena hospitals would remain unchanged. Both entities would also retain existing employees, religious affiliations, licenses and capital assets, said a news release.

Registered nurse Leigh Glasgow criticized St. Joseph Health for reportedly falling short of its charity care obligations. She said the attorney general’s office should conduct a fresh analysis of both providers instead of relying on a previous study of St. Joseph Health that was conducted when it merged with Providence Health in 2016.

In Northern California, St. Joseph Health has four hospitals in this proposed agreement, including the Queen. This part of the partnership accounts for about 70 percent of revenues within the joint agreement.

The Adventist group has five hospitals as part of this agreement, including St. Helena Hospital, and accounts for about 30 percent of revenues within the joint agreement.

The new affiliation applies to a wide range of facilities, services and clinics. Those include Adventist Health St. Helena, Queen of the Valley Hospital, the St. Joseph Home Care Network, Santa Rosa Memorial Hospital, Adventist Health Howard Memorial, Adventist Health Ukiah Valley, Adventist Health Clear Lake, Adventist Health Vallejo Center for Behavioral Health, St. Joseph Hospital Eureka and Redwood Memorial Hospital.

Comments on the proposed partnership may be emailed to Deputy Attorney General Scott Chan at scott.chan@doj.ca.gov.

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