As many as 100 supporters and opponents of the proposed merger of St. Joseph Health System, the parent of Queen of the Valley Medical Center, with Providence Health & Services attended a public meeting at City Hall on Thursday morning to comment.
The meeting was hosted by the state Attorney General’s office as part of the regulatory review of the merger.
Providence Health & Services is the third-largest not-for-profit health system in the United States and serves Alaska, California, Montana, Oregon and Washington.
More than a half dozen community groups praised the merger, which would create a new nonprofit called Providence St. Joseph Health. They said it would improve Queen of the Valley’s ability to provide services in Napa County.
Queen of the Valley registered nurses, who are involved in protracted negotiations for their first contract, said they feared reduced services from an enlarged health care organization.
“I support forming the new organization,” said Queen CEO and President Walt Mickens. The two companies have similar missions and “with this partnership we’ll have the resources and expertise” of a combined and larger organization.
Benefits will include increased access to care and more clinical partnerships, new services and more innovation, said Mickens, who called this “a perfect partnership.”
“We do not intend to reduce jobs” or services as a result of this merger, Mickens said.
Dr. Susana Gonzalez, who works at the Queen, said the merger “will enhance our ability to provide excellent clinical care to this region.”
As an example, she spoke of programs the Queen operates that work to help patients more effectively manage chronic diseases.
“We need good partners to do this work,” she said. “This partnership is what Napa needs.”
Not everyone agreed.
The California Nurses Association is asking California Attorney General Kamala Harris to deny the merger.
According to a news release from the CNA, nurses remain “deeply troubled … about access to essential healthcare services, patient safety and the working environment” in St. Joseph Health System and Providence hospitals.
Queen registered nurse Leigh Glasgow said she was also troubled about the proposal to create “a vast new health care system.”
Registered nurse Mary Lou Bahn said she was concerned about how the Queen would fare as part of an even larger health care organization. “Are we going to be a little fish in a big pond? Are we going to be forgotten in the process?”
Bahn said she was also concerned that the merger could affect the as-yet-unnegotiated CNA union contract. Nurses voted to join the CNA in 2013, but have yet to sign their first contract during protracted talks. This has sparked occasional picketing outside Queen of the Valley.
Nurses’ concerns about patient safety and staffing levels and other issues need to be addressed, she said.
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Registered nurse Marc Ebeling argued that there was “no financial necessity for this merger.”
He wondered what might happen after the deal is completed. The Queen has already outsourced some services, such as renal care. If the merger is approved, “do we see other services evaporate?”
Nurse Crystal Malinowski said that the lack of a signed union nursing contract “has led to an exodus of nurses to other hospitals.” By her calculation, 151 nurses have left the Queen in the past three years.
“We have had more nurse turnover recently,” St. Joseph Health spokesoman Vanessa deGier said after the meeting. The Queen averages about 18 percent turnover currently and the national average is 14.6 percent, she said.
DeGier attributed this to multiple factors, including wage increases that have not been finalized because of the unsigned union contract and nurses who have retired.
Representatives from local nonprofits praised the proposed merger.
“Queen of the Valley Medical Center has made a positive impact in our community,” said Community Health Initiative Executive Director Elba Gonzalez-Mares.
“We are thrilled and fully support the partnership” because it will ensure that “organizations like ours can continue to address the health care needs of our community.”
“It makes sense,” said Fernando Diaz, a spokesman for Ole Health. “I support this merger.”
“Our partnership with St. Joseph has been an essential part of our ability” to help clients, said Tracy Lamb, executive director of Napa Emergency Women’s Services (NEWS). “We trust the administration of the hospital to know what is in the best interest of our community.”
The merger is a good idea, said George Porter, chairman of the Queen of the Valley Medical Center Foundation.
“Bigger businesses get better prices,” which will help make expensive medical equipment and services more affordable. “That helps everyone,” he said.
Representatives from Operation Access in Napa, the Napa Valley Coalition of Nonprofit Agencies, On the Move, and the Napa Chamber of Commerce also spoke favorably of the merger, said deGier.
A final decision on the merger could be made by the end of May or early June, she said.
As of 2015, Providence’s services included 34 hospitals, 475 physician clinics, senior services, supportive housing and many other health and educational services. The health system and its affiliates reportedly employ more than 76,000 people across five states.
St. Joseph Health is smaller. It includes 16 hospitals, physician organizations, home health agencies, hospice care, outpatient services and community outreach services. It serves patients in California, Texas and Eastern New Mexico. As of June 2014, it had a reported 24,733 employees.
Both systems maintain a strong tradition of Catholic health care but also include non-Catholic health care affiliates. The Sisters of St. Joseph of Orange will continue to sponsor the Catholic heritage of the hospitals.