Merger Talks Help to Defuse Hospital Feud

For 10 months, former Ventura County administrator Harry Hufford has been leading secret talks on merging the county’s public hospital in Ventura with a private competitor down the street--or even moving the county hospital to Oxnard, The Times has learned.

But after numerous sessions, little progress has been made.

County Executive Officer Johnny Johnston hired Hufford to broker the meetings between Ventura’s rival public and private hospitals--Ventura County Medical Center and Community Memorial Hospital.

The hospitals, located two blocks apart, have waged a bitter war for a decade, competing for patients and squaring off over costly ballot measures. Hufford, who resumed work as a consultant in March, continued talks with Community Memorial that he initiated as the county’s interim chief administrator.

Johnston said last week that progress has been painfully slow.

The two sides have agreed so far on one issue: the county’s need to replace antiquated kitchen and laboratory facilities at its hospital in central Ventura.

But the central issues of merging services or one day assuming control of St. John’s Regional Medical Center in Oxnard are far from resolution.

“You have to wait for the opportunity to present itself,� Johnston said last week. “It doesn’t seem to make sense right now. But that doesn’t mean it won’t make sense next year or the year after that.�

Both sides say the best result of the talks may be an end to years of fighting over patients.

“The dynamic has shifted dramatically,� said Community Memorial’s administrator, Michael Bakst. “It’s not one hospital dealing in isolation with another. It’s a climate of cooperation instead of a climate of negativity. And that’s a very positive step.�

For the past 10 years, Bakst has accused the county of upgrading its health facilities so it can go after privately insured patients. County Health Care Agency Director Pierre Durand has countered that his goal is only to create a public health system that operates efficiently and does not drain the county’s budget.

In 1996, Community Memorial spent more than $1.5 million to lead a successful ballot campaign that killed a proposed $56-million county hospital expansion. That was followed by the private hospital’s ballot initiative last year seeking to transfer $10 million in annual health care funding from the county to private hospitals. Though Community Memorial spent $2.7 million on Measure O, it was soundly rejected by voters.

But the bruising battle convinced Hufford, Johnston and other county leaders that it was time to find another way settle differences.

Hufford was nearing the end of a temporary stint as Ventura County’s chief administrative officer and was a natural choice to lead the talks, Johnston said. A retired Los Angeles County administrator, Hufford was a respected diplomat and already knew the players in Ventura County.

Hufford was also familiar with the complex issues involved in health care, because he helped merge city and county health services during his years in Los Angeles. Johnston hired him on a $125-an-hour consulting contract that ends in December.

Supervisors Frank Schillo and Steve Bennett have also been involved in the discussions, along with Durand, Bakst and other Community Memorial officials. The talks were never publicly announced, Schillo said, because no decisions were being made.

“We’re not under pressure to accomplish something,� Schillo said. “But I think the public wants these meetings. They don’t want to be dealing with a war between two hospitals on one street in Ventura. Competition between the two should be taken care of with discussions and never become a public problem.�

Johnston acknowledges that discussions have covered a variety of topics--including the possibility of merging the county hospital with Community Memorial.

Participants have also discussed whether it would make sense to move the county medical center to a more centralized location.

That could mean merging some county services with St. John’s Regional Medical Center in Oxnard or taking over the sprawling campus, Johnston said. But the latter would only be considered if the hospital chain that runs St. John’s should decide to pull out of the Ventura County market.

St. John’s hospital administrator Mike Murray said the facility is running at about 70% capacity and that its parent company, Catholic Healthcare West, has expressed no desire to sell it.

“I’m certainly willing to look at what options there are,� said Murray, who has been on the job for only one month and has not yet met with county officials. “Maybe there are ways to help out. But I can tell you unequivocally that we have no plans to leave this facility.�

Seismic Safety a Selling Point

St. John’s is attractive to the county not only because of its location but because its decade-old facilities meet the latest seismic standards. All California hospitals, including Ventura County Medical Center, are facing a 2008 deadline to complete costly earthquake retrofits.

But the county chief stressed that the talks have so far been hypothetical and that no deal-making for either a merger or a move has taken place.

“I’m not negotiating anything,� he said. “We’re looking for the best long-term answer to provide quality health care for the county.�

What’s more likely for the short term, Johnston said, are agreements to share services so the hospitals can avoid duplicating expensive units. Right now, for instance, Ventura County Medical Center sends some of its cardiac patients to Community Memorial for specialized treatment.

More of that kind of cooperation should occur, he said. Bennett, whose Ventura district includes the hospitals, agrees.

“My priority is improved communication so we have professional medical people who work cooperatively,� Bennett said. “They used to work more cooperatively together and we want to reestablish that.�

The first hint of a truce came in March, when officials announced one concrete achievement.

In exchange for Community Memorial supporting upgrades to Ventura County Medical Center, the county has promised not to extend the county’s low-cost health care plan to private-sector patients. Schillo had proposed expanding the program to the uninsured working poor late last year.

The county also agreed not to expand a network of clinics and to send some cardiac patients to Community Memorial.

Monty Clark, regional spokesman for the Healthcare Assn. of Southern California, said cooperation between public and private providers is becoming more common. And any forum that helps hospitals respond to tumultuous changes in health care systems is a good thing, Clark said.

“All hospitals are going to have to work together to maintain access to health care for all patients,� he said.

Johnston said he intends to continue the talks and extend them to include other private hospitals in Ventura County.

Hufford said he, too, hopes the talks will continue.

“The good news is, we are working together,� Hufford said last week. “Good public health policy benefits every resident of Ventura County.�

Not everyone is rallying around the group’s efforts. Supervisor John Flynn said he is uneasy about the direction the discussions could take and thinks all supervisors should be informed about the talks’ progress.

“Cooperation between the two hospitals is important, as it is with other hospitals in Ventura County,� Flynn said. “But I probably would not be in support of a merger between the hospitals. I think the public always needs to have a public hospital and public clinics.�

That may be true, Johnston said. But it can’t hurt to talk.

“We should have been doing this all along. How do you avoid things like Measure O?� he said. “That’s the value of what we’re doing.�