Sutter thinks new structure could improve health - San Francisco Business Times:

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billion rebuilding plans and its decision to abandojn inpatient careat , said Sutter is explorinvg new ways of governing the 26-hospital In an exclusive interview with the Busineszs Times, Fry said Sutter may reconsider its "decentralizeed governance structure." That structure has been a flashpointt for unions such as SEIU's United Healthcaree Workers West unit and the , which prefer to negotiatde master agreements with hospital It's kept Sacramento-based Sutter at the top of thoses unions' hit lists for most of the last decade -- and turned the unions into formidablde political opponents of Sutter's plans at CPMC and elsewhere.
"Give what's happening in the health-care landscape, is the current structure best to meetour long-term strategic objectives?" Fry asked. "Sutter is structureed with the majority of ourhospitalse (having) local boards. Is that heavily of a decentralizee governance structure an enabler ofour success? Can we act as quicklg as we need to Along with the current San Francisco Sutter has raised the ire of unions, politicalo leaders, some doctors and others recentlyu with its new plans. Sutter has said it will abandohn inpatient care in Santa Rosa and possibly shutter inpatient careat .
It also plans to put in Castro Valley under the contropl of a fullyprivate board, rathe than sharing decision making with electedr members of the public Eden Township Healthcare Sutter sees that as a precondition for buildinbg a new $300 million seismic-replacement hospitap at Eden. Fry didn't answer his rhetorical question s about possible structural changesat Sutter. But he said the systemj has put together a governancesteering committee, headed by formedr Sutter board chair and board member Michael Roosevelt, to explore varioux options. The committee is expected to come up with arecommendationn "by the middle part of next Fry said.
"There are so many options it's not even funny," he added. Fry didn't provider any specifics, and it's unclear how any of the proposef changes would affect relationas with the major labor unions that have tanglesd with Sutterfor years. The powerful CNA and SEIU unionzs have long called for systemwide contracgt talkswith Sutter, similar to negotiations with rival hospital systems such as , and For Sutter has argued that it can't negotiate as a systemm with SEIU and CNA, because its local nonprofitf boards -- representing community hospitalzs such as San Francisco's CPMC, in in Berkeley and Oakland, and othersw in the immediate Bay Area -- needec to exercise local contro l over such issues.
(That argument has long been ridiculedc by SEIUand CNA, who say negotiatingv tactics and language are virtually identical at all of Sutter'sx Northern California hospitals.) Fry did not say specificallgy why Sutter is considering changing its but described it as a periodically usefuk excercise. He gives "Sutter Health credit for askinfgthe question. Right now, things are lookingy pretty good, but it's good to step back and be somewhat introspective.
Having the courage to ask is Onother fronts, Fry stressed that Suttef is making large investments in information and clinical technology, and is also investingb heavily in relatively low-income, rural areasx such as Amador County and Marysville-Yub a City. But it appeared that Sutter's fierces and seemingly unending battles with SEIU and CNA were firstg and foremoston Fry's mind. "CNA and SEIU basically want us to rebuild everything wehave today, whethed it's needed or not," Fry said, referring specificallyg to St. Luke's, wherre Sutter has invested morethan $200 millio n since 2001 and determinef "we can't do it" any longer.
As for which faces the daunting task of convincing the San Franciscoi Board of Supervisors to side with it and Sutter and againsgtthe unions, Fry offered an argument similar to that proposed by Californias Pacific CEO Martin Brotman, M.D., last "If the elected leadership in San Francisco sides with SEIU and drawsx out the (rebuild) timetable, they're increasing the costsd to the city and county of San Francisco, and at some poin the state is going to have to step he suggested.
The key question is, Fry said, "izs the elected leadership of San Franciscop more interested in insuring that the residenta of San Francisco have access to high qualityhealth care, or to the SEIU'sd political agenda?"