First contested election for Sonoma Valley Health District since 2010

A retired physician, a retired engineer and an incumbent are vying for two open seats on the board of the financially challenged Sonoma Valley Health Care District.

Incumbent and current board chair Joshua Rymer joins Michael Mainardi, a retired gastroenterologist who has served on the hospital’s quality committee for four years, and Douglas Ghiselin, a retired engineer, as the contenders on the Nov. 6 ballot. It’s the first contested election for the healthcare district since 2010.

Both Rymer’s seat and that of board member Peter Hohorst, the latter of whom did not file papers to run for re-election, are up for grabs. The top two vote-getters will be elected.

Though Rymer and Mainardi’s positions differ greatly from Ghiselin’s in many ways, all three agree that increasing the hospital’s revenues and keeping costs down is important.

Board Chair Rymer, 61, of Glen Ellen, has a distinguished record of community service including stints with the Sonoma Valley Fund, Community Foundation Sonoma County, Education Outside and the hospital, where he has also served on the board’s strategic planning, quality and finance committees.

“I am running because we are in the midst of a major restructure and I couldn’t imagine not seeing that through,” Rymer said via e-mail from France. The board chair said his top priority is “seeing through the reinvention of the hospital that we began this past year.”

The board chair added, “The hospital’s leadership developed a new vision for the future, focused more on emergency care and outpatient services than the traditional inpatient services,” Rymer said. “Successfully managing through this change will be the most important task for the next several years.”

The reinvention process includes steps that are already under discussion at board meetings, such as the new Outpatient Diagnostic Services. The project will modernize and expand medical imaging and create an expanded cardiology service in the Hospital. Both will help the hospital to stay relevant in the current healthcare environment while reducing costs and supporting revenue growth in the years ahead.

Also, the health care district has opened three clinics in Sonoma in recent years and brought in more than 20 specialists in a range of fields, so residents can find the care they need without traveling.

Rymer said, “We will need to leverage the partnership that has been developed with (the University of California, San Francisco) to bring more specialty care and procedures to the Valley,” which he said would bolster the revenues and services available locally “and continue to create a healthier community.”

The hospital’s partnership with UCSF was announced earlier this year. Dr. Sabrina Kidd, a dual board-certified colorectal and general surgeon, was recruited as Sonoma Valley Hospital’s medical director. She will also serve on the UCSF faculty and act as its medical director for Sonoma Valley Hospital.

“UCSF has a comprehensive tele-neurology program which will be key in SVH gaining stroke certification for our emergency department and giving our hospital-based physicians access to neurology consultations,” Rymer said.

“Second, we are working on creating a state-of-the-art UCSF physician clinic with their world-renowned physicians,” Rymer said.

He described the present board as “an impressive group of people who bring their expertise to advising, overseeing and guiding our hospital and its leadership,” and said, “Our board has gotten much better at working together on strategic planning.”

The board chair said, “I think our hospital does a pretty good job of marketing its services in a small community on a very, very small budget.”

Rymer added, “I also think we have an opportunity to improve the way we communicate with the community about the large number of changes at the hospital … if we want the community to continue to support the hospital by voting for the parcel tax, we owe it to the community to broaden the dialogue.”

To generate revenue, Rymer said, “One of the two most important challenges is increasing our volumes, revenue and services available to the community, particularly outpatient-oriented. Bringing more physicians and services here is therefore a top priority and will help with increasing revenue.”

Candidate Michael Mainardi, 77, of Sonoma, seemed to share the goal of bringing more physicians and services to the hospital. Mainardi is a retired gastroenterologist who has served on the quality committee of the Sonoma Valley Hospital board for the last four years.

In addition to his service on the quality committee, Mainardi is the chair of the board of directors of the Sonoma Valley Community Health Center.

He has also served on the board of directors of the George Ranch Community Association, the homeowners association for his neighborhood, for the past seven years.

Mainardi, who was on the clinical faculty of UCSF for 25 years, said he’s running because “maintaining the quality of our hospital is key for me. The quality of the hospital is superb.”

The doctor noted that there are many potential benefits to the hospital working with the Community Health Center, whose board he chairs.

“The Sonoma Valley Hospital has an affiliation with UCSF. We are going to expand that and bring specialists to our community and our hospital. At the Community Health Center, we need an endocrinologist and a neurologist,” so Mainardi envisions a setup where perhaps the doctors could see patients at the Community Health Center in the morning and at the hospital in the afternoon.

“We don’t have enough specialists. Community members have to drive to Petaluma, to Santa Rosa, even San Francisco,” Mainardi noted. “I want to see us plug holes in specialties we don’t provide for the community.”

Another benefit to teaming up with the Community Health Center: efficiencies of scale, Mainardi said.

“The hospital has excess space and the Community Health Center needs more space because we are growing rapidly. It’s a win-win for the community if the center can rent space in the hospital,” Mainardi said.

The doctor said of the hospital board, “The board works well with Kelly Mather (the hospital’s chief executive). I respect all the board members. They are well-qualified.”

As to how the board could improve, “We need to do a better job communicating with the community. The closure of (the obstetrics department) could have been done in a different way,” Mainardi said.

The doctor was referring to moves made as part of the hospital reinvention that included closing the money-losing obstetrics department and transferring the hospital’s home care service to another nonprofit. The board is pondering closing the hospital’s skilled-nursing facility, which is also losing money.

Mainardi added, “The idea that they brought the transfer of health care and the potential closure of the skilled nursing facility all at one time – I think it needed to be spread out more to give the community more time to digest these ideas and a chance to speak out.”

Communicating with the public is a central concern of candidate Douglas Ghiselin, 77, of Sonoma, who is a retired engineer. Ghiselin has served on the board of the Lake Almanor Country Club.

Ghiselin said he is running because he feels the current board is too far removed from the details of the operation, and as an engineer, he feels he is in a good position to drill down into those details.

“The board doesn’t ask enough probing questions about finances,” Ghiselin said. “At one board meeting I attended, the administration presented data that supposedly supported the position that the (obstetrics department) was losing money, and nobody asked for substantiating data,” he said.

“I’m primarily looking at the finances, and the methods the current board is proceeding with to reduce the costs just seem to be reducing services,” the retired engineer said.

“At all the board meetings I’ve attended, when numbers are presented, people just nod their heads and say, ‘Oh, very good,’” Ghiselin said.

His top priorities for his term would be keeping administrative costs down and trying to retain the services to the community. “Don’t give up the services we currently have,” he said.

To generate revenue for the hospital, Ghiselin would support adding services such as the bariatric surgery that is now performed at the hospital, he said.

Ghiselin said he would like to see the hospital do a survey of community members and ask what they need from the hospital, and then market to that.

Reach Janis Mara at janismara@sonomanews.com.