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Endorsement: Rymer, Mainardi for hospital board

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The last time there was a contested race for the Sonoma Valley Health Care District board was 2010. To put that into context, consider this: It was 2010 when then-President Obama signed into law the Affordable Care Act; “Lost” was a top-10 show in the Nielsen ratings; and the term “uber” meant little more than a German prefix denoting something extreme.

In other words, it’s been a long time.

But after three straight healthcare district elections which saw only board incumbents file to run, this time longtime SVHD board member Peter Hohorst decided not to seek re-election, opening up one seat to new blood, while incumbent and current board president Joshua Rymer seeks to retain the seat he’s held since appointment in 2013.

Joining Rymer on the Nov. 6 ballot are retired engineer Doug Ghiselin and retired gastroenterologist Michael Mainardi.

Whichever two candidates earns the seats on the board, they’ll find themselves serving a district that’s navigating major challenges in a 21st century healthcare world. Like many communities of its size, the Sonoma Valley Hospital is adapting to a healthcare landscape of rapidly advancing technologies in an aging community amid lower government reimbursements for Medical and Medicare patients.

These are challenging times for community hospitals, to be sure.

And this year the Sonoma Valley Healthcare District has made some difficult – and not always popular – decisions, such as eliminating its under-used child-birth services and transferring its home-care program to Hospice By the Bay. As of this writing, hospital officials are brainstorming for solutions to help make its skilled-nursing program financially viable as well.

Joshua Rymer, 61, has served as board chair in 2018, a year of transition for SVH, which is in the midst of cost-cutting measures to mitigate a more than $6 million deficit this year – made only somewhat more palatable by the $3.85 million in annual parcel tax revenue thanks to last year’s narrowly voter-approved Measure B.

“Healthcare is going through huge changes,” Rymer told the Index-Tribune in a recent interview. “We’re a relatively small player – fighting to stay alive every day, every week, every month.” He said the cost-mitigating measures the district is considering are an effort to shore up revenues for the hospital’s most essential services.

“We can’t live without an emergency department,” Rymer said.

If he earns another four years on the board, Rymer said he would continue to push hospital management to “think proactively -- out into the future,” and acknowledge to the community that the recently renewed – and increased by $55 in 2017 – parcel tax is likely here to stay. “I don’t see a way to claw back from a $6.5 million loss” without it, he said about the district’s $250 per year levy through 2022.

If he had one message to voters, he says he “wishes people would remember how far this hospital has come in the last eight years.”

Warns Rymer: “We’re a nonprofit -- but that’s a tax designation. We can go out of business.”

Michael Mainardi is a retired gastroenterologist who’d practiced mainly in the South Bay before hanging up his colonoscope a few years back and moving to Sonoma. Since then he’s served four years on the SVH quality committee and currently chairs the board of the Sonoma Valley Community Health Center.

Mainardi, 77, said if he were on the hospital board he’d work to bring SVH and the health center closer together. He sees several benefits to a tighter working relationship between the two entities, including the potential to share resources. He points to the hospital’s underutilized space and the health center’s need to expand. “It’s a win-win for the community if the center can rent space in the hospital,” Mainardi told the I-T.

He names “finances” as the district’s primary challenge in the coming years, but says district officials need to also keep their eyes on the impending 2030 deadline for seismic upgrades.

Mainardi would like to see the hospital do a better job communicating its vision to the community. “The closure of (the obstetrics ward) could have been done in a different way,” he said.

He’d like to see the district send the message to the community that: “We’re going to have high-quality, affordable and compassionate care.”

Douglas Ghiselin is a retired engineer who says he spent 33 years working in the nuclear industry. He was inspired to run for the healthcare district board after attending the board’s regular monthly meetings and growing frustrated over what he believed to be a lack of proper inquiry from the board members.

“The current board is too far removed,” Ghiselin, 77, told the Index-Tribune. “Get a report, say ‘thank you,’ go to the next one.”

He says board members need to press for more information before accepting recommendations from hospital management. “I’d ask the questions – ask for the data, in public.”

If elected, Ghiselin said among his priorities would be “looking into the administration” of the hospital – and comparing it to what other, similarly sized hospitals do.

“I’m not convinced we can’t cut enough” to avoid raising the parcel tax when it expires in 2022.

He says cost-cutting measures shouldn’t be limited to programs. Ghiselin would look at “the whole structure – do we need that many administrators at a small hospital?”

We like Ghiselin’s moxie. And we applaud his calls for greater transparency. He’s entirely right that the board members should ask tough, probing questions – and call for data to support recommendations of hospital management. Especially when some decisions carry lasting effects on the community, such as changes to the skilled nursing facility, or the closing of the SVH childbirth services.

That being said, at this critical moment for the healthcare district, the experience Rymer and Mainardi would bring to the board is hard to pass up.

Rymer has shown himself to be a thoughtful and transparent board chair -- and has demonstrated commendable leadership not only with the hospital board, but in his work with the Sonoma Valley Fund and other local nonprofit groups. He’s pretty open about mistakes the district has made in the past, but seems to share a vision for keeping the hospital viable into the future. The hospital’s recent partnering with UCSF, as well as the difficult decision to end obstetrics, are firm steps forward for both financial viability and overall quality of service.

Mainardi, meanwhile, would bring to the board a valuable medical-world perspective. And his work with the Sonoma Valley Community Health Center could help cement a stronger relationship between the Valley’s two most significant health facilities.

In the first contested hospital board election in eight years, Valley residents are fortunate to have three strong candidates.

We recommend Joshua Rymer and Michael Mainardi for Sonoma Valley Healthcare District board.

– Jason Walsh, associate publisher & editor

– Emily Charrier, publisher