Voter Guide 2004: Sequoia Healthcare District's future in the balance Voter Guide 2004: Sequoia Healthcare District's future in the balance (October 13, 2004)

Voters have a clear choice for Sequoia Healthcare District board, with chance to create a new majority

By Renee Batti
Almanac News Editor

On November 2, voters will see on their ballots the names of four candidates for two seats on the Sequoia Healthcare District board. But when they cast their votes, their decisions will determine far more than who will be facing the public from the board dais come December.

Those who vote will essentially be deciding whether the taxpayer-funded health-care district will continue its partnership with Catholic Healthcare West (CHW) in the ownership and governance of Sequoia Hospital in Redwood City -- and maybe even whether the district will continue to exist at all.

Candidates include the two incumbents, Kathleen Kane and Malcolm MacNaughton, who strongly support the hospital partnership; and two challengers who want to join fellow Libertarian Jack Hickey on the board to make sweeping changes. The challengers are Warren Gibson and Sonya Sigler, who ran unsuccessfully in 2002 for seats on the board.

Ms. Kane has served on the five-member board for 12 years, and Mr. MacNaughton for seven. It is a board that administered the public district with typically unanimous decisions until Mr. Hickey won a seat on it in 2002. At that time, three seats were open, but only two incumbents ran -- successfully -- to keep their seats.

Challengers Sigler and Gibson say that if they are elected, they will challenge the very purpose of the health-care district, which now collects an average of $60 per parcel annually from property owners living in Menlo Park, Atherton, Woodside, Portola Valley, Redwood City, San Carlos and Belmont.

History and purpose

Formed in 1946 to build and administer Sequoia Hospital, the district -- then called the Sequoia Hospital District -- collected taxes that directly funded hospital operations. But in the mid-1990s, the hospital was in deep financial crisis, as were many other community hospitals, because of rapid and dramatic changes in the health-care world.

In 1996, voters approved the sale of the hospital to a newly created nonprofit entity, called Sequoia Health Services (SHS), to be governed by a 10-member board. The health-care district and CHW have equal representation on the board, with five appointees each. CHW has a 30-year contract with the district to operate the hospital.

Since 1996, the district's role shifted to providing oversight for the hospital and supporting health-care agencies throughout the district. It collects about $5 million annually in property taxes, and has about $70 million in assets.

The district awards grants to nonprofit agencies and programs, such as San Mateo County's Children's Health Initiative, which insures every child in the county whose parents cannot afford insurance; and the Samaritan House, which provides free health care to the uninsured and working poor.

It also has provided grants to Sequoia, and several months ago committed $25 million to help rebuild the hospital; the nearly 55-year-old facility must be rebuilt or retrofitted to meet seismic safety standards by 2013.

Voters will decide

Mr. Gibson says he wants to be part of a new board majority that will work toward abolishing the district completely and turning the hospital over to the private CHW.

Ms. Sigler takes a less drastic approach: The voters, she says, should be asked whether they want the district to exist, and if they do, how they want the district to spend the public funds it collects. "Let the voters choose: Do they want their money back? Do they want it to go to all three hospitals in the area?"

Although Ms. Sigler, Mr. Gibson and incumbent Hickey have stated or suggested publicly that taxpayer money can be returned and the tax bill can be reduced if the district were abolished, that scenario is not possible under current law.

The tax burden for district residents would remain the same even if the district were dissolved, but the money would be distributed among the other special districts and cities in the county that share in the property-tax revenue pot, according to county officials.

Mr. Gibson and Mr. Hickey have said they will try to find a legal way to return money to taxpayers and reduce taxes. But failing that, Mr. Gibson said, the money could be applied "to pressing public needs such as police and fire."

District supporters, including incumbents Kane and MacNaughton, argue that the $5 million collected annually by the district now is put to worthwhile use supporting health care in the area. They say that the taxes will be collected regardless of whether the district exists, and that it's better that the district continue operating so that the tax money remains to help meet the health needs of the community.

Both incumbents cite the grants given to the Samaritan House and the county's insurance program for poor children as examples of good choices the board has made toward that end.

Regarding the Samaritan House, which runs a primary-care clinic run by volunteer doctors and other health-care professionals, Ms. Kane noted that during the first six months of this year, there were 1,922 patient-visits to the clinic.

"Were it not for the district's funding, individuals would have looked to over-burdened and cash-strapped San Mateo Medical Center (the county's hospital) for health care, or much worse, received no care at all," she said.

Indigent care

Sequoia and other area hospitals -- including Kaiser and the Palo Alto Medical Foundation -- have come under criticism by county health officials for not taking on enough of the burden to provide care for the poor and uninsured. The county's hospital provides 95 percent of that care now, and is buckling under the heavy financial strain.

Ms. Kane said that, as the board's president, she recently initiated conversations with the county hospital's CEO "to explore programs they sponsor that could be supplemented by our funds for their services provided to our district residents."

Mr. MacNaughton pointed to Sequoia Hospital's "excellent emergency care facility that has benefited many." He said that "although a number of hospitals in California have been closing their emergency rooms, primarily due to costs, at this point Sequoia is committed to keeping their emergency room open to all who come for care."

Mr. Gibson acknowledged indigent care is a tough problem, and one that concerns him. "Too many people are using emergency rooms for primary care," he said.

One possible solution, he added, "is to make everyone pay something for medical care, even it it's only $5. This will discourage frivolous use and drive home the point that health care doesn't grow on trees." He also said that nonprofit, low-cost clinics should be encouraged "to take over some of the primary care that now comes to emergency rooms."

Ms. Sigler said the issue is yet another example of why voters should be asked to decide how the district moves forward and spends money. The district's millions of dollars in assets could go toward indigent care if that's what the public wants, she said.

A public choice

The challengers are supported by Citizen Advocates for Private Philanthropy, a group headed by Jack Hickey.

A flier published by the group that includes photos and endorsements of Ms. Sigler and Mr. Gibson states forcefully: "It's time for ... phony philanthropy and the obsolete hospital tax to end. The District must be dissolved."

If the challengers are elected, it is likely that the new board majority would launch the process that could lead to dissolving the district. But such a move would require a separate vote of district residents.

CANDIDATE BIOS:

Warren Gibson
Residence: Belmont
Profession: Retired engineer; currently, instructor in engineering at Santa Clara University.
Education: Ph.D., engineering, Case Western Reserve University.
Civic experience: Current chair, Belmont Planning Commission; former board member, San Juan Canyon Preservation Trust; former board member, Psoriasis Research Institute.
Age: 61

Kathleen Kane
Residence: Redwood Shores
Profession: Human resources consultant
Education: Degree in human resources and organizational development, University of San Francisco; surgical technician studies, Stanford University Medical Center.
Civic experience: Currently, Sequoia Healthcare District board member, 12 years, and current board president; sustaining member, Woodside-Atherton Auxiliary for Lucile Salter Packard Children's Hospital; member, President's Council, Canada College; member, San Mateo County Horsemen's Association; member, Redwood City/San Mateo County Chamber of Commerce.
Age: 59

Malcolm MacNaughton
Residence: Woodside
Profession: Business -- finance and real estate
Education: Stanford University; Harvard Business School
Civic experience: Currently, Sequoia Healthcare District board member, about seven years; involved in numerous scholarship and education programs, including Bridge Fund Textbook Program, Canada College scholarship fund; past member, Sequoia Hospital Foundation and the Canada College Foundation Advisory Board.
Age: 66

Sonya Sigler
Residence: San Carlos
Profession: Lawyer, business executive
Education: Degree in philosophy, University of California, Berkeley; law degree, University of Santa Clara.
Civic experience: Past member, Women in Technology and Nova Vista Symphony boards.
Age: 37

Candidate forum

A September 30 candidate forum sponsored by the League of Women Voters will be broadcast on Tuesday, October 12, at 3 p.m.; and Thursday, October 14, at 7:30 p.m. on Peninsula TV-Channel 26.

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