$10,000,000 Sequoia Healthcare District Nursing Education Program

A statistical report entitled "SFSU/Sequoia Nursing Program stats" was presented to the SHCD Board at their October 10, 2012 meeting.
The report shows the following annual hiring of graduate nurses by Sequoia Hospital:
2006 - 16
2007 - 20
2008 - 14
2009 - 5
2010 - 11
2011 - 13
2012 - 0

Average for the first 5 years was 13.2 nurses hired at Sequoia Hospital per ~40 graduates, or 33%. That is hardly a majority as reported in the e-mail exchange below.

From: Lee Michelson
Sent: Thursday, February 17, 2011 10:31 AM
To: 'Jack Hickey'
Subject: nurses

The majority of nurses graduating from our program end up being hired at Sequoia Hospital with a few being hired at Kaiser. The last two years have proven to be difficult due to the economy so about half the graduates have left the area to seek employment including a group of nine that went to the Palm Springs area. Obviously we will continue to monitor the issue and I will encourage San Mateo Medical Center to take a look but they are not doing much hiring these days either. These nurses are really looking for hospital based jobs and have not been to receptive to community nursing or mental health care where there is a bigger need. It is possible that many of those who have gained employment elsewhere may move back here once employment opportunities become more available.

I then sent the following to Kim Griffin, President of the Sequoia Healthcare District Board:

From: Jack Hickey [mailto:jackcapp@sbcglobal.net]
Sent: Thursday, February 17, 2011 2:46 PM
To: Kim Griffin
Subject: Fw: nurses

Kim, based upon these results, I suggest that we seek alternative funding for this program. Clearly, the beneficiaries are the nurses and their union. I have suggested in the past that the unions front the $25,000 per nurse (x 40= $1,000,000/yr), which the District now pays. It would be easy for them to recoup the money from the newly unionized nurses, regardless of their place of employment. And, it would level the playing field for health care providers.

Jack

This was Kim's response:

From: Kimberly Griffin
Sent: Friday, February 18, 2011 9:07 AM
To: 'Jack Hickey'
Subject: RE: nurses

Hi Jack. I am considering what we are going to do with this grant. I’m not sure what the rationale was when this was approved for ten years. Keep in mind that unions do not hire nurses or determine their educational level. All of the nursing unions represent nurses with ADNs (like me) through anyone with an advanced degree in the bargaining unit. Dues are not based on educational level. I think if you really look at this program it is clearly the nurses and schools that have benefited. I think the issue that really struck me the last time the program presented at a board meeting was the fact that the average outstanding loan amount for these graduates was 20K, which I find to be a relatively small amount compared to most college debt these days. With a few years and hard work you can pay this off fairly quickly as a nurse. I think it’s going to have to be like a lot of the other universities where tuition will have to be raised. This is difficult for me because I know how important nurses are to health care. We will see a lot shortage again at some point and there we will be. The hospitals would prefer to have unlicensed people at the bedside and I saw that experiment fail to the extent that it was fatal to patients! The girl who used to run the Slurppy Machine at the 7-11 is not someone you want drawing up insulin or giving a blood transfusion.

My response:

From: Jack Hickey
Sent: Friday, February 18, 2011 11:57 AM
To: Kimberly Griffin
Subject: Re: nurses

Kim, as I understand it, this is a $1,000,000/yr GRANT program, not a loan. That’s a $25,000 gift for each nursing student.
Unions need only execute a debt instrument with these nursing students, which includes a defined payback as a percentage of wages.
The unions benefit significantly from this program. They should be a natural sponsor.
Question: At what meeting did the alleged presentation referring to: “... the average outstanding loan amount for these graduates was 20K...”
I would like the audio recording to verify that. Let’s get all our meetings on audio CD’s and our website.

Jack Hickey

Katie Kane, incumbent Board Member and candidate for re-election says this about the Nurses Program:

Since its' inception more than 320 registered nurses have graduated and the majority work locally.

Not true, as information in this thread reveals.

Web Link

Come to the District's special meeting on this subject.

Web Link

Time for some honesty.....Katie Kane says,

"Since its' inception more than 320 registered nurses have graduated and the majority work locally."

Jack Hickey says it is not true, who is right?

My report on the October 30, 2012 special meeting of the Sequoia Healthcare District re: Nursing Education Program

In attendance were:

Lynette Landry of SFSU and her associates,

Ron Galatolo, Chancellor of San Mateo County Community College and associates,

Glenna Vaslelis, CEO of Sequoia Hospital, and associates

Notably absent were representatives of the California Nurses Association, who I invited.

The presentation from the partners in the program quickly established a general concensus that the program was worthwhile.
My concerns as to whether all the graduates were employed as nurses were addressed by SFSU.
A Sequoia Hospital Nursing Supervisor was persuasive in characterizing the graduate nurses employed by the hospital (now only 60) as a cut above the rest with their modern skills and commitment.

Acknowledging the general success of the program in providing quality nurses in a global sense, I was able to steer the discussion to the relevant issue, how did the program benefit residents of the Sequoia Healthcare District. I was joined in this pursuit by Director Shefren.
The question of who would provide future financing of the program became the main issue. My questioning of the actual benefit to the Sequoia Healthcare District Community, addressed the issue of nurses who chose to work in the District, which is considerably less than 50%. Less than 20% of graduates are employed by Sequoia Hospital, a few are employed by Kaiser and SMCMC, a few are employed as school nurses whose salaries are likely paid for by the District. Nine are known to have gone to Palm Springs.

Directors Kane and Faro were quite clear in their support of continuing full funding of the program by the District regardless of where the nurses were employed. President Kim Griffin, a nurse, is highly likely to support continued funding.

A role for the Hospital Consortium in funding nurses training was suggested.
I suggested that the nurses pay back the cost of their education.

Lee Michelson, CEO of the SHCD, will coordinate efforts to identify alternative funding for the program. Lee, who managed golf tournaments which raised Millions for Ronald McDonald Charities, is a fundraising superstar.
Let's see if he can earn his $182,000 salary.

Interestingly, one of the big winners in the program was the SMCCCD. Ron Galatolo said the nursing program was very uplifting to the community college environment. I asked Ron if that might not translate into a fundraising opportunity for the SMCCC Foundation in support of the Nursing Program. That question deserves an answer, particularly since the College District has Foundation Executive Director, Stephani Scott, on the District payroll at $148,000/yr. Stephani plunked down $64,260 of Foundation money in the successful effort to ram the District's parcel tax (Measure G) down the taxpayer's throat!

Appended below is an update from SFSU on the employment status of nurses who have graduated from the program. Note a correction to the total number of graduates which is 253, not the 320 which I posted earlier. Bottom line is that less than 30% of graduates work in the District.

The following is an update on the Sequoia alumni from the survey and phone calls to our former students conducted in October of 2012. 58 students out of our 253 Sequoia graduates responded via the survey we emailed, the remaining 86 students responded via telephone survey. 64 students out of the 253 Sequoia graduates are currently employed at Sequoia Hospital- which is 25% of our graduates.
The following is a breakdown of where our Sequoia Alumni is working as of October 2012:

Sequoia Hospital - 64 students
Kaiser RWC - 5 students
El Camino Hospital - 2 students
Mission Hospice & Homecare in San Mateo - 1 student
Redwood City School District - 3 students
Belmont School District - 1 student
Kaiser out of area - 12 students
Stanford Hospital - 8 students
Mills Peninsula - 2 students
VA Palo Alto - 2 students
PAMF Pediatric Medical – 1 student
Lucille Packard - 1 student
Children's Hospital Oakland - 1 student
Military - 1 student
Out of bay area (work in nursing jobs) - 40 students

Sequoia Healthcare District spent $7,000,000 for the education of 280 nurses in the program who should have graduated by 2012. Only 253 are reported to have graduated. Of those, only 73 are working as nurses in the District. Since each received a subsidy of $25,000 from the oia Healthcare District, the total benefit to the community served by the District is $1,825,000. That means that $5,175,000 of property tax dollars left the District over the seven year period covered by the report from SFSU. Put another way, $739,000+ each year has been expended with no benefit to the community served by the District.
The District continues to claim that "One dollar and twenty-seven cents returned for every tax dollar collected"
Web Link

Original post on this topic: Web Link

Action item on next SHCD Board Meeting Feb. 6, 2013.

5. New Business
Action a. Request for Funding Of SFSU/Canada College/Sequoia Hospital Nursing program For Fiscal Years July 2014-June 2019 - Dr. Lynette Landry

See: Web Link

An e-mail sent to Directors contained a correction of the request for District funding committments for the first two years. See page 6 of the proposal in agenda item 5A.
First year $408,907 s/b $470,237
Second year $519,698 s/b $597,653

This grossly misleading statement appears in the proposal on Page 4.:

"At least half of the Partnership’s graduates are serving district residents at Sequoia Hospital as well as with organizations throughout the region such as San Mateo Medical Center, Kaiser Permanente Hospital Redwood City, Stanford Hospital and the Lucile Packard Children’s Hospital, Mills Peninsula Health Services, the public school systems, assisted living centers, nursing care facilities, and many others"

Facts, from a previous post:
Appended below is an update from SFSU on the employment status of nurses who have graduated from the program. Note a correction to the total number of graduates which is 253, not the 320 which I posted earlier. Bottom line is that less than 30% of graduates work in the District.

The following is an update on the Sequoia alumni from the survey and phone calls to our former students conducted in October of 2012. 58 students out of our 253 Sequoia graduates responded via the survey we emailed, the remaining 86 students responded via telephone survey. 64 students out of the 253 Sequoia graduates are currently employed at Sequoia Hospital- which is 25% of our graduates.

The following is a breakdown of where our Sequoia Alumni is working as of October 2012:

Sequoia Hospital - 64 students
Kaiser RWC - 5 students
El Camino Hospital - 2 students
Mission Hospice & Homecare in San Mateo - 1 student
Redwood City School District - 3 students
Belmont School District - 1 student
Kaiser out of area - 12 students
Stanford Hospital - 8 students
Mills Peninsula - 2 students
VA Palo Alto - 2 students
PAMF Pediatric Medical – 1 student
Lucille Packard - 1 student
Children's Hospital Oakland - 1 student
Military - 1 student
Out of bay area (work in nursing jobs) - 40 students

Also noteworthy is the fact that more than 30% of Sequoia Hospital's patients are not District residents.

The beneficiaries of this program are the Nurses, their union, the San Mateo County Community College District, SFSU and the employers of these nurses ( Sequoia Hospital, etc.). They should be funding the program, not taxpayers of the Sequoia Healthcare District.

Sequoia Healthcare District Boardmember, Katie Kane said: "Since its' inception more than 320 registered nurses have graduated and the majority work locally." Web Link
She was mistaken.
There were only 253 graduates out of 270 students who completed the course.
Monitors of the program report that only 144 graduates are recorded as being employed as nurses. Of those, Sequoia Hospital has 64, Kaiser RWC has 5 and schools in the District have 4.
Thirty percent of Sequoia Hospital patients reside outside the Sequoia Healthcare District. Kaiser RWC numbers are similar.
Only 70% of the service provided by those 69 nurses benefits District residents. That makes the total benefit to District residents 52.3 nurses. The 270 students who completed the course cost Sequoia Healthcare District taxpayers $6,750,000. In return we got $1,307,500 worth of nursing services.

In spite of these facts, the Sequoia Healthcare District Board of Directors approved continued funding of the program.
Here's their Press Release:

FOR IMMEDIATE RELEASE

Feb. 8, 2013

Contact: Don Shoecraft • Sequoia Healthcare District • Public Information

650-594-0556

THREE-YEAR UNIVERSITY NURSING EXTENSION BY SEQUOIA HEALTHCARE DISTRICT WILL ADD 96 TO NURSING COHORT

REDWOOD CITY, CA/FEB. 6, 2013 — Directors of Sequoia Healthcare District and representatives of San Francisco State University (State) and the San Mateo County Community College District Wednesday reached agreement on a final three-year extension of a 10 year-old program that has allowed more than 250 nursing students to obtain advanced bachelor’s degrees, with many returning to jobs within the Sequoia Healthcare District.

Annual support of $1 million from the district to the nursing baccalaureate partnership will be reduced by approximately half. State School of Nursing administrators said student tuition and fees for the program have been increasing for years. Three-year cost to Sequoia Healthcare District will be $1.69 million.

Demand for nurses in medical professions in California is cyclical. One of the reasons Sequoia Healthcare District directors reevaluated the program is the fact that demand has entered a down cycle while the 10 year-old contractual obligation of the district to fund the program was fixed at 40 students per year. The national economic recession is a major reason for this as retirement-age nurses with jobs are holding onto them longer.

The School of Nursing presented evidence that the cycle is on the brink of reversing, because as the economy improves, older nurses retire and Baby Boomers reach age 65 in the next few years the need for nurses may once again become critical.

At the time Sequoia Healthcare District created the program the district owned Sequoia Hospital, which could not find enough qualified nurses to fill available jobs. It has been extremely successful in meeting its goal. Ninety-five percent of bachelor’s degree students have graduated, with 93 percent passing the National Council Licensure Examination compared to the state average of 89 percent.

More than half of partnership graduates serve district residents at Sequoia Hospital and at facilities such as San Mateo Medical Center, Kaiser Permanente Hospital in Redwood City, Stanford Hospital, Mills-Peninsula Health Services, Lucile Packard Children’s Hospital, public schools, assisted living centers, nursing care facilities and others.

The new agreement will pay 56 percent of student tuition for 32 students per year for three years.

Sequoia Healthcare District directors also agreed to form a subcommittee of the board to follow the program for a year and report periodically on its status.

In a subsequent statement the university commended Sequoia Healthcare District for its past and future support.

“SF State appreciates the Sequoia Healthcare District’s ongoing support of nurse education. The district is visionary in recognizing the connection between first-rate education and first-rate patient care, and we are honored to be a partner in this effort,” said Lynette Landry, RN, PhD; Director, San Francisco State University School of Nursing

Last on Wednesday’s agenda was reorganization of the board. Gerald Shefren, M.D., was elected to a one-year term as board president, succeeding Kim Griffin, a pediatric cardiology nurse. Arthur Faro, retired chief executive of Sequoia Hospital, was elected vice-president. Director Katie Kane, a human services professional, was returned as board secretary.

Sequoia Healthcare District provides major funding to numerous non-profit community health organizations that directly assist more than 50,000 women, children and seniors in the district, which includes the cities of Atherton, Belmont, Menlo Park, Portola Valley, Redwood City, San Carlos, Woodside, and portions of San Mateo and Foster City from Skyline Boulevard to the Bay.

There are two Letters to the editor on this subject in today's Daily Journal. Web Link
One is from Mary Ann van Dam, RN, PhD, PNP Director, School of Nursing
San Francisco State University the other from yours truly. These followed and OpEd by John McDowell Web Link and an LTE in response from Sequoia Healthcare District CEO, Lee Michelson Web Link

Here are the archived links:

One is from Mary Ann van Dam, RN, PhD, PNP Director, School of Nursing
San Francisco State University Web Link the other from yours truly.
Web Link

In response to the 2012-2013 Grand Jury regarding benefits accruing to District residents from it's Nursing Program,
the Sequoia Healthcare District said it "...has requested changes in admissions policies of its collaborative partners ... and has obtained changes that further favor district residents.
Here is an update from CEO Lee Michelson: "Just came back from a meeting with the Nursing Program regarding next cohort to start studying this September… 32 students of which 12 live in District and another 12 are other San Mateo County residents… the highest ranked applicant lives in San Carlos and the 3rd highest ranked lives in Portola Valley. The resident breakdown includes: 2 from san Carlos, 1 from PV, 4 from Belmont and 5 from RWC." That means only 37.5 % of these new students reside in the District.
The Grand Jury said: "Over the ten-year period, SHD provided $10 million for the program and $650,000 for a nursing lab at Cañada College. Three hundred fifty students graduated from the program." and, "The most recent information (10/12) shows approximately 50 alumni work in the County, 50 in the Bay Area, and 40 out of the area."
The District responded: "Approximately 50 percent of graduates who responded to a recent survey indicated that they have found jobs in healthcare settings utilized by District residents"
The Nursing Program should not be funded by District property owners.