UPDATE: Fallbrook and Tri City healthcare districts forge JPA; more physicians to be recruited to Fallbrook as a result

Fallbrook Healthcare District (FHD) made a strategic move and forged a Joint Powers Authority (JPA) with Tri City Healthcare District (TCHD) on June 27 in a special Closed Session meeting.

"We feel this partnership will work well for the community, since people have had to go in so many different directions to get their advanced healthcare," said Stephen Abbott, board member of FHD.

According to FHD administrator Vi Dupre and TCHD CEO Larry Anderson, the JPA is designed to enhance the level of medical and healthcare services provided to Fallbrook area residents.

Both Abbott and Dupre explained that a great deal of consideration went into creating a JPA with another hospital. The primary focus, they said, was to select a hospital that would be the best fit to expand services for Fallbrook patients.

"It was important to choose a hospital in San Diego County, because going into Riverside County creates its own issues with insurance," said Abbott. "Kaiser is not an option, so we focused on [deciding between] Palomar and Tri City."

Distance played a key role in Abbott's opinion.

"Mileage does play a factor; the 17 miles to Tri City Hospital is more beneficial than the 30 miles to Palomar," he said. Since Abbott's employment is as a division chief with North County Fire Protection District, he said time is of the essence when it comes to emergency medical services.

"In reference to the difference in transport times, I go back to the old saying regarding trauma that 'time is muscle' – with a heart attack or stroke, the outcome is all predicated on how soon you can get the patient to surgical intervention," said Abbott. "It's a straight line correlation – the sooner you receive treatment, the more likely you will have a beneficial outcome."

Abbott also said the improvements that have been made so far to State Route 76 have "dramatically improved travel time and eliminated congestion" that used to plague the roadway.

Dupre said not only was its geographical location conducive to selecting Tri City, but its healthcare district "has worked wonderfully well with us" (compared to Palomar).

"

is a fine facility, but it's no secret they are experiencing financial duress," said Dupre.

Abbott said, "Tri City had an approach that seemed to work more in the interest of the citizens of Fallbrook and Fallbrook Hospital."

What the Fallbrook Healthcare District hopes the JPA will do is "provide uniform access to tertiary care" with ease for local patients. Tertiary care is described as a higher level of specialty care requiring highly specialized equipment and expertise. Examples of this would be: specialized cardiac procedures such as a catheterization lab and bypass surgery, stroke care/recovery, broader oncology services, renal or

hemodialysis, robotic and minimally-invasive surgeries, and many other complex treatments and/or procedures.

Tri City Medical Center is a Gold Seal-approved, full service, acute-care medical center with two advanced clinical institutes and over 500 physicians practicing in 60 specialties.

Abbott stands firm about the decision to form a JPA with Tri City, saying "there will be an improvement if we can keep healthcare predominantly between two hospitals." He said from an emergency services expertise, "it is important to an emergency patient to transport them to the closest, well-equipped hospital for their condition."

Dupre said while some might recall incidents of board conflict at Tri City in the past, "there was never a question about its quality of care."

Given the fact that Fallbrook Healthcare District is in the midst of a 30-year lease with Community Health Systems (CHS), Dupre said when the agreement expires "if we renew with CHS, we renew; but if not, we have to have a relationship to continue managing our hospital – for immediate need and the long term. It's very natural alignment for the district to pursue."

Both Fallbrook and Tri City healthcare districts are supported by property taxes.

"Tri City has a larger budget and larger obligation," said Dupre.

The JPA does not mean joined financials.

"There will not be any co-mingling of funds as a result of this arrangement," said Dupre. "There is no monetary incentive up front to form this association. There will not be a consolidation of boards; it's more of a collaborative. We will plan; we will talk; but we will remain separate entities to protect each of our individual identities and interests."

In information shared previously by the healthcare district, some of the losses suffered by Fallbrook Hospital over the past two years have been the result of business directed to other facilities by the large, physician-owned Graybill Medical Group. Some patients previously sent to Fallbrook Hospital by Graybill for inpatient and outpatient services have reportedly been sent to other facilities.

"We aren't placing blame on any entity; we just have to fix a problem," said Dupre. "The bottom line is patient flow is still down and Fallbrook Hospital has tightened its belt, but they can only do that so far."

According to Graybill Medical Group CEO Floyd Farley, "In our mission to provide quality care and services to our patients in North County, our group also utilizes Tri City Medical Center and Palomar Medical Center.

We will need to see how the joint effort evolves and may impact us, but we are supportive of efforts that bring resources to our local community."

Farley said Graybill "has worked diligently to serve the Fallbrook community."

"Graybill continues in its growth in the Fallbrook community and in welcoming many new patients to our Fallbrook offices," he said. "Graybill physicians admit more than a thousand patients a year to Fallbrook Hospital and Skilled Nursing Facility, as well as utilize a broad range of services within the Fallbrook community. We look forward to serving the Fallbrook community for the many years ahead."

Creating a JPA with Tri City will mean more physicians being recruited to Fallbrook, Dupre said, so as to offer residents a broader choice in healthcare.

"Under this association, it is our intent to develop a stronger physician base in Fallbrook, bringing in more primary care physicians that will send patients to Fallbrook Hospital, not Palomar," said Dupre. "We are not saying we are going to bypass physicians that we already have and we are not saying they aren't good physicians."

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(previous version)

(Thurs., June 27, 2013)

Fallbrook Healthcare District enters into Joint Powers Agreement with Tri-City Healthcare District

FALLBROOK AND OCEANSIDE - At 9 p.m. on Thursday, June 27, following a Closed Session meeting, an announcement was made that Fallbrook Healthcare District and Tri-City Healthcare District entered into a Joint Powers Agreement designed to enhance the level of medical and healthcare services provided to the residents throughout Fallbrook Healthcare District’s service area.

The agreement is the culmination of discussions and efforts between the two agencies over the past several months and will enable the Fallbrook Healthcare District to support potential expansion of the quality services available locally in Fallbrook.

This benefits patients, their families, the local healthcare system and the entire economic base of the Fallbrook community.

Vi Dupre, Administrator of the Fallbrook Healthcare District and Larry Anderson, Chief Executive Officer of Tri-City Healthcare District, issued a joint statement regarding the new affiliation, as follows:

“It is the intent of both districts that, through this Joint Powers Agreement, we will be able to execute strategies that have the potential to give residents of Fallbrook, and surrounding communities, access to the highest quality of healthcare, provided primarily in their local community. We understand the burden of families having to travel to distant facilities in order to receive care.”

About Fallbrook Healthcare District - Fallbrook Healthcare District (FHD) is a local special district. It is a single function, non-enterprise, independent government agency serving the Fallbrook, Bonsall, Rainbow and DeLuz areas. It was originally formed in 1950, as a Hospital District, to build and operate Fallbrook Hospital. In November 1998, the District Board, with voters’ consent, signed a 30-year agreement with Fallbrook Hospital Corporation, to operate and manage the Fallbrook Hospital. At that time, the District re-organized to become a Healthcare District operating under the Local Health Care District Law of the State of California. In addition to furthering its stated mission of preserving the programs and services of Fallbrook Hospital for the community, FHD maintains an active role in identifying, promoting and facilitating community health care programs and activities in collaboration with multiple agencies that are also aware, concerned and involved with the health and well-being of the people of the greater Fallbrook community.

About Tri-City Healthcare District - Tri-City Healthcare District, which includes parts or all of Carlsbad, Oceanside, San Marcos, and Vista, administers Tri-City Medical Center. This Medical Center is a Gold Seal-approved, full-service, acute-care Medical Center with two advanced clinical institutes and over 500 physicians practicing in 60 specialties.

About Tri-City Medical Center - Tri-City Medical Center has served its community for more than half a century and has become the county’s leader in robotic and minimally invasive surgical technologies, including being the exclusive county-wide provider for the Mazor Renaissance Surgical Guidance System for surgical repair of spinal deformities, injuries and rehabilitation; and the NavioPFS' system (“Blue Belt”) for robotic knee repair, which is less invasive and preserves the existing knee. Tri-City Medical Center also has the only Level III Neonatal Intensive Care Unit in North San Diego County, now with the NICView System, a password-protected webcam system that allows parents and relatives to remotely view their newest family member. Tri-City Medical Center was named by the editors of Becker's Hospital Review both one of the “100 Great Hospitals in America” and one of the “100 Great Places to Work in Healthcare.” Selected from over 5,700 hospitals, Tri-City Medical Center was recognized as an innovator in medical treatments, research, technology and care delivery as well as an anchor of health in the country.

For more information about Tri-City Medical Center and Tri-City Healthcare District, please visit www.tricitymed.org.

For more information about Fallbrook Healthcare District, visit www.FallbrookHealthcareDistrict.net.