Group raises funds to combat WSMC Downieville medical cutbacks |

Group raises funds to combat WSMC Downieville medical cutbacks

Western Sierra Medical Center's Downieville clinic has stopped all 24-hour care, leaving residents in the area with a cutback in urgent care services after 5 p.m. everyday.
Dan Farrington |

At a recent meeting of the Downieville Clinic Patient’s Advocacy Committee — a group of Sierra County residents fighting Western Sierra Medical Center’s termination of 24-hour medical services in Downieville, chair Ingrid Larson asked the group of 50 people to answer one question.

“I asked, ‘How many of you in this room believe you might no be (alive) today, had this clinic not been available to you after hours?” Larson said. “At least 50, if not 75 percent, of the people raised their hands.”

To find a solution for the lack of emergency medical care in their community, Larson and her group recently formed their own nonprofit group, Sierra Frontier Medical Resources Inc., whose sole purpose is to raise funds to make up for the loss in medical care they are experiencing due to Western Sierra Medical’s cutbacks.

“The real vital issue is western Sierra County needs primary care and 24-7 care for urgent and emergency needs,” said Larson. “That’s what we’ve had, that’s what we’ve bargained for, and that’s not what is being provided by them.”

“The real vital issue is western Sierra County needs primary care and 24-7 care for urgent and emergency needs. That’s what we’ve had, that’s what we’ve bargained for, and that’s not what is being provided by them.”Ingrid Larson Downieville Clinic Patient’s Advocacy Committee chair

In October 2014, WSMC announced that they would be eliminating 24-hour medical service at their Downieville clinic effective Jan. 1, 2015, changing their hours of operation to 8 a.m. to 5 p.m. Monday through Friday, adding that on Fridays, primary medical care would not be available.

“The board gave it a lot of careful assessment, and what it comes down to is the biggest issues are the number of patient visits aren’t high enough to allow us to provide a higher level of care,” WSMC Planning and Development Director Cheryl Rubin said. “We are committed to providing a level of care and service in Downieville, and are looking forward to having a healthy community and working with people to have that happen.”

Founded in the mid-19th century during the Gold Rush, Downieville at its peak boasted around 5,000 residents. Surrounded by the Yuba River District of the Tahoe National Forest, the town’s demographics have declined significantly since the late 1860s.

According to the 2010 U.S. Census Bureau, Downieville currently has a population of around 300.

WSMC Downieville clinic was founded in 1975 by a group of community volunteers. The nonprofit became a funded Federally Qualified Health Center in 2007, and a year later added a community mobile clinic.

In January 2010, WSMC and the Miners Community Clinic in Grass Valley merged to become a single corporation under Chief Executive Officer Scott McFarland.

WSMC currently serves clients in Grass Valley, Downieville and Camptonville.

Larson, a former WSMC board member, said when the Downieville clinic merged with Grass Valley’s Miners Clinic, Downieville brought with it a federal grant of $600,000, now in excess of $800,000, and property in Downieville to use.

Larson said Miners clinic brought the necessary amount of patients needed to fulfill the grant requirements, and the merger agreement included provisions to maintain Downieville clinic services, including on-site medical care on a 24-hour, seven day a week basis.

“They got the best of both worlds,” said Larson. “They merged with us, got the federal funds, they got the prescription funds and the ability to borrow against our real property to build their new (center), and now they’re dumping on us. They are not providing their end of the agreement.”

In a June 2014 letter to McFarland, Congressman Doug LaMalfa stated his concerns about the cutback of Downieville medical services.

“While I appreciate that WSMC is working toward solutions to meet the growing demands of the community, I am concerned that the unintended consequences of this decision could exacerbate the already limited resources made available to these residents and those visiting the area,” LaMalfa wrote. “… I urge you to take into account these local concerns and include more community input and engagement in the process.”

Larson added that for several years WSMC has also had a base hospital extension agreement with Enloe Medical Center in Chico, which dispatches helicopters to transport emergency patients in Downieville. But with the elimination of emergency care, WSMC asked to change the agreement.

“Now the ambulance will not be able to go to the clinic,” Larson said. “If you’re picked up in the middle of the night in the ambulance, you are going to either go straight to the helicopter or straight to the emergency room, but not the clinic, because it’s no longer 24-7.”

Residents in Western Sierra County formed the advocacy committee, also known as DC-PAC, which has held meetings since June to address the Downieville service cutbacks.

“This is a merger agreement that gets registered with the Secretary of State,” said Larson. “We say this cannot be amended, this can’t be changed because the parties on both sides no longer exist as two separate entities. This is what we bargained for and this is to stay this way … The (WSMC) board of directors and Scott McFarland say no, and they formally voted to amend this document. Our position is that it’s not an amendable document.”

On Nov. 19, 2014, the DC-PAC filed a complaint with California’s Attorney General’s office to seek either enforcement of the merger agreement or dissolution of the agreement for noncompliance, including a return of the WSMC name, and refund of all pre-merger assets.

Larson said the attorney general’s office has responded to the complaint, saying it is investigating the issue.

“They indicated that breach of contract actions they don’t get involved in,” said Larson. “And if they call it that, then they aren’t going to get involved.”

When asked about the complaint against WSMC, Rubin said she would not “engage on any legal issues.”

McFarland also declined to comment on this issue, though in a November 2014 letter addressed to an Enloe Medical Center official, he attributed the center’s cutback in emergency services to losing a nurse practitioner “due to burnout.”

McFarland wrote the nurse was expected to be on call five days a week, for 24 hours a day, seeing anywhere from 10 to 13 patients a day, while also responding to urgent county jail calls. He stated the service provider schedule was “unsustainable.”

While it is uncertain what the cost of staffing the Downieville clinic with 24-hour care would be, according to the Bureau of Labor Statistics, the median annual wage for a nurse practitioner runs around $93,000 a year.

“WSMC is in the unpleasant and reluctant position of needing to adjust the services it provides to the people in the Downieville area to the staffing and financial resources it has available,” the letter states. “… (WSMC) can no longer support its Downieville site operating as a (Free Standing Emergency Department); cannot continue its contractual relationship with Enloe Medical center, and can no longer be a provider of emergent services to the community.”

In December, WSMC opened a new 19,000-square-foot Grass Valley center, a $4.9 million development funded through a loan from the Rural Community Assistance Corporation.

McFarland previously told The Union that WSMC is looking into expanding the new center even more.

“It gives us a nice expansion opportunity as we continue to grow,” he said in December. “There’s still room for another 24,000- to 30,000-square-foot building attached to this current floor plan.”

Rubin points out that WSMC’s new Grass Valley facility also does not offer 24-hour care, and has similar hours of operation to the Downieville clinic.

“What we want people to know as we move forward is the biggest factor is our capability — we think people are better off calling 911 for an emergency,” Rubin said. “That kind of care that’s received when 911 is called is best provided by professionals and the facilities that are best equipped for those situations.”

Rubin added that WSMC’s wants to collaborate on providing Downieville patients with paramedic services, but Larson says the paramedic would not be able to work out of the Downieville clinic because an ambulance can’t transport patients to the clinic anymore.

“The problem is if you have a heart attack, stroke or some kind of emergency between 5 p.m. Thursday, and 8 a.m. on Monday, you have no guarantee of advanced life support help. None,” said Larson.

Downieville resident Duane Sorenson said the loss of emergency care at the clinic not only affects the health of the local community, but the economy.

“The real estate and the value of businesses in the area starts to deteriorate when an area doesn’t have the necessary medical services needed to treat residents and visitors,” Sorenson said. “I’m afraid that one or more people are going to have to die before this issue actually really comes to a head.”

To contact Staff Writer Ivan Natividad, email or call 530-477-4236.

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