The opinions expressed in this piece do not necessarily reflect the views of The Mendocino Voice. We value the diverse opinions of our readers and we welcome robust, wide-ranging thoughts and ideas on subjects relevant to Mendocino County. Opinion pieces can be sent to info@mendovoice.com.
I love our Mendocino Coast community. We are resilient, we love living off the beaten path, and we are strong advocates for the causes that matter to us. Thirty years ago, I saw the benefits of these traits when a committed group of local residents came together to maintain quality healthcare on the coast after the County proposed closure of its Fort Bragg health clinic. That is when Mendocino Coast Clinics was born; I was among the handful of early employees, working as a Spanish-speaking interpreter, biller, and family planning counselor at the time.
Now, as MCC’s executive director, I am witness to how the healthcare landscape continues to shift nationally and to the many ways our residents have spoken up, donated to support new services, and adapted as healthcare has changed on the coast.
Even for those of us who work in healthcare, the medical system can be hard to navigate. If I weren’t part of the local healthcare network, I don’t know how I would keep everything straight when half of the medical facilities have “Mendocino Coast” in their names!
So, given that healthcare has been in the paper a lot lately, I thought I would try to provide some context. It is important to start from a shared understanding of the major entities involved.
Mendocino Coast Health Care District is a taxable district responsible for ensuring that the approximately 25,000 people living on this coast have continued access to essential healthcare. The district is led by an elected five-member board of directors, all of whom live in the healthcare district, which ranges from Usal to Elk.
Mendocino Coast Clinics (MCC) is an independent, nonprofit health center committed to providing healthcare for every person who seeks it, regardless of insurance status or ability to pay. Our healthcare services include primary care (non-emergency medical services for ongoing well-being), pediatrics, dental care, reproductive care, and behavioral health. MCC is not a branch of or operated by the County, and we are not affiliated with the hospital.
As a Federally Qualified Health Center, MCC has a patient-driven volunteer board of directors and receives funding from the Health Resource Service Administration Health Center Program to provide primary care services in medically underserved areas. Unfortunately, those funds are limited. We earn the majority of our funding by billing insurance or state and federal programs for our services. We raise the remaining funds through grants and local donations.
Adventist Health Mendocino Coast is the region’s hospital, formerly run as Mendocino Coast District Hospital. In 2020 when the hospital was in dire financial straits, Adventist Health signed a 30-year contract to take over the lease and management of the hospital from the district. Adventist Health was one of only two entities to respond to the district’s request for a proposal at that time. The option to roll the hospital over to a private entity had to be passed by district voters, which it was with about 90% favoring privatization. The hospital is designated as a critical access hospital, which means it provides critical and acute care and cannot have more than 25 beds. As the only provider of hospital services for our coastal region, the hospital offers 24-hour emergency care and assistance with preventive and rehabilitation services. Adventist Health now runs all three hospitals in Mendocino County (in Fort Bragg, Willits, and Ukiah) and has primary care clinics in these cities, too. Adventist Health is a faith-based, nonprofit health system with hospitals throughout California and beyond. It is headquartered in Roseville, California.
The Mendocino Coast Healthcare Foundation was founded 40 years ago to raise funds to support the district hospital, though the foundation was and remains an independent nonprofit organization–not part of the hospital or any health clinic. Through the years, donations from the foundation have enabled the hospital to purchase ambulances, mammography equipment, diagnostic imaging equipment, and to afford essential remodeling and construction. In recent years, the foundation has shifted from primarily supporting the hospital to supporting workforce development and healthcare entities broadly across the district, including MCC.
Rising to Meet the Challenges Ahead
Living here on the coast is wonderful, but it does come with challenges. It can be hard to recruit young families and professionals given our remote location, housing shortage, and limited infrastructure (including limited broadband access), not to mention our lack of labor and delivery services. If we cannot recruit more people to work in our healthcare facilities, it is difficult to expand care, and given the aging population in our community, it is likely people will need more healthcare rather than less.
Given financial constraints, staffing challenges, and other limitations, we will almost certainly face more difficult decisions with regard to healthcare in the months and years ahead. I work directly with each of the entities dedicated to providing quality, accessible healthcare on the coast, and I have faith that we all have the community’s best interests at heart. Still, we are at a point where we will need to make some tough decisions about what services we maintain, and that will inevitably cause tension. I encourage everyone to stay engaged in the process, even when it is difficult. Respectful discussion and listening to alternate positions is important, and we should set a goal of being our best selves as we enter into these conversations.
Here are a few other actions I urge all of us to take:
- Vote in every election.
- Attend town halls and open forums to discuss healthcare. Ask questions about the process and the reasoning behind decisions if the management of the hospital changes. Speak up if you have questions about any of our entities’ governing boards, leadership, funding sources, or affiliations.
- With each healthcare decision, ask yourself: Who does this benefit? Does this decision prioritize the best interests of Mendocino Coast residents?
- When faced with difficult choices, ask which option will best meet our residents’ needs. We have already lost labor and delivery. If financial constraints make it necessary to close other hospital services, we need to carefully consider what we can travel for and what we need to maintain here.
- Listen, reflect and consider other opinions with a thoughtful process and questions.
We need the voices of our coastal residents to be heard. Your involvement directly impacts decisions that are made. Each of us needs to follow developments in local healthcare and reach out to our representatives and leaders when we have questions about the process, making sure to keep all comments civil and constructive.
I am deeply thankful for the ongoing support and engagement of our community.
Lucresha Renteria
Executive director, Mendocino Coast Clinics
Thank you for explaining this and for your service to our communities!
Thank you Lucresha, very helpful information. As our population ages, of course we need more, not less care. I hope we can continue to provide it and even increase it. But it sounds like at this point the pressure is to cut services. Very disappointing.
Deborah Karish