Candidate Q&A: Joel Hernandez for SVMHS Board of Directors.

What are the biggest issues facing Salinas Valley Memorial Healthcare District in the next four years, and why are you the best candidate to address them?

Workforce: The hospital industry in general is going through a very challenging time. The pandemic has presented one of the most difficult periods in healthcare that we’ve seen in our lifetime. We are looking for ways to support the resilience of our staff and continue to keep them safe, and employed. We are seeing a nationwide healthcare workforce shortage, and we are working to address that on many fronts.

Our area is one of many in the state that does not have enough primary care providers. Our recruitment of physicians and providers continues to be an area of focus for us.

Finances: More than half of all hospitals are projected to experience negative margins this year. Hospital costs are rising, workforce shortages are presenting a huge challenge, and supply chain disruptions continue to be problematic. 2022 is turning out to be the worst year for hospitals since the beginning of the pandemic.

At SVMHS, we have been very careful stewards of public funds, and we are now financially stable. However, our margins—while still positive—are significantly lower than they were pre-pandemic levels. So we will have to continue to be very careful with finances.

Affordability & Access to Care: Affordability and access continue to be challenges we face as a nation, and issues we continually work on at SVMHS. We have addressed access by creating the Salinas Valley Medical Clinic, which now has more than 160 providers, and we created that to be payer blind – accepting all patients regardless of their insurance status. As each physician office came under our umbrella and became payer blind, access to care expanded significantly for thousands of people overnight. We also created the Mobile Health Clinic program—to bring medical care to those areas of our community that are medically underserved. Patients are not charged anything for those services, and in addition to medical care we provide gas and grocery cards, food staples, and other supplies our patients need. Our collaboration with Montage Health to provide a cost-effective health plan in Aspire Health is another example of what we are doing to achieve affordability and access.

I’m very proud of the fact that SVMHS was recently recognized as 5th in the nation in social responsibility by the Lown Index. The index ranks hospitals on their value, outcomes, and equity.

Behavioral Health: This is an area of tremendous need in our community, and we need to innovate in order to meet that need. We are providing virtual services, which may be the only way to achieve appropriate scale. It is something we must continue to actively address.

Community Health & Well-being: I believe that a community’s health starts at home, and in neighborhoods. It is why we have invested in the Blue Zones Project, a collection of best practices that has been shown to move the needle on community health. We need to work outside the four walls of the hospital and physician and urgent care practices, and have a presence in the community. We are doing that with the Blue Zones Project, our Mobile Health Clinic, community education offerings, etc.

I’m the best candidate in Zone 5 because of my expertise in the nonprofit sector forming community-led groups to advocate for better health and housing conditions; since my appointment to the board I’ve dedicated time and effort to learn about the healthcare industry in order to represent constituents living in Zone 5.

How often do you currently attend SVMHS board meetings? Do you think the current board is effective?

I’ve attended every monthly meeting since my appointment to the board in July of 2020 with the exception of two meetings due to health conditions. I believe the current board is effective.

How do you think SVMHS did at handling Covid-19? What policies should be in place going forward?

SVMHS did great handling Covid-19 and continue to play a role to diminish the effects of the virus. In the early months of the pandemic SVMHS nurses were deployed to the community and agriculture fields to educate our community of the ever changing virus.

In a matter of weeks the hospital transformed sections of the building in Covid-19 units in order to meet the demand and needs of the region. In December of 2020, SVMHS received the high rating “A” for patient safety during the pandemic.

We need to continue to have policies restricting the number of visitors allowed in our hospital, require the appropriate personal protective equipment and vaccines necessary to keep staff and patients safe while under our care.

Do you think SVMHS’ presence beyond the hospital is the right-sized footprint, or should there be more or less outpatient services? 

I firmly believe that our current footprint is necessary, and creates greater access for patients.

We need to provide services in a way that makes it easy for patients to get care—access to healthcare is a priority. The Mobile Health Clinic is an example of that, and so is our clinic in Gonzales. We were able to create a Rural Health Clinic—the Taylor Farms Family Health & Wellness Center—that now has primary and specialty care—many services that just weren’t available to people before we built the clinic. And our urgent care centers are designed to be accessible to people when they need help. A wide-ranging footprint is necessary in order to meet the healthcare needs of the community.

It could be possible that we will need to develop other outpatient services in locations that need them. However, we need to be fiscally conservative, and be sure that we are moving forward in a way that will not jeopardize our financial stability.

The seismic retrofit project has been years in the making and is finally moving forward, along with other construction. Is there anything you would change about the retrofit process or anything you would have done differently? If elected, what will you do to keep big construction projects moving forward and on budget? 

If there was anything I could change about California’s approach to seismic safety, it would be to have the state fund the mandates it imposes. Seismic safety is important to all of us, and we will be able to meet the deadline requirements because of our financial health. Not all California hospitals are that fortunate.

About our project specifically – the Board has strict practices in place that provide very close monitoring of budgeting and expenses for projects big and small. We have access to all the information we need to make sure a project is on track, and we are updated regularly on progress. I look forward to continuing my close examination of all capital projects – from proposal phase to completion. Being attentive to detail, and taking the time to fully understand what is being presented, is important when you are in the position of making decisions on projects that require tens of millions of dollars in financing.

Just a few years ago, the SVMH board was looking for a private buyer. What is your philosophy about whether SVMH should remain a standalone hospital into the future? What will you do to help keep the finances sustainable? 

I believe our community benefits from having independent, nonprofit hospitals serving this area, and it is my hope and intention to do everything I can to ensure a bright future that includes remaining independent. We are a mission-driven organization, with no shareholders looking to make profits; so every bit of revenue over expenses is invested into the community, our people, plant & facilities, and technology. Our profile would be very different – and the benefit to the community would change drastically – if we were a small offshoot of a large hospital system that had to prioritize profits.

Regarding my role in keeping finances sustainable – it is vital to be engaged, to ask questions, to challenge when appropriate, to be unafraid to dig into the details, and perhaps most importantly, to make sure the President/CEO is doing what is necessary to keep this valuable community resource healthy. I also need to make sure that as a board, we support the CEO to do what is necessary and in the best interest of the community. I also believe it is my responsibility to educate myself about the complexities of modern healthcare. It is daunting, but it is a challenge I find rewarding.

Do you think the four hospitals in Monterey County work effectively together? What would you change, if anything, about the relationships between hospitals? 

I strongly believe the four hospitals in our county work effectively together. During the pandemic all four hospitals partnered to ask healthcare workers and community members to get vaccinated. In July of 2022, SVMHS and Montage Health received the American Hospital Association Dick Davidson NOVA Award for the collaboration on The Monterey County Diabetes Collaborative (MCDC) that aims to reduce Type 2 diabetes in our county. Lastly, the four hospitals, Monterey County Health Department and United Way have built the Monterey County Health Needs Collaborative that aims to leverage resources to meet common health goals.

Please rate the performance of the current president/CEO. 

Pete Delgado, President/CEO, continues to have a high performance leading SVMHS.

Who are you supporting for the other open seats on the SVMHS board? 

Richard Turner because he’s an asset to our board. Richard’s 30 plus years of experience as a financial executive is critical on our board. Before being on the SVMHS board, he was a board member of the SVMHS Foundation for six years. His story of why he loves the institution is inspiring.

Dr. Rolando Cabrera because of his medical and business experience. Dr. Cabrera specializes in family medicine which is a need as we recover from the pandemic. In the short time we’ve met, he’s shown a high level of integrity and respect for the work he has done and continues to do.

What is the proudest endorsement you have received? 

The full support of all other four SVMHS board members along with every other endorsement received are all an honor.