The Santa Barbara County Public Health Department terminated a longtime contract for women’s health services in the name of cost savings last month, and then quickly signed on new providers to serve those patients.
The county has contracted with Dr. Lawrence J. Bines since at least July 1997 for women’s health care at Public Health clinics, and related hospital care for those patients.
Bines also used subcontractors, including several obstetrics and gynecology (OB/GYN) physicians from Sansum Clinic, to provide the services. Last year, the county paid $977,092.67 for the contract.
The most recent contract with his professional group, for the fiscal year starting July 1, was for a maximum amount of $1,079,408.
Public Health Director Dr. Mouhanad Hammami asked the Board of Supervisors to terminate the agreement on Nov. 15, citing the cost of the contract, and they agreed.
“The contract itself is over a million dollars, and as operational and business decisions, I was looking at this the minute I walked in,” said Hammami, who started as director in January. “There are other ways of providing those services.”
The department said it expects to save $250,000-$300,000 by changing the contracts.
The supervisors said they appreciate the services Bines provided for county patients over the decades, and they delayed the decision a week to request more information from staff. They unanimously voted to terminate the contract on Oct. 17.
The county now has a $150,000-per-year agreement with Dr. Pedram Rashti for Santa Barbara Cottage Hospital inpatient services.
“County patients continue to deliver at our local hospitals, and this service has not been interrupted or impacted,” county spokesperson Kelsey Gerckens Buttitta said last week.
Bines’ patients will be transferred to other providers at county health care centers. That includes employed and contracted OB/GYN physicians and registered nurses, Gerckens Buttitta said.
Dr. Susanne Ramos is the new lead physician for women’s health services in Santa Barbara. Dr. Carol Karamitsos will be the lead physician for women’s health in Lompoc, starting Nov. 16, and Dr. Carolyn Griffith and Dr. Keith Dillon in Santa Maria will be joined by Dr. Jan Eperjesi in November, according to the county.
At the Oct. 10 Board of Supervisors meeting, the first time the contract termination was discussed, Bines said the decision hurt Public Health’s reputation and ability to care for patients.
County representatives said there was no interruption in service due to contract changes.
Bines also said county staff did not mention “shifting business needs” in June, when they gave him a 2% cost-of-living raise for the yearly contract.
“We made the decision based on purely efficiency and cost effectiveness and how we want to operate our clinics,” Hammami said in response.
“Now we have three providers instead of one,” he added.
Hammami and Bines both referred in their comments to the Human Resources complaint investigation of Bines, which in September restricted him from clinic duty at the Santa Barbara, Franklin and Carpinteria health centers.
That investigation was ongoing, according to Bines, who is a contractor and not a county employee.
A week later, at the Oct. 17 supervisors meeting, Bines said he realizes he has an at-will contract and won’t contest it, but wanted to call out department leadership.
“I am here to put the work of your Public Health director and his team on your radar. I’m here to put you on alert that the largest revenue-generating specialty in healthcare services is at risk. I’m here to make you aware of how poorly two of your departments have treated me after 31 years of proud service,” Bines told supervisors.
“You have some of the finest, most caring, capable people working in the trenches at your clinics,” Bines said. “It’s been my honor to work with them all these years, and hope you’ll honor them by providing them with effective leaders.”
The supervisors said they appreciated hearing from people in the women’s health field – including a couple who wrote emails supporting Bines.
If the contract came back for less money, Chair Das Williams said, he’d be open to it.