Targeting the closure of nonprofit hospitals

East Bay lawmakers are pushing a bill to stop Sutter Health from shuttering its Alta Bates Summit Medical Center in Berkeley — a measure with major statewide implications.

The bill was prompted by issues surrounding Alta Bates, but it would apply to any emergency rooms across California run by nonprofits.

“We’re seeing closures of urban hospitals around the state and around the country that are jeopardizing emergency medical care in our communities.” — John Gioia

Backers of the legislation, SB 687 by Sen. Nancy Skinner, D-Berkeley, say the law would preserve Californians’ access to emergency medical services. Skinner authored the bill after Sutter announced it would close the Alta Bates campus.

“When hospitals and emergency rooms close, patients pay the price with longer wait times and decreased health outcomes,” Skinner said earlier in a press release. She contended that her bill “will create a layer of protection for the health of our communities.”

Sutter Health said in a March 2017 written statement that its hands were tied. To afford the cost of a state seismic safety standards, Sutter said they to rebuild Alta Bates as an outpatient-only facility and consolidate the emergency and in-patient beds to an Oakland location.

The bill has already cleared the state Senate, and lawmakers have until Friday, the last day of this year’s legislative session, to pass it out of the Assembly. According to a spokesperson from Skinner’s office, a vote is expected today.

Contra Costa County Supervisor John Gioia suggested that the bill is crucial. “We’re seeing closures of urban hospitals around the state and around the country that are jeopardizing emergency medical care in our communities,” he said.

Since the 2015 closing of Doctors Medical Center in San Pablo, an increasing number of Contra Costa residents have relied on Alta Bates for emergency medical care.

Alta Bates “is crucial for providing timely healthcare services for the people of Berkeley and cities beyond Berkeley’s border.” — Kriss Worthington

Assemblyman Tony Thurmond, D-Richmond, said earlier during a press conference that the closure of Doctors Medical Center tripled the number of ER visits to the city’s Kaiser hospital, which boasts just 50 emergency beds.

Gioia also argued nonprofit hospitals that receive a tax break should be held to a higher level of accountability.

Jan Emerson-Shea, a spokesperson for the California Hospital Association (CHA), disagreed. “Many hospitals are struggling with their bottom lines, due mostly to low Medi-Cal reimbursement rates,” she said.

She said that Skinner’s bill does nothing to address the underlying issues of why a hospital decides to close a facility. “It just adds another level of bureaucracy on top of it,” Emerson-Shea said.

One of those issues, according to Emerson-Shea, is the cost of the state-mandated seismic retrofitting. There is no specific timeline for the closure, but in Sutter’s statement indicated it would be sometime before 2030 to adhere to the requirements set out by state law.

In a July 2016 resolution opposing Sutter’s announcement, Councilman Kriss Worthington wrote that Alta Bates “is crucial for providing timely healthcare services for the people of Berkeley and cities beyond Berkeley’s border.” The resolution also stated that the national average of acute-care beds was just under three per 1,000 residents. But in Contra Costa County, it was about half that: 1.4 beds per 1000 residents.

“No one wants to close a hospital. If you’re losing money from reimbursements, you can’t afford to keep your doors open.” — Jan Emerson-Shea

“Will there will be impacts on Richmond-area residents? Yes,” Gioia said. “What will the extent of those impacts be? I think we’re trying to fully understand that. Clearly, they will be negative.”

The supervisor also said there are no guarantees that the number of emergency-room beds will remain the same at a rebuilt Alta Bates. And, even if they did, there would still be a loss of inpatient beds, and an increase in travel time along the I-80 corridor for Contra Costa County residents.

If the bill is voted through by Friday, it will head to Gov. Jerry Brown’s desk. Though it is presumed the majority-Democrat Legislature will pass SB 687, the governor can be unpredictable: He doesn’t always approve bills along partisan lines.

Sign or veto, the battle for Alta Bates won’t end with the governor’s pen. If Skinner’s bill is enacted, it will then be up to the state attorney general to assess the impact of the hospital’s closure. This process would include a public hearing.

“No one wants to close a hospital,” Emerson-Shea said. “If you’re losing money from reimbursements, you can’t afford to keep your doors open.”

Gioia agreed; he noted that Doctors Medical Center was ultimately forced to close because it had too few patients with private insurance, and too many uninsured or on Medi-Cal.

But the supervisor doesn’t believe Alta Bates faces the same situation, because it’s part of a larger medical system. “They can make a decision to keep a hospital open because they’re getting revenues from other sources,” Gioia said.
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Ed’s Note: A version of this story has appeared in Richmond Confidential, a news site operated by the UC Berkeley Graduate School of Journalism.