Clendaniel: Counties must find a way to keep 4 hospitals open

Aug. 21--I went for a hike earlier this month with my wife, Barbara, in the Forest of Nicene Marks. We wanted to relax with a stroll along Aptos Creek, hoping to take in the sights and smells that only a redwood forest can deliver.

I had an ulterior motive, as well. I wanted another look at the park 10 miles northeast of Santa Cruz that was the epicenter of the Loma Prieta earthquake, the 6.9 shaker in 1989 that killed 63 people and injured an additional 3,757.

Mother Nature has a way of letting us know that we shouldn't get lolled into a false sense of security even in the most peaceful of settings.

The question on my mind was whether we have sufficient medical facilities to deal with the next major earthquake, especially if Verity Health Systems closes two hospitals in Santa Clara County and two more in San Mateo County. The four hospitals have a combined total of 924 beds. The Bay Area already has a shortage of hospital beds, and California has fewer emergency rooms per capita than any other state.

We were fortunate in 1989 that we had the hospital facilities necessary to deal with Loma Prieta quake.

And lucky.

If the earthquake had struck closer to a more-populated area, the number of injuries could have doubled, or even tripled, putting additional pressure onemergency rooms and facilities. Officials estimate that a major earthquake along the Hayward Fault, for example, could result in 800 deaths and 18,000 injuries.

Verity announced in July that it might put the four hospitals up for sale, and Santa Clara County Executive Jeff Smith said the county is interested in buying San Jose's O'Connor Hospital (358 beds) and Gilroy's Saint Louise Regional Hospital (93 beds). If a buyer can't be found, it's possible that they would close.

Smith believes the county needs the beds not only for an emergency, but also to care for the daily needs of the county's growing population. Were O'Connor and Saint Louise to close, it's almost certain that the county would need to spend hundreds of millions to build additional beds at Valley Medical Center or build a new facility elsewhere. Hospital construction costs anywhere from $1 million-$2 million, gulp, per bed.

The population of Santa Clara County has grown from 1.49 million in 1989 to 1.75 million today. And projections are that the county will be home to 2.3 million by the year 2030.

But can the county afford to buy and operate the two hospitals? It's a complex, challenging question. One that requires a crystal ball to determine the future of the Affordable Care Act and federal and state health care funding.

The state Attorney General's office required as part of the 2015 purchase from the Daughters of Charity that Verity maintain Medi-Cal contracts and services at each hospital site for 10 years and provide charity care to indigent patients at historic levels. It's one of the reasons Verity reported an operating loss of $55.8 million in the eight months that ended March 31. The hospitals' owners are also dealing with a challenging pension fund issue that the county would have to absorb or negotiate as part of any sale.

It's imperative that the county show how it could operate the hospitals without damaging other essential programs. Construction and acquisition costs could be made with lease revenue bonds, but any debt service and operating costs of the facilities and their employees would fall to the general fund.

Some health care experts have suggested that the county could consider a public-private effort with, say, Stanford or El Camino Hospital, that could benefit all. It's even possible that San Mateo County could join a regional joint powers agency that could also save Seton Coastside (116 beds) in Moss Beach and Seton Medical Center (357 beds) in Daly City. A package deal may be of more interest to the hospital owners than trying to sell them piecemeal.

The first priority for the county if it makes an offer for the two hospitals is to demonstrate to taxpayers that it pencils out. One way or another, Santa Clara County and San Mateo County need to find a way to keep O'Connor, Saint Louise and the two Seton hospitals open to meet residents medical needs, whether it's for planned medical treatments or for injuries from a natural disaster. Every resident should have the expectation that on those occasions when they need a hospital bed, one should be available to meet their needs.

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