LAKEPORT – As Sutter Lakeside Hospital gets closer to completing a process to reduce its number of beds, leaders of several county fire agencies are voicing their concerns about the move's ultimate impact on local health care and the need to transfer more patients to out-of-county facilities.
Last fall, Sutter Lakeside Hospital announced its plans to seek Critical Access Hospital designation. The move would reduce the hospital's bed count from 69 to 25, while gaining a higher reimbursement rate from Medicare.
Sutter Lakeside spokesman Mitch Proaps said, currently, only one out of every five patients who visit the hospital covers the cost of care, a number he said will be raised to four out of five with the new designation.
The California Hospital Association reports that community hospitals around the state are feeling the financial pinch due to several factors – the billions required in seismic retrofits, $5.4 billion in underfunding from government programs and the nation's largest uninsured population, an estimated 6.8 million, a number which is growing.
The result, the association says, is that nearly 50 percent of all state hospitals are operating in the red.
It's that kind of financial pressure that Sutter Lakeside's officials said led the hospital's board of directors to choose what they believe is the best option – the Critical Access Hospital designation, which was granted to Redbud Hospital a few years ago.
Proaps said the decision was not motivated by profit, but rather by the fact that Sutter Lakeside has not been able to cover its own expenses. “Our shortfall for Medi-Cal, Medicare and the uninsured is too great.”
The Critical Access designation, he said, will allow the hospital to retain staff, cut the least amount of services and actually allow Sutter Lakeside to grow by generating revenue through higher reimbursements.
However, concerns about seeing the county's bed count further reduced and what the designation change will ultimately mean have landed the item on the Board of Supervisors' Tuesday agenda, where the board will discuss its position on the proposal.
The designation change also is raising concerns with the leaders of local fire districts, who say Sutter Lakeside has not been open with them about its situation or its plans, plans which they say could have huge impacts on the fire districts and the community.
The basis of fire agencies' concerns
To better understand the concerns expressed by the fire districts, it's important to go back to 2004.
From 2000 to 2004, Redwood Empire Life Support (RELS), a private, Santa Rosa-based ambulance company, contracted with the county to provide interfacility transport – taking patients from one hospital or medical facility to another, both inside and outside of the county.
In March 2004, RELS abruptly dropped its local services with no warning and no official notice to the county.
The move left the county without the interfacility transport services.
In response to the need, and with the knowledge that they could provide reliable, consistent response, the county's fire agencies took over the responsibility of providing ambulance services, adding staff – including former RELS employees – to do so.
Kelseyville Fire Protection District Chief Howard Strickler said that Kelseyville, Lakeport and Lake County Fire Protection Districts became responsible for interfacility transport. All fire districts also provide 911 patient transport.
Strickler said he has two ambulances that make the transport trips, one staffed by a full-time crew and the second with a part-time, volunteer crew.
Last year, Kelseyville Fire made 464 out-of-county transports, averaging 45 per month, said Strickler. Most of those trips were to St. Helena Hospital, with the second-most common destination Santa Rosa Memorial Hospital or a cardiac testing facility in Santa Rosa.
Lakeport Fire Chief Ken Wells said he has one ambulance devoted to interfacility transports that is staffed by a part-time crew. He has two 911 ambulances on call at all times, and explained that out-of-county transports don't interfere with local emergency response.
Captain Bob Ray of Lakeport Fire, who oversees the department's medical transports, said that for calendar year 2007 the agency made 339 out-of-country transfers from both Sutter and Redbud, and 378 within the county from either one hospital to another or between other care facilities. That's an average of just under two a day, said Ray.
Lakeport Fire mostly transports patients to St. Helena Hospital, followed by Santa Rosa Memorial, Sutter Santa Rosa and Kaiser Santa Rosa, Ray said. One transport from Sutter Lakeside to St. Helena can take up to five hours, counting the round trip and paperwork.
Other trips – to Sacramento, UC Davis Medical Center, San Francisco or Stanford Medical Center – can take many more hours than that, Ray added.
Proaps said Sutter Lakeside currently transfers about 350 patients per year to other hospitals mainly for higher levels or specialty care that isn’t available in Lake County. Any increase in transfers after Critical Access Hospital designation, said Proaps, would be to Lakeport Skilled Nursing, Ukiah Valley Medical Center or to St. Helena Hospital for the same or lower level of care provided at Sutter Lakeside.
United Healthcare Workers (UHW) West, which represents between 150 and 170 of Sutter Lakeside's staff, offered its own analysis on patients treated out of county.
UHW stated that in 2006 838 Lake County residents were treated at either Sutter Medical Center in Santa Rosa or Santa Rosa Memorial Hospital, although it was not clear if those patients were direct transfers from Sutter Lakeside.
If the designation goes through, and beds are reduced, UHW estimates another 300 patients will need to seek care out of county.
Statistics for Lake County Fire Protection District and South Lake Fire Protection District were not immediately available.
Tomorrow: Fire officials explain their concerns, which include Sutter Lakeside's failure to contact them directly to discuss the ramifications of the status change.
E-mail Elizabeth Larson at
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