09 Staff Report - Closure and Transition of Community Hospital
DATE: TO: FROM: COUNCIL AGENDA REPORT MARCH 12, 2009 MAYOR AND TOWN COUNCIL GREG LARSON, TOWN MANAGER MEETING DATE: 3/16/2009 ITEM NO: 9 SUBJECT: PRESENTATION REGARDING THE TEMPORARY
CLOSURE AND TRANSITION OF THE COMMUNITY HOSPITAL OF LOS GATOS RECOMMENDATION: No action is required or recommended at this time; this is primarily an opportunity to gather information
regarding the forthcoming closure and reopening of the Commuuity Hospital of Los Gatos. Relevant Council directi?n to staffwould be appropriate upon majority action ofthe Council. BACKGROUND:
In the middle of2008, it was announced that Tenet Corporation, the current operator of the Commuuity Hospital of Los Gatos (CHLG), had settled a series of property disputes with HCP,
Inc., a real estate trust based in Long Beach that currently owns CHLG. That settlement included the termination of Tenet's lease ofCHLG as of June 1,2009. In August, 2008, the Town
Council unanimously adopted a resolution reaffirming the current zoning and land uses on the CHLG property, indicating that any substantive change to residential or other use would need
fo be considered as part of the General Plan Update process and its associated environmental review. Last fall, it was announced that EI Camino Hospital of Mountain View would acquire
and operate CHLG as of June 1, 2009. Subsequent to that announcement; Tenet reported that they would need to close CHLG as of April 10 to allow for their orderly vacation of the premises
and El Camino stated that they would need the hospital available to them for approximately 90 days before re-opening. Town stafftalked with the CEO's ofboth Tenet and El Camino to encourage
the shortest closure possible and to offer whatever assistance the Town could provide to minimize the service delivery impacts on .Los Gatos residents and the broader region. Both organizations
committed to using their best efforts to accelerate the reopening of CHLG. PREPARED BY: GREG LARSON Town Manager GL:pg N:\MGR\AdminWorkFiles\2009 Council Reports\3-16-09 Community Hospital
afLas Gatos Tmnsition.doc Reviewed by: MAssistant Town Manager__Town Attorney __Clerk Administrator __Finance __Community Development
PAGE 2 SUBJECT: PRESENTATION REGARDING THE TEMPORARY CLOSURE AND TRANSITION OF THE COMMUNITY HOSPITAL OF LOS GATOS MARCH 12, 2009 DISCUSSION: It
is currently anticipated that CHLG will cease all or most operations as of April 10, 2009 with a .possible re-opening as early as August, 2009. Based on previous meetings, reports and
discussions, staff is optimistic that CHLG will re-open as Ii high quality and full service hospital and medical facility that . . will meet the needs of Los Gatos and the broader region.
Nonetheless, the temporary closure could have significant impacts on the community and region. Most significant would be the loss oflife or serious injury due to lack ofpublic awareness
about the temporary closure of the emergency room and hospital. To assist the hospital operators in this regard, Town staff will be undertaking a voluntary public information program
about the closure, including: . • Appropriate street signage changes • Display advertising • Bulk direct mail The total anticipated cost is under $20,000 and can be absorbed under Manager
authority within existing appropriations. Guest speakers have been invited to the Council meeting to present their perspectives and information on the closure and recopening of CHLG.
Those speakers include: • Mr. Ken Graham, CEO ofEl Camino Hospital • Dr. Paul Beaupre, COO & Chief Medical Officer of Good Samaritan Hospital • Mr. Bruce Lee, Director of Santa Clara
County Emergency Medical Services Attached is information provided by each organization regarding their efforts. ENVIRONMENTAL ASSESSMENT: Is not a project defined under CEQA, and no
further action is required. Attachments: 1. 3/12/09 El Camino Hospital Press Release 2. 3/3109 Santa Clara County memorandum to Board of Supervisors on closure of Community Hospital
of Los Gatos 3. Good Samaritan informational post card Distribution: Kenneth D. Graham, Chief Executive Officer -EI Camino Hospital, 2500 Grant Rd, Mountain View 94040-4378 Dr. Paul
Beaupre, COO & Chief Medical Officer of Good Samaritan Hospital --2425 Samaritan Drive, San Jose, CA 95124 Mr. Bruce Lee, Director of Santa Clara County Emergency MediCal Services --645
South Bascom Avenue, Suite lP141 -San Jose, CA 95128
3/12/2009· Press Release (From website) EI Camino Hospital Updates Community on Progress with Los Gatos Campus Activation· Some clinical services decisions determined for ECH 'sister'
site Mountain View, Calif., March 12, 2009 -El Camino Hospital, the hospital of Silicon Valley, today announced some of the services that will be available when the new Los Gatos location
re-opens for service this summer. The Los Gatos site will offer acute care services, including emergency, medical, surgical, intensive care and labor and delivery services, as well as
continuing the location's commitment to orthopedicslspineand urology. El Camino Hospital (ECH) is currently scheduled to take possession of the campus and buildings on June 1, or possibly
sooner if an agreement is reached, and will need a minimum of 90 days to re-open the,campus. 'We,are very happy with the activation 'progress at this point and appreciate the great response
we've received from the community" said Eric Pifer, M.D., chief medicai officer, Ei Camino Hospital and incoming president of the Los Gatos site. "In addition to these services, we have
determined our medical staff structure, and put a department structure into place for when the Los Gatos location re-opens. We will be continuing to hold medical staff meetings under
EI Camino Hospital's license during the closure period." "During the coming closure period, we will be working closely with County Emergency Medical Services, Good Samaritan Hospital,
and other health providers to make sure the community continues to have multiple care options available. We will also be expanding the services and availability at EI Camino Hospitai
to minimize the impact the closure will have on the community." Task Forces Assigned for Transitions To help with the decision to offer labor and delivery services, the activation team
met with obstetrics and gynecology physicians in the Los Gatos and Saratoga communities. A task force of physicians and clinicians is being formed to help with the transition and development
development of the future OB/GYN program. In addition, ECH announced that Community Hospital of Los Gatos' current orthopedics and spine department, which has received five-star ratings
from HealthGrades, will also be among the services· offered at the new Los Gatos campus. EI Camino Hospital to Participate in Los Gatos Job Fair ECH representatives will be among the
area hospitals participating at a job fair to be held at Community Hospital of Los Gatos on Tuesday, March 24, from 11 a.m. to 4 p.m. Tenet, the current hospital operator, is hosting
the fair as part of its outplacement effort. 'We have received an overwhelming response from physicians interested in joining the ECH medical staff famiiy400 and counting -and as we
progress in determining all of the clinical services that will be offered, more positions will become available, so we encourage all interested health care professionals to either attend
the job fair, visit us at our liaison office, or send us their resumes," said Dr. Pifer. ATTACHMENT 1
Liaison Office Open to Public Questions about the Los Gatos campus, including clinicai service offerings, position openings, patient and emergency care questions and others are being
addressed at the new liaison office located at 825 Poliard Road, in Los Gatos. The office is set up to serve as a community resource for South Bay physicians, potential ECH employees
and members of the community who have questions about the activation plans for the hospital's new Los Gatos location. The office staff are available to answer questions and provide updated
information during normal business hours. Staff can also be reached by phone at 650-962-4949. To [earn more about this acquisition, please cali 1·888·650·5124. People interested in future
openings with EI Camino Hospita[ can send resumes to hr@elcamlnohospital.org with "Los Gatos" in the subject line or visit E[ Camino Hospital's Job Finder to view our current job opportunities.
Physicians are encouraged to cali the physician hotline at 650-988-7698. More information about EI Camino Hospital's Medical Staff is available at www.elcaminohospital.org/medstaff.
. Media Contacts: Judy Twitcheli JudLTwitcheli@elcaminohospital.org 650·988·7767 office Brigette Beaudoin, Ede[man Brigette.Beaudoin@edelman.com 415·486·3234 office 415·525-9464 mobile
E-mail: questions_losgatos@elcaminohospital.org
BOS Agenda Date: March 3, 2009 Agenda Item No.4 County of Santa Clara Santa Clara Valley Health &Hospital System Public Health Emergency Medical Services HHSOI 030309 Prepared by: Bruce
H. Lee EMS Director Reviewed by: Dan Peddycord, RN, MPA/HA Pnblic Health Administrator DATE: TO: FROM: March 3, 2009 Board of Supervisors Kim Roberts SCVHHS -Chief Executive Officer
SUBJECT: Closure of Commuuity Hospital of Los Gatos RECOMMENDED ACTION Hearing to consider and evaluate impacts upon the community resulting from the closure of Community Hospital ofLos
Gatos and its emergency-related services. Possible action: a. Open public hearing and receive testimony. b. Close public hearing. c. Direct Administration to prepare and submit the fmal
Impact Evaluation Report, including information from public testimony, to the California Department of Public Health and the California Emergency Medical Services Authority on or before
March 8, 2009, in compliance with California Health and Safety Code, Division 2.5, Sections 1255 1255 and 1300. 1 ATTACHMENT 2
r BOS Agend[l Date: March 3,2-009 Agenda Item No.4 .FISCAL IMPLICATIONS There is no inipact on the General Fund as a result of this action. REASONS FOR RECOMMENDATION On Janumy 8, 2009,
Conununity Hospital ofLos Gatos (CHLG), a Tenant Hospital, gave the Santa Clara County Emergency Medical Services Agency the legally required 90-day notice that the hospital would close
on April 10, 2009. Under State law, the Local Emergency Medical Services Agency must hold a public hearing and draft an inipact report within 60 days of receipt describing how the closure
of CHLG's emergency-related services will impact hospitals, emergency service providers, and conununity access to emergency care. This report must be submitted to the State Department
of Public Health and the State Emergency Medical Services Authority. At the request of Supervisor Gage, a public hearing was held at the Los Gatos Town Hall on FebmalY 19, 2009, from
6 8 pm. The hearing was noticed in accordance with the Brown Act and the notice was distributed distributed through the various stakeholder groups.. Approximately 20 individuals attended
the hearing, with three providing oral testiniony. Those presenting testimony included: a physician representative from Good Samaritan Hospital who provided a sunnnary of activities
that their facility is iniplementing to prepare for the closure of CHLG; a nurse manager from Conununity Hospital of Los Gatos stating the iniportance of the hospital in regard to emergency
care; and the Chief Medical Officer of the El Camino Hospital District expressing general timelines related to the future services that may be available at the CHLG site. Attached to
this transmittaHs the draft Impact Evaluation Report for the Closure of Community Hospital of Los Gatos, as required by the California Health and Safety Code, Division 2.5, Sections
1255 and 1300. The report will be updated with infOlmation from today's public hearing and submitted to the State by the required deadline. BACKGROUND Pursuant to the California Health
and Safety Code, the Emergency Medical Services (EMS) Agency, a division of Santa Clara County's Public Health Department, is responsible for performing the required impaclevaluation
consistent with its statutory mandate to "plan, iniplement and evaluate an emergency medical services system...consisting of an organized pattern of readiness and response services based
on public and private agreements and operational procedures." The EMS Agency is charged with oversight of the emergency medical services system in Santa Clara County. The Emergency Medical
Services System is a network ofpublic and private organizations, regulated by the Agency. These organizations and service providers include fIre, law enforcement, ambulance services,
hospitals, communications centers, physicians, nurses, paramedics, emergency medical technicians, and support personnel, as well as their accompanying physical and operational infrastrncture.
In Santa Clara County, there are 10 fire departments, fIve permitted ground ambulance companies and currently 12 hospitals (11 with emergency depmtments). It is through this inter-dependant
stmcture that the high quality emergency services the public has come to expect are delivered. Dismpting any part of the strncture affects the entire system and it is that potential
dismption that is the focus of the . impact evaluation. The impact evaluation process provides a forum for the involved parties to work collectively in communicating their concerns and
fostering a collaborative approach to identify the anticipated impacts that may occur to the EMS System. The purpose of the inipact evaluation is not to assess a hospital's value to
the conununity, but to examine what affect the downgrade or closure of emergency services will have on the conununity and the other emergency service providers. The impact evaluation
is in addition to the requirements made of the hospital to notify state and local health services, 2
BOS Agenda Date: March 3, 2009 Agenda Item No.4 health care service plans and the public of the planned reduction/elimination of emergency services.. Impact Evaluation Report Overview
and Key Findings The Los Gatos Community Hospital (CHLG) service area primarily consists of the cities ofLos Gatos and Monte Sereno, and parts of San Jose and Campbell. Los'Gatos and
Monte Sereno cities are among the smallest of the 15 cities located in Santa Clara County. In the zip codes of the cities of Los Gatos and Monte Sereno (95030, 95031, 95032, 95033),
there are an estimated 31,500 residents. Of the residents, 48% are male, and 52% female; 21% are under age 18 and 17% were age 65 or older. In these cities, the population is older than
Santa Clara County as a whole, where only 10% of the population is age 65 or older. According to infOlmation obtained from the California Office of Statewide Health Planning and Development
(OSHPD) 2007 data, CHLG is licensed to operate and maintain 143 general acute care hospital beds ((4% ofthe County total) of which 8 are designated as coronary care beds and 7 as intensive
care beds. There are no acute psychiatric beds. Other approved services include 19 emergency medical treatment stations, or Emergency Department (ED) beds. CHLG received 13,470 (4%)
of the total number of 377,858 Emergency Department visits with 11% of these ED visits resulting in an admission to the hospital. CHLG received 1,105 ambulance transports from 911; this
amounts to 2% of the total 68,809 ambulance transports that occurred in Santa Clara County. . The following is a summary of the key findings contained in the report: Impact on Prehospital
Services As some ambulances may have to drive farther and take longer to reach a hospital, overall ambulance response times may increase due to extended time on task for each ambulance
call. Ambulance tum-around times at hospitals (dropping patients off at the hospital) may be extended due to increased ED overcrowding and bed availability. Impact on Hospital Emergency
Services CHLG closure may exacerbate the growing problem of emergency department overcrowding -a significant problem in Santa Clara County and throughout the nation. Increased Emergency
Department overcrowding may produce an increase in ambulance diversion. While providing temporary relief for one emergency department, diversion produces other system problems (i.e.,
patients are transported to other hospitals and increase theworkload of those hospitals, patients' transport time is increased, patients' ability to choose a hospital is limited). With
the closure of CHLG, the remaining 10 emergency departments in Santa Clara COUllty will have to absorb annually over 1,000 additional emergency department patients, many of which are
urgent care type patients. 3
BOS Agenda Date: March 3; 2009 Agenda Item No.4 There are a total of five acute care facilities within ten miles of CHLG. Of these facilities, two are within five miles" Good Samaritan
and Valley Medical Center. These two facilities will experience the most impact from the closure of CHLG. Conclusion Based on the findings in this repoit, it is clear that the closure
ofLos Gatos Community Hospital will have an impact on the delivery of emergency and urgent care services in the Los GatoslMonte Sereno/Campbell area. The closure will have collateral
impacts on the entire EMS System in Santa Clara County. There are limited additional capacities available in certain areas within the local hospital system to absorbthe loss of resources
at Los Gatos Community Hospital (i.e. inpatient beds). Therefore, the impact from the loss of emergency and urgent care services will be difficult to mitigate. The County recommends
that the State consider conducting a thorough review of the apparent statewide trend with hospital downgrades and closures. The State should also seriously consider the development of
new mandates to assure that local communities receive longer notice and more time to plan for hospital closures. Note: It is undcrstood that EI Camino District Hospital of Mountain View
intends to purchase the CHLG property and re-open the facility as a licensed acute care hospital at some point later in the 2009 calendar year. If this intended action occurs, most if
not all of the closure impacts will be mitigated. CONSEOUENCES OF NEGATIVE ACTION Failure to approve the recommended actions will put the County at risk ofnon"compliance with State law.
ATTACHMENTS • Impact Evaluation Report -CHLG 4
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