The California State Assembly’s approval of Senate Bill 687 on Friday may prevent the closure of the Alta Bates Medical Center on Ashby Avenue, which contains Berkeley’s only emergency room.
State Senator Nancy Skinner, D-Berkeley, first introduced the bill into the senate in February to address the lack of emergency care in California. The bill also passed in the State Senate in the spring and will now go to Gov. Jerry Brown’s desk. If signed into law, nonprofit hospitals statewide — Alta Bates included — will be required to receive the state attorney general’s approval before closing emergency departments.
“Right now, there’s nothing in California law that protects you and I from nonprofit hospitals closing either the whole hospital or the emergency room,” Skinner said. “There’s nothing to provide any kind of consumer protection.”
America’s Emergency Care Environment gave the state a grade of “F” in the Access to Emergency Care category in its 2014 EM Report Card. According to the report, California has the lowest number of emergency departments per capita in any U.S. state.
SB 687 received only 36 favorable votes in the assembly Thursday night — five short of the 41 votes needed for approval — before being reconsidered and ultimately passed by 46 assembly members Friday.
According to Skinner, the current law requires the attorney general’s review and consent for any sale of nonprofit hospitals. SB 687, however, would extend the attorney general’s approval to the closure of emergency rooms, such as Alta Bates.
Sutter Health intends to close the Alta Bates location in Berkeley and relocate acute care services to its Summit Campus in Oakland by 2030. The organization cited financial difficulties in its efforts to comply with seismic regulations as the reason for the proposed closure of the Berkeley emergency center.
State Assemblymember Catharine Baker, R-Dublin, who voted against SB 687, expressed concern in an emailed statement about the increased political influence on hospital closures, stating that “these decisions should stay local to the communities most affected.”
Jan Emerson-Shea, vice president of external affairs for the California Hospital Association, said she believes the bill will only add “another layer of bureaucratic oversight” without addressing the underlying reasons behind emergency department closures.
She added that many hospitals do not receive the amount of money needed from the state to retrofit their facilities to comply with the state’s seismic requirements, and she also pointed to low reimbursement rates from Medi-Cal as a primary cause of hospital closures in California.
“No one ever wants to close a hospital, but unfortunately there are circumstances when there are no other options,” Emerson-Shea said. “It almost always comes down to money.”
In response to financial concerns, Skinner said the attorney general will take into account the financial state of an emergency room when assessing a proposed closure.
“Clearly, if an emergency room is just not financially viable, then the attorney general is not going to interfere with the closure,” Skinner said. “But if the closure is going to seriously impact a community’s access to essential health care services and financial viability is not the real reason for the closure, then the intent is the attorney general will intervene.”
California State Assemblymember Marc Levine, D-Marin County, said he voted in favor of the bill because he believes emergency care to be critical to health in any community.
“There is concern that some hospitals may close emergency departments in favor of other services that bring in greater revenue,” Levine said. “This bill is in response to those concerns.”
Berkeley Mayor Jesse Arreguín said the potential closure of the Alta Bates Medical Center in Berkeley would limit access to emergency care for thousands of Berkeley residents — as well as students, faculty and staff on the UC Berkeley campus — because it contains Berkeley’s only acute care hospital room.
Arreguín said the city is willing to work with Sutter Health to resolve issues and to ensure basic emergency care will be provided for all residents.
“I strongly support SB 687 because currently, local jurisdictions have no voice in the closure of hospitals,” Arreguín said. “(Alta Bates’ closure) will have a huge impact on the residents of Berkeley and the East Bay to get access to emergency care. It will put people’s lives at risk.”