For at least a couple of decades, the San Pablo hospital that serves the poorest of West Contra Costa's residents has struggled financially. Formerly Brookside Hospital, the Doctors Medical Center, which emerged from bankruptcy in 2008, again faces closure. This time it is due largely to a massive state budget cut.
The California Medical Assistance Commission, which distributes money to financially struggling medical facilities, cut the annual subsidy for Doctors from $12 million last fiscal year to $1.2 million in the current year.
"That very act put us in 90-day closure," Eric Zell, vice-chair of the West Contra Costa Healthcare District. "We will likely have a public health crisis" if Doctors closes, he said.
So last week the governing board of the public, non-profit hospital agreed to place a parcel tax on a Nov. 15 mail-only ballot in hope of saving it. The tax would apply to residential and commercial properties between El Cerrito and Crockett.
If voters approve the tax, homeowners would pay $47 a year, on top of an existing $52 annual parcel tax approved by voters in 2004, to keep the Doctors emergency room open. Apartment building owners, business owners and industrial property owners would pay from $282 to $940 per parcel per year, depending on parcel size. If voters approve the tax, it would take effect in July, 2012. The tax would expire if Doctors were forced to close.
Without an infusion of money, the only full-service emergency room in the region is likely to shut down in early 2012. Patients then would be taken to the much smaller Kaiser emergency room in Richmond or to facilities in Berkeley, Vallejo or Martinez.
The Doctors emergency room is the most likely destination for most emergency cases in the West County area, regardless of a patient's insurance status.
"If you get in a car accident or if have a heart attack, you will come to Doctors," Zell said. "Even if you are a Kaiser member, you end up in the Doctors emergency room."
Closure of Doctors would at least double Kaiser's daily average of 78 cases per day, according to a consultant's report on emergency care released in July. Doctors averages from 100 to 120 emergency patients per day, said Gisella Hernandez, the hospital's spokesperson.
A closure also would increase waiting time for emergency room patients, Zell said.
Revenue from the tax is expected to be about $5 million a year for the 189-bed hospital, which serves mostly poor and uninsured patients. It's possible that an infusion of money and a stabilization strategy might encourage the state commission to reconsider its assistance level.
The hospital has a long history of fiscal challenges. Only 10 percent of its patients have private health insurance. Another 10 percent pay out of their pockets. The other 80 percent are either on Medi-Cal or Medicare or they have no insurance. For that 80 percent, the hospital is reimbursed for far less than the cost of treatment, hospital authorities say.
Contra Costa County has twice loaned the hospital $10 million, most recently this year, after the first $10 million had been repaid, Hernandez said.
John Muir and Kaiser medical centers provided $5 million in assistance for a three-year period, starting in 2007, helping Doctors to emerge from its bankruptcy.
The new tax wouldn't close an estimated $18 million budget deficit.
"The parcel tax will only be a piece of the puzzle," Zell said.
The hospital is trying to refinance debt at a savings of about $2 million and achieve $6 million in savings by improving efficiencies, Zell said.
The attached consultant's report on regional emergency medical care, released in July, concluded that the hospital's closure would be "catastrophic" to medical services for West County.
Besides emergency treatment, the hospital delivers care for cancer patients and other services.