Tulare County board declares health care emergency

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Proclamation may help provide funding to reopen Tulare hospital before October deadline

By Reggie Ellis @Reggie_SGN

TULARE – Each day Tulare County is without a third hospital it puts patients needing emergency care at risk. 

Since Tulare Regional Medical Center (TRMC) closed on Oct. 28, 2017 ambulances must transport patients further and patients already at the emergency room must wait longer as Kaweah Delta Medical Center in Visalia and Sierra View Medical Center in Porterville work to accommodate an additional 80 emergency patients each day. 

TRMC is owned and operated by the Tulare Local Hospital District which encompasses an area of 483 square miles and serves a population of more than 85,000 residents through the hospital and three Federally Qualified Health Clinics. Since 1999, Tulare County has seen the closure of four hospitals in Exeter, Lindsay, Dinuba and now Tulare which has lost 56% of its total hospital bed capacity. Prior to TRMC’s closure, Tulare County already consistently ranked in the bottom 10% of many health factors including access to clinical care, especially for economically disadvantaged populations.

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“We feel this is an emergency of immediate peril for the residents of our city, the residents of our district and county as well as all of our visitors,” said Kevin Northcraft, president of the Tulare hospital district.

Northcraft made his comments before the board of supervisors at its June 5 meeting to request officials declare a local emergency in Tulare County. The board’s unanimous action proclaimed a local emergency for “conditions of disaster and extreme peril to the safety of persons” and requests that the governor declare a state of emergency for Tulare County and make funding available to help the Tulare hospital reopen by Oct. 28, 2018 when its acute care license will expire.

“Tulare County has a health care system and when one of the significant parts is unable to provide services, it affects everyone,” said Supervisor Pete Vander Poel, who represents Tulare in District 2. “We need help and it’s in the whole county’s best interest.”

Northcraft said the board has been working diligently to reopen the hospital but two of its most promising plans recently fell through. He said the board was in discussions with Community Medical Centers of Fresno/Clovis but said they were unable to provide assistance. Assemblyman Devon Mathis and state Sen. Jean Fuller were pushing the state for providing the hospital a $22 million grant as part of the state’s fiscal budget. That plan has been stalled in an Assembly committee, but the effort continues to still get the funding included in the state budget.

The hospital’s latest attempt to reopen may be more fruitful. On June 8, TRMC officials reported that four hospitals submitted letters of interest in partnering or managing the Tulare hospital – Adventist Health, Dignity Health, Community Regional Medical Center of Fresno, and Kaweah Delta Local Health Care District in Visalia.

Adventist Health operates a hospital in Hanford. Dignity Health was formerly called Catholic Healthcare West. Fresno Community had already expressed an interest in partnering with Tulare Hospital and Kaweah Delta has been supportive of the hospital’s efforts to reopen.

A committee appointed by the hospital will now look at the proposals with a goal to have the board select a potential affiliate-partner-lessee by June 30.

The goal is to have the hospital reopened by Oct. 1.

Tulare Hospital officials are hoping to secure a known and capable health care provider to assist the District with the reopening of the hospital and to work on a long-term lease to manage the operations of the medical center and clinics for years to come.  Northcraft said a pro-forma, a projection of financials, shows that even operating a moderate level TRMC will be a “successful hospital and self-sustaining.”

The new board’s original plan was to reopen the hospital within 30 to 60 days after its closure Oct. 28, 2017, but the hospital district says it was left with a financial mess created by the former management company Health Care Conglomerate Associates (HCCA). Northcraft alleges that HCCA left the hospital in serious debt, about $27 million, and the former CEO placed liens on hospital property which has prevented the new board from borrowing necessary funds to reopen the hospital.

Larry Blitz, Interim CEO of TRMC, announced that “all four of the targeted organizations have expressed interest in becoming involved in the RFP process.”

While interest is initially indicated, some of the organizations need to gain governing board acceptance before full scale participation is begun.

“We are all excited that unanimous initial interest is present which illustrates the excellent opportunity that is anticipated by these seasoned providers of health care,” Blitz said.

Each of the four targeted candidates now has the opportunity to inspect the physical plants, review the budget forecast and review all considerations. On-site inspections, presentations to the board’s ad-hoc committee composed of two board members and five community representatives, and the selected ad-hoc finalists will make presentations to the board and the community later in the month.

Based on the presentations and proposals, the board will then decide on its future partner. 

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