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Proposal Would Curb California Hospital Emergency Department Closures

News  |  By Doug Desjardins  
   March 06, 2017

Not-for-profit facilities would need the state attorney general's sign-off in order to shutter their EDs, according to new legislation.

This story originally appeared in California Healthfax.

Legislation introduced in the California Senate last month would create stricter protocols for hospitals to follow if they plan to shut down their emergency departments.

Senate Bill 687, authored by state Sen. Nancy Skinner (D-Berkeley), would require not-for-profit hospitals to receive approval from the State Attorney General before closing a hospital emergency department.

The bill would also require hospitals to hold at least one public hearing on the impact of the ED closure and notify the California Department of Public Health at least 90 days in advance of a planned closure.

Current state law requires a hospital to provide 90 days notice to the California Department of Public Health before shutting down operations.

"Closing hospitals and emergency rooms worsens health outcomes and increases deaths," said Skinner. "There are longer waiting times for services, longer ambulance travel times, and overcrowding at facilities."

Is it Still a Hospital if There's No ER?

Skinner cited statistics from the American College of Emergency Care that show California has only 6.7 emergency departments per 1 million residents, the lowest ED-to-resident ratio of any state in the nation.

"California is already the state with the fewest emergency departments per capita," said Skinner. "Further emergency department closures put all Californians at risk."

SB 687 would "require any nonprofit corporation that operates or controls a health facility … that provides emergency services at a licensed emergency center, to provide written notice to—and obtain the written consent of—the [State] Attorney General prior to a reduction in the level of emergency medical services provided, or their elimination."

Lost Emergency Services
In recent years, some hospital closures in California have raised more concerns about the elimination of emergency services than the actual loss of inpatient care.

The 2015 shuttering of Saddleback Memorial Medical Center in San Clemente, which left the city of San Clemente and surrounding communities without an ED, was a notable example.

In an attempt to address the closure of Saddleback Memorial, state Sen. Patricia Bates and Assembly Member Bill Brough drafted companion bills that would have allowed the city of San Clemente to operate a stand-alone ED without an acute care hospital to support it.

Imminent Hospital Closure Roils Clinicians, Spurs Admins into Action

Both bills failed, prompting Bates and Brough to draft a joint statement contending the failure of the bills was "the clearest indication yet that Sacramento has no plan to deal with the closing of emergency rooms in California."

The California Hospital Association is still evaluating SB 687 and has not yet taken a position on the bill, said CHA vice president of external affairs Jan Emerson-Shea.

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