May 7, 2002
County of San Luis Obispo Board of Supervisors
Room 370
County Government Center
San Luis Obispo, CA 93408
Dear Members of the Board of Supervisors:
Consumers Union urges you to provide more time for the appropriate evaluation of the impact of closing San Luis Obispo General Hospital. The Beilenson hearing scheduled for May 21, 2002 will be conducted with information that does not adequately address the healthcare needs of the county’s indigent population. As such, the notice does not comply with the legal requirements of CA Health & Safety Code § 1442.5 (2002)
(attached).
The statute requires that “[t]he notice shall contain a list of the proposed reductions or changes, by facility and service” “prior to . . . closing . . . a county facility.”(1) Further, “[t]he notice shall include the amount and type of each proposed change, the expected savings, and the number of persons affected.”(2) Here, the notice provided by the Office of County Counsel fails to give the requisite detail as to the amount and type of each proposed change, as considered in Smith v. San Francisco, 216 Cal.App.3d 862 (1989) (attached).
Under the “Description of Options that Will Be Considered,” the proposed changes to San Luis Obispo General Hospital are wholesale abolishment of services identified only as “Medical-Surgical Services, including ICU, Obstetrics, Nursery, Inpatient Surgery and Outpatient Surgery,” “GH Emergency Room and Walk-In Clinic,” “Pharmacy Services Necessary for Medical-Surgical Services, ER, and Walk-In Clinic,”(3) “Laboratory Services Necessary for Medical-Surgical Services, ER, and Walk-In Clinic,” and “Radiology Services Necessary for Medical-Surgical Services, ER, and Walk-In Clinic.” We object to this notice for the following reasons:
· In regards to the “Medical-Surgical Services,” “the County would discontinue operation of Medical-Surgical Services at General Hospital, including the Medical-Surgical Unit, the Intensive Care Unit, Obstetrics, Nursery, Inpatient Surgery and Outpatient Surgery.”(4) There is no further description of the specific changes, but rather a description of the types of patients “for whom the County is legally responsible.”(5)
· The proposed changes to the “Emergency and Walk-In Clinic Services” is articulated as “discontinuance . . . of the (1) emergency medical services for patients who have emergency medical conditions, and (2) unscheduled outpatient services on a walk-in basis for patients who do not have an emergency condition.”(6) No list is provided as to the specific changes, but there are details about the EMS system and the capacity of other hospitals within San Luis Obispo County.
· Under “Pharmacy, Laboratory, and Radiology Services that Support Inpatient Services,” there is no listing of the specific changes, except to say that “the County would no longer need the portions of Ancillary Services that support Medical-Surgical services, the Emergency Room, or the Walk-In Clinic.”(7) The notice recognizes, however, that depending on the outcome related to the “Inpatient Psychiatric Unit or Psychiatric Health Facility,” some Ancillary Services would be needed and would be provided for with “support from the private hospital with which it affiliates,” but which remains unnamed.(8)
· In regards to “Pharmacy, Laboratory, and Radiology Services that Support Outpatient Services,” there is no list of specific changes to what is provided by San Luis Obispo General Hospital, but there is a description of them in the context of being available elsewhere, especially for those with “private health coverage.”(9) The notice briefly mentions an idea for the County to act as a purchaser and supplier of certain prescription drugs for “all patients seen at a County clinic,” but there is no further information provided as to how that would be accomplished.(10)
As Smith makes clear, “bulk” descriptions are inadequate.(11) What the above “descriptions” lack is any information related to the “amount and type of each proposed change” (italics added) as required by § 1442.5. This notice defeats the legislative intent of § 1442.5 as it was described in Smith, namely insuring that “the duty of counties to provide healthcare to indigents is properly and continuously fulfilled.”(12) It is impossible to discern how San Luis Obispo County will “properly and continuously” fulfill its responsibilities to serving the healthcare needs of its indigent citizens.(13)
The San Luis Obispo Board of Supervisors proclaims that it “is committed to the implementation of such policies and the provision of such services that will enhance the economic, environmental and social quality of life in San Luis Obispo County.”(14) We suggest that in order to “fulfill [your] duty to provide care to all indigent people” you must find that the notice discussed above is inadequate under both statutory and case law.(15)
Sincerely,
Leslie Bennett
Staff Attorney
Janki Darity
Staff Attorney
Consumers Union West Coast Regional Office
Footnotes:
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(1) CA Health & Safety Code § 1442.5(a).
(2) Id.
(3) Notice of a public hearing to consider service delivery changes at General Hospital and the Family Care Centers, David Edge, County Administrator, to San Luis Obispo Board of Supervisors, May 7, 2002 at 1.
(4) Id. at 2.
(5) Id. at 3.
(6) Id. at 4.
(7) Id. at 5.
(8) Id.
(9)Id. at 6.
(10)Id.
(11) Smith v. San Francisco, 216 Cal.App.3d at 872.
(12) Id. at 870.
(13) Id.
(14) San Luis Obispo County Board of Supervisors, last visited May 3, 2002, <http://www.co.slo.ca.us/Board_of_Supervisors_Inter.nsf/index.htm?OpenPage>
(15) CA Health & Safety Code § 1442.5(b).