Ericka Cruz Guevarra: I’m Ericka Cruz Guevarra and welcome to the bay. Local news to keep you rooted. The regional medical center of San Jose is months away from losing its trauma center. It’s the only place of its kind treating severe and unexpected medical emergencies. On the east side of Santa Clara County. And community members are warning that its planned closure this August is a matter of life and death for the county’s low income communities of color.
Raj Gupta: And if you take this lifeline of where would these people go? Every day, there’ll be at least 5 to 7 patients who will either have increased mortality or morbidity.
Ericka Cruz Guevarra: South Bay leaders, advocates and health care workers are now asking the state to step in. Today, what the trauma centers closure could mean for the entire county.
Joseph Geha: Trauma centers in general. While each case can be different, they provide care for people who are in traumatic injuries.
Ericka Cruz Guevarra: Joseph Geha is a South Bay digital editor for KQED.
Joseph Geha: They are dealing with life threatening and serious injuries that can sometimes result from major car accidents or a shooting or other kinds of calamities that are generally unexpected but very severe.
Ericka Cruz Guevarra: Joseph, I wonder if you can just first describe for me in broad strokes the role that the regional medical center in San Jose plays in the health care ecosystem of Santa Clara County?
Joseph Geha: It’s situated near East San Jose in the eastern part of Santa Clara County. And it serves a lot of patients in a lot of different capacities. This is where historically there have been communities of color, people who have been underserved by other parts of public life. The trauma center handles about 2450 trauma patients annually, according to a county report.
Joseph Geha: And that’s about a quarter of all the trauma cases for the trauma system in the county. They also handle a considerable portion of stroke patients in the county with no insurance. It’s about 65%. 20% of all stroke cases in the county arrive at Regional Medical Center. It’s the only comprehensive stroke center on the northeast, east and southeast side of the county.
Ericka Cruz Guevarra: This medical center plays a really significant role in the health care ecosystem there. But there are some pretty big changes coming to the hospital. Right? What’s happening?
Joseph Geha: Yeah. So the hospital’s ownership, it’s a company called Hospital Corporation of America, and the parent company is HCA Health Care. And the owners of this hospital are proposing some closures and some cuts at the hospital. So while the hospital itself will remain open, they are proposing a closure of their level two trauma center.
Joseph Geha: They are also proposing to eliminate their serious heart attack treatment program. It’s called the Stemi program. It stands for Elevation Myocardial Infarction. It’s essentially a very severe heart attack that requires specialized, quick treatment. And they’re going to eliminate that from their service portfolio as well. And they’re talking about reducing their stroke services.
Joseph Geha: Essentially, what they’re talking about is lessening the specialization of their stroke care. So they’re going from what is called a comprehensive stroke center to a primary stroke center. So as of now, the date that HCA health care has announced for these closures to take effect and for these cuts to take effect is August 12th.
Ericka Cruz Guevarra: Well, why is the hospital making this change? Like, why did they decide to do this?
Joseph Geha: What HCA Healthcare has said in its limited public statements about this is that this is about seeing less patients in their trauma center at Regional Medical Center and seeing less patients making use of or needing the care of their severe heart attack program for their stroke services.
Joseph Geha: They haven’t really said whether or not those patient numbers are dropping, but it seems that in general, most of the cuts and closures that HCA is proposing and has done in the past, they are attributing them to less patients using those services. And so it appears to be a cost saving measure.
Ericka Cruz Guevarra: You just described, Joseph. How important of a role regional medical center plays and these really big changes that are coming as a result? I mean, what’s been the reaction to the news.
Joseph Geha: Since Regional Medical Center and HCA health care announced this planned closure? Alarm bells have been going off around the county. People are raising major concerns about this and they’re not being shy about speaking to what they believe will be a very severe impact.
Joseph Geha: You have everybody from patient advocates to county leaders like Supervisor Cindy Chavez has been very outspoken about this. The county board of supervisors themselves has been hearing reports in public about the severe potential impact of this closures and cuts.
Joseph Geha: And then you’ve got doctors themselves just very recently last week, doctors who work at this hospital standing 100 yards from the entrance, decrying what they call shameful and irresponsible closures and cuts.
Raj Gupta: Is a big, big step backwards.
Joseph Geha: One of the doctors who spoke very extensively about his concerns was Dr. Raj Gupta, who’s the director of stroke and neuroscience services at Regional Medical Center, speaking against his own hospital’s decision to go for these closures and cuts.
Raj Gupta: If you look at all the studies, when any major trauma center is closed, the mortality mortality in the population increases by 29%.
Joseph Geha: And he said it’s going to greatly impact the health of patients who would otherwise be coming to this hospital, who now might have to be driven farther afield to Valley Medical Center, a county hospital about eight miles away and maybe 15 or 20 minutes away in in good traffic, or Stanford Medical Center up the peninsula. And, you know, more than 20 miles away.
Raj Gupta: A regional medical center. It is covering one third of the population of the county, almost 600,000 population. And if you look at the west side of the town, you’re covering 1.2 million and you have eight hospitals. It’s such an unequal distribution of resources to begin with. And if you take this lifeline of where would these people go?
Joseph Geha: He called this irresponsible and shameful, and he said it’s going to greatly impact the health of patients who would otherwise be coming to this hospital.
Raj Gupta: We do believe in first rule in medicine to not harm. And this action will harm our patients, our community. It’s everybody is impacted.
Ericka Cruz Guevarra: And you mentioned elected officials are really worried about this, too. What are they saying and what are they hoping to do about this?
Joseph Geha: You have a major figure in Santa Clara County and South Bay politics supervisor Cindy Chavez, who’s been around for a long time and has a long record of experience and has overseen other major health issues in the county health system.
Cindy Chavez We are one of the largest municipal areas in the country, and we will have fewer trauma center rooms and trauma center beds than any other major metropolitan area in the United States.
Joseph Geha: And she is so concerned about what’s happening that, you know, she has taken part in a rally recently asking Attorney General Rob Bonta to step in and stop this proposed closure and cuts.
Cindy Chavez We’re asking Attorney General Rob Bonta to investigate the predatory practices of HCA.
Joseph Geha: And, you know, she’s gone as far as to say that if what they’re doing is not against the law herself and other advocates need to be working to make it against the law, because she characterized this move as putting people’s lives at risk.
Ericka Cruz Guevarra: Coming up, what advocates and local leaders want Attorney General Rob Bonta to do about this. Stay with us.
Ericka Cruz Guevarra: How exactly do they want to see Attorney General Rob Bonta step in? What do they want him to actually do in response to the potential closure of this trauma center?
Joseph Geha: The advocates and the elected leaders are hoping that Attorney General Bonta will use his authority, which they say he has, because this hospital was once a nonprofit hospital before it was bought by HCA in 2002. They are saying that Attorney General Rob Bonta has the authority to step in and stop these cuts and closures because they would have a discriminatory impact.
Joseph Geha: So this isn’t the first action that leaders and advocates have taken to get a higher authority involved. In April, the entire county Board of Supervisors sent a case to the California Department of Public Health to ask them to step in and deny this closure of the trauma center and these cuts.
Ericka Cruz Guevarra: I mean, how has the Hospital Corporation of America responded to these criticisms by patient advocates and and local leaders?
Joseph Geha: HCA has been kind of quiet about this. What they’re saying is we have evaluated our options carefully and this is what we think is best to continue serving the community. They’ve also recently reacted to these calls by people like Supervisor Cindy Chavez in a negative fashion.
Joseph Geha: A spokesperson said that they were disappointed by the actions of supervisor Cindy Chavez and City Council member Peter Ortiz for rallying outside of the hospital and decrying the HCA, as, you know, proposed cuts. They have noted that over the past decade, HCA claims it has invested $186 million in emergency services in this community.
Joseph Geha: And a spokesperson said the Hospital Regional Medical Center intends to spend an additional 10 million this year to grow its emergency department from 43 beds to 63 beds. So there they’re pointing to some other investments they’re making to say, look, we’re not completely divesting.
Joseph Geha: However, those other investments that they’re making have not changed. The concerns that have been raised by the people, like the advocates and the city and county leaders who are saying the services that you are choosing to cut are going to have a greater impact despite these other expansions or these other past investments.
Ericka Cruz Guevarra: Well, Joseph, what is next here? Any response from Attorney General Rob Bonta at this time about whether he will, in fact, step in?
Joseph Geha: It’s unclear. We’ve reached out to him for comment, but haven’t heard back. But one of the advocates who signed on to a letter to Attorney General Bonta suggested that he was receptive to it and that he had committed to them in a phone call that he would do what is right and that he would do what he needs to do to protect the community health in this area. But what that outcome might look like and how deep those commitments are, you know, it’s it’s too soon to say.
Ericka Cruz Guevarra: If Bonta doesn’t agree to intervene. There is still this request that county leaders made to the State Department of Public Health. I mean, what’s going on with that? And like what other options are on the table?
Joseph Geha: There are other options still on the table. And one of them, though it might be a big step, is that the county could potentially try to purchase this hospital from HCA health care and make it part of the county health care system.
Joseph Geha: What’s unclear, though, is whether or not regional medical center is open to a purchase offer. There have been discussions between regional medical center officials and county officials, but those are happening behind closed doors because they’re confidential.
Joseph Geha: So it’s unclear how serious the county is at this moment about potentially purchasing this hospital to keep these critical services in the community and to continue to ensure that there is a a lifeline, a literal lifeline for East San Jose and East Santa Clara County residents in this area.
Ericka Cruz Guevarra: I mean, I do want to come back to what this all means for the residents of this area. I mean, let’s say August rolls around and this trauma center does close. I mean, if you’re someone living nearby and you need health care immediately, I mean, what does that mean for you.
Joseph Geha: If these closures and these cuts are to take effect? What I’m hearing from folks who live in this area who are most concerned, who are raising the alarms, is that they are going to literally have their lives put up for sale, essentially. They are going to see a much greater struggle to get immediate and necessary emergency and other traumatic kind of health care needs addressed.
Joseph Geha: They’re going to have to travel farther distances. They might lose precious minutes in the time that is needed for their immediate treatment. And they’re worried in general about the members of their community who live and work in this area. They’re worried that people are going to die.
Ericka Cruz Guevarra: Joseph, thank you so much for joining us on the show.
Joseph Geha: Thank you for having me.
Ericka Cruz Guevarra: That was Joseph Geha, who covers the South Bay for KQED. This 33 minute conversation with Joseph was cut down and edited by Tamuna Chkareuli and senior editor Alan Montecillo. Maria Esquinca scored this episode and added all the tape music courtesy of the audio network.
Ericka Cruz Guevarra: By the way, before we go, today is producer Maria Esquinca’s last day working with us. Maria is one of three folks who work on this show every day. So when someone leaves, it’s a really, really, really big deal for us here. We appreciate all the work Maria has done for this show in the last two years, especially her episodes during National Poetry Month.
