Closure of Mills Health Center Standby Emergency Department

Coun
nty off San Mateeo, Caaliforn
nia Impact Evaluaation:
Closuree of Millls Health
h Centeer Stand
dby Emeergency Department
Octo
ober 20112
Emergen
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Agency
San Ma
ateo Cou
unty Heealth System
IMPACT EVALUATION: CLOSURE OF STANDBY EMERGENCY DEPARTMENT AT
MILLS HEALTH CENTER
TABLE OF CONTENTS
I. SUMMARY
A. Background of Service Area and Services
B. Evaluation Process and Community Input
C. Impact and Mitigation Plans
D. Conclusions and Recommendations
II. PURPOSE, SCOPE, AND LIMITATIONS OF IMPACT EVALUATION
A. Assessment of impact on community
B. Areas of impact
III. BACKGROUND
A. Geography and Demographics Related to Facility and Services
B. Hospital Designation History
C. Specialty Care Services
D. Patient Volume
IV. IMPACT EVALUATION PROCESS and NOTIFICATION TO THE PUBLIC
A. San Mateo County EMS Agency Impact Evaluation Process
B. Reason for Closure
C. Consultation with Appropriate Health Care Providers
D. Public Hearing
E. Newspapers and Media
F. Mitigation Plan
1. Emergency Ambulance Transport Provider Impact
2. Receiving Hospital Emergency Departments
3. Patient Information and Resource Alternatives
4. Aero-Medical Responses
5. Patient Education, Health Promotion, Injury Prevention
V. CONCLUSIONS AND RECOMMENDATIONS
VI. APPENDIX
1. Original Mills-Peninsula Health Services Notice Letter
2. Mills Patient Notification Letter
3. California Health and Safety Code 1255.1
4. California Health and Safety Code 1300
5. San Mateo County EMS Agency Impact Evaluation Policy
6. California Senate Bill 1953: Seismic Retrofit Program Overview
7. EMS Agency / Health System Public Notice
8. Public Hearing Summary
9. Mills-Peninsula Health Services Press Release
10. San Mateo Daily Journal Article
11. San Jose Mercury News Article
12. The Almanac Article
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IMPACT EVALUATION: CLOSURE OF STANDBY EMERGENCY DEPARTMENT AT
MILLS HEALTH CENTER
I. SUMMARY
A. Background of Service Area and Services
Mills-Peninsula Health Services, part of the Sutter Health Network, is a not-for-profit health
care provider with locations in San Mateo & Burlingame, California. The Mills Health
Center is located at 100 South San Mateo Drive, San Mateo. In 1997 with the expansion of
the Peninsula Medical Center’s emergency department, inpatient care was consolidated at
Peninsula and Mills Health Center’s emergency department status was downgraded from a
basic emergency department to a standby emergency department. While Mills Health Center
has 21 licensed acute care beds, they are not used to directly support patients whose care was
initiated in the standby emergency department. Patients requiring acute hospital care are
transferred to the Peninsula Medical Center. San Mateo County EMS Agency policy directs
ambulance traffic for patients with the potential for hospital admission to the closest
appropriate basic emergency department. Since 1997 ALS ambulance traffic to Mills Health
Center has been limited to non-urgent transports. Between August 2011 and July 2012 the
Mills standby emergency department treated 12,618 patients, with an average of 34.5 patients
per day. An average of six patients per month (August 2011 and July 2012) was transported
by ALS ambulance to the Mills standby emergency department by the EMS system. The
majority of patients served there walk in.
B. Evaluation Process and Community Input
On August 21, 2012, the San Mateo County Health System’s EMS Agency received
notification from Mills-Peninsula Health Services regarding the intended closure of the Mills
Health Center standby emergency department effective December 1, 2012. This decision
was based on several factors related to the requirements to meet seismic safety requirements
for general acute care hospitals as specified in Senate Bill 1953. As required by Health and
Safety Code § 1300, the EMS Agency held a public hearing on September 27, 2012, to
receive community input. The public hearing included a presentation of the proposed plan by
the Mills-Peninsula Health Services Chief Executive Officer and answers to questions from
the public.
C. Impact and Mitigation Plans
In reviewing their patient data Mills-Peninsula Health Services has determined that a
majority of the patients that they treated at the Mills Health Center standby emergency
department would be appropriate for urgent care level treatment. To continue to meet this
need in the community, the standby emergency department will be replaced an urgent care
center in the same location in the fourth quarter of 2013. The urgent care center will be
developed and operated by the Mills-Peninsula Division of the Palo Alto Medical
Foundation.
Mills-Peninsula Health Services has led an extensive community education outreach
campaign to advise the public about the upcoming closure to reach all current and potential
future patients. These efforts included: public advertising, mailed letters, and press releases
to local newspapers. As part of their mitigation plan Mills-Peninsula Health Services has
committed to have a person stationed at the site for eight weeks after closure on December 1,
2012 to redirect anyone arriving in error who needs emergency care. They will also be
posting signage and fliers in Spanish, English and Chinese which include directions to the
hospital in Burlingame.
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D. Conclusions and Recommendations
The closure of the Mills Health Center standby emergency department will not have a
negative impact on the delivery of emergency medical services in San Mateo County. Due to
the close proximity of two acute care hospitals, Peninsula Medical Center and the San Mateo
Medical Center, patients seeking emergency medical care via 911 ALS ambulances will
experience no change in the level of service they currently receive. It is recommended that
the State Department of Health Services approve the cancellation of the special permit for
basic standby emergency services by Mills Health Center.
II. PURPOSE, SCOPE, AND LIMITATIONS OF IMPACT EVALUATION
On August 21, 2012, the San Mateo County Health System’s EMS Agency (EMS Agency)
received notification1 from Mills-Peninsula Health Services regarding the intended closure of
the Mills Health Center standby emergency department (MHC-ED) effective December 1,
2012. In addition to notifying the EMS Agency, Mills-Peninsula Health Services also
notified their patient population with a letter2 discussing the closure of the standby
emergency department.
A. Assessment of Impact on Community
Health and Safety Code section § 1255.1(a)3 requires a hospital to notify both the State
Department of Health Services and the local EMS Agency (LEMSA) no later than 90 days
before a planned reduction or elimination of services. Health and Safety Code section
division 2, section § 13004 requires the LEMSA to conduct an impact evaluation to
determine the effect the closure will have on emergency medical services provided by the 91-1 system and other hospitals in the surrounding area. As part of the impact evaluation, the
LEMSA is required to conduct at least one public hearing. The impact evaluation has to be
completed within 60 days of notification by the hospital and submitted to the State
Department of Health Services.
This report will assess the impact of the closure of the MHC-ED upon the community,
including the impact on community access to emergency care, and emergency services
provided by other hospitals.
B. Areas of Impact
The impact evaluation is guided by both Health and Safety Code section division 2 § 13004
and the San Mateo County EMS Agency policy titled “Impact Evaluation Proposed
Downgrade or Closure of a Hospital's Emergency Services” (Facilities #8)5. The report
addresses the following areas: geography, hospital designation, trauma, specialty services,
patient volume, public notification, impact evaluation process, and recommendations.
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III. BACKGROUND
A. Geography and Demographics Related to Facility and Services
Geography
The area that the MHC-ED most directly provides service to is the City of San Mateo, which
covers an area of approximately 16 square miles. The City of San Mateo is considered
urban. The 2010 U.S. Census states that the population of the City of San Mateo is 97,207,
with a population density of 6120.1 people per square mile. The MHC-ED is located 3.5
miles from the San Mateo Medical Center which has 420 licensed beds and is located 4.3
miles from Mills-Peninsula Medical Center, which has 241 licensed beds, as seen in the map
above.
Demographics
The 2010 U.S. Census states that the racial makeup of San Mateo is: 56,214 (46.8%) White,
2,296 (2.4%) African American, 505 (0.5%) Native American, 18,384 (18.9%) Asian, 1,998
(2.1%) Pacific Islander, and 12,264 (12.6%) from other races. Hispanic or Latino of any race
was 25,815 persons or 26.6% of the total population. The population is spread out with
20,254 people (20.8%) under the age of 18, 6,915 people (7.1%) aged 18 to 24, 30,772
people (31.7%) aged 25 to 44, 25,286 people (26.0%) aged 45 to 64, and 13,980 people
(14.4%) who were 65 years of age or older. The median age was 38.9 years. For every 100
females there were 95.4 males. For every 100 females age 18 and over, there were 92.8
males.
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B. Hospital Designation History
The Mills Health Center is part of Mills-Peninsula Health Services which also includes
Mills-Peninsula Medical Center in Burlingame, California. In 1997 with the expansion of
Peninsula’s emergency department, inpatient care was consolidated at Peninsula and the
MHC-ED status was downgraded from a basic emergency department to standby emergency
department. In 2011 Mills-Peninsula opened a new hospital with 241 licensed beds and a
larger emergency department than its prior building. Since 1997 ALS ambulance traffic to
the MHC-ED has been limited by local EMS Agency policy to Code 2 (non-urgent)
transports.
C. Trauma Care
The Mills Health Center is not a designated trauma center. Currently patients who met
trauma criteria are transported to either San Francisco General Hospital in the City of San
Francisco, or Stanford Hospital in the City of Palo Alto, both of which met criteria as a level
one trauma center.
D. Specialty Care Services
The following represents the impact of the MHC-ED closure on the listed area’s below:
1. Neurosurgery: Mills Health Center does not provide neurosurgery services. Closure of
the standby emergency department does not affect this service.
2. Obstetrics: Mills Health Center does not provide obstetric services. Closure of the
standby emergency department does not affect this service.
3. Burn Center: Mills Health Center does not provide burn care services. Patients needing
burn care are transported to St. Francis Memorial Hospital Bothin Burn Center located in
San Francisco. Closure of the standby emergency department does not affect this service.
4. Acute Stroke Care: Mills Health Center is not designated as a Primary Stroke Center.
Patients arriving at the MHC-ED are transferred immediately to the Mills-Peninsula
Medical Center Primary Stroke Center
5. Acute cardiac care/STEMI: MHC does not provide acute cardiac care. Patients arriving
at the MHC-ED are immediately transferred to the Mills-Peninsula Medical Center ED.
6. Pediatric Critical Care: Mills Health Center does not provide pediatric critical care
services. Closure of the standby emergency department does not affect this service.
7. Psychiatric: Mills Health Center Acute Psychiatric Distinct Part inpatient services unit,
while residing in the same building as the standby emergency department, is not is not
affected by Senate Bill 1953’s seismic safety requirements because patients are
ambulatory. Closure of the standby emergency department does not affect this service.
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E. Patient Volume
Total Emergency Department Patient Volume for MHC-ED vs. County of San Mateo
The MHC-ED reported a total patient volume of 12,618 for the time period of August 2011July 2012, with an average monthly volume of 1,052 patients, and an average daily volume
of 34.5 patients. This includes both walk-in and ambulance transported patient. In
comparison, the other acute care hospitals in San Mateo County had an average monthly
emergency department census of 2,423 patients and an average daily volume of 79 patients.
Ambulance Patient Volume for MHC-ED vs. County of San Mateo
During the time period of August 2011-July 2012, there was a total ALS ambulance patient
volume of 30,734* for all of San Mateo County, of which Mills received 75* (0.24%) 9-1-1
ALS transports. It is not known what percentage of their patients arrived via BLS ambulance
providers. Due to the low volume of patients transported by ambulance to MHC-ED, there is
no negative impact on the population that is currently served by the MHC-ED via the
emergency 9-1-1 system.
City of San Mateo Patient Population Seeking Medical Services
During the time period of August 2011-July 2012, there were a total of 4,311* 9-1-1 ALS
ambulance transports (monthly average = 359) for incident locations occurring within the
geographic boundary of the City of San Mateo. Of the 4,311* 9-1-1 ALS ambulance
transports resulting from incidents within the City of San Mateo, there were 55* (1%) that
went to MCH-ED (see chart below). Due to the low volume of calls originating from the
City of San Mateo that were transported to the MHC-ED, there is no negative impact on the
population that is currently served by the MHC-ED via the emergency 9-1-1 system.
*Source: San Mateo County Public Safety Communications Computer Aided-Dispatch.(CAD)
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IV. IMPACT EVALUATION PROCESS and NOTIFICATION TO THE PUBLIC
A. San Mateo County EMS Agency Impact Evaluation Process
In accordance with Health and Safety Code section § 1255.1(a)3, Mills-Peninsula Health
Services (MPHS) notified the San Mateo County EMS Agency (EMS Agency) of its intent to
close the Mills Health Center standby emergency department (MHC-ED). Notification2 to the
EMS Agency occurred on August 21, 2012, meeting the requirement for the hospital to
provide notice of closure at least ninety (90) days prior to a planned reduction or elimination
emergency services. The notice of closure for the Mills Health Center standby emergency
department noted that its reason for closing was due to its inability to meet seismic safety
requirement found in Senate Bill 19536.
In accordance with both Health and Safety Code, division 2 section § 13004 and the San
Mateo County EMS Agency policy titled “Impact Evaluation Proposed Downgrade or
Closure of a Hospital's Emergency Services” (Facilities #8) 5, the EMS Agency notified all
other receiving hospitals, ground and air ambulance providers, Emergency Medical Care
Committee, paramedic service providers, the Board of Supervisors, and local media.
Additionally, the EMS Agency is required to hold a public hearing to gather comments from
the community. The public hearing for the closure of MHC-ED was held on September 27th,
2012. The EMS Agency, in consultation with its Emergency Medical Care Committee,
evaluated the impact of the closure of the MHC-ED within sixty (60) days of receipt of the
notice. This report documents that impact study.
B. Reason for MHC-ED Closure
Senate Bill 19536 was the reason given by MPHS for the closure of MHC-ED. It was
estimated by MPHS that the cost to retrofit the MHC-ED would have been between $60-80
million dollars. The Office of Statewide Planning and Development (OSHDP) states the
following: “Senate Bill 1953 (SB 1953) requires hospitals that have Structural Performance
Category 1 (SPC-1) buildings (those that are considered hazardous and at risk of collapse or
significant loss of life in the event of an earthquake) to be replaced or retrofitted to higher
seismic safety standards by 2013, or later with an approved extension. Otherwise, acute care
services may no longer be allowed to be provided in the building(s).
SB 1953 was introduced on February 25, 1994. It was signed into law on September 21, 1994
and filed by the Secretary of State on September 22, 1994. The bill was an amendment to and
furtherance of the Alfred E. Alquist Hospital Seismic Safety Act of 1983 (Alquist Act). SB
1953 (Chapter 740, 1994), is now chaptered into statute in Sections 130000 through 130070
of the Alfred E. Alquist Hospital Facilities Seismic Safety Act, and part of the California
Health and Safety Code. The regulations developed as a result of this statute are deemed to
be emergency regulations and became effective upon approval by the California Building
Standards Commission and filing with the Secretary of State on March 18, 1998.”
(Citation: http://www.oshpd.ca.gov/FDD/seismic_compliance/ )
C. Consultation with Appropriate Health Care Providers
The San Mateo County Health System consulted with Mills-Peninsula Health Services on the
public hearing, in addition to material released to the press/media. Due to the low volume of
patients provided services at the MHC-ED, no other hospitals were identified as being
adversely impacted. Due to their being the closest acute care hospitals, both the San Mateo
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Medical Center and the Peninsula Medical Center contacted for consultation purposes. Dr.
Susan Ehrlich, CEO of San Mateo Medical Center stated, “The volume of emergency visits
at Mills Health Center is so small that we do not expect their closure to have any impact on
the emergency services provided at the Medical Center.” In the public hearing Dr. Bob
Merwin (Chief Executive Officer, Mills-Peninsula Health Services), stated that “80% of
these patients will be appropriately treated by the proposed Urgent Care Center”.
D. Public Hearing
In accordance with both Health and Safety Code, Division 2,section § 13004 and the San
Mateo County EMS Agency policy titled “Impact Evaluation Proposed Downgrade or
Closure of a Hospital's Emergency Services” (Facilities #8) 5, the public were notified seven
calendar days before the public hearing. Physical notices7 were placed on the public
entrances to the San Mateo County Health System building, as well, as at both Mills Health
Center and Peninsula Medical Center. The EMS Agency also had the noticed posted on the
Health System website, in addition to notifying the press of the public hearing and sending
out an email announcement to all EMS Agency partners.
A public hearing took place on September 27, 2012 from 5:00-6:30 p.m. at the San Mateo
County Health System campus located at 225 37th Ave., San Mateo, California. Public oral
comments were limited to three minutes per person. Written comments of any length were
allowed to be submitted at the same time. Public comments could also be emailed by 6:00
p.m. September 27th. Representatives from the Mills-Peninsula Health Services and the San
Mateo County Health System’s EMS Agency were available to answer the public’s
questions. There were three members of the public who attended the hearing, one of which
asked a series of questions. The low attendance was not due to lack of publicity as the
hearing was publicized in several local newspapers. The public hearing was documented
both through manual note taking and digital recording. Detail of oral comments is presented
in an appendix document titled “Public Hearing Summary”8.
The following principle themes were raised at the public hearing:
1. Concern over losing a local resource. A member of the public wanted to know where
ambulances would take patients from the community who lived near Mills Hospital.
2. Concern over the capabilities the urgent care center that would be put in place of the
standby ED. A member of the public wanted to know if the urgent care center could take
care of seriously ill patients.
3. The public expressed gratitude for the quality services that MHC-ED had provided to
the community over the years it has been open.
E. Newspapers and Media
The San Mateo County Health System’s Public Information Officer notified the local press
and media of the public hearing. Mills-Peninsula Health Services also issued their own press
release9 concerning the closure which resulted in three articles appearing in local news
papers10, 11, 12.
F. Mitigation Plan
The impact study found that the closure of the MHC-ED had no significant or detrimental
impact on any patient population in San Mateo County. Due to this, a mitigation plan was
not needed for the following areas:
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1.
2.
3.
4.
5.
Emergency Ambulance Transport Provider Impact
Receiving Hospital Emergency Departments
Patient Information and Resource Alternatives
Aero-Medical Responses
Patient Education, Health Promotion, Injury Prevention
In reviewing their patient data Mills-Peninsula Health Services has determined that a
majority of the patients that they treat on a regular basis would be appropriate for urgent care
level treatment. To continue to meet this need in the community, Mills Health Center will be
opening an urgent care practice in the same location in the fourth quarter of 2013. Until that
time, patients have been advised to seek care at the Peninsula Hospital ED or the facility of
their choice.
Mills-Peninsula Health Services has led an extensive community education outreach
campaign to advise the public about the upcoming closure to reach all current and potential
future patients with at least 90 days advanced notice. These efforts included: public
advertising, mailed letters2, and press releases9 to local newspapers. As part of their
mitigation plan Mills-Peninsula Health Services has committed to have a person stationed at
the site for eight weeks after closure on December 1, 2012 to redirect anyone arriving in error
who needs emergency care. They will also be posting signage and fliers in Spanish, English
and Chinese which include directions to the hospital in Burlingame.
V. CONCLUSIONS AND RECOMMENDATIONS
Based upon the information discovered through the findings of impact study, the closure of the
Mills Health Center standby emergency department will not have a detrimental impact on the
delivery of emergency medical services to the residents of San Mateo County, or the residents of
the City of San Mateo.
It is therefore recommended that:
The State Department of Health Services approve the cancellation of the special permit for basic
standby emergency services by Mills Health Center.
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VI. APPENDIX
1. Original Mills-Peninsula Health Services Notice Letter
2. Mills Patient Notification Letter
3. California Health and Safety Code 1255.1
4. California Health and Safety Code 1300
5. San Mateo County EMS Agency Impact Evaluation Policy
6. California Senate Bill 1953: Seismic Retrofit Program Overview
7. EMS Agency / Health System Public Notice
8. Public Hearing Summary
9. Mills-Peninsula Health Services Press Release
10. San Mateo Daily Journal Article
11. San Jose Mercury News Article
12. The Almanac Article
10 | P a g e
Appendix 1: Original Mills-Peninsula Health Services Notice Letter
Appendix 2: 1. Mills Patient Notification Letter
Dear (name)
I’m writing to thank you for visiting the Standby Emergency Department at Mills Health
Center during the last year and to let you know about upcoming changes in emergency
services at Mills-Peninsula.
The Standby Emergency Department at Mills must close on Dec. 1, 2012. In order to
meet earthquake safety standards set by the State of California. All the other programs
and services provided at Mills meet applicable earthquake safety standards and will
continue operations.
We are replacing the Standby ER at Mills with an Urgent Care Center in the same
space, scheduled to open in fall 2013.
In the meantime, we look forward to continuing to provide emergency and urgent care
services to our entire community at the Emergency Department at Mills-Peninsula
Medical Center in Burlingame, just four miles north of Mills. The new Medical Center
opened last year, and our Emergency Department there is designed to care for twice as
many patients as before.
Patients have been giving us very high ratings for care and service in this beautiful new
facility, and while we hope you won’t need us, we welcome the chance to serve you
there.
Mills-Peninsula Medical Center is easily accessible from California Drive or El Camino
Real. For your convenience, a map is included on the reverse side of this letter, along
with addresses of other Emergency Departments in the area.
You can read more about the upcoming changes by visiting
www.millspeninsula.org/MillsER. If you have questions or concerns, please contact our
Director of Patient Relations, Irene Zbiczak, at 650-696-5565.
Cordially,
Allan J. Brody, M.D.
Medical Director, Emergency Services
Mills-Peninsula Health Services
Mills-Peninsula Medical Center
Basic Emergency Services
1501 Trousdale Dr.
Burlingame, CA 94010
Distance: 4.3 miles
Travel Time: 10 minutes
Other Emergency
Departments in the area:
San Mateo County
Medical Center
Basic Emergency Services
222 West 39th Ave.
San Mateo, CA 94403
Distance: 3.4 miles
Travel Time: 9 minutes
Sequoia Hospital
Basic Emergency Services
170 Alameda De Las Pulgas
Redwood City, CA 94062
Distance: 9.1 miles
Travel Time: 16 minutes
Appendix 3: California Health and Safety Code 1255.1
California Health and Safety Code Section 1255.1
(a) Any hospital that provides emergency medical services under Section 1255
shall, as soon as possible, but not later than 90 days prior to a planned reduction
or elimination of the level of emergency medical services, provide notice of the
intended change to the state department, the local government entity in charge of
the provision of health services, and all health care service plans or other entities
under contract with the hospital to provide services to enrollees of the plan or
other entity.
(b) In addition to the notice required by subdivision (a), the hospital shall, within
the time limits specified in subdivision (a), provide public notice of the intended
change in a manner that is likely to reach a significant number of residents of the
community serviced by that facility.
(c) A hospital shall not be subject to this section or Section 1255.2 if the state
department does either of the following:
(1) Determines that the use of resources to keep the emergency center open
substantially threatens the stability of the hospital as a whole.
(2) Cites the emergency center for unsafe staffing practices.
Appendix 4: California Health and Safety Code 1300
California Health and Safety Code Section 1300
(a) Any licensee or holder of a special permit may, with the approval of the state
department, surrender his or her license or special permit for suspension or
cancellation by the state department. Any license or special permit suspended or
canceled pursuant to this section may be reinstated by the state department on
receipt of an application showing compliance with the requirements of Section
1265.
(b) Before approving a downgrade or closure of emergency services pursuant to
subdivision (a), the state department shall receive a copy of the impact
evaluation of the county to determine impacts, including, but not limited to, an
impact evaluation of the downgrade or closure upon the community, including
community access to emergency care, and how that downgrade or closure will
affect emergency services provided by other entities. Development of the impact
evaluation shall incorporate at least one public hearing. The county in which the
proposed downgrade or closure will occur shall ensure the completion of the
impact evaluation, and shall notify the state department of results of an impact
evaluation within three days of the completion of that evaluation. The county may
designate the local emergency medical services agency as the appropriate
agency to conduct the impact evaluation. The impact evaluation and hearing
shall be completed within 60 days of the county receiving notification of intent to
downgrade or close emergency services. The county or designated local
emergency medical services agency shall ensure that all hospital and prehospital
health care providers in the geographic area impacted by the service closure or
change are consulted with, and that local emergency service agencies and
planning or zoning authorities are notified, prior to completing an impact
evaluation as required by this section. This subdivision shall be implemented on
and after the date that the county in which the proposed downgrade or closure
will occur, or its designated local emergency medical services agency, has
developed a policy specifying the criteria it will consider in conducting an impact
evaluation, as required by subdivision (c).
(c) The Emergency Medical Services Authority shall develop guidelines for
development of impact evaluation policies. On or before June 30, 1999, each
county or its designated local emergency medical services agency shall develop
a policy specifying the criteria it will consider in conducting an impact evaluation
pursuant to subdivision (b). Each county or its designated local emergency
medical services agency shall submit its impact evaluation policy to the state
department and the Emergency Medical Services Authority within three days of
completion of the policy. The Emergency Medical Services Authority shall
provide technical assistance upon request to a county or its designated local
emergency medical services agency.
Appendix 5: 1. San Mateo County EMS Agency Impact Evaluation Policy
Facilities – 8
Impact Evaluation – ED Closure or Downgrade
Page 1
IMPACT EVALUATION PROPOSED DOWNGRADE OR
CLOSURE OF A HOSPITAL’S EMERGENCY SERVICES
APPROVED:
EMS Medical Director
EMS Administrator
1.
Any hospital which serves as a receiving hospital for San Mateo County shall
notify the San Mateo County Emergency Medical Services Agency (EMS
Agency) of its intent to downgrade or close the emergency services it provides
pursuant to its license or special permit by the State of California Department of
Health Services. Such notification shall occur as soon as possible but in no case
less than ninety (90) days prior to a planned reduction or elimination emergency
services.
2.
Upon receiving a notice described in #1 above, the EMS Agency shall notify all
its other receiving hospitals, ground and air ambulance providers, Emergency
Medical Care Committee, paramedic service providers, the Board of Supervisors,
and local media.
3.
The EMS Agency, in consultation with its Emergency Medical Care Committee,
shall evaluate the impact of such closure or downgrade of the hospital’s
emergency medical services within sixty (60) days of receipt of the notice. Such
impact evaluation shall include:
3.1
At least one public hearing and a review of the written and oral testimony
presented.
3.2
An analysis of the anticipated effects related to:
3.2.1 The hospital’s geographic location to include the service area
population density, travel time and distance to other hospitals with
emergency services, the number and type of other hospital
emergency services serving the county.
3.2.2 How availability of emergency ambulances will be affected.
3.2.3 How voice communications for medical direction to paramedics at
emergency scenes will be affected to include number of calls, radio
and cellular telephone communication, and ability of the remaining
hospitals to manage additional calls for medical direction.
3.2.4 The specialty services are currently provided by the hospital
proposing to downgrade or close its emergency services including
Issue Date: April 1, 2002
Effective Date: April 1, 2002
Review Date: April 2004
Facilities – 8
Impact Evaluation – ED Closure or Downgrade
Page 2
major trauma, pediatric, pediatric critical care, obstetric,
neurosurgery, and burns. The availability and proximity to such
specialized services at other receiving hospitals will be considered.
3.2.5 The volume of patients using emergency services at the hospital
proposing the closure or downgrade to include patients arriving by
ambulance and by all other means. The capacity of other hospitals
to accommodate the additional patients.
4.
The EMS Agency will send the results of the impact evaluation to the State
Department of Health Services within three days of its completion.
Issue Date: April 1, 2002
Effective Date: April 1, 2002
Review Date: April 2004
Appendix 6: California Senate Bill 1953: Seismic Retrofit Program Overview
Office of Statewide Health Planning and Development
Facilities Development Division
1600 9th Street, Room 420
Sacramento, California 95814
(916) 654-3362
Fax (916) 654-2973
www.oshpd.ca.gov/fdd
Seismic Retrofit Program Overview
The Alquist Act establishes a seismic safety building standards program under
OSHPD's jurisdiction for hospitals built on or after March 7, 1973. The Alquist Act was
initiated because of the loss of life incurred due to the collapse of hospitals during the
Sylmar earthquake of 1971. The Alquist Act emphasizes that essential facilities such as
hospitals should remain operational after an earthquake. Hospitals built in accordance
with the standards of the Alquist Act resisted the January 1994 Northridge earthquake
with minimal structural damage, while several facilities built prior to the act experienced
major structural damage and had to be evacuated. However, certain nonstructural
components of the hospitals did incur damage, even in facilities built in accordance with
the structural provisions of the Alquist Act. The provisions and subsequent regulation
language of SB 1953 were developed to address the issues of survivability of both
nonstructural and structural components of hospital buildings after a seismic event.
Therefore, the ultimate public safety benefit of the Alquist Act is to have general acute
care hospital buildings that not only are capable of remaining intact after a seismic
event, but also capable of continued operation and provision of acute care medical
services after a seismic event.
Hospitals as defined in Section 129725 and licensed pursuant to subdivision (a)
of Section 1250 of the Health & Safety Code shall comply with the regulations
developed by OSHPD as mandated by SB 1953. There are approximately 470 general
acute care hospital facilities including the 2,673 hospital buildings that will be impacted
by the provisions of SB 1953. If a facility is to remain a general acute care hospital
facility beyond a specified date, the owner must conduct seismic evaluations, prepare
both a comprehensive evaluation report and compliance plan to attain specified
structural and nonstructural performance categories which must be submitted to
OSHPD in accordance with these regulations.
The seismic evaluation procedure regulations consist of eleven articles. The
primary purpose of these regulations is to evaluate the potential earthquake
performance of a building or building components and to place the building into
specified seismic performance categories. The evaluation procedures were developed
from experience gained in evaluating and seismically retrofitting deficient buildings in
areas of high seismicity.
One of the main provisions of SB 1953 is the development of earthquake or
seismic performance categories, specifically the Structural Performance Categories
(SPC) as found in Article 2 and the Nonstructural Performance Categories (NPC)
as found in Article 11. These include seismic performance categories for new and
existing general acute care hospital facilities in various subgradations, i.e., from
those capable of providing services to the public after a seismic event to those at
significant risk of collapse and that represent a danger to the public. Each facility
would receive both an SPC and NPC, with both seismic performance categories
State of California – Health and Human Services Agency
Arnold Schwarzenegger, Governor
considered for determination of a facilities compliance with the provisions of the Alquist
Act.
The seismic retrofit regulations, also known as Division III-R, apply to all existing
general acute care hospital buildings. The goal of these regulations is to develop retrofit
and repair designs for existing hospital buildings to yield predictable seismic
performance, whether at the essential life safety level or post-earthquake continued
operations level. The requirements of Division III-R must be used to upgrade from an
existing seismic performance category to a higher category level. Specifically, these
regulations were explicitly developed for use in the retrofit, repair, modification or
alteration of existing hospital buildings.
Each general acute care hospital facility must be at certain seismic performance
category levels by specified timeframes. For example, all general acute care hospital
facility buildings must be at the SPC 2 ("Life Safety Level") by January 1, 2008 to be in
compliance with the provisions of the regulations. In addition, timeframes for submittal
of seismic evaluations, compliance plans, and other seismic performance levels are
cited in the seismic evaluation procedure regulations.
Appendix 7: EMS Agency / Health System Public Notice
SAN MATEO COUNTY
HEALTH SYSTEM
Emergency Services Agency, County of San Mateo
Notice of Public Hearing
(Pursuant to California Health and Safety Code Section §1300)
Proposed Closure
Mills Health Center Standby Emergency Department
Effective December 1, 2012, Mills-Peninsula Health Services intends to close Mills Health
Center’s Standby Emergency Department located at 100 South San Mateo Drive, San Mateo, CA.
This closure is due to the fact that the building at Mills Health Center, which contains the standby
emergency department, does not meet Senate Bill 1953 Seismic Safety requirements for general
acute care hospitals.
As required by California Health and Safety Code Section §1300, the San Mateo County
Emergency Services Agency will evaluate the impact of this change and produce a report for the
State prior to State approval of the change.
The public is invited to hear about the proposed closure of the standby emergency department
and to comment on it prior to implementation at a public hearing that will take place on Thursday,
September 27, 2012 from 5:00 p.m. until 6:30 p.m. in Room 100 of the San Mateo County
Health System at 225 37th Avenue, in San Mateo, CA 94403.
All those wishing to make oral comments are invited to attend the public hearing. To ensure
prompt review and consideration, oral comments will be limited to three minutes per person,
although written comments of any length may also be submitted at the same time. Public
comments may also be emailed by 6:00 p.m. to [email protected] or mailed to her at the
below address post marked no later than September 27th.
For further information, contact: Jan Ogar, San Mateo County Emergency Medical Services
Agency, 225 37th Ave, San Mateo, CA 94403, (650) 573-3509.
In compliance with the Americans with Disabilities Act, Title II (ADA, Title II), the County
will provide reasonable accommodations for persons with disabilities. If possible, please
give three (3) days advanced notice of any accommodation needs by calling (650) 5733509 (voice) or dial 711 to the California Relay Service for persons who are deaf, or hard
of hearing or, speech disabled. For the comfort and safety of those who are sensitive to
airborne chemicals, please refrain from wearing chemical-based products.
Appendix 8: Public Hearing Summary
Public Hearing Summary
Proposed Closure
Mills Health Center Standby Emergency Department
September 27, 2012
5:00 pm - 6:30 pm
Louise Rogers, Deputy Chief of the San Mateo County Health System and
Interim EMS Administrator moderated the public hearing on the proposed closure
of Mills Health Center’s standby Emergency Department pursuant to the
California Health and Safety Code Division 2, Section 1300. Ms. Rogers
introduced Bob Merwin, Chief Executive Officer, Mills-Peninsula Health Services
and Dr. Brian Roach, President, Mills-Peninsula Division of the Palo Alto Medical
Foundation.
Announcements:
Ms. Rogers stated that the standby Emergency Department at Mills Health
Center is scheduled to be closed by December 1st, 2012. The purpose of the
public hearing is to provide an opportunity for citizens to ask questions and make
public comments about the proposed closure in accordance with Section 1300 of
the California Health and Safety Code.
- Jan Ogar, RN, EMS Clinical Services Manager will accept written comments
until t 6:00pm on September 27th, 2012. Comments are to be mailed to:
San Mateo County EMS
Attn: Jan Ogar
225 37th Avenue
San Mateo, CA 94403
Presentation:
Bob Merwin made a presentation on “Changes in ED Services at Mills Health
Center.” During the presentation, the following specifics regarding the
transformation of the current Mills Emergency Department into an Urgent Care
Center were provided:
- State law SB 1953 requires that the standby Emergency Department at Mills
Health Center close by December 1, 2012 if the facility is not retrofitted to meet
current seismic standards.
-The decision to close the standby Emergency Department was made due to
several factors including cost, patient volume and the status of the building’s
current condition that does not meet State’s seismic safety standards.
-It is believed that the proposed Palo Alto Medical Foundation Urgent Care
Center will serve the community and the San Mateo County residents more
appropriately than its current set-up.
-Data that supports this decision include the following:
- Ambulances carrying critical patients have not come to Mills Emergency
Department since 1997; and
- Mills Emergency Department sees an average of 34 patients per day.
80% of these patients will be appropriately treated by the proposed Urgent
Care Center.
-There were two options concluded prior to the decision of closing the Mills
Standby Emergency Department and opening an Urgent Care Center:
- Option #1: Close the facility; or
Option #2: Bring the building up to seismic safety standards, which would
cost upwards of $60-80 million.
-The new Peninsula Medical Center Emergency Department in Burlingame was
built with the assumption that the Mills standby Emergency Department would
most likely close. Therefore, the Peninsula Medical Center Emergency
Department was expanded by 60% to accommodate additional patients.
-The proposed Urgent Care Center does not have to meet the same seismic
safety standards as the standby Emergency Department. The space will be
renovated to meet compliance with the Americans with Disabilities Act and other
safety codes.
-The Urgent Care Center is anticipated to open in the fall of 2013. It will be
staffed by physicians from the Mills-Peninsula Division of the Palo Alto Medical
Foundation. Services will include: diagnostic services, radiology, imaging,
treatments (e.g., fluid therapy, casting, wound suturing, urgent minor surgical
procedures, etc.) and respiratory therapy treatments. There will be extended
hours of operations 365 days/year.
Questions/Comments from the public:
This question and answer interaction took place between one resident (Gretchen
Warner). Answers to her questions are indicated below and included responses
from: Louise Rogers (Deputy Chief of the San Mateo County Health System and
Interim EMS Administrator), Dr. Brian Roach (President of Palo Alto Medical
Foundation), Brad White (General Manager of American Medical Response) and
Dr. Bob Merwin (Chief Executive Officer, Mills-Peninsula Health Services).
Mrs. Warner: “I have a question about this hospital. Is this Hospital (San Mateo
Medical Center) part of the Mills-Peninsula system? Is there an Emergency
Department at this hospital or not? The ambulances do not come here right?”
Louise Rogers: “There is an Emergency Department here and ambulances do
transport here and there are no planned changes for the hospital here. They will
continue to receive.”
Mrs. Warner: “So a call to an ambulance would take a person to Burlingame,
right?”
Louise Rogers requested that Brad White explain how calls will be triaged and
how a call results in an ambulance transporting a patient to Burlingame versus
San Mateo Medical Center
Brad White: “Today, if there is a life threatening emergency, those patients go
to the closest, most appropriate facility, which today would not be Mills. So, life
threatening patients go to other facilities based on their medical condition. And
today, if they have a non life threatening circumstance they can request to go to
Mills, but it’s very seldom. We only transport about five patients per month
currently to Mills. So what will happen with those average of five patients a
month is that they would request to go to any of the other facilities throughout the
county and we’ll take them to their preference. I hope I answered your question.”
Mrs. Warner: “I may as well stand up, since I’m talking. I’m Gretchen Warner, a
San Mateo resident. Ok, thank you very much, but it seems like those people
would be going to Mills Peninsula in Burlingame right? So, I would just want to
say that I’ve experienced some very good experiences with my husband whose
been sick several times. And we’ve gone to Mills because I’ve driven there and I
understand about the Earthquake safety and so forth, but there’s a lot of good
things about the Mills center. And I think a lot of us will feel very badly to have it
closed, even though I understand why it’s being closed. And I’m very glad that
the Urgent Care will be brought in its place, but we’ve had just wonderful
response every time we’ve gone there.
It was a stroke in one circumstance and Urinary tract leaking and other
items, other types of problems he’s had. And we have driven straight to Mills and
the waiting room is a place for him to sit down while I talk to the intake person.
They’ve taken him right back and spend a lot of tender loving care there and I’d
hate to lose it. I really do hate to lose it. I’m very grateful to the doctors and
nurses there. They’ve been terrific and I can’t speak more highly of them. So,
it’s going to be sad and I think a lot of people have a very warm spot in their heart
for the Mills facility. So I just wanted to emphasize that and show my gratitude
towards everybody who works in that facility. I’m curious since my husband has
had some strokes, what would happen if I took him to the Urgent Care thinking
he has the flu and it turned out he had a stroke after he was there? Because we
live so close to it. Thank you”
Dr. Roach: “My name is Dr. Roach. First let me say thank you for your
comments about Mills. I’m an internist speaking with 22 years of practice there.
I’m also former chief of staff…”
Mrs. Warner: “I should say one of my children was born there too!”
Dr. Roach: “It’s really a challenge that I’m quite willing to take on to provide the
best care that I can. In an Urgent Care setting we do have a triage nurse who is
able to make some assessments based on the nature of the condition. If it’s not
apparent during the initial interview with the patient, and the physician sees the
patient, and if the physician determines that it is a stroke or a heart attack, then
the patient would be transported via the EMS system just like if you were in a
physician’s office. The physician would call 911 and transport you urgently to the
most appropriate facility, probably in Burlingame. The aim is to recognize the
nature of the illness and appropriately and rapidly take care of the patient.”
Mrs. Warner: “So before starting treatment, I understand that you can’t always
tell if the person is having a stroke or not. My husband had the flu this last…”
Dr. Roach: “There is some pretty good medical science. We have good
indicators that would confirm our suspicions. We would generally start an IV and
start some stabilization patterns, such as a cardiac monitor or oxygen monitor.
We would do some basic… One of the first things the medics would do if the
patient were picked up from home would be to try and stabilize the patient and
expeditiously transport the patient.”
Mrs. Warner: “What would the person be? If when the ambulance comes and
then are you at that point admitted to the hospital, is that right? So that when
they’re actually in the ambulance the process starts? Or did I misunderstand?”
Dr. Roach: “This facility will be operated. It will be in the Mills Hospital building,
but it will actually be operated by Palo Alto Medical Foundation. Both are
subsidiaries of Sutter Health, but it’s a separate corporation.”
Dr. Merwin: “I think another piece to your question is: does the patient’s
treatment begin in the ambulance? They are not actually admitted to the
hospital, but there is communication between the base physician and the team in
the field and they oftentimes begin protocols. So this is where the treatment
starts.”
Mrs. Warner: “My understanding is that they are, I think somebody told me that
they can actually set it up so that, any equipment that’s necessary in the ER is,
that they know that somebody’s coming in, so they need it. Would the Urgent
Care have that option?”
Dr. Roach: “EMS staff dials the 4 digit extension and talk to our colleagues.
One of the things that we’ll be doing here, since Urgent Care is sort of knee jerk
and Primary Care is more emergency care. Most of the physicians in the other
Palo Alto Medical Foundation care centers are a combination of family practice
physicians, urgent care and ER physicians, so we’ll actually be staffing with a
mix. We’ll have the best of both worlds, so we will have every piece on site, to
make appropriate medical decisions in how to treat patients”.
Mrs. Warner: “I have one other question, what will the hours be?”
Dr. Roach: “Still to be worked out. Probably 7am-10pm or 7am-11pm. It will not
be 24/7 but it will be 365 days a year.”
Meeting Adjourned
The public hearing was adjourned by Louise Rogers. She thanked the public,
Palo Alto Medical Foundation and Mills-Peninsula staff for attending. She
informed the audience that the next step in the process will be to complete the
impact evaluation of the Mills standby Emergency Department closure and send
an Impact Evaluation Report to the State. Comments from the public will be
included in the Impact Evaluation Report.
Appendix 9: Mills-Peninsula Health Services Press Release
For General Release Contact: Margie O’Clair 650‐504‐3771 Sept. 19, 2012 New Urgent Care Center to Replace Standby Emergency Department at Mills Health Center State Earthquake Safety Law Prompts Change To meet earthquake safety standards set by the State of California, the Standby
Emergency Department (ER) at Mills Health Center in San Mateo must close on Dec. 1,
2012. The Standby ER will be replaced with an Urgent Care Center in the same space,
scheduled to open in fall 2013.
California Senate Bill 1953 requires that as of Jan. 1, 2013, all California acute care
facilities either retrofit their buildings to meet stricter standards or discontinue acute care.
The law is intended to protect the most acutely ill patients who are confined to bed and
couldn’t be easily evacuated in the event of an earthquake.
At Mills-Peninsula, critical emergency care has been provided exclusively at MillsPeninsula Medical Center in Burlingame since 1997, when all acute inpatient care was
consolidated at that location. Emergency surgery and other care services required for
treating critical emergencies have not been provided at Mills since the 1997
consolidation.
“We examined the use of the Mills Center Standby ER in recent years and found there is
a greater need for urgent care in the area,” Bob Merwin, CEO, said. “Ambulances have
bypassed Mills Health Center to take critically ill or injured patients to Mills-Peninsula
Medical Center in Burlingame since the Mills ER was downgraded to standby status.”
In 2011, the Mills Standby Emergency Department served about 34 patients a day,
compared to about 100 at Mills-Peninsula Medical Center and up to 145 a day at San
Mateo County Medical Center. Between midnight and 7 a.m., on a daily average, three to
four people come to the Mills Standby ER for care.
“Steep construction costs combined with the proximity of the new hospital and
emergency services in Burlingame made the retrofit of the Mills Center economically
unfeasible,” Merwin said. Estimated retrofit costs for the Mills Center were as high as
$80 million.
The building that houses the Standby Emergency Department is he only building at Mills
affected by the law. All the other programs and services provided at Mills meet
applicable earthquake safety standards and will continue operations.
“The new medical center that opened in Burlingame last year has a full service
emergency department that was designed to serve twice as many people. We are
consolidating our emergency services and are ready to care for all of the patients who
traditionally have used the standby emergency department,” Emergency Services Medical
Director Allan Brody, M.D., said.
Mills-Peninsula Medical Center is only four miles away and easily accessible from
California Drive, El Camino Real or Highway 101.
Mills-Peninsula is working closely with state regulatory agencies and local government
to ensure the public is well informed about the changes.
The San Mateo Emergency Services Department is holding a public hearing on the
closure on Sept. 27, 5-6:30 p.m., in Room 100 of the San Mateo County Health System at
225 37th Ave. in San Mateo.
Mills-Peninsula also is implementing extensive community outreach including personal
letters to patients, advertisements and presentations to senior residences and community
groups. A detailed “Question & Answer” sheet is being provided in the Standby
Emergency Department at Mills.
The Difference between Emergency and Urgent Care
Generally, an emergency is a condition that may threaten a person’s life or cause
impairment if treatment is delayed. Urgent care treats medical problems that, while not
emergencies, do require prompt care within 24 hours. According to Brian Roach, M.D.,
president of the Mills-Peninsula Division of the Palo Alto Medical Foundation, who is
developing the Center, it will offer:
• Diagnostic services including laboratory and radiology
• Treatments such as IV fluids and medications, splinting and casting, wound
suturing, urgent minor surgical procedures
• Respiratory therapy treatments
• Extended hours, 365 days a year
• Urgent care for all patients, regardless of insurance type
Sutter
to close
Appendix
10:San
SanMateo
MateoER
Daily Journal Article
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Sutter to close San Mateo ER
September 20, 2012, 05:00 AM By Bill Silverfarb Daily Journal staff
State / National / World
Sports
Opinion / Letters
Business
Arts / Entertainment
The emergency room at Mills Health Center in San Mateo will close Dec. 1
to meet earthquake standards set by the state, hospital officials announced
yesterday.
Lifestyle
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The standby emergency department will be replaced with an urgent care
center in the same space, scheduled to open in late 2013.
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It would cost between $60 million and $80 million to retrofit the one affected
building at Mills which hospital officials said is “simply not feasible.”
With its closure, emergency and urgent care services will be provided at
the emergency department at Mills-Peninsula Medical Center in
Burlingame, a Sutter Health affiliate, which has expanded capacity since
the new hospital opened last year and is just four miles from the San Mateo
ER.
Most patients who visit the standby ER at Mills today require urgent care
services rather than critical emergency care. Ambulances have bypassed
Mills Health Center to take critically ill or injured patients to Mills-Peninsula
Medical Center in Burlingame since the Mills ER was downgraded to
standby status in 1997, according to a hospital statement.
An urgent care facility will be a better fit for the community in San Mateo,
Bob Merwin, chief executive officer at Mills-Peninsula Health Services told
the Daily Journal yesterday.
Merwin does not expect the standby ER’s closing in San Mateo to
negatively affect the community.
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“I actually think it can be very good for the community. It will also be a lower cost to the consumer,” Merwin said about the
difference from receiving care in an urgent care facility compared to an emergency room.
Most people who use the ER in San Mateo are really in need of urgent care, he said.
The Mills standby emergency department in San Mateo served about 34 patients a day in 2011, compared to about 100 at
Mills-Peninsula Medical Center and up to 145 a day at San Mateo County Medical Center, according to the hospital. From
midnight to 7 a.m., on daily average, only one to three people come to the standby ER for care, according to the hospital.
But Patricia Lane, a nurse at Mills in San Mateo, told the Daily Journal yesterday that the ER at Mills Health Center serves a
vital community need.
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“It is heavily used,” Lane said. “It will clearly be impactful to seniors who chose to live near the hospital.”
Many people use the ER for primary care, she said, bringing in their children for pediatric care.
“People are still brought to Mills with acute conditions who then get sent to Burlingame,” she said.
Another nurse, Luchiana Kincer, who works at the Burlingame campus said it is another example of Sutter putting money over
care.
“It will be sad for us to lose. Once it is gone it will never come back,” said Kincer, a nurse for 37 years.
Sutter has already eliminated acute rehabilitative services at the two campuses, she said, and has contracted out other
services, such as dialysis, to private companies.
“It’s a money game,” she said.
However, she thinks the ER in San Mateo should close since it has been “dumbed down” over the years.
The Mills structure in San Mateo does not meet the newest, most stringent building codes that go into effect Jan. 1 and
upgrading it is too costly, hospital officials said.
A public hearing is scheduled next week for public comment and hospital officials met with San Mateo city officials yesterday to
discuss the closure and have informed the local health care district board of the decision.
“The Peninsula Health Care District board was made aware of this decision, however, since this service is operating out of
Mills, the district board does not have any oversight of that facility, nor does it have any say in what services are provided,” the
district’s Chief Executive Officer Cheryl Fama wrote the Daily Journal in an email. “Our district board would definitely be
involved in the decision-making had this been at the Peninsula campus located on the district’s land and covered by the 50year master agreement between the district and Sutter Health.”
Generally, an emergency is a condition that may threaten a person’s life or cause impairment if treatment is delayed. On the
other hand, urgent care can treat medical problems that, while not emergencies, do require prompt care within 24 hours,
according to a hospital statement.
The new urgent care center at Mills in San Mateo will offer:
• Diagnostic services including lab and radiology;
• Treatments such as IV fluids and medications, splinting and casting, wound suturing, urgent minor surgical procedures;
• Respiratory therapy treatments;
http://www.smdailyjournal.com/article_preview.php?id=1755067&title=Sutter
9/20/2012
Sutter to close San Mateo ER
Page 2 of 2
• Extended hours, 365 days a year; and
• Urgent care for all patients, regardless of insurance type.
Standby emergency departments do not care for critical emergencies. At Mills-Peninsula, critical emergency care has been
provided exclusively at Mills-Peninsula Medical Center in Burlingame since 1997, when all acute inpatient care was
consolidated at that location.
Emergency surgery and other care services required for treating critical emergencies have not been provided at Mills since the
1997 consolidation, according to the hospital.
California Senate Bill 1953 requires that, as of Jan. 1, 2013, all acute-care hospitals in the state either retrofit their buildings to
meet stricter standards or discontinue acute care.
The San Mateo County Emergency Services Department will host a public hearing Thursday, Sept. 27, to allow public
comment on closure of the standby emergency department at Mills Health Center. The hearing is set for 5 p.m. to 6:30 p.m. in
Room 100 of the San Mateo County Health System at 225 37th Ave. in San Mateo.
Bill Silverfarb can be reached by email: [email protected] or by phone: (650) 344-5200 ext. 106.
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9/20/2012
http://www.mercurynews.com/san-mateo-county-times/ci_21592355/mills-health-center-standby-emergency-room-close
Appendix
11: San Jose Mercury News Article
Mills Health Center standby emergency room to close
By Aaron Kinney [email protected] San Jose Mercury News
Posted:
MercuryNews.com
SAN MATEO -- Mills-Peninsula Health Services will close its standby emergency room in downtown San Mateo
and convert it to an urgent care clinic to avoid a state-mandated seismic upgrade that could cost as much as $80
million, the health care group announced.
The standby emergency department at Mills Health Center will close Dec. 1 and be replaced late next year with a
facility that provides many of the same services as well as primary care, Mills-Peninsula officials said this week.
The new Mills-Peninsula Medical Center in Burlingame, which opened in 2011, has enough capacity to handle
any extra emergency visits that arise from now on, they said.
"We examined the use of the Mills center standby ER in recent years and found there is a greater need for urgent
care in the area," Mills-Peninsula CEO Bob Merwin said in a statement. Mills-Peninsula, a Sutter Health affiliate,
operates both the Burlingame hospital and San Mateo health center.
Most people who visit the Mills standby emergency department are treated for non-critical injuries, as is typically
the case at urgent care centers, according to Mills-Peninsula. Major surgery and other critical emergency care have
been provided at Mills-Peninsula Medical Center and not Mills Health Center since 1997.
Mills-Peninsula officials said the impending change is due to a state law that requires any "acute" health care
facility -- a category the Mills emergency department currently falls under -- to meet certain seismic safety
standards by Jan. 1, 2013. Turning the facility into an urgent care clinic will allow the hospital to provide the same
services as in the past without having to spend millions on a retrofit.
Mills-Peninsula spokeswoman Margie O'Clair said the law is focused on people in acute care who are confined to
hospital beds and can't exit a building on their own in the event of an earthquake.
"It will be seismically safe for the programs and services that will be there," O'Clair said of the San Mateo facility.
The standby emergency room served about 34 people a day in 2011, compared with 100 at Mills-Peninsula
Medical Center and 145 at the San Mateo County Medical Center in San Mateo, according to Mills-Peninsula.
Services at the new urgent care facility will include lab tests and radiology; respiratory therapy; splinting and
casting; wound suturing and minor surgical procedures.
The San Mateo Emergency Services Department will hold a meeting on the closure at 5 p.m. Sept. 27 in Room
100 of the San Mateo County Health System at 225 37th Ave. in San Mateo.
Contact Aaron Kinney at 650-348-4357. Follow him at Twitter.com/kinneytimes.
Page 1 of 1
03/10/2012 18:31 PM
Page 1 of 2
Uploaded: Wednesday, September 26, 2012, 4:20 PM
Appendix 12: The Almanac Article
Select FILE --> PRINT to print this story.
Thursday: Hearing on closure of emergency room
Anticipating public concern regarding the anticipated closure of the Mills Health Center standby emergency department in San Mateo, the county has
scheduled a public hearing for Thursday, Sept. 27.
The standby department will close Dec. 1 and be converted to an urgent care clinic in the fall of 2013, according to Mills-Peninsula Health Services.
The switch would allow the health care organization to avoid spending $60 million to $80 million on state-mandated seismic retrofits. The
department, which handles non-critical emergencies, saw about 34 patients a day last year, about two-thirds less than other local facilities.
The public hearing starts at 5 p.m. in Room 100 of the San Mateo County Health System at 225 37th Ave. in San Mateo.
http://www.almanacnews.com/news/story_print.php?story_id=12121
10/3/2012