A new move by Berkeley officials and the release of a health impact report have injected a new surge of energy into what’s become a years-long effort to push back against Sutter Health’s plans for Alta Bates.
The healthcare giant says it will relocate emergency and other acute care from the Berkeley hospital to its Summit campus in Oakland by 2030, the deadline for California hospitals to make seismic upgrades.
Sutter has said the seismic work to buttress the buildings that hold acute care is too costly to complete at the Ashby Avenue hospital and that inpatient care is down anyway. (The areas of the hospital providing non-acute care do not have to be upgraded.) Officials across the region and the nurses union have argued that Sutter can afford the upgrades and that relocating to Oakland will put people who have to travel a long way to get there in danger.
Berkeley’s elected leaders have made their positions clear, unanimously passing a council resolution in 2016 opposing Sutter’s plans. Tuesday, after a press conference that drew a few dozen red-clad nurses and supporters, the City Council passed an item directing the city manager to ask Sutter to rebuild in Berkeley or sell the property to a full-service hospital that is willing to — or to at least work in earnest with Berkeley to — come up with a different solution, such as moving emergency and maternal care to another site in the city.
“The mayor and I have been in talks with Sutter to pursue as many alternatives as possible…to safeguard our residents,” Councilwoman Lori Droste, whose Elmwood district includes Alta Bates, told Berkeleyside.
Mayor Jesse Arreguín said Berkeley is pushing Sutter to provide “a concrete plan.”
“Do they intend to stay in Berkeley? What is the cost of rebuilding? We’re leaving no stone unturned. The whole council is united,” he told Berkeleyside.
In 2017, the council adopted an ordinance requiring hospitals to give additional notice and information on potential impacts before moving forward with a closure or reduction of acute services.
Tuesday’s council item, sponsored by Arreguín, Droste, and Councilwomen Sophie Hahn and Kate Harrison, says the city has repeatedly asked Sutter for “evidence” of the estimated cost of retrofitting Alta Bates to meet the state’s requirements.
Asked about the cost, the council’s action, and the details of the company’s current plan, Sutter emailed Berkeleyside a statement that said, “Sutter Health is committed to serving the East Bay Area and to working with the community to develop a regional solution that works for all.”
California’s Office of Statewide Health Planning and Development confirmed to Berkeleyside that there are five buildings at Alta Bates in need of retrofitting by 2030. The company has said there are other hurdles to retrofitting the Berkeley property, like its proximity to the property line and the impact of heavy construction on patient care. Summit Hospital, at Hawthorne Avenue and Webster Street, has several buildings in need of seismic work as well.
Sutter has previously said it will expand the Summit campus, constructing a new building to support the relocated emergency services and all current Alta Bates staff. Alta Bates’ popular maternal and neonatal services —nearly 5,900 babies were born there last year, according to the city — will be rebuilt there, elsewhere in Berkeley or at another Sutter facility, the company has said. Outpatient care will be expanded at the Alta Bates campus or at Herrick, on Dwight Way and Milvia.
Sutter has already moved some of Alta Bates’ major services, like its cardiac program, to Oakland in recent years.
Chuck Prosper, the former CEO of Sutter who resigned in the spring, told Berkeleyside earlier this year that all of Alta Bates’ emergency and delivery services would remain intact until they were fully up and running in Oakland — likely not for another 10 years. At the time there were rumors that Alta Bates might close as early as 2019.
The projected 10-year timeline for the expansion project has prompted some skepticism from local officials and nurses, who question whether the Oakland hospital’s growth will be as extensive as promised.
“There’s been no permits, nothing taken out,” said Mike Hill, California Nurses Association union rep at Summit. If new facilities aren’t added, he said, “we cannot handle this influx of patients over at Summit.”
Alta Bates handled 50,000 emergency room visits in 2017, up from 46,000 in 2016, according to a new health impact report. Summit had 47,000 visits in 2017, so the consolidated site could see double the number of patients seeking immediate care. Summit also currently has just slightly more beds than Alta Bates.
At the press conference, Arreguín spoke about the potential effects of Sutter’s plans on patients from the north, whose new hospital will be three more miles away. The closure of Doctor’s Medical Center in San Pablo in 2015 made Alta Bates the only full-service hospital on the I-80 corridor, other than Kaiser, between Rodeo and Berkeley. There are fears that ambulances will get held up on the congested freeway until it’s too late.
“We’ve seen in recent decades this move toward consolidation and closure,” Arreguín said at the press conference. “This is a hospital that serves the entire East Bay.”
At the event, El Cerrito Mayor and Alta Bates nurse Rochelle Pardue-Okimoto had strong words about her employer: “Sutter is more interested in monopolizing the healthcare in this community and making a profit.”
Report shows potential increases and decreases in travel time to Summit
A task force assembled by Arreguín in 2016 commissioned the UC Berkeley Institute of Urban and Regional Development to conduct a Rapid Health Assessment, synthesizing existing data to analyze the impacts of a closure of Alta Bates. The report was recently released.
Responding to the concern about the increased travel time to Summit, the researchers looked at GPS data to estimate how much longer, exactly, it would take a patient to get to the emergency room.
Notably, they found that it would actually be up to 10 minutes quicker for all patients from the West Contra Costa cities they studied to get to Summit instead of Alta Bates at 8:30 a.m. or 12 a.m. This may be due to the traffic up Ashby Avenue after exiting into Berkeley, or alternative routes available. During the 5:30 p.m. sample time, however, it would take patients 5 to 20 minutes longer to get to Summit from all cities — between Berkeley and San Pablo — than it would to go to Alta Bates.
Arreguín commented Tuesday on the risk of making a heart attack victim wait on a sluggish freeway. However, cardiac services have already moved to Summit. Others have spoken about the danger of relocated the birthing services and potentially putting pregnant people on a longer journey to a hospital.
From Berkeley, the slightly increased travel time could have a significant impact on the city’s emergency services. According to the report, Berkeley EMS spends 10-12 minutes longer on a task when transporting patients to Summit.
Berkeley, unlike neighboring cities, has its own paramedics. Fire Chief Dave Brannigan spoke at a “Save Alta Bates” event in February about the complexity and time-sensitivity of the department’s emergency response system. If all emergency services relocate to Summit, Berkeley will have to overhaul that system, add ambulances and restructure dispatch, he said.
The health impact report also found that populations facing greater health risks tend to live far away and could be more heavily affected by the relocation of Alta Bates’ services.
“A wealth of evidence suggests that vulnerable populations may be more severely impacted by hospital closures, and should be taken into special consideration in the context of Alta Bates and the capacity of the East Bay regional healthcare network,” the authors wrote.
In 2016, more than half the emergency room patients at Alta Bates were people of color, according to the report. Forty-one percent of all patients at the hospital were uninsured or had Medi-Cal. In 2017, a quarter of Alta Bates’ patients were from Contra Costa County. The county’s residents in the hospital’s coverage area are less white, lower-income and face higher health risks than those in Alameda County.
Across the state, there are increasing numbers of hospitalized elderly patients, so ER and inpatient visits might increase more in the coming years, the authors noted.
The study also examined the potential impact of a disastrous event on hospital visits locally.
“There are a number of manmade and natural disasters we know could happen, and we need to have an ER to provide the essential emergency care,” Arreguín said at the press conference. In an earthquake scenario estimating the impact a 7.0-magnitude quake on the Hayward Fault, 14,000 people would receive injuries and more than 800 would seek emergency care.
Throughout the press event, impassioned shouts of “save it or sell it” rang out through the crowd.
With the passage later that evening of the council item, the city manager’s office will now get to work crafting a letter to Sutter.