City, medical center to work on options

Barbara Diamond

If wishes were horses, beggars would ride, and if they were dimes

South Coast Medical Center wouldn’t even consider leaving Laguna

Beach.

“The possible loss of the hospital is one of the most crucial

issues facing us,” Mayor Cheryl Kinsman said.

A study presented Tuesday by a city-hired consultant, with an

addendum by a second consulting firm, made the possibility look more

like a probability.

Consultant Steve Valentine of Camden Group, who prepared the

Essential Health Care Needs Assessment, told the council the hospital

suffered losses of almost $5 million in 2001 and 2002 and $2.5

million in 2003. The projected loss for this year is a vastly

improved deficit of $400,000, but still a substantial loss.

To make matters worse, the state mandated seismic standards that

the center must meet will cost $72 million.

“SCMC needs access to capital, additional medical office space,

more patients, more specialists and higher revenue per unit,”

Valentine reported. Sixty percent of the city’s residents already use

other hospitals, Valentine said, some for services the hospital does

not offer, such as open heart surgery or a trauma center.

However, Kinsman is most worried about the loss of the

highly-rated emergency room at the medical center.

“You can’t have an emergency room without a hospital, or it drops

to the level of urgent care,” Kinsman said.

That is a state law, now under scrutiny.

Valentine said that if the hospital moves out of town, emergency

medical services will be available within 30 minutes, considered an

acceptable time frame. But it might take longer in peak traffic,

according to Valentine’s study, which would take paramedic trucks out

of the city for a considerable time.

“Seventy-eight percent of all our paramedic calls go to South

Coast Medical Center,” Kinsman said. “We have only two paramedic

engines. If they are out of town, you don’t want to call 911.”

The city Fire Department and Police Department told Valentine that

losing the hospital would be an inconvenience and increase costs --

perhaps as much as $1 million a year. More than two paramedic engines

and trained personnel would be needed to cover the city and the

city’s disaster plan, which is predicated on nearby medical services,

would have to be revamped.

Hospital options include staying and paying to retrofit; finding a

buyer for the hospital; converting to a free-standing emergency

medical center at the site, if the state changes it laws; converting

the old hospital to a new specialty hospital or building a new one on

the site; forming a hospital district or relocating.

“We have had financial problems, which the retro-fit exacerbates,”

hospital Foundation President Orsak said. “Retrofitting all the

hospitals [in California] will cost more than all their assets.”

Orsak was tracked down at a restaurant and asked to represent the

hospital at the council meeting since no other hospital official

showed up.

“Your report agrees with our own consultants,” Orsak said. “We

would love to stay here. However, we fill an obligation, not only to

Laguna Beach, but to the rest of our service area.”

The area also includes Laguna Hills, Lake Forest, Mission Viejo,

Aliso Viejo, Laguna Niguel, Dana Point, San Clemente and San Juan

Capistrano, where a potential relocation site has been identified.

However, San Juan officials are not overly enthusiastic about the

development of a hospital on the parcel, which is zoned for a hotel.

“Everybody wants bed tax these days,” Orsak said.

Kinsman asked First Strategies consultant Paul Freeman, a former

councilmember, what it would take to keep the hospital here.

“The quick answer is I don’t know,” Freeman said. “The [Camden

Group] report emphasizes the site is constrained. They need 1,000

square feet per bed and they can’t do it. There is no way to

retro-fit the tower. To reconfigure and intensify the campus may not

please neighbors. The hospital might survive, but it won’t thrive.”

Freeman and Mayor Kinsman were appointed to serve on a joint task

force to work on options with hospital representatives that include

Orsak and former Mayor Kathleen Blackburn, a hospital board member.

“Sometimes the things we want we have no control over,” said

Councilman Steve Dicterow, who recommended that the task force also

study a parallel track, if all efforts fail to keep the hospital in

Laguna.

“As far as I am concerned, [the hospital] is not leaving,” Kinsman

said. “You may find me strapped up on the side of the tower, but you

are not leaving.”