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By Shawn Raymundo
As hospitals in Orange County stand by for a potential surge in patients who have contracted COVID-19, the city council is seeking Gov. Gavin Newsom’s help in getting the shuttered 73-bed hospital in San Clemente reopened to care for any non-coronavirus-related patients.
The request comes at a time when the county’s hospitals continue to operate below capacity, ensuring that there are enough hospital beds available to meet the needs of any influx of coronavirus patients that might occur.
On Tuesday, April 21, the council voted, 3-0 with two abstentions, in favor of sending a letter to the governor, calling on him to consider using MemorialCare’s former medical campus on Camino de los Mares as a site to treat non-COVID patients.
“Through guidance from the state, as counties and cities prepare for surge capacity, we urge the state to send in an independent third party to conduct a critical survey of the site and make a determination as to whether it may be a suitable location as a surge hospital during this pandemic,” the letter states as read by Councilmember Chris Hamm during the meeting that was conducted via teleconference.
“Opening this site helps protect existing hospitals, allowing further surge capacity,” the letter continued.
MemorialCare closed the hospital in 2016 but is currently using the grounds as a mobile testing center for the coronavirus—an endeavor launched last week that the city partnered with the health care operator on and gives priority access to San Clemente residents.
Both state officials and medical experts have stated that the ramping up of testing for the virus will be a key component in getting California’s economy reopened. MemorialCare Vice President Tony Struthers touched on that point in an email to the San Clemente Times on Thursday, April 23.
The state, he wrote, “identified enhanced testing capability as being among the prerequisites for ultimately relaxing the stay-at-home orders and reopening the economy.”
Just this week, the Orange County Health Care Agency launched its COVID-19 Testing Network, which will expand testing throughout the county for those exhibiting symptoms of the virus but are unable to receive testing through a health care provider.
Asked about MemorialCare’s position on the council’s action taken this week, Struthers noted that neither he, nor members of the community, were notified of the councilors’ plans to discuss the matter. He went on to say that hospital capacity has been addressed countywide, while the state has opened the Fairview Development Center in Costa Mesa for additional capacity.
“MemorialCare remains committed to these efforts, particularly as it and other health systems have already established their capacity to address any surge in COVID-19 patients at their existing medical centers and the State further implements its alternative care site at the Fairview Developmental Center,” he wrote.
According David Souleles, deputy agency director for the county’s health office, hospitals throughout the county have been operating below capacity, with about 50% of beds available. In recent weeks, hospitals have taken steps to defer elective surgeries and keep availability open as part of the effort to prepare for a surge in admissions.
While hospitals had been bracing for an influx to occur this month, the surge, Souleles recently told the Orange County Board of Supervisors, is now likely to hit in May—a possible indication that the state’s stay-at-home directive is working to slow the spread of the virus and flatten the curve.
“State officials have indicated that actions taken by California are working and suggests our surge will likely be later in May,” Souleles said on April 14, before adding that county health officials remain cautiously optimistic that the measures are beginning to make an impact.
According to the health office’s latest data on Thursday, there have been a total of 1,827 cases of the virus reported in the county, with 36 deaths. Between Wednesday and Thursday, there were 78 new cases.
Nearly 160 people are currently being treated at a county hospital, including 59 who have been admitted to intensive care units. More than 20,800 people in Orange County have been tested to date.
On Tuesday, Hamm explained that he had been working in collaboration with Councilmember Gene James to draft the letter over the past couple of weeks and proposed it be included on the agenda for council discussion as an immediate action.
Mayor Pro Tem Laura Ferguson and Dan Bane, the now-former mayor, abstained from voting on the item on Tuesday night. Bane had recused himself from the discussion, because his law firm represents MemorialCare in unrelated matters.
From the outset, Ferguson had opposed the letter because, she said, it was inappropriate to ask for the state’s help when the city is already seeking proposals from interested parties that may want to reopen the hospital with an emergency room.
“I don’t think the letter is appropriate for the particular reason that we, this city, did an RFP (request for proposal) process, initiated an RFP process, about almost eight weeks ago,” Ferguson said. “The deadline had come and passed. And we had a response to that RFP.”
The details regarding responses to the RFP have not yet been made public, she noted, but have been shared with the council in closed-session talks.
In December, the council had approved the initiation of the RFP process, setting a deadline for responses in early February. According to a draft of the RFP that was publicized and later gutted prior to the council’s vote this past winter, the city estimated the cost to renovate the hospital was about $62.81 million, while a whole new facility was anticipated to cost about $163 million.
Ferguson said she would have supported the letter if the council had added a paragraph encouraging the state to foot the cost of refurbishing the hospital, “because our city doesn’t have the funds for this.”
Responding to Ferguson’s concerns, Hamm said the request to the governor and the RFP are two separate actions. He also said that while he was open to adding in the line asking the state to fund the cost of reopening the facility, securing government funding was essentially the goal of the letter.
“There’s funding out there,” he said, referring to county, state and federal monies. “The idea behind this letter is to wave a flag and get the attention of the people who are going to be writing those checks, to give us some of that assistance as a community.”
In previous and separate correspondence from MemorialCare, Struthers explained to the SC Times that the “reopening of the hospital campus for acute care would require considerable time to bring it up to the proper quality standards.”
Struthers had also said the hospital “would necessitate the diversion of significant numbers of doctors, nurses and critical resources from operational facilities that are already equipped to best isolate and treat patients infected with COVID-19.”
The SC Times, this week, obtained an email thread between Tammi McConnell, medical health operational area coordinator for the Orange County Emergency Medical Services, and Brent Finkel, Assemblymember Bill Brough’s chief of staff.
In the exchange, Finkel inquires about the feasibility of the hospital being used for surge capacity, with McConnell responding that multiple sites have been considered but that “it was apparent in our discussion with Memorial Care (sic) that the property is derelict and missing vital functions to be able to quickly mobilize to support COVID-19 response efforts.”
Hamm and James, however, would like the state to conduct its own independent assessment of the site to determine whether it’s feasible to address surge capacity.
“This body would be remiss if we did not call upon the representatives of this great state to make their own assessment of this location at a time when swift and immediate action is necessary to save lives,” the letter states. “We ask that the state coordinate this effort with this body and our local labor partners who have exhibited both the will and the ability to get this hospital online as deemed appropriate.”
David Miller, research director for SEIU-United Healthcare Workers West, told SC Times this month that the union is supportive of reopening the hospital and believes there are enough medical professionals to fill any need in San Clemente.
“We think we can help. That is the one part we can definitely help with … especially respiratory therapists. We have a lot in our union who are looking to really help here,” Miller said.
Though the union hasn’t physically visited the shuttered hospital, Miller said it would be a significant endeavor to reopen the site. Accomplishing such a feat, he said, will depend on whether a health care operator is willing to come and do the work, as the state isn’t in the business of running a hospital.
“We need a strong partner if we’re going to get it open,” he said. “It’s less of a state issue and more of a ‘who’s going to run it?’ ”
The city has been without a hospital since May 2016, when MemorialCare closed the Saddleback Memorial Medical Center. The operator wanted to turn the facility into an urgent care location. However, residents and the city council at that time rejected such a notion, advocating instead for an emergency room and hospital facilities.
An action taken by the city that same year to zone the parcel for emergency services prompted litigation between the city and MemorialCare. The medical provider sued the city over claims that the city’s “spot zoning” was unfair and made it difficult financially to support the hospital.
MemorialCare had previously cited a lack of patients and could not provide the services required. It had also sought $42.5 million in retribution, the estimated value of the property, news files state.
The two parties reached a settlement agreement last June. Since then, the city has intended to reopen the hospital, providing inpatient acute care, as well as surgical, outpatient, clinical and emergency room services.
During an initial vote on the letter on Tuesday, it passed 3-1-1, with Ferguson opposed and Bane recusing himself.
Afterward, however, Ferguson raised concerns over potential Brown Act violations as members of the public weren’t given notice of the item, only leaving a short window to submit any comments.
“Since we received this letter yesterday via email, should this have been posted or noticed to the public so they would have had an opportunity to comment?” Ferguson asked.
City Attorney Scott Smith responded that the letter must be available at the meeting, which was done when Hamm read the letter aloud for the record.
Ferguson also questioned why, if Hamm and James had been working on the item for a couple of weeks, it wasn’t noticed beforehand. She also asked whether it could wait until the following meeting on May 5.
Because the council had already voted to agendize the item and subsequently vote on it, Hamm left it up to his colleagues to decide whether to reconsider and continue discussion to the next meeting.
With no one else objecting to moving forward, Ferguson decided to abstain from voting on the matter altogether and requested that her name be removed from the letter.
Shawn Raymundo is the city editor for the San Clemente Times. He graduated from Arizona State University with a bachelor’s degree in Global Studies. Before joining Picket Fence Media, he worked as the government accountability reporter for the Pacific Daily News in the U.S. territory of Guam. Follow him on Twitter @ShawnzyTsunami and follow San Clemente Times @SCTimesNews.