Copyright Santa Rosa Press Democrat
Sonoma County pediatricians are warning of dire consequences if Santa Rosa Memorial Hospital follows through on plans to close its inpatient children’s ward, a move they say would leave families across the North Coast without local options for overnight pediatric care. Providence, which operates Santa Rosa Memorial, announced late last month that it intends to shutter the ward, citing financial pressures and low patient volume. The closure would force low-income families across Sonoma, Mendocino and Lake counties to seek care outside the area for children who need nonemergency hospital stays. At a Nov. 6 meeting, members of the Sonoma County Maternal, Child and Adolescent Health Advisory Board blasted the plan and vowed to increase public pressure on Providence to reverse course. The county-appointed body advises local health officials and the Board of Supervisors. “It’s obvious we’re in somewhat of a crisis mode,” said Michael Perry, a retired Santa Rosa dentist and advisory board member. “We have an underserved population that’s not going to be taken care of at an acceptable level.” Pediatricians with Providence Medical Group estimate the inpatient unit treats about 500 patients each year. Without it, roughly 300 children annually would need to be transferred to hospitals outside Sonoma County. Board members argued the move would disproportionately harm Medi-Cal families, who already face barriers accessing specialty care, since Sutter Health’s Santa Rosa hospital has no inpatient pediatric unit and Kaiser Permanente, which does, generally serves only members. During the advisory panel meeting, Dr. Deborah Britt, a pediatrician with Providence Medical Group, raised concerns about how the hospital plans to care for children once the ward closes. She said plans are for some infants younger than 28 days will be treated in the neonatal intensive care unit, some patients older than 14 will be placed in the adult medical-surgical unit, and children needing very short stays — eight to 12 hours — will be kept in the emergency department. “Given all of that, it’s anticipated that there will be about 300 kids a year that will need to be transferred to an out-of-county hospital,” Britt said. “So one of our major concerns is who will accept those kids?” Britt noted that during winter respiratory surges, Bay Area hospitals such as UCSF Benioff Children’s in Oakland often operate at or near capacity. Transferring young patients also adds financial and emotional strain for families. The board’s criticism has been building for weeks. In mid-October — about a week before Providence made its decision public — members sent a letter to county supervisors urging them to oppose the closure and request a government review of Providence’s compliance with state and federal requirements. The letter also asked the county to engage state agencies to explore funding options and convene a public forum so families most affected could share their concerns. “Sonoma County’s children deserve access to safe, local, and equitable inpatient care,” board chair Elizabeth Vermilyea wrote. “We ask for your leadership in ensuring that this essential service remains available to our community.” In a statement, Providence officials said the decision was “not made lightly or in haste,” but followed a deliberative process that began several years ago. Scott Ciesielski, chief administrative officer for Providence Sonoma County, said the unit is severely underused, averaging only two pediatric patients per day. He said the wing should be reconfigured for adult patient use. “The logistical and financial challenges of maintaining a near-empty pediatric unit, while managing an increase in demand for complex adult care, have become more acute each year,” Ciesielski said. “Repurposing the inpatient pediatric unit to expand adult inpatient capacity where demand is significantly higher enables us to align our limited recourses with the evolving needs of the community.” Many physicians sympathetic to the hospital’s financial strain still called the move short-sighted. Roughly 85% of Memorial’s pediatric patients are covered by Medi-Cal, which reimburses hospitals for only about 75% of care costs — among the lowest rates in the nation. “These closures are policy failures, not proof that children no longer need local hospital care,” wrote Drs. Elizabeth Culhane and Heather Iezza, pediatricians with Providence Medical Group Santa Rosa, in a recent Press Democrat Close to Home piece. “Decisions of such profound consequence should not rest solely on a balance sheet, nor should they be made in isolation.” Board of Supervisors Chair Lynda Hopkins said she opposes the closure and encouraged the panel to contact state lawmakers, including Senate President pro Tempore Mike McGuire. McGuire did not respond to a request for comment. Assemblymember Damon Connolly, D-San Rafael, called the decision “deeply concerning for families and children” throughout Sonoma County. Connolly, whose district director Melissa Apuya serves on the advisory board, said families will be forced to travel long distances to get hospital care for their children. “That added stress can be overwhelming,” he said. The advisory board, Britt and other local pediatricians are urging Providence to pause its plans and work with county and state leaders to find a solution that keeps the unit open. Ciesielski said Providence has already engaged with “both internal and community stakeholders” about the unit’s future, but offered no indication the hospital would revisit its decision. You can reach Staff Writer Martin Espinoza at 707-521-5213 or martin.espinoza@pressdemocrat.com. On Twitter @pressreno.
