'Patients are going to die': Hospital access meltdown in Central California leaves officials in search of solutions

It has been nearly three weeks since Madera (Calif.) Community Hospital began to shut down services, and residents and nearby hospitals are feeling the effects. Local, state and federal officials have proposed a number of potential moves to keep the city's only hospital in operation, but a concrete solution has yet to emerge.

The Madera County Board of Supervisors met Jan. 10 to weigh options that would resume operations at the 106-bed hospital and maintain employment for 700 people. Those include reallocating $7 million of the county's remaining $14 million in federal pandemic funding and hiring an outside consultant. The county's board of supervisors will meet next Jan. 24, fresnoland reported. 

Congressmen Jim Costa and John Duarte wrote a letter to HHS on Jan. 6 requesting that a local health emergency be declared in Madera County -- the Sheriff's Office declared a local state of emergency on Dec. 29, citing the "significant impact" the closure will have on the community.

State lawmakers have also called on Trinity Health to renegotiate a failed acquisition of Madera Community, radio station KVPR reported Jan. 13. Trinity's plan to buy the hospital fell through because the health system did not accept the conditions set forth by California Attorney General Rob Bonta.

In addition, Madera Community CEO Karen Paolinelli, MSN, RN, has been in contact with the lawmakers to work on potential solutions.

"I asked her for a plan of action as to what can we do, even when they go into bankruptcy, in terms of trying to reopen. That way they keep their license current,” Assemblymember Esmeralda Soria told the news outlet.

Ms. Soria said she is looking to secure an organization that could operate the hospital with the license. If it remains active, the hospital can operate an acute care facility. She also said Gov. Gavin Newsom told her he is working to "figure something out."

Meanwhile, Madera County's 160,000 residents are left in a healthcare desert, facing at least a half-hour drive to hospitals in neighboring Fresno County, which declared its own local emergency Jan. 3. On Jan. 10, Madera Community's three affiliated clinics in Madera, Mendota and Chowchilla also closed. 

"Patients are going to die," Dr. Jonathan Mayer, an OB-GYN who practiced at Madera Community, told fresnoland Jan. 14. "If you have a car accident, you have to go to Fresno. If you have a heart attack or stroke, you've got to go to Fresno. If you're in labor and there's a problem, you've got to go to Fresno or Merced. If someone needs acute care and there's delay in transport, it can mean the difference between life and death."

Fresno County's largest health system, Clovis, Calif.-based Community Health System, operates four hospitals, a cancer institute and other outpatient facilities in the area.

On Dec. 31, in-network contracts expired between Community and several commercial payers, including UnitedHealthcare, Cigna and Anthem Blue Cross, making access issues in the region even more challenging — though all involved parties say they are negotiating.

Community Regional Medical Center in downtown Fresno is one hospital bearing the brunt. Danielle Campagne, MD, head of emergency department care at Community Regional, said the facility is already "blowing up" with patients, with dozens being cared for in hallways, KVPR reported Jan. 5.

"We're in dire straits. Patients are struggling and it's really hard," she told the station. "Madera … is going to be the tipping point for us."  

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