Central California county ends emergency declaration as capacity, finance issues persist

The Fresno County (Calif.) Board of Supervisors on Feb. 7 voted to end a state of emergency that had been in place since early January. Despite the emergency declaration's formal end, Fresno area hospitals continue to operate at or above capacity in wake of Madera (Calif.) Community Hospital's closure — the city's only hospital for 160,000 residents. 

Fresno's state of emergency was put in place Jan. 3, days after Madera Community Hospital closed and when the "tripledemic" was adding further strain to hospitals. Despite the wind down of flu, COVID-19 and respiratory syncytial virus, most Fresno hospitals continue to operate under "untenable conditions," Fresno County, Saint Agnes Medical Center and Community Health System — Fresno's largest health system — said in a joint statement. 

Community Regional Medical Center in downtown Fresno is one hospital bearing the brunt from an influx of patients who would normally seek care at Madera Community Hospital or its three affiliated clinics, which also closed Jan. 10. Community Regional is also grappling with a surge of patients from two large state prisons in Madera County. Danielle Campagne, MD, head of emergency department care at the hospital's emergency department, told The Fresno Bee that the unexpected increase in prison patients is "really the straw that's breaking the camel's back." 

Officials are still weighing a number of options to revive Madera Community Hospital, which ultimately closed because of the inability to keep up with the rising costs of care, and most of its patients were on Medi-Cal. Meanwhile, hospital and county leaders in Fresno continue calls for more state and federal dollars to avert a similar fate. 

"Since the pandemic, hospital expenses related to labor and supplies have skyrocketed. Government funded healthcare (Medi-Cal and Medicare) does not cover the cost of providing care," Fresno County, Saint Agnes and Community Health System said in their statement. "More people have access to coverage through these expanded programs, but hospital reimbursement rates have not seen a legislative increase in the last decade, resulting in an added financial burden. Federal and state dollars are needed to ensure hospitals in our region can weather the current situation."

During their Feb. 7 meeting, Fresno County supervisors said they are committed to continue working with local hospitals and representatives to address the region's healthcare challenges. There have also been concerns surrounding financial challenges at Kaweah Delta Medical Center in Visalia, Calif., about 44 miles away from Community Regional, according to a Fresno Bee report. In January, KVPR reported more than 1,000 employees and local residents wrote a letter to Gov. Gavin Newsom regarding the hospital's financial challenges. 

"If that hospital falls ... I think we could all fall," Dr. Campagne of Community Regional said, according to the Fresno Bee. 

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