The rumors are true.
The urgent care center on Fifth Street in Brookings will be closed as Curry Health Network (CHN) officials make way for a stand-alone Emergency Department sometime “soon,” network CEO Gini Razo confirmed at a county commissioner meeting Wednesday.
The health care clinic offices there will remain open.
The hospital district has been promising for years to transform Curry Medical Center into an emergency department for years, Razo said, but was constrained by finances. The district recently built a $30 million, state-of-the-art hospital in Gold Beach and has been waiting until it had enough cash on hand to start work in Brookings.
“It’s been a long-standing objective to open the Emergency Department in Brookings,” Razo said. “In 2015, we planned for 2016. We didn’t have the cash reserves to do so.”
She didn’t have a specific date, but said they are waiting on federal and state policy and regulations to be approved.
“At this time, we continue preparing to open,” she said. “We have no firm date. We’d hoped to have it open in April. That’s a target date.”
She noted that the new emergency department will add about 25 jobs, as well.
The district is also proposing a “first phase” of a feasibility study to determine if a proposal by the South Coast Health Care Alliance, a vocal citizen-based group that wants a satellite hospital in Brookings, would be permitted and if it would be financially feasible for CHN.
The district has been challenged from the outset.
In the midst of construction of the new hospital, Razo learned her then-chief financial officer had a “more optimistic” outlook on the financial status of the district than she did, which resulted in the first major delay of any changes at the facility in Brookings.
The district has slowly built up its cash reserves, Razo said. As of the end of February, the network had 46 days of cash-on-hand, meaning that if all revenue sources were discontinued, it would be able to cover its financial obligations for that period of time.
Razo said the delay was not the result of a ballot question asking South County residents to join the hospital district, whose southern border is in the Pistol River area. Opponents of that ballot question claimed the district merely wanted South County residents to join the district so their tax dollars would help pay for the new hospital.
Controversy still swirls regarding whether the Curry General can split its hospital license to have some of its in-patient beds in a facility in Brookings. The South Coast Health Care Alliance, in which Commissioner Sue Gold is active, believes that option is available despite a law that says critical access hospitals cannot be within 35 miles of one another. Curry General in Gold Beach is 28 miles from Brookings; Crescent City’s Sutter Coast Hospital, which is not a critical access hospital, is 25 miles away.
It’s those cumbersome distances that have inspired the alliance to pursue the option, as well as the fact the largest population base in Curry County is in Brookings and the majority of patients in the area take their medical problems — and money — to California.
Brookings is also the only city of its size in the state without a hospital.
A recent challenge the district faced was a fierce winter storm in February that took out a quarter-mile of U.S. 101 about 12 miles north of Brookings, Razo said. The hospital lost some $650,000 in revenue when they saw a 23 percent drop in in-patients and a 17 percent drop in out-patient visits. Most people needing hospital care opted to go to Sutter Coast rather than negotiate the steep, winding road over Carpenterville for the two weeks a detour was in place.
From the public
Many residents who spoke in Wednesday’s commission meeting said they’d prefer the urgent care clinic stay, as there is no other option when clinics in town close for the day.
Judy Kaplan of Brookings noted, too, that Medicare will not pay for non-emergent care conducted in an emergency room.
“Who has decided that serving perhaps five ER patients is better for South County than serving 50 urgent care patients?” asked Brookings resident Teresa Lawson, a one-time candidate for mayor. “Is this another case of ‘follow the money?’ ERs make more money than urgent care. Some urgent care services may be offered, but at ER rates that are significantly more cost to patients, insurance companies, Medicare and OHP. Would insurance even cover a non-emergency visit to the ER? Would OHP cover this expensive care? Follow the money: more profit for CHN, more cost to everybody else.
“I am not against an ER,” Lawson said. “I am against an ER at the expense of losing our urgent care … without any study to justify this decision.”
Others asked if it was prudent to take a patient with a serious ailment or injury from the emergency department in Brookings to the hospital in Gold Beach only to have a physician there determine they needed to be transported to a larger city for definitive care.
Razo said the emergency room in Brookings would have a physician that could send a patient in dire need directly to definitive care.
“When the ER opens, it will be fully staffed like Curry General or Sutter Coast,” Razo said. “If it’s determined you need a higher level of care, a patient will go to the next appropriate facility — Medford, Eugene or wherever you need to go.”
The city of Brookings, which recently obtained the airport from Curry County, has been working with Cal-Ore Life Flight to provide flight services from Brookings to major medical facilities when the emergency room opens.
Others wanted to know where they were supposed to go for urgent problems that aren’t emergencies. Some noted it can take weeks to get an appointment with their primary physician — if they even have one — and going to the emergency room would be prohibitively expensive. It was also noted situations like that are driving up the cost of health care nationwide.
Razo said people needing urgent care services will be able to make same-day appointments at the clinic when it is open, and said they are working on where patients could go after-hours. Until then, however, people needing urgent care would likely be directed to the emergency department.
“We have the exact same situation in Gold Beach,” Razo said. “Unfortunately, emergency rooms serve in that capacity when clinics close (at the end of the day).”
Gold wanted to know if an emergency room patient would have the option of choosing the hospital to which they wanted to be transported. Curry Health Network has said in the past that under an agreement with Cal-Ore, those needing transport to a hospital would be taken to Curry General at no additional ambulance cost, but those wanting to go to Sutter Coast would have to address the cost with their insurance agent.
“We are working to be compliant with all rules and regulations,” Razo said. “We are working on those details. It’s not that I don’t want to answer; I’m not trying to hide anything. And I am not going to speak on behalf of Cal-Ore. I’m not an expert about the ambulance business. We do not operate, own or direct how Cal-Ore does business. I simply don’t know the answers to those questions.”
South County resident Catherine Wiley requested a workshop be held to address the South Coast Healthcare Alliance’s hospital proposal. When Commissioner Chris Paasch suggested the group present that to the health district board of directors, some in the audience laughed.
Commissioner Court Boice said Brookings needs an emergency department more desperately than anywhere else in the state. He cited the 2011 tsunami, a 2015 sinkhole on U.S. 101 in Harbor that slowed southbound traffic, health problems created by the 2017 Chetco Bar Fire and this year’s Hooskanaden Slide on U.S. 101 between Brookings and Gold Beach that diverted traffic onto Carpenterville Road for two weeks.
In a letter he wrote to the Legislature, Boice noted that 90 percent of emergency room patients are treated and released, while 7 percent require admission to a hospital and the remainder are transported to big-city hospitals where they can receive a higher level of care.