Brookings City Council agreed to pen a letter to Gov. Kate Brown in support of an emergency department (ED) in town, despite numerous questions posed by residents who don’t want to lose the urgent care facility in the process.

Curry Health Network CEO Gini Razo announced last week the health district plans to open an ED “soon” but it will come with the closure of the urgent care clinic on Fifth Street. Physicians clinics there will remain open, she said, for people who might have gone to the urgent care facility instead.

That didn’t sit well with many residents in Monday night’s council meeting, who said while they support an ED, they didn’t want to lose the urgent care facility.

“My concern is that doctors are not available for same-day appointments when patients are sick,” said Brookings resident

Teresa Lawson. “There’s a shortage of doctors, and patients end up in urgent care.”

The cost of being diverted for urgent care to the ED was a concern to others, as well, as emergency room care can cost much more than that received in an urgent care facility.

“An ER would be better,” said Brookings resident Candice Michel, “but the cost is five to 10 times more than urgent care. That’s a significant factor in our poor rural area where people have to choose between medicine and food.”

She wondered if a 24/7 urgent care facility might be an option.

“It isn’t the cash cow an ER is,” she said. “But that’s not what the issue is. The issue is what’s the best health care option for Brookings and the surrounding community? In setting a vision for Brookings, this question needs to be answered first.”

Dan Sherman of Brookings said he had two friends from Oklahoma who were forced to go to an emergency room for care and later committed suicide when they couldn’t pay the bills.

Marsha Thibodeau of Brookings said nationwide, communities are opting to open urgent care facilities rather than EDs.

“The best practices is not a stand-alone emergency room,” she said. “Where do we go when we need help that’s not at the emergency level? Doctors don’t often take new patients, and no one’s there on the weekends.”

Another concern is that people who end up in the emergency room in Brookings would have little choice but to be transported to Curry General in Gold Beach for hospital care.

Lawson told the council she spoke with Cal-Ore ambulance CEO Dan Brattain over the weekend and he didn’t know if ER patients would have the choice to go to Sutter Coast Hospital in Crescent City.

According to Razo, patients in the Brookings ER could opt to be transported to California, but it would be “against medical advice.” Razo said that because she doesn’t know regulations surrounding ambulance operations, she wasn’t sure if an ambulance could transport someone if a physician would only release them against medical advice.

Baby steps to hospital

Former Brookings City Manager Gary Milliman spoke in favor of the letter of support for an ER, saying that in focus groups over the past decade, people have told him the most important issues facing the town are “a lack of health care, a lack of emergency care and a lack of health care and lack of emergency care.”

He said the Oregon Hospital Association said during the administrative rule changes that were finalized in 2016 that the association doesn’t want an ER here to open the door to more stand-alone emergency rooms throughout the state.

“They want to protect their hospitals and this is taking revenue away from them,” he said. “That was the largest issue in crafting the administrative rule.”

He said getting an ED open in Brookings could be seen as the first of future steps to get a hospital in town, particularly as Brookings is the largest city in the state without one.

Councilor Ron Hedenskog said Brookings residents should consider themselves lucky to get an ED.

“We have urgent care on the grace of Curry Health Network,” he said. “They saw a vision to get a facility into South County. They paid the bill. When you look at someone else’s money, you should be grateful, rather than looking a gift horse in the mouth. They’re doing us a favor.”

Councilors Bill Hamilton and John McKinney agreed taking baby steps was the best way to proceed. Hamilton also pointed out taxpayers in South County should be willing to pay for any services offered in the future, as well.

“It’s going to cost money,” he said. “It’s going to cost a lot of money. We have to have the support of the community to get that. I know the loss of urgent care is a bad thing, but we can get better care going to the ER.”

A hospital?

Brookings-area resident Catherine Wiley asked the council not to sign the letter and instead support a hospital at the Fifth Street offices. She is part of the South County Health Care Alliance, which has advocated for a hospital in town for years.

The city worked with Curry Health Network in 2014 to get a state administrative rule changed to allow Curry General Hospital in Gold Beach to “split” its license and allow for a few hospital beds at the Brookings facilities.

State law says hospitals are not allowed to be within 35 miles of one another so they don’t financially undermine each other. But Wiley noted a loophole allows them to be within 15 miles of each other in mountainous areas, and the city council should consider the best possible options for Curry County residents.

“Curry Health Network might just meet that criteria,” she said. “The health district officials can divide the hospital and ER into two campuses.”

Michel concurred.

“Is a stand-alone emergency room the best possible health care option for Brookings?” she asked. “I think not. A hospital with beds is a much better choice. Your job is to set the vision for the future of this city. Lack of good health care is one of the key reasons people leave the area.”

“You need to step back,” said resident Barbara Bronstein. “I’d hate to lose urgent care. There’s going to come a time I’ll need a hospital — there’s going to come a time you’ll need a hospital. And having a hospital 30 miles away … that’s a long way to go.

“Think bigger, as the city grows,” she continued. “I get that some bottom line has to do with following the money. I understand they’ve invested $30 million in the (Curry General) hospital. I understand Curry General doesn’t want to go under. But why an ER? Let’s have a hospital and not get rid of urgent care.”

County officials seem torn, as well.

Commissioner Sue Gold penned a letter two weeks ago to the governor — on letterhead listing all three commissioners — in support of funding for a hospital. Commissioner Court Boice then sent one to the legislature — on his letterhead — asking for general funds to support the ER.