RICHMOND -- The effort to save Doctors Medical Center from closure could receive a significant boost Tuesday as Richmond city leaders weigh whether to redirect $20 million from a community benefits package negotiated with Chevron toward the moribund San Pablo hospital, which has drastically reduced services in recent months.
The infusion would come on top of $3 million in one-time funding from a bill signed into law by Gov. Jerry Brown last month. But even if the City Council approves the expenditure at Tuesday's council meeting, questions would remain about when the money would become available and the impact it could have on the hospital's long-term prospects for survival.
"It'd be a tremendous short-term solution to basically give us some time to find other solutions, get other components in place," said DMC's chief of staff, Dr. Richard Stern, before cautioning that a one-time infusion is not enough. "We still need the county, the community and philanthropic organizations to be part of a long-term solution."
A stakeholders group including local hospitals and health care experts is studying the possibility of restructuring the hospital into a satellite emergency department or, more likely, an advanced urgent care center, while many DMC nurses and doctors push to keep it open as a full-service facility.
City Council members and the chairman of the West Contra Costa Healthcare District, which manages and funds DMC, came under fire this summer for failing to earmark any money from the $90 million Chevron investment package for the hospital. The package was a condition of the city approving Chevron's $1 billion modernization project and was negotiated between Chevron lobbyist Eric Zell, the chairman of the health care district board, and Richmond council members Tom Butt, Jim Rogers and Jael Myrick.
The council members said they were led to believe any money for the hospital would be too little, too late to make a difference, but Zell disputed that, saying Rogers and Butt showed no interest in helping DMC despite a proposal by Myrick to fund the hospital.
Councilman Corky Boozé added an item to Tuesday's council agenda that would carve out $20 million for the hospital, which is no longer receiving emergency ambulance traffic and has closed some units. DMC, which runs an $18 million annual deficit, is the only public hospital in West County but does not receive any subsidies from the county.
"I want the hospital open," Boozé said. "Therefore, I am willing to rework the contract. Chevron says they don't care how we spend the money as long as they get the (refinery modernization) permit."
Butt, Myrick and Rogers say that while they support finding a way to keep the hospital open, the money from the Chevron package cannot be cut from some of the proposed projects that are required for reducing greenhouse gas emissions. They also question whether the money would come in time to help the hospital, which only has enough cash to run as-is through February 2015.
"I really think that the hospital is important," Butt said. "Having said that, trying to get the money out of this Chevron agreement to guarantee the hospital is going to stay open, well, there are very few ways that it'd be effective."
The Chevron agreement mandates that $30 million go toward greenhouse gas reduction programs. Boozé is looking to redirect funds from a solar farm project and green transportation programs.
If the council passes the item, it remains unclear whether the $20 million could be made available up front or spread over the 10-year span of the package. Boozé suggested the city could advance DMC the money then reimburse itself from the Chevron funds.
A one-time cash infusion of $20 million would at best provide the hospital with enough money to stay open as a full-service facility for one year, Stern estimated. But it would not solve the problems of low reimbursement rates and need for a costly retrofit at its current facility.
In an email, Chevron spokeswoman Melissa Ritchie confirmed that the company would not negotiate on changing the funding timeline for the benefits package.
"Distribution of the bulk of the funding will not be initiated until all legal challenges to the modernization project are resolved and Chevron USA Inc. is given clearance to proceed with construction," Ritchie wrote.
Under the best-case scenario, Chevron would start construction during the first quarter of 2015 -- which would mean that it would start paying out 60 days later -- but pending litigation and the permit process could push that date back months, or even years.
While the $20 million redirect might not be possible, Butt and Myrick said the council is considering other options.
"I think when this thing comes up, there may be some alternative plans floated out and something ultimately supported by the council," Butt said. "I don't think it's going to be $20 million, and I don't think it's going to be a slam dunk."