RICHMOND -- A decision this week to try to steer $15 million in promised community grants from Chevron toward Doctors Medical Center has raised hopes that the cash could keep the troubled hospital afloat at least through 2015.

But even with City Council support to earmark that money for DMC, the question remains whether a one-time cash infusion can buy enough time for the San Pablo hospital to survive. And it's not clear when the money might be available because it is tied to approvals for a Chevron refinery modernization project.

The hospital runs an $18 million annual deficit and has drastically reduced services in recent months.

Even if the $15 million materializes before the hospital is expected to run out of cash at the end of February, DMC is unlikely to reinstate emergency ambulance traffic that was halted in August -- a diversion that speakers at Tuesday's City Council meeting claimed had already resulted in the loss of lives because of longer transport times to other hospitals. Officials said the money likely would allow the pared-down DMC to operate as-is for less than a year after it becomes available but not restore recently cut services.

"It would take six to eight months just to restore services and staffing that have been reduced over the last three to four months," said Eric Zell, chairman of the West Contra Costa Healthcare District board, which manages the hospital. "It can't happen overnight."

The cash infusion could put on hold proposals to restructure the hospital into a satellite emergency room or advanced urgent care center, either of which would lack inpatient services.

"It gives us a bridge to the possibility for a long-term solution," Zell said, adding that many of the options the council recommended -- partnering with other government entities and hospitals -- have been tried repeatedly without success by the district over the years. "Our goal is to keep a full-service hospital open. We'll do anything, and we'll do it as many times as we need to. We will talk with everybody again if that is what it takes."

Kevin Keane, a spokesman for the stakeholders group of local health care officials and hospitals that is working to find long-term solutions for DMC, said a one-time cash infusion won't change much. "While we welcome the effort from the Richmond City Council, it doesn't change the fact that we need to stay on course to look for viable alternatives to a full-service facility," he said.

The City Council's vote late Tuesday stipulated that the money could only be used to support a full-service hospital, but Zell reiterated Wednesday that trying to sustain such an operation long term with the hospital's current payer mix of largely Medicare and Medi-Cal patients "is almost impossible."

"(DMC) needs to be part of a larger system," he said.

So far, there hasn't been any interest from other networks, including nearby hospitals or the county, to partner with DMC and take on its deficit. Hospital advocates hope that could change if the Chevron money goes through and DMC is able to leverage it for additional funding. It would also allow time to pursue legislative options, including higher reimbursement rates for Medicare and Medi-Cal patients, that have so far failed.

Doctors and nurses continue to lobby Contra Costa County to take over funding the hospital, but county officials say the money does not exist.

Speaker after speaker on Tuesday urged the council to restructure the $90 million Chevron benefits package -- negotiated as a condition of the company's $1 billion refinery modernization project -- to include a lifeline for the area's only public hospital. Recent cutbacks in emergency services, they said, have already resulted in Kaiser Permanente's Richmond emergency room -- the only other ER in West County -- being flooded with patients.

"Richmond Kaiser cannot accommodate the additional load," said Rachelle Bradley, director of transitional care at DMC, during the meeting. "People are still coming to us from all over; they're walking in, being driven in or wheeled in."

The $15 million would be carved out for the hospital by taking an equal percentage cut of all the programs in the community programs section of the benefits agreement, but the bulk of it would come from a $35 million college scholarship fund for Richmond public school students. One-third of the investment package is earmarked for environmental programs that are required as mitigation for refinery greenhouse gas emissions.

As part of the resolution, the city will also lobby other West Contra Costa agencies and cities to contribute to saving the hospital. The council directed city staff to meet with Chevron about reallocating the money and report back Oct. 21.

Chevron has said previously that it would allow city leaders to decide how to spend the bulk of the money in the agreement. But most of the grants, including any earmarked for DMC, would not be made available until all legal challenges to the refinery modernization are resolved and the company is given the go-ahead to start construction.

In an email Wednesday, Chevron spokeswoman Melissa Ritchie wrote, " ... we will not entertain changes to the total funding level, the length of the funding period and the implementation date."

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.


Reposted from the Contra Costa Times.