Emergency department patients held in hallway at St. Agnes Medical Center in Fresno, California, on Jan. 28, 2023. Credit: Submitted / Submitted

What's at stake?

Fresno County officials and hospital leaders say the region needs state and federal help to address long-term hospital system needs.

Fresno County formally ended its state of emergency declaration Tuesday — but warned that the local hospital system needs state and federal help.

“Our hospitals…still are at capacity or over capacity,” David Luchini, director of Fresno County Public Health Department said during the Fresno County Board of Supervisors meeting on Tuesday.

Fresno supervisors voted Tuesday to end the local state of emergency which was enacted following the closure of Madera Community Hospital in early January. The emergency order was put in place at a time when Fresno County hospitals were seeing a surge in patients due to the “tripledemic” of the flu, COVID-19, and RSV — in addition to an influx of patients from Madera County.

By late January, however, Fresno County leaders and hospital officials said they weren’t getting much help from the state and were being burdened by an the arrival of unannounced state prison inmate patients.

But county officials said Tuesday the emergency order served its purpose in bringing renewed attention to the region’s hospital and healthcare access challenges — especially from the state.

Supervisor Brian Pacheco said that he has had conversations with local representatives such as state Sen. Anna Caballero, a Democrat from Merced, and Assemblymember Esmeralda Soria, D-Fresno, who he said are “diligently” working on the problem.

But county and hospital leaders say they need more state and federal help.

In a joint statement, Fresno County, Saint Agnes, and Community Health System, the umbrella organization that owns Community Regional Medical Center, said hospital expenses have “skyrocketed” since the pandemic and that government-funded healthcare such as Medi-Cal and Medicare does not cover the cost of providing care.

“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,” the group said in the statement. “Federal and state dollars are needed to ensure hospitals in our region can weather the current situation.”

“We’ve got a serious problem in our hospital systems in Fresno County and the Central Valley,” Supervisor Steve Brandau said on Tuesday.

“Underlying this short-term state of emergency, there’s actually a bigger crisis,” he said. “Our hospitals are not getting reimbursed at the rate that allows them to be sustainable.”

Hospital execs warn of other state, regional concerns

Robyn Gonzales, chief operating office of Community Regional Medical Center, told the Board of Supervisors that there will be new local challenges when California lifts its COVID-19 declaration of emergency at the end of February.

Gonzales said the current COVID-era waivers allow the hospital flexibility for things such as employing nurses with out of state licenses and the ability to see non-admitted patients in tents as “surge spaces” in the emergency department.

“The fact of the matter is that we’re going to keep the tents,” Gonzales said, “we cannot operate without them.”

Dr. Danielle Campagne, the chief of CRMC’s Emergency Department, also pointed to concerns around the Tulare County-based Kaweah Delta Medical Center. Last month, KVPR reported that over 1,000 employees and local residents wrote a letter to Gov. Gavin Newsom about the hospital’s financial struggles.

“If that hospital falls,” Campagne said, “I think we all could fall.”

County officials shared similar sentiments.

“Given the current trends,” Dr. Rais Vohra said in the news release, “our County and region cannot afford to lose one more hospital.”

Supervisors on Tuesday expressed their commitment to working in collaboration with local hospitals and representatives to addressing chronic issues in the local healthcare system.

Some of the other longer-term needs discussed include increasing the number of hospital beds in the county and the need for more local education pipelines that encourage students to pursue careers in healthcare.

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Melissa is a labor and economic inequality reporter with The Fresno Bee and Fresnoland.

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