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Pending closure of Alta Bates a “perfect storm” for Richmond’s expectant mothers

on October 10, 2018

First San Pablo’s Doctors Medical Center closed in 2015.

Now Sutter Health’s Alta Bates hospital in Berkeley is planning to shut its doors.

This means patients in Richmond, who already have fewer hospitals to turn to for critical medical care, could see the options shrink further. Pregnant women and new mothers could be the ones to most acutely feel the squeeze.

Alta Bates hospital, expected to close in 2030, has by far the highest number of live births of any medical center in the region, state government data shows. And it delivers high quality care that women in Richmond and the area have come to count on.

Rachele Savola, a representative for the California Nurses Association, calls the prospect of the Alta Bates closure, “the perfect storm.” Her nurses’ association is publicly campaigning against the closure.

Clayton Warren, a spokesperson for Alta Bates’ parent company Sutter Health, said “there will be no disruption in maternity care or any other clinical services,” when the Berkeley hospital is closed. He said his company is considering building a new maternal care and delivery center adjacent to its Alta Bates Summit Medical Center in Oakland, about 3 miles away from the Berkeley site.

Richmond and area communities are already reeling from Doctors hospital shutting its doors three years ago.

More people have been showing up in the emergency room at Richmond Medical Center, which is part of Kaiser Permanente Northern California.

“We’re getting a ton of patients who would never have come to us before, and they’re mostly coming through the emergency department,” says Leah Kihagi, a nurse who’s worked at the Richmond center for 14 years.

Jeff Collins, Senior Vice President and Area Manager for Kaiser Permanente in the East Bay, said the number of emergency department visits at the Richmond center has increased 50 percent since the closure of Doctors, while admissions from the general community have roughly tripled since 2014.

He said “we remain concerned about the limitations of the overall capacity in the community,” even though Kaiser has “invested several million dollars to expand exam rooms to help address the community’s need.”

Kihagi says most of the new patients who show up are either uninsured or waiting to qualify for MediCal, the free or discounted health care program for low-income California residents. She says many come from San Pablo, where the Doctors hospital was located.

Not only are there many more patients now, but they are sicker than before, Kihagi says.

“They’re harder to treat and they need to stay for longer,” she says.

The hospital has tried to address this rising caseload, including by hiring more nurses and putting beds in hallways, despite this being against protocol, several nurses interviewed by RichCon say. Some patients reviewing the hospital on Yelp said they were treated in the ER and given a bed in the hallway. Kaiser did not respond to requests for comment on beds in the hallway.

The Emergency Department only has 28 beds, the nurses interviewed say. And while staffing has increased, the nurses say it’s not enough.

“If there’s an emergency, we’re in bad shape,” says Camla Ramjit, a nurse at the center.

There’s no maternity ward at Kaiser in Richmond, so women who show up in labor are sent to the Kaiser operated Oakland Medical Center if they have Kaiser insurance, explains Guadelupe Reader, a pre-natal counselor who works with women in Richmond, particularly those who are low-income and immigrants.

But if the women in labor are on other insurance plans or have no insurance at all, they are transferred elsewhere, explains Reader. Many end up at Alta Bates, which has also seen an increase in patient numbers since the closure of the Doctors hospital.

As a result of the closure, there was a 24 percent increase in patients visiting the Berkeley Alta Bates campus from Contra Costa County from 2013 to 2016, according to Jason Corburn, a professor at UC Berkeley’s School of Public Health who has been working in Richmond for many years. There’s been a 39 percent increase during the same period when considering only patients from four cities close to the closed Doctors hospital: Richmond, San Pablo, EL Cerrito, and El Sobrante.

In 2016, Alta Bates hospital supported 5,863 live births, more than twice the 2,881 born at Kaiser’s Oakland and Richmond hospitals combined, according California’s Office of Statewide Health Planning and Development, which tracks all of the state’s hospital usage.

There were 2,103 babies born at the Contra Costa Regional Medical Center in Martinez, where may other un-insured and under-insured women go, the same state office says.

Across the state and the country, childbirth is the number one reason for hospitalization, according to the California Health Care Foundation, a non-profit research and advocacy group.

Corburn is helping lead a regional health task force to assess the impact of the Alta Bates closure, which Sutter says is planned by 2030 as the building has been deemed seismically unfit.

“It’s a real concern for women across the region, because there are so many births there, and so many good quality outcomes compared to other birthing centers in the region, especially for women of color,” he says.

Alta Bates is the facility of choice for Richmond’s expectant mothers because they provide good care and it’s closer than Martinez’s Contra Costa Regional Medical Center, Reader says. For this reason, the prospect of it closing is frightening for people in Richmond.

Angelica, 31, who had a baby at Alta Bates four months ago and asked only to be identified by her first name for privacy reasons, says she fears for other women if the hospital were to close.

She was taken to Alta Bates after her doctor at Brighter Beginnings, where Reader works and where Angelica was receiving pre-natal care, identified she was showing signs of pre-eclampsia, or high blood pressure that can be dangerous to the mom and baby. Staff at Alta Bates tried to induce labor, and failing that, delivered her baby by C-section.

She was admitted for over a week due to high blood pressure. After discharge, she received in-home follow-up visits from an Alta Bates nurse.

“I can’t imagine what women would do if it closed,” Angelica said. The last thing a pregnant woman wants to stress about is where you’re going to deliver, she says: “It should be a no-brainer.”

Sutter’s Warren said in an email that, “Sutter plans to rebuild its exceptional Women and Infants program and neonatal intensive care unit.”

“Sutter is currently exploring rebuilding [the unit] at the Oakland campus,” he said.

But Warren said, “a final decision on when we rebuild and move our services to Oakland hasn’t been decided yet.”

He said Sutter was currently conducting a review of emergency services to ensure that residents of Berkeley, West Contra Costa County and UC Berkeley continue to have good access to emergency medical services.

In a hopeful sign, at least one other healthcare facility might open in Richmond to help fill the gap.

LifeLong Medical Center is building a large, new clinic on Harbour Way that will provide health care for children and adults. While this will include pre-natal care, it won’t have a specific maternity ward. The new clinic will open in 2019.

Nurse Kihhei, who works at Kaiser’s overwhelmed Richmond center, says even the new LifeLong Medical won’t be enough. “We need either an extended hospital or a hospital opened in a nearby community,” she said. “We just can’t keep up with the caseload.”

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