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Prescription for Pain

Kaiser, the grandaddy of HMOs, is consolidating--and Santa Teresa could be the loser By Richard Sine South San Jose Kaiser members could face a long haul to a hospital bed if Kaiser Permanente decides to close its 218-bed Santa Teresa facility and consolidate services at its Santa Clara hospital, located some 13 miles further north. Kaiser Permanente, one of the earliest providers of low-cost managed health care, says hard times may force it to close the southern site, along with a hospital in Redwood City. The HMO, serving one in four residents of the South Bay region, announced plans to close a facility in Oakland earlier this year. Kaiser spokeswoman Michelle Mann says that if the closure occurs, the inpatient services once provided by the south San Jose site would be transferred to a Santa Clara facility. The chain is also looking at contracting for beds from other hospitals throughout the area to meet the demands of its 155,000 clients in south San Jose. The closing could force south San Jose residents to drive a half hour or more to Santa Clara for inpatient care. Mike Honda, the county supervisor who lives in and represents Santa Teresa, says the closure of the longstanding HMO would leave the neighborhood without a hospital. "We need hospitals in well-situated geographical areas," Honda said. The supervisor's wife is a Kaiser member and the plan is offered by numerous Silicon Valley companies. The new Santa Clara hospital, to be completed in 1999, is being rebuilt at Lawrence Expressway and Homestead Road near the Sunnyvale border. The Santa Clara City Council approved the Kaiser hospital last summer, overruling neighborhood concerns about traffic impacts. The new hospital will have more beds than the old one and will conform to seismic codes. According to Mann, bed usage among Kaiser hospitals has dropped in the South Bay, from nearly 70 percent five years ago to just over 50 percent today. Hospitals nationwide are facing similar changes with the advent of new surgical techniques, advances in pharmacology and improved preventive care. At the same time, price pressures from consumers have led Kaiser and other HMOs to discourage long, expensive hospital stays. Kaiser has already announced plans to close its large tower hospital in Oakland and plans to contract for beds at three other East Bay hospitals. At the same time, it is opening a large new outpatient center in San Francisco, reflecting a trend toward outpatient care. Mann downplays the South Bay changes, saying only 11 percent of Kaiser care occurs in hospitals. She says clinics in Mountain View, Gilroy and Milpitas will be unaffected, and that doctor's offices will remain in their current cities. Mann would not say when an announcement would be made on the status of the hospitals, but a source close to union negotiations said Kaiser promised to tell employees of upcoming changes by the beginning of April. The source also said that a call-in appointment center may be moving to South San Jose. Meanwhile, labor groups currently in talks with Kaiser have formed "Consumer Advisory Boards" throughout the state. Santa Clara's board is scheduled to begin meeting at the end of March. San Jose Councilmember Margie Fernandes and Santa Clara Councilmember Lisa Gilmore are among the public officials who have agreed to join the board. Regional Kaiser spokesman Tom Debley said he hadn't heard of the consumer board before a Metro reporter called, and that Kaiser already has advisory boards. Nevertheless, Amy Dean of the South Bay Labor Council says the boards will ask for community meetings on the changes at Kaiser. "Quality-of-care decisions are too important to be made behind closed doors," says Dean. [ Metro | Metroactive Central ]