Despite urgent pleas by county leaders and local activists, state officials won’t intervene in the closure of lifesaving hospital services in East San Jose.

The California Department of Public Health (CDPH) told Bay Area state legislators that the state has no authority to deny the closure or reduction of services at Regional Medical Center because these cuts are classified as supplemental services, sources tell San José Spotlight. The state informed the lawmakers of its decision in response to a June 17 letter the local delegation sent asking the department of public health to intervene. The letter — signed by Assemblymembers Ash Kalra, Marc Berman, Alex Lee, Evan Low and Gail Pellerin — urged the state to review the situation.

“Your urgent action is necessary to protect the well-being of our constituents and uphold HCA’s promise to put patients first,” the letter reads.

The only option left is for Attorney General Rob Bonta to intervene on HCA’s plan, after receiving a complaint letter from community activists that called the decision “discriminatory.”

Bonta’s office didn’t respond to requests for comment.

The Santa Clara County Board of Supervisors in April called on the state to intervene. Community health advocates responded to the state’s decision on Monday with a protest outside Regional Medical Center, where private owner HCA Healthcare plans to reduce stroke services and close its heart attack and trauma services on Aug. 12.

The state has the authority to stop HCA’s decision if it determines action is warranted to avoid public harm, but has historically refused to intervene on hospital decisions. Community health advocates warn the closure will disproportionately impact low-income people in East San Jose — as well as uninsured populations around the Bay Area who will now have to wait longer for care at Valley Medical Center, the next closest hospital.

Relying on life-saving proximity

Before Chris Cobillas became a San Jose firefighter and community services director for the firefighters’ union, Local 230, he worked at Regional as a patient registrar in 2005. He said Regional’s cardiac and trauma care saved the lives of multiple firefighters on his team.

“My family still lives in East San Jose,” Cobillas told San José Spotlight. “The closest hospital would be Valley Medical Center, and we know they serve the greater San Jose area now… (and) the next closest hospital is Stanford. When saving lives we’re relying on minutes — minutes equals blood and tissue and brain.”

Every general acute care hospital is required to provide eight basic services: Medical, nursing, surgical, anesthesia, laboratory, radiology, pharmacy and dietary services. The state public health department considers emergency medical services, maternity care, pediatric care — including neonatal ICU — psychiatric care and stroke services to be “supplemental.”

... When saving lives we’re relying on minutes — minutes equals blood and tissue and brain.

Chris Cobillas, SAN JOse firefighter

“While any reduction of supplemental services is concerning, CDPH cannot compel facilities to provide them,” A CDPH spokesperson told San José Spotlight. “CDPH is monitoring this situation, and basic services at the hospital continue to be provided.”

For four months, the idea of losing one of the county’s only trauma centers — and sending patients with life- threatening medical conditions to other county waiting rooms that are already full — has prompted protests from county elected officials and public hospital leaders.

Emergency response workers also warn it could send life-threatening ambulance delays rippling across the region, since patients needing services no longer offered after August would either have to be transferred elsewhere or drive half an hour to the next closest trauma center.

County doctors have publicly deemed the idea “dystopian” at public hearings earlier this year, warning the closures could send a 70% surge in trauma patients, or about 2,600 cases per year, to the ill-equipped and under-resourced Valley Medical Center eight miles away.

Minimal impacts?

The national private health corporation behind the planned cuts has dismissed county officials’ warnings.

“This campaign against Regional Medical Center chooses exaggeration and theatrics to generate a false fear among members of the community we serve,” HCA spokesperson Carmella Gutierrez said in a statement that claims the trauma center closure will affect less than “2% of patients treated daily.”

In 2023, Gutierrez said the hospital received an average of four patients per day who met trauma triage criteria, with half sent home from the emergency department. She said patients who have less severe injuries, such as lacerations, non-complex fractures and minor head injuries will still be treated at the hospital.

“Going forward, we will arrange transport for the few patients who need a higher level of care,” Gutierrez said.

Regional Medical Center’s stroke center serves 65% of the county’s uninsured stroke patients, according to county data.

HCA has a reputation for placing profits over patients. In San Jose, the multibillion-dollar corporation has been systematically closing services that rely on Medicare and Medi-Cal patients due to lower profit margins.

In 2004, HCA closed San Jose Medical Center, the city’s only downtown hospital. In 2020, the corporation shut down the maternity ward at Regional, which had an immediate effect on East San Jose residents. In 2023, HCA shuttered its acute care psychiatrist services and neonatal intensive care unit at Good Samaritan Hospital in San Jose.

In 2023, the North Carolina Attorney General took similar action against HCA over severe service cuts to a local nonprofit hospital HCA acquired — forcing patients in that state to travel further distances for care. Regional Medical Center was also run by a nonprofit before being acquired by HCA in 1998.

“Regional Medical Center is available for all health care emergencies. We’re expanding our emergency department by adding 20 more beds,” Gutierrez said. “We will triage all trauma victims just as we have done and we are prepared to provide initial treatment to all STEMI and stroke victims. Again, just as we have done.”

Contact Brandon Pho at [email protected] or @brandonphooo on X, formerly known as Twitter.

This story originally appeared in San José Spotlight.