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County services adjust to MCH closure

Wendy Alexander/The Madera Tribune

Madera Community Hospital Trustees member Stel Manfredi talks to the Madera County Board of Supervisors about ways to help the hospital during an emergency board meeting last Thursday.


With the closure of Madera Community Hospital looming, Madera County departments that dealt with MCH had to maneuver quickly to make sure county services remained operational.

Madera County Emergency Services Director Dan Lynch provided an update to the Madera County Board of Supervisors during last Thursday’s Emergency Board of Supervisor’s meeting.

“We started working with the hospital to see how to help close it,” Lynch said. “We’ve been working very closely with Karen Paolinelli and her staff. This is a terrible situation. This has been very good in the coordination to make sure patients are safe and taken care of. We have been working to discharge and transfer patients out of the hospital as quickly and as safely as possible to other locations. The hospitals in Fresno are heavily impacted, but we have been successful in moving patients out of the hospital.”

Lynch also wanted the Supervisors to be aware of the concerns for emergency services with the hospital closing. Lynch has reached out to make agreements with Sierra Ambulance out of Oakhurst and American Ambulance from Fresno.

“One of the big concerns when the hospital closes is ambulances that would transport to the hospital are now transporting patients to Fresno or Merced. he said. “There are a significant number of patients that go to Fresno. We looked at about 12-13 patients a day that went to MCH. It’s not a big number, but it is a significant number now that the ambulances have to go to Fresno and we are left without ambulances in Madera, or at least the Valley because they are at a Fresno hospital. American and Sierra will provide additional resources to help back up the valley. The dispatch centers are attached. We would locate ambulances to Madera to make sure coverage is adequate.”

However, Lynch was quick to note that its was a temporary fix.

“If we don’t have ambulances available in the valley, they are going to be responding from further away,” he said. “That means our firefighters are going to be on scene waiting for an ambulance. We’ve made sure we have appropriate coverage on the ambulance side. That’s a temporary solution. That’s not something that we’re going to leave for long-term. We feel like we have a strong plan to have adequate coverage of EMS. We will work to see where we go in the long-term and fix the problem.”

Madera County Sheriff Tyson Pogue sees a negative effect on health care and emergency services in the county.

“The closure of our beloved hospital will have long lasting negative effect on public safety,” he said. “The ripple effect of this closure will be seen throughout the law enforcement community and our EMS system. We will see impacts in every division of law enforcement, not only in Madera, but all over.”

MCSO Lieutenant Ian Weaver sees reporting of violent crimes impacted.

“I see a potential decrease in the reporting of domestic violence, child abuse and sexual assault crimes,” he said. “Nurses and doctors are mandated reporters. Often, these types of crimes are reported to the sheriff’s office by these mandated reporters, and not necessarily by the victim of the crime.”

MCSO Seargent Manuel Ramirez, who supervises the coroner’s office, says his department will reach maximum capacity really quickly.

“Over the last three years, there have been 547 cases documented out of MCH that have fallen under our jurisdiction. Out of these 547, 121 cases have directly come to our morgue facility for investigation. Through additional investigation, 116 cases have been investigated by deputies responding to the hospital and were directed to funeral homes.

“With the closure, we expect these cases to come directly to our morgue. That will double our number of decedents who are housed at our facility and require drastic increase in investigator workload from the coroner staff. We can house up to 27, but we expect to face capacity issues. With the workload, we are near the maximum on certain weeks. The morgue will need to expand to accommodate the expected increase. The increase of overall mortality rate is because of longer travel times along with reduction of medical care. We expect an increase in county rates. The lack of availability of convenient medical care will cause many not to seek medical care immediately, and ultimately it will increase our case load for mortality rate in Madera County.”

MCSO Undersheriff Darin McMechan proposed purchasing a transportation unit that will be responsible for going to hospitals out of the area so that it doesn’t impact the ambulance service in the county.

“This unit will be used to transport those individuals who are rejected at bookings or inmates at the facility that need to be transported for medical care or psych patients (5150),” he said. “This unit will be comprised of five deputies and 10 correctional officers. This will cost approximately $1.8 million annually. This will also require five patrol units and two transports for about $700,000.”

Madera County Public Health Director Sara Bosse said that many services offered by her department work with MCH and it will be tough to disentangle themselves from MCH.

“It’s hard to identify what doesn’t work with MCH in some way,” she said. “The most significant impacts will be programs that work heavily with the hospital in terms of referrals,” she said. “We really experienced the importance of MCH for a county our size during COVID. They were tested. In the background, all of the requirements for emergency preparedness grants and contracts, MCH is written into all of those contracts. It will be a process to work with our hospitals in Fresno and we will work closely with Fresno Department of Public Health and our plan will be merged with theirs.”

Dr. Simon Paul, Health Care Officer of Madera County, said that those who will be most affected are those with the fewest resources and least ability to react to the changes the health care delivery system.

“It’s a huge loss to the community and the patients they serve,” he said.

Madera Police Commander Gino Chiriamonte said that by losing the hospital means the city loses a safe place for community members.

“Our most vulnerable won’t be able to receive treatment, maybe from a criminal act from which they are not comfortable going to law enforcement. The safe place is to seek medical care knowing that the medical will be a mandatory reporter. Those are domestic violence victims,” he said.


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