Hospital unlikely to stay

Barbara Diamond

South Coast Medical Center officials offered little hope this week

that the hospital could stay in town, intact, even if it could afford

to meet state safety standards.

“We are maxed out on our campus,” said Joe Orsak, president of the

South Coast Medical Center Foundation. “We need more room for

programs and physicians. And adding $72 million for this facility

would bankrupt us.”

Center officials said that they have been forced to consider

relocating the hospital because of the more than $70 million it would

take to bring the building up to code and because of the need to

expand services and attract patients. The cost of retrofitting the

hospital to withstand an 8.0 earthquake has been estimated at $52

million, and it might cost $20 million more to upgrade the

infrastructure.

“Given the volume of service we provide, we cannot afford that

debt without more patients,” said Gary Irish, chief executive officer

of the center since January 2002. “That’s what it comes down to.”

Laguna Beach residents say they have heard similar arguments

before when a beloved, not to mention essential, local institution

was in danger of slipping from its moorings.

“It’s the Laguna Art Museum all over again,” longtime resident

Doris Shields said. “Moving might seem to be better for the hospital,

but it wouldn’t be better for Laguna Beach. It would be awful for us

to lose it.”

Local activists blocked the attempt to merge the museum into a

larger institution out of town and were successful in foiling a later

attempt to move the Pageant of the Masters to San Clemente.

“I think it would be horrible, horrible, for the city to lose the

hospital,” Planning Commissioner Anne Johnson said. “We absolutely

have to have something here.

“A young man house-sitting across the street from us had a

stroke,” Johnson said. “We found him, and he would have been a dead

duck if he hadn’t gotten to the hospital quickly.”

The need for a hospital in Laguna Beach became a priority in the

mid-1950s when a police officer shot in the line of duty died on his

way to a distant hospital. Even Mission and Saddleback hospitals were

still 10 or 15 years down the road.

Laguna Beach residents organized to raise money to build the

not-for-profit “South Coast Community Hospital” on land donated by

Myford Irvine.

Cherry and Vern Spitaleri were among the founders.

“I worked with [Dr.] Vince Carroll to raise the money,” said Vern

Spitaleri, who later served on the hospital governing board for about

10 years. “When you consider all the local people who raised money to

build the hospital, it’s pretty low down [to move it].

“I could almost smell it coming when Adventist took over, and the

hospital was no longer independent, locals no longer had a say,” Vern

Spitaleri said.

South Coast’s governing board voted in 1998 to merge with

Adventist Health System, a source for sorely needed financial

support, management and technology, Orsak said. The center operates

under the guidance of a 21-member board of directors, three of whom

live in Laguna Beach.

The foundation, which raises funds for the center, split at the

time to become independent. The merger deal stipulated that three of

the five foundation directors (two are from Laguna Beach) must

approve any decision by the hospital’s governing board to curtail

core hospital services, such as surgery during a 12-year transitional

period.

That period has about 6 1/2 years to go, about the time that Irish

figures is needed to plan and build a new facility.

With the lead time required for a new project, the center would

still have to meet the state’s 2008 retrofit deadline unless an

extension is granted, which Irish thinks is likely. Meantime,

retrofit plans and program development are moving forward, center

officials said.

Irish said that some of the programs could remain in town, even if

the hospital moves.

“We are going full steam ahead,” Irish said. “We have to live here

and provide health care while plans [for a new facility] are

developed. I want to see this hospital survive in this community and

I want to see it thrive in this community.”

“Thirty percent of our patients come from Laguna Beach, 15 percent

from the west end of Laguna Niguel and most of the rest from Dana

Point, San Juan and San Clemente,” Orsak said. “About 5% are referred

from other areas.”

A new, bigger, more centrally located hospital would cost an

estimated $100 million. That apparently sounds like a better deal to

hospital officials than spending $72 million on the 44-year-old South

Coast facility, which they will still consider inadequate and in an

inconvenient location for doctors.

Doctors want to be where their patients are, Orsak said.

“If doctors are doing 75% of their specialty in the Saddleback

area, it takes time for them to come here,” Orsak said.

Locals point out that the reverse is true. It would take time for

local patients -- and that includes the masses of people who come to

Laguna to enjoy the beaches, the restaurants and cultural activities

-- to get medical help if the hospital moved.

“No way could someone get to Hoag Hospital in Newport or to

Saddleback in the summer as quickly as they could get to South Coast,

if at all,” Johnson said.

“We are keeping afloat now by serving patients that cannot get

admitted to Saddleback or Mission,” Orsak said.

South Coast was the first hospital in South County. It had no

competition when it opened in 1957. Now it does, Irish said, and the

competition has hurt.

Irish presumes that a larger facility with more services on a site

more accessible to a larger population base would draw more patients.

County Supervisor Tom Wilson, who sits on the governing board of the

hospital, has been active in seeking a site closer to the Santa Ana

Freeway, but still close to the coast.

“It is not our intention to leave Laguna Beach without medical

care, and if we moved, it would only be about seven miles away,”

Irish said.

Discussions about relocating have been underway for more than a

year -- in that time, approved plans for a separate cancer center

were scuttled as too costly and unnecessary when an office building

in front of the hospital went into bankruptcy. The medical center

bought the building to house cancer research and treatment, a project

touted as unique in South County.

Irish said the hospital also operates the only behavioral program

in South County. The hospital’s substance abuse program is highly

rated, and the Emergency Department was recognized this year for its

efficient and caring services to the community.

No formal plans to relocate have been discussed. Committees are

being formed, Orsak said, and hospital officials plan to meet with

officials of Laguna Beach.