County pressured to stop AGH closing


Published: Sunday, January 18, 2009 at 6:01 a.m.
Last Modified: Saturday, January 17, 2009 at 11:54 p.m.

Alachua County commissioners are being pressured to save Shands at AGH from its planned closing in October, but the county has no interest in getting back into the hospital business that it got out of with the sale of Alachua General Hospital in 1983, commissioners say.

Several county committees are studying options to ensure adequate health care for low-income and east Gainesville residents in advance of the planned closing of AGH later this year.

"Given the county's financial situation, it is not feasible for the county to get the hospital back," said Commissioner Cynthia Chestnut, who works for Shands HealthCare. "That is the reason why we are trying to work with the community, work with Shands, work with the powers that be on other alternatives."

Shands CEO Timothy Goldfarb said he has met with community leaders, civic organizations and health care agencies to learn what sort of care is needed and in what form it should be delivered.

Goldfarb said a short-term program for the next 12 to 24 months should be in place by the time AGH closes in October. A long-term plan will follow.

The short-term emphasis will likely be on expanding primary care services at existing facilities such as UF's Eastside Clinic or Shands' SW 4th Avenue Family Medicine Center. The facilities could be open more hours to enable people to get treatment at night or on weekends. A new facility will also be considered.

Also needed, Goldfarb said, is a change in the tradition and culture of low-income residents going to the emergency room for primary health care for financial reasons and because it is open at all hours.

"The emergency departments have become a de facto provider of primary care, when many times people can more conveniently and efficiently be handled in another setting if that setting were available. We've been trying to develop some programs that will respond to that," Goldfarb said. "My staff has a work group that is due to come back to me at the end of this month with a proposal that not only includes potential sites for programs but also staffing and sources of funds."

Several residents have suggested the county reacquire the hospital, which it operated as Alachua General Hospital before selling it to Santa Fe Health Care in 1983 for $1.

Santa Fe in 1996 sold AGH to Shands at the University of Florida.

"I'm very concerned about a rather cavalier attitude that the current doctors and staff go to work at the (Shands) cancer center. Some of the doctors are the sorts of doctors who will not be working at the new cancer center," resident Abby Goldsmith told commissioners last week. "May I humbly suggest the County Commission buy it back (for $1). I am aware the hospital loses money. If this is the hospital that does the most indigent care, these indigent patients are going to go elsewhere and shift the problem to somewhere else."

Meanwhile, some doctors and other staff members critical of AGH's closure have accused Shands of mismanagement.

Goldfarb said the fact that Shands tried various ways to boost AGH by shifting some operations there indicated its commitment to the hospital. He believes many of the changes have worked out well but added the structure would need extensive renovations that would be too expensive.

Commissioners said that, at this point, all they can do is try to work with Shands and UF to make sure that access to health care in east Gainesville and by low-income residents remains available.

Studying the matter are three County Commission advisory boards: CHOICES, poverty reduction and health care.

The committees are expected to report back to the commission in a few months.

Lorraine Austin, director of the county CHOICES health care program for low-income workers, said the closing of AGH could be an opportunity to provide enhanced primary care services.

Austin said CHOICES has wanted to partner with Shands to develop a plan to keep residents from relying on the emergency room for primary care treatment of minor illness or infections.

Commissioner Paula DeLaney added that greater access to health care is more crucial than ever and is likely to become even more important with the economic downturn and escalating medical costs.

"There are more poor people. There is more demand," DeLaney said. "To me the debate that needs to go on is how are we going to create access to affordable health care for our citizens, not what building or where it is. In any negotiation with Shands, I want to see what we can get in terms of better access to care."

Contact Cindy Swirko at 374-5024 or at swirkoc@gvillesun.com.

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