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as an independent community -based hospital and would join the ETHD as a full- service District • Hospital. Additionally, SLH's license as an acute care hospital would be restored and it would return to service as a second full service District Hospital under the governance and operational control of ETI -ID. The SRH /SLH proposal has been developed in response to a separate proposal by Sutter Health and the Alameda County Medical Center (ACMC) to change the current operational model of SLFI. Under this Sutter proposal, SLH would remain open for five more years and would continue providing emergency room services, after which it would close to be converted to an acute care rehabilitation hospital. The Sutter proposal would potentially require a $3 -6 million subsidy (theoretically from County funding sources) to operate SLH as an acute care rehabilitation hospital and it would eliminate emergency room services at SLH. In 2009, there were more than 27,000 visits to the San Leandro Hospital ER. On April 19, the Alameda County Board of Supervisors asked that the 2009 MOU for the Sutter proposal not move forward. Proponents of the responding SRH /SLH proposal indicate that the proposed collaboration would allow SLH to regain its license and remain fully operational, including operating its ER (27,175 visits in 2009) and Acute Care Services (17,280 inpatient days in 2009). Both hospitals are seismically retrofitted in accordance with State mandates through 2030; and the consolidation of purchasing, financial management, legal and compliance functions, and regulatory coordination will generate efficiencies and operational cost savings. The financial pro -forma put forth by SRH indicates that the SRH /SLH proposal would not require any operational subsidy, whereas the Sutter proposal would require a subsidy of between $3 -6 million annually: The proponents also argue that the SRH /SLH proposal will enhance the financial viability of both organizations and will improve the access and outreach of safety net providers in the County. Senator Ellen Corbett and several other local elected officials have expressed support for the SRH /SLH proposal. There has been no organized opposition to the SRH /SLH proposal. However, some critics have argued that the financial model for the proposal is unclear and not fully vetted. There are also concerns that the ETHD Board has inappropriately spent a significant amount of money on legal fees in a recent lawsuit with Sutter, which does not appear to be warranted or on solid legal ground. Further, there have been concerns expressed about the loss of SRH autonomy by being under the direction of a regional, elected body; and the loss of the strong connection between the Hayward community and SRFI as it is currently governed by a local Board of Trustees. FISCAL AND ECONOMIC IMPACT There are no known or anticipated negative or positive financial impacts of this proposal directly on the City of Hayward. The SRH /SLFI proposal would potentially improve the access and outreach of safety net providers in the larger County Eden Area, which could benefit low income and under - served residents in Hayward. The proposal, according to SRH representatives, would also allow continuation of community outreach initiatives, including: SRH Silva Pediatric Clinic; Community Care -A -Van; Women's Center; and other programs provided by SLH that provide low- income care to women, children, and seniors in the ETHD. It is unclear whether these programs would be eliminated if the SRH /SLH proposal does not move forward. Resolution Supporting San Leandro and Saint Rase Hospital Proposal 2 of 3 May 17. 2011 135