SAN LEANDRO HOSPITAL | The letter of intent signed two weeks ago by Sutter Health and Alameda Health System does not include language assuring the emergency room at San Leandro Hospital stays open.

The proposed deal to transfer title of the facility to the former Alameda County Medical Center along with a $22 million subsidy from Sutter must be finalized by July 1, according to county officials, or risk closure of the hospital.

Keeping the emergency room in continued service has been a pivotal issue for many members of the community and the impetus for over four years of bitter opposition against Sutter’s initial plan to shutter the facility in late 2009.

The five-page letter of intent signed May 14 contains no mention of what happens to the emergency room once a deal is struck. However, a side letter offered by Alameda County Supervisor Wilma Chan to Alameda Health System’s (AHS) 15-person Board of Directors briefly outlines her desire to keep the emergency open for three more years.

Funding for operation of the emergency room would come from the Eden Township Healthcare District, according to the county, but that group expressed doubt during a special meeting last week they could afford such an expenditure without bankrupting the publicly-elected body.

District Board Director Les Friedman and its attorney were especially confused by a section of the letter of intent dealing with Sutter’s claim damages following their protracted legal battle with the District ultimately leading to the transfer last year of the hospital to Sutter.

In the letter, Sutter offers to “release the District from any obligation to pay damages…so long as District provides financial assistance to support the ongoing operations of the Hospital in an amount that Sutter reasonably deems to be sufficient support in light of the District’s financial condition.” Colin Coffey, the District’s attorney, admitted last week not having a clue over the passage’s meaning, while focusing on the word “reasonably.”

The letter of intent, which is non-binding, also asks Alameda County Healthcare Services to release nearly $2 million in trauma funds slated for the new Sutter Medical Center Castro Valley (formerly Eden Hospital), which can be doubled in value through federal matching funds. Chan held up release of the funds earlier this year. On Tuesday, the Alameda County Board of Supervisors approved releasing the trauma funds to Sutter.

Curiously, Sutter also attached specific language to the letter of intent insuring those involved represented the proposed deal by portraying Sutter in a positive light. The Sacramento-based health care provider is notoriously sensitive to even the slightest negative publicity.

It suggests public officials labeling the potential transfer as a “donation” by Sutter that “will allow for the continued operations of the Hospital. The section is the only legally-binding part of the letter of intent.

Several news outlets, including the San Francisco Business Times, KPIX and Patch followed by the request. In an op-ed piece, Chan also characterized the deal as a donation.