Frustrated questions regarding the closure of Shands at Alachua General Hospital went unanswered as Timothy Goldfarb, Shands CEO, was not present at a special meeting held by the Alachua County Commission on May 5.
Instead, a two-page letter from Goldfarb and a team of assistants recording questions and concerns filled his place.
In the letter, Goldfarb expressed gratitude toward commissioners for meeting with him individually regarding the impending hospital closure, scheduled for October.
However, some commissioners felt it was a mistake for Goldfarb to miss an opportunity for discussion in a public forum.
"I am very saddened he's not here, that no one is here to speak on [Shands'] behalf," said Commissioner Rodney Long. "This is a very important community issue."
Despite Goldfarb's absence, community advisory groups presented suggestions for dealing with the loss of health care services.
Jean Munden, Alachua County Health Department administrator, said the loss of AGH will increase demand for services such as basic medical care, which would be offered by the health department. To meet the demand, the department would begin to offer extended business hours by July, Munden said.
Beyond the impact of straining other area hospitals with patient overflow, the loss of a community hospital is a concern for several community group representatives.
Ed Jennings Jr., chairman of CHOICES, a county health care service provider for the uninsured, said health care access would be problematic for many residents.
"The conversation needs to be about what to do now," Jennings said. "How do we make sure primary care is provided to our most needy citizens?"
According to Jennings, about 20 percent of Gainesville's 250,000 residents live in poverty.
Social services program director Candie Nixon echoed Jennings' concerns, saying, "Poor people will not have access to primary care with AGH closing."
In an effort to curb an influx of patients needing primary care, Goldfarb noted in his letter that Shands is working with Solantic, an urgent-care provider, to open a center at Ayers Medical Plaza.
Other issues raised included employee placement, increased emergency room wait times and the impact on rural bordering counties. Levy County Emergency Medical Services Director Trish Seibold said roughly a quarter of the county's 39,000 residents go to AGH for services.
With only seven total ambulances for the entire county, Seibold said the increased wait time for an emergency bed poses a problem.
"Our wait times are anywhere from 20 minutes to an hour," she said. "With the hospital closing, we're looking at one-to two-hour wait time."
The impact on rural counties is one consequence among many that commissioners hope to discuss in a future meeting to be held within the next 90 days.
Goldfarb is being pressured by the commission to appear at the meeting or provide a representative to address citizen concerns.