A day after the Palm Drive Hospital board approved plans to eliminate inpatient and emergency services, the local community — from business leaders to health care professionals to the police chief — is grappling with the broader impact of losing the only Sonoma County hospital west of Highway 101.

The closure of Palm Drive, which was projected to spend $34.3 million in the current fiscal year, will likely be a financial blow to Sebastopol, said Kenyon Webster, the city's planning director.

"It is one of the largest employers in Sebastopol — other businesses, doctors offices, nurses, testing labs have relationships and businesses that derive from the hospital," Webster said.

The hospital, which employs 242 people, allocated $18 million for labor costs and $2.8 million on professional medical fees. It was poised to spend an additional $9.7 million on services and supplies this year.

On Monday, the Palm Drive Health Care District moved to eliminate the hospital's acute inpatient services and shutter the emergency department by April 28. The hospital filed bankruptcy to gain relief from its creditors — vendors the hospital has not paid for some time.

Hospital officials say Palm Drive could no longer survive as an acute inpatient facility because of dramatic declines in overnight hospital stays and decreasing payments from government and private insurers.

The hospital board said it hopes to shed money-losing inpatient care and expensive medical services and replace it with a more financially sustainable model, possibly as an urgent care center with outpatient and some lucrative inpatient surgery.

Local doctors are pushing for a speedy transition before the hospital closes. Palm Drive officials said Monday that inpatient services are scheduled to close April 21 and the emergency department is expected to close April 28.

Teresa Ramondo, executive director and CEO of the Sebastopol Area Chamber of Commerce, said the closure will impact the community beyond patients and medical providers.

"It is that trickle-down effect," Ramondo said of both direct and collateral job losses. "Where will they go for lunch? Where will they spend their dollars?"

Ramondo and Webster both said they were concerned about the possible loss of doctors and specialists who rent offices near Palm Drive and work closely with the hospital.

"What becomes of those empty spaces?" she said. "It's not just about not having the medical care, but the economics of what happens when people of that magnitude take their jobs somewhere else."

During Monday's meeting, members of the public repeated an ominous refrain — that people will die if Palm Drive closes.

Don Spradlin, development director for the Palm Drive Health Care Foundation, said Tuesday that west county residents would be forced to drive to Santa Rosa hospitals if the facility loses its emergency room.

"I personally have friends that would have died if they had to drive an extra 15 or 20 minutes," he said.

In a survey conducted by the foundation, donors listed the emergency room as the most important service at the hospital, Spradlin said. The foundation is still trying to keep the hospital from fully closing, he said.

Sebastopol Police Chief Jeff Weaver said Tuesday that closing Palm Drive would likely force Sebastopol police officers to spend more time transporting suspects and jail inmates to hospitals in Santa Rosa.

Such delays can become a safety issue, considering the Sebastopol police force has only two officers on duty 50 percent of the time, he said.

When someone is arrested for driving under the influence, the suspect is required by law to either provide a blood sample or submit to a breath test, Weaver said. If the person chooses a blood test, police must drive the suspect to the hospital, unless an ambulance is available to go to the police station. Blood draws, however, are low on ambulance drivers' priority list, he said.

In some cases, Weaver said, suspects who are arrested in Sebastopol and taken to Sonoma County Jail in Santa Rosa require a medical clearance before they are booked. Sebastopol police officers usually drive the suspects back to Palm Drive instead of taking the suspect to a Santa Rosa hospital because they can be seen much quicker.

"Our experience was if we tried to go up to Sutter or any other place the wait is just too long," Weaver said. "When we only have two police officers on, we can't have a police officer waiting in an emergency room in Santa Rosa."

Weaver said the ability to interview victims, such as assault victims, at a local hospital will also be hindered with Palm Drive's closure.

Mary Szecsey, executive director of the West County Health Centers, the area's largest primary care provider, said the closure would directly impact many of the organization's 15,000 patients. Patients at its clinics in Guerneville, Occidental and Sebastopol often require urgent X-rays or lab work and sometimes are sent to the emergency department at Palm Drive.

"It's going to be harder for people to get into Santa Rosa," she said.

Dr. Jim Gude, a Sebastopol physician with strong ties to Palm Drive, said Tuesday that he plans to join forces with other Sebastopol physicians who want to keep the hospital open as an urgent care center with financially viable surgical services.

Gude and Sebastopol orthopedics surgeon Dr. Michael Bollinger have proposed separate plans that would turn management of the hospital over to a foundation and provide emergency services in the form of an urgent care center.

Palm Drive officials will meet this week with local doctors to discuss possible transition scenarios.

Meanwhile, local political leaders say they are closely watching the direction hospital officials are taking.

Assemblyman Marc Levine, D-San Rafael, a vocal opponent of the move to close Palm Drive, said the facility is important for access to medical care and the local economy.

"I'm committed for the long haul to help the hospital succeed," he said. "I will work with all the stakeholders to support a plan that will benefit the community."