Re Flu creates space crunch (Our Region, Jan. 12) : California is slowly improving in its support for emergency care, but still ranks near the bottom of the country in a Access to Emergency Care. According to the just-released, state-by-state report card Americas Emergency Care Environment by the American College of Emergency Physicians, California earned an overall grade of C-minus, but is still ranked 42nd in the country, with an F for access to emergency care, the same grade it earned in 2009. The biggest contributors to Californias failing grade are hospital and workforce shortages. The state has the lowest number of emergency departments per person and an inadequate number of hospital beds, as well as shortages of orthopedists, hand surgeons and registered nurses. Our huge and diverse state has complex problems that create barriers to care. Our state legislators need to make access to emergency care a top priority. -- Douglas Brosnan, Roseville, M.D.