County eyes ways to fund medical care
Officials try to figure out how to overcome huge deficits in financing of hospitals and clinics
By Rebecca Vesely, STAFF WRITER, Oakland Tribune
Sunday, September 14, 2003 - 3:29:54 AM PST

Alameda County residents' knowledge of local hospitals and health care issues is being tested in research and focus groups, which officials are conducting to help craft a tax measure that would fund health services.

In recent weeks, county Supervisor Nate Miley has moved forward with focus groups and polling on how supportive residents would be of a countywide sales or parcel tax to underwrite the Alameda County Medical Center.

Such a ballot initiative will likely go to the voters in March 2004.

"What we've learned is that people's knowledge of the medical center and health care services in the county is not strong," said Joe DeVries, health policy staffer for Miley. "But what's been very positive is that people are supportive of health care being provided for everyone."

The Alameda County Medical Center includes Highland and Fairmont hospitals, John George Psychiatric Pavilion and three outpatient clinics -- Eastmont Wellness in Oakland, Winton Wellness in Hayward and the Newark Health Center.

The medical center -- as these facilities are collectively called -- is facing a $45.7 million budget deficit this fiscal year and in June closed two outpatient clinics in Oakland and at Fairmont Hospital due to budget constraints.

Medical center officials and an independent audit by PriceWaterhouseCoopers contend that without a large new funding source, more services will have to be slashed, perhaps including the trauma center at Highland Hospital -- the only trauma center serving the northern part of the county.

The county's auditor-controller last month began his own audit of the medical center's books at the request of the county board of supervisors. On Tuesday, the supervisors voted to remove medical center CEO Kenneth Cohen from the center's board of trustees, and appointed three other community and business leaders.

The medical center now requires $13 million every two weeks to keep running, Supervisor Gail Steele said. The county just filled its own fiscal deficit of $112 million in July, and faces another $30 million in debt passed on when the state approved its budget in August.

This dire situation is creating momentum for the ballot initiative.

To get on the March ballot, language for the initiative must be approved by the county supervisors and then submitted to the county Registrar of Voters by Dec. 5. Given this strict timeline, the supervisors will likely vote on the proposed languageby Thanksgiving, DeVries said.

Nancy Friedman, executive director of Vote Health, an advocacy group, said the initiative must lay out clear goals for the money raised, according to focus groups.

"Voters seem to want very specific language about where the money is going and what it will be used for," Friedman said.

It's projected that a half-cent sales tax would raise close to double that of a parcel tax -- or an estimated $85 million to $95 million a year. Officials are still undecided which tax they would put forth on the ballot.

"There are certain aspects of a sales tax that are more attractive," DeVries said. "It spreads out the cost to everyone in the county, not just homeowners."

Also under consideration is using the money raised from the tax to fund other hospitals and clinics in the county that care for low-income or indigent patients. Or, another idea put forth is to bankroll health insurance for low-income people not covered by Medi-Cal.

The medical center spent $31 million last year to care for patients with no means of paying for services. But other hospitals, such as St. Rose in Hayward, also have high numbers of charity cases.

"I don't think it will end up being insurance-based," Friedman said. "The initiative might include charity care reimbursement for other hospitals."

What is clear from focus groups is that the county will have to explain to voters why they should fund a facility that many have never been to and that primarily cares for the poor in Oakland.

"A big component is raising money to educate people about what the medical center is," he said.

Last month, Miley set up the Alameda County Health Care Initiative Fund and sent out a letter to labor and other groups that might provide financial support.

Contact Rebecca Vesely at rvesely@angnewspapers.com.

measure campaign.

So far, Miley has spent just under $25,000 in his office's discretionary funds to retain noted political consultant Larry Tramotola to conduct the research.

"We still believe the only way out of the huge budget deficit is to pass a ballot initiative," Friedman said.