County may gain influence in medical center
By Guy Ashley, CONTRA COSTA TIMES
Posted on Wed, Mar. 10, 2004

OAKLAND - An Alameda County supervisor on Tuesday proposed making two colleagues trustees of the beleaguered Alameda County Medical Center, a move that could signal the county regaining control of public health care operations struggling with massive deficits.

Supervisor Keith Carson said his plan to add supervisors Scott Haggerty and Nate Miley to the center's board of trustees is in response to months of frustration over the county being asked to provide emergency funding for the medical center, while being given little information about steps being taken to correct the center's financial troubles.

The proposal came amid more bad news for the medical center, a network of three public hospitals and three clinics struggling with a financial shortfall estimated at nearly $72 million this year.

An outside consultant hired to help the center streamline its operations told a special meeting of the county Board of Supervisors on Tuesday that a federal agency has ordered the county's psychiatric hospital to correct numerous "deficiencies" uncovered during a probe of two troubling deaths at the facility late last year.

James Braley, vice president of Cambio Health Solutions, said the federal Centers for Medicare and Medicaid Services on Monday slapped a "statement of deficiencies" on the John George Psychiatric Pavilion in San Leandro, following a surprise inspection at the 80-bed facility.

The inspection of John George, part of the medical center network, was prompted by the beating death of a physician in an examination room in November and a patient suicide in December.

County Health Director David Kears said the "deficiencies" will have to be corrected quickly or John George could lose eligibility for Medicare and MediCal reimbursements. Since these funding sources pay up to half of John George's operating costs, losing them would force the county to shut down the operation and find someone else to provide psychiatric care for low-income and indigent residents, Kears said.

Carson's proposal, meanwhile, raises new doubts about the future of the Alameda County Medical Center Authority, the special entity county supervisors set up in 1998 to run the medical center network.

The authority was set up to provide more expert oversight of the center at a time when managed care was sparking sea changes in health care. But as the center's fiscal troubles have ballooned, county officials have felt mounting frustration at being asked to provide millions in subsidies while having little influence on the budget-balancing program.

Carson and Braley both warned that the success of Measure A, the sales tax measure passed last week that will provide the medical center with an estimated $67.5 million annually, could dull the sense of urgency for fundamental change at the medical center.

Though Supervisor Gail Steele asked the board to hold off on Carson's proposal, both Haggerty and Miley said they were ready to move ahead.

Reach Guy Ashley at 510-763-8045 or gashley@cctimes.com.