Alameda County hospitals in need of more aid
Kay Eisenhower, Vote Health
(article published in The Oalkand Tribune)
Article Last Updated: 09/20/2005 07:40:46 AM

JUST over a year ago, Alameda County residents began to pay an extra half- cent sales tax to fund health care services. Voters approved Measure A, the Essential Health Care Services initiative, in March 2004, and this modest tax increase pumped an additional $100 million into health care services for uninsured and low-income county residents.

Like other public hospital systems, the Alameda County Medical Center faces an untenable situation ‹ even as the ranks of the uninsured are growing, federal, state and county government aid for public health is shrinking.

The medical center shuttered two of its five clinics ‹ Central in Oakland and Fairmont in San Leandro ‹ in 2003 because of this financial squeeze.

Thanks to Measure A, the medical center's clinics are seeing more patients, its midwives and obstetricians are delivering more babies, its trauma team is responding to more emergencies.

Yet all is not well at the county's hospital system. Last year, county voters did their part to fix the medical center's financial crisis. It's time for the county Board of Supervisors to do its part to fix the political problems that prevent the hospital system from fulfilling its mission .

Ten years ago, the Board of Supervisors took the dramatic, and controversial, step of establishing an independent hospital authority and appointed a Board of Trustees to run the medical center. The supervisors hoped the new board would escape the bureaucratic constraints of county government and respond more quickly to changes in the health care "market."

Instead, what county residents got was a public hospital that's not accountable to the public:

• The Board of Trustees adopted its $390 million budget in June without holding a single public hearing.
• Last year, the trustees hired a Tennessee-based consulting firm, Cambio Health Solutions, to manage the medical center without putting the contract out for competitive bid. After 18 months it remains unclear what the trustees, and county taxpayers, got for their $5 million.
• Of the 76,000 patients who sought treatment in Highland's emergency room last year, 13,600 ‹ 17 percent ‹ left without being seen because of long waits and insufficient staff.
• Experienced staff nurses are leaving the medical center and are being replaced with temporary nurses who have no commitment to the institution or its patients, and are less familiar with the medical center's systems and procedures.

To be fair, the Board of Supervisors gave the trustees an impossible task. The supervisors failed to make the needed investments in that would have made the medical center more efficient. And even as the ranks of the uninsured were swelling and the cost of health care was skyrocketing, the supervisors refused to increase county support for the medical center. The supervisors gave the medical center the same level of funding this year as it did last year and the year before.

We urge the county Board of Supervisors to take another dramatic step ‹ establish a county Health Commission. A county commission would integrate the system of care provided by the medical center and the network of community clinics with the county's public health and mental health services to ensure that all county residents have access to medical care, regardless of ability to pay.

Kay Eisenhower is chairwoman of Vote Health, a grassroots health care advocacy group.