Imagine if there weren't a county Medical Center
OAKLAND TRIBUNE
Article Last Updated: Monday, October 11, 2004 - 3:37:34 AM PST

IF you think the East Bay and Alameda County have problems meeting all its residents' medical needs now, imagine what it would be like without the three hospitals and trio of clinics that constitute the Alameda County Medical Center.

That could happen if the Medical Center doesn't correct the problems found in a surprise inspection on Aug. 12. It has until Nov. 10 to adequately dispose of shortcomings in four areas.

If it doesn't do so, the federal Centers for Medicare and Medicaid Services, or CMS, could halt Medicare and Medicaid reimbursements to ACMC. Since that would subtract millions of dollars from the center's $347 million operating budget, it could literally close Highland Hospital in Oakland, the John George Psychiatric Pavilion and Fairmont Hospital in San Leandro, and perhaps the clinics.

The flood of uninsured, indigent, emergency and trauma patients and others could, quite frankly, swamp the other hospitals in the area, further complicating and, in many cases, slowing the delivery of medical care.

That's why it's essential that Alameda County Board of Supervisors, ACMC Board of Trustees, doctors, staff and other employees of the center do everything possible to erase the deficiencies the Department of Health Services found in medical records, the pharmacy, physical environment and food and dietary services.

The deadline is the latest in a series of crises that have plagued the Medical Center the past couple of years, including drastic budget problems, layoffs, the killing of a physician by a patient at John George and a patient suicide at the same facility.

The August inspection was a follow-up to a February examination after the suicide and killing at John George. It found that the institution was still allowing psychiatric patients access to harmful objects; not properly monitoring, documenting and treating patients; and failing to repair security systems.

A sign of hope occurred last week, however, when workers, administrators and policy-makers at ACMC ended an acrimonious labor dispute triggered by plans to eliminate 10 percent of the work force. The layoff plan was abandoned when both sides agreed to eliminate 120 positions through vacancies and attrition while forming a labor-restructuring committee to examine economics, efficiencies, procedures and quality of services at the center's hospitals and clinics.

Workers conducted a one-day strike in August, arguing that further cuts would hurt patient care. County voters in March had approved a half-cent sales tax increase that is to provide the medical center with $70 million a year for 15 years. And, the trustees hired Cambio Health Solutions at a cost of $3.2 million for

18 months to try to correct its administrative woes and stanch ACMC's fiscal bleeding.

The latest problem reflects some of our misgivings about the Medical Center and how it has been managed. We've said all along that the Board of Supervisors, which is elected to oversee the county's affairs and operations, has been too lax in its oversight of ACMC and has delegated too much authority to the board of trustees as a way of avoiding responsibility. That appears to still be the case.

To ACMC's credit, most of the problems found in February have been corrected. County taxpayers have invested in its future and we hope the stewards of that public trust pay the same attention to detail when addressing the August deficiencies.

And, we applaud the effort to work together. But the center has been in crisis for several years and the need for cooperation, not conflict, has been apparent throughout.

This new spirit doesn't end ACMC's many problems. If the Medical Center is to survive, it needs all the help it can get and can't afford to do anything but cooperate. Internal strife has added to, not detracted from, its woes. And, we still think the elected county supervisors should step up and take more responsibility for the center and its future.

The flood of uninsured, indigent, emergency and trauma patients and others could, quite frankly, swamp the other hospitals in the area, further complicating and, in many cases, slowing the delivery of medical care.