Sales-tax increase taking the lead
Measure A would raise $90 million for public health
Rick DelVecchio, Chronicle Staff Writer, The San Francisco Chronicle
Wednesday, March 3, 2004

A sales-tax boost to bail out Alameda County's struggling public- health system appeared headed for victory in late returns Tuesday.

Measure A required a two-thirds vote to pass. Sponsored by county leaders and health advocates, the measure was designed to raise $90 million a year through a half-cent increase in the county sales tax, to 8.75 percent.

"This is a victory and a major step in helping preserve public hospitals and clinics in Alameda County," said County Supervisor Keith Carson, predicting the measure would pass.

Three-quarters of the money was intended for the Alameda County Medical Center, which operates three public hospitals in Oakland and San Leandro, and community clinics in Oakland, Hayward and Newark. The balance was directed to support private health care providers that serve indigent and Medi-Cal patients.

The Alameda County Medical Center is the state's third-busiest public health care system for poor and Medi-Cal patients. Like other county health complexes in California, it is facing greater demand from patients who lack private health insurance and is getting less money from state and federal health programs.

The crisis threatened to close county hospitals throughout the state and thrust their patients on private hospitals, which have financial problems of their own.

Alameda is the third California county to ask taxpayers for help maintaining public health care. In 2002, Los Angeles County voters approved a measure keeping the county's trauma and emergency services intact. In December, more than 60 percent of Monterey County voters said yes to a sales-tax increase, but that was short of the two-thirds needed to pass.

Measure A advocates cast the proposal as an essential part of a plan to put the medical center on solid financial ground. The center already has closed two clinics and is considering program cuts as it tries to trim operating costs and do a better job collecting payments from insurers.

The center's board of trustees has hired a consultant, Cambio Health Solutions, and given it the task of making any changes necessary to make the system financially stable. No additional program cuts have been identified, but officials said they would be unavoidable if voters rejected Measure A.

"We're still going to have to make corrective actions," Carson said. "But it would have clearly been much worse if we lost. We would have closed other clinics and downsized the institution, even further compromising people's lives."

The campaign over Measure A also underlined questions about how the center is governed. It is run by an independent board but lacks its own source of revenue. The split has caused friction between the center's board and county supervisors and resulted in a string of resignations, including the last chief executive officer hired to turn the institution around.

Five trustees quit in September. Four signed a letter citing "intolerable" structural problems at the center.

E-mail Rick DelVecchio at rdelvecchio@sfchronicle.com.