Run-off for County Supervisor Keeps Health Care at the Forefront

The primary election for County Supervisor in Alameda County District 3 ended in a run-off between incumbent Supervisor Alice Lai-Bitker (42.5%) and Mayor of the City of Alameda, Ralph Appezzato (46.3%). Tony Daysog, Councilmember from the City of Alameda came in 3rd (11%). Supervisor Lai-Bitker was appointed to fill Wilma Chan's seat, so this was her first time standing for election.

This is a highly significant result from the perspective of Vote Health. Two of the three services at Alameda County Medical Center facing closure - the Fairmont Skilled Nursing Facility and Alameda Health Center - are both located in the 3rd Supervisorial District. Vote Health will be raising the preservation of these services as a top priority issue for the candidates up through the General Election on November 5th. We plan to host a candidate's forum, hopefully at Fairmont Hospital. Community members want to know where each candidate stands and compare their commitment, not only to keeping the Fairmont SNF open but also to rebuilding the campus with county financing. We will be asking each of the candidates to provide us with a written plan for the future of Fairmont Hospital, which we will print in a future newsletter.

Vote Health to Alliance for Health: Establish an Indigent Care Fund Now!

Vote Health and SEIU Local 616 organized a delegation to attend the Alameda Alliance for Health meeting on February 28th. We were there to support the Alameda County Medical Center's (ACMC) proposal that the Alliance establish an "indigent care fund." The Alliance is a public/private partnership that acts as an HMO for Alameda County Medi-Cal recipients; it was one of many "Local Initiatives" set up in California counties for the purpose of helping to protect safety net hospitals such as ACMC. Unfortunately for our county's uninsured residents and the ACMC, the Alliance has diverted most of the Medi-Cal patients to the private sector.

We were met at the meeting by many Alliance players who were organized to speak against any additional funding going to the Medical Center. None of these private practitioners or administrators conceded that ACMC plays a special role in local health care. As ACMC Trustees President Melinda Paras pointed out, the safety net system sees 70,000 to 80,000 indigent patients annually who are not eligible even for Medi-Cal.

Irene Ibarra, the Alliance CEO, gave a prepared speech detailing suggestions she has for the ACMC to improve its budget situation. She did not acknowledge the many steps taken so far to whittle down the original $18 million deficit to $8 million. She focused on the money the Alliance gave ACMC last year, while failing to note that they also gave a very large sum to St. Rose Hospital (in Gail Steele's district) and a major increase in reimbursement rates to Children's Hospital. One of Vote Health's complaints with the Alliance is that many of its policy decisions are made in closed sessions and specific details are never released to the public. Since they are spending public money, we believe these details should be public.

In the end the Alliance postponed taking action on the proposal for an indigent care fund, although it was pointed out that such a fund would benefit all Alliance members who provide care to the indigent. The ACMC administration is preparing answers to a number of the issues raised, and the proposal will most likely be voted on during their March 28th board meeting.

It is obvious, since the Alliance Board is appointed by the Board of Supervisors, that we need to focus our activities on the BOS members who have resisted commitments to retaining and rebuilding Fairmont Hospital. To that end we are continuing to hold smaller meetings in the community, such as one recently with the Fairmont Service League and one upcoming with local area church activists. We are especially pleased with the interest shown in our campaign by a number of local churches; many of them have ties with Fairmont patients and their congregations are in the central and south county supervisorial districts where we need to put the most pressure.

With this support building we may be able to dodge the deficit bullet this year, but the long-term campaign to rebuild Fairmont Hospital must continue past this budget year. With next year's state and federal cuts, Fairmont's services will always be vulnerable unless a strong community showing demonstrates that it will be costly in many ways to allow it to atrophy or close.

Governor Davis Plans To Eliminate CHDP

The CHDP program (Child Health Disability Prevention) is a state-run preventive health program serving low income children and youth, 53% of whom are ineligible for other government insurance programs. It is an important gateway program, performing screenings and check-ups necessary to get into the Women, Infants and Children program (WIC), or to get immunized to go to school. Through CDHP, eligible children receive regular preventive medical and dental exams.

In an effort to close the budget deficit, Governor Davis is proposing eliminating CHDP funding and enrolling families in the Healthy Families Program (HFP), which requires a monthly premium. If premiums are not paid after 2 months, the family is dropped and cannot re-enroll for 6 months. At the present time, these children can receive CHDP services without the red tape of Medi-Cal and the premium hurdle of HFP.

There were 70,706 CHDP health assessments in 2001. Out of those, 27,313 were non- Medi-Cal visits (to receive CHDP services, the family income must be low but an active Medi-Cal card is not needed.) The elimination of state funded CHDP will result in an increase in health problems in poor children that could be prevented or corrected or severity reduced by prompt screening, diagnosis and treatment. Please see our website for a sample letter to write to your state legislators, Governor Davis and State Senator President Pro Tem John Burton to protest the cutting of this important program.

Vote Health members are encouraged to write to their state legislators as soon as possible (a decision may be made by the end of March):

Governor Gray Davis
State Capitol Building
Sacramento, CA 95814and

State Senator John Burton
455 Golden Gate Avenue
Suite 14800
San Francisco, CA 94102

Assemblywoman Dion Aroner
918 Parker Street
Suite A-13
Berkeley, CA 9471

Assemblywoman Wilma Chan
Capitol Office
State Capitol
Room 4098
Sacramento, CA 94249-0001

Following is a sample letter:

Dear Governor Davis,
I am a California resident who is concerned about your proposal to eliminate the CHDP program. CHDP is a preventive health program. It serves low income children (including the undocumented) by providing comprehensive medical and dental exams and treatment. Elimations of the CHDP funding could cause:

• Children will not be able to start school without all appropriate immunizations and exams.
• Loss of screening and treatment, which will increase the incidence of communicable diseases including tuberculosis, measles and other life the threatening diseases.

In lieu of this program, many children will end up in the emergency room, further burdening our emergency rooms and increasing the cost to taxpayers.

I realize the state budget deficit requires some painful cuts, but eliminating the CHDP program is not the answer. You may save money now, but the elimination of CHDP will cost the taxpayers more and jeopardize our children's future.

Please preserve the CHDP program.

Sincerely,

Newsletter committee:
Nancy M. Friedman, Sue Bergman, Julie Hawthorne, Dan Hodges, Margot Smith, Kevin Reilly, CNA Staff