QUESTION AUTHORITY-ACMC'S

On March 31st, over 35 people (including at least 13 Vote Health activists) attended a meeting called by SEIU Local 616 and the California Physicians Alliance (CAPA) to discuss visions for the future of the Alameda County health care delivery system.

Floyd Huen, Medical Director of Lifelong Medical Clinic, gave a presentation to make the case for a progressive, expanded system. Many agree that the independent hospital authority with responsibility for ACMC has not been working effectively for some time, if ever, in its 6-or-so-year lifetime. Dr. Huen called for a health commission to oversee and integrate the current Health Care Services Agency (administered by Dave Kears and including behavioral care, public health, environmental health and contracts for indigent care), with the Alameda County Medical Center and possibly the community based clinics, 10 of which are organized under the umbrella known as the Consortium. Such a commission's relationship to the Alliance for Health, Alameda County's managed care Medi-Cal agency, would need to be determined.

San Francisco has had a similar model, with a seven person Health Commission, appointed by the mayor. The Director of Health reports to the Commission and oversees the two public hospitals, behavioral health, primary care clinics and community health and safety services. As in Alameda County and elsewhere, the same patients use both systems, who are best served by a single organization. The community-based clinics in San Francisco are not part of the city/county administration.

The agenda for the "post-Measure A" meeting included brief discussions about the role of the Cambio Health Solutions group at ACMC, ACMC's budget deficit and its "recovery" plan, planning to replace the seismically unsound hospital buildings, the SB2 recall in November, and the status of SB921, the single payer legislation. For information about a future meeting of this group, contact Bradley Cleveland, 510/452-2366, or bcleveland@seiu616.org.

COUNTY BUDGET HEARINGS

There were initial county budget hearings on April 5-7, which will continue sporadically until mid-June. All county agencies were asked to develop maintenance of effort budgets based on 20% of the amount of money that the county contributes from the general fund to the agency. The Health Care Agency must cut $18 million, Sheriff's Department $27 million, and Social Services $14-15 million (after having already taken a $14 million hit midyear).

ACMC'S (WORRISOME) NEWS

Cambio has stated they are looking at the long term financial stability of the medical center, and that they understand ACMC can't compromise quality of care because attempts to increase revenue will be undermined. However, layoffs are back on the table, and a new "System-Wide Eligibility Redesign" is in effect.

Despite the intention of county voters to support medical care for the indigent, ACMC has adopted a policy of requiring large deposits for basic medical care from the poor, as well as 25-50% of the remaining balance for services received. Most middle class families with health coverage would balk at these costs - how can poor people begin to afford them?

patients who qualify for "charity care" coverage - earning between 200-300% of the federal poverty level - cannot schedule a clinic visit without first paying a deposit and then agreeing to pay 25% of the remaining total charges. A family of four with an annual income of $37,700 would thus have significant annual medical bills if each member had only one clinic visit per year with related lab work. Imagine if any person in this family has a chronic condition such as diabetes! There are many questions outstanding about how this policy will be applied and how many people will be affected - Vote Health will be monitoring this closely and protesting the potential denial of basic health care access to low income families.

OTHER HEALTH CARE NEWS

• The Alameda Alliance for Health will eliminate health insurance coverage for about 4,000 beneficiaries beginning July 1, 2004 under their Family Care plan, which provides health coverage to low-income children and families.
• The Breast Cancer Fund is asking for support for the Healthy Californians Biomonitoring Program, SB1168, which would institute a biomonitoring program to determine the quantity and types of chemicals in people's bodies as a measure of environmental exposure, as well as AB 2025, which eliminates hazardous chemicals in cosmetics. For information: California Body Burden Campaign, 415-346-8223 or www.breastcancerfund.org/calbbc.

A Personal Note From Activist Nancy Friedman

On the crest of victory celebrations for Measure A, I have decided to end my ten-year run of activism with Vote Health. Like many others, I first came to Vote Health in 1994, after working hard on Proposition 186, the Single Payer Initiative. After approximately a year of "getting the hang" of Vote Health, I joined the Executive Committee and soon thereafter assumed the role of Treasurer. In January 2001, I became the chair of Vote Health and newsletter editor, and in November 2002, I became Executive Director. Vote Health has offered me a place to express and develop an important part of my political vision; aside from two bouts of serious illness, I have missed fewer than five general, executive- or local committee meetings in ten years. Planning to leave Vote Health as soon as I can train a new administrator, I'd hoped to take stock for awhile. Instead I've plunged into a project to defeat the Bush administration. I will continue my private psychotherapy practice, which I have maintained since 1980. I plan to continue to utilize the knowledge and skills I've gained through these years as a health care policy activist, in particular advocating for ACMC. I strongly support the mission of Vote Health and Health Care for All, and look forward to seeing you out there as we work to make health care accessible to all.

Activist Nancy Friedman

Newsletter committee:
Nancy M. Friedman, Brad Cleveland, Kay Eisenhower
Our thanks to CA Nurses Association for their help in producing this newsletter.