ACMC Staff Reductions Whittled Down, but Still Threaten Patient Access

After vigorous protests by Vote Health, SEIU and ACMC workers, on July 26th, the Alameda County Medical Center Board of Trustees (BOT) adopted a revised budget for fiscal year 2004-2005. Several trustees noted that labor and community suggestions had resulted in a number of revisions that restored approximately 40 full-time positions. For example, the revised budget no longer includes Alameda County's attempt to raise the rent for the Medical Center's buildings from $1 per year to $1.7 million!

SEIU gave a dramatic presentation demonstrating serious flaws in Cambio's proposed budget projections. For example, Cambio assumes that patient visits to the Emergency Department will decrease slightly next fiscal year, despite the hospital's own data showing an increase of 21% since July 2003! Cambio's labor productivity assumptions that ACMC is overstaffed are contradicted by state data that indicate this is not true.

The original figure of 348 full-time positions to be cut has been reduced to approximately 185 as of Aug. 2, or 8.3% of total ACMC staff. Most of these remaining cuts are front-line staff such as nursing assistants, LVNs and physical therapists, who are essential to providing patient healthcare services. Vote Health has reminded the Board of Trustees several times that we don't believe any cuts in positions are justified by the information currently available to the public. Even if positions are cut through voluntary retirement or other methods less drastic than layoffs, we object to those vacant positions not being filled. It makes no sense to cut non-RN nursing staff who team up with RN positions and then expect the higher-paid RNs to do the work of their former team members. In effect that reduces the time RNs have to spend with their patients. Anyone who spends time in the clinics or the pharmacy or the ER can tell from the long lines and waits that ACMC is currently understaffed and unable to provide adequate access to quality health care for county residents who need it most.

Trustee Dr. Floyd Huen presented a number of budget options that would further reduce the staff reductions by half, restoring $4.3 million to the ACMC budget. While his initial motion failed, his suggestions were incorporated into the motion adopting the budget and will be considered at the next Board meeting on August 30. For example, he proposed restoring $500,000 to the budget which had been allotted for strike preparation funds! Sometimes it looks like Cambio is hoping for a strike!

Vote Health urges all those concerned with this damaging budget to attend the Aug. 30 Board of Trustees meeting. It will be held at Highland Hospital, most likely in Classroom A, starting around 5:30pm. Our pressure has resulted in some changes to the budget, but we need to go much further to save quality health care for the county's most vulnerable residents.

Vote Health also strongly recommends that readers and supporters send letters to the editor of your local newspaper urging that the Board of Trustees adopt Dr. Huen's suggestions for revenue enhancements. Please make the following points in addition to your own:

• I am writing as a strong supporter of Measure A
• There are currently long lines of patients waiting for clinic visits, ER services, and pharmacy services. This situation will get worse with layoffs.
• The proposed revenue enhancements would cut in half the projected staff reductions by restoring $4.3 million to the ACMC budget - saving 75 fulltime positions.
• Urge the BOT to adopt the amendment to the budget and help to provide healthcare for all.
• Sign your name, address, and phone number.

Flash from the Frontlines!

Some 150 workers from the Eastmont, Winton and Newark clinics walked off the job for several hours on Tuesday, Aug. 3 to protest imminent cuts which threaten ACMC patients. Threebuses transported the workers to Oakland, where they were joined by supporters to rally at the Board of Supervisors meeting. Speakers stressed the negative impact on patients if ACMC proceeds with cutting almost 200 positions, mostly frontline health care service providers. The day before, SEIU held informal meetings with patients waiting in line at the clinics and at Highland and signed up 325 of them to get involved in the fight to properly staff ACMC.

Despite these militant actions, Aug. 3 ended on a sour note. The ACMC Board of Trustees and the Board of Supes held a joint meeting at 3pm, originally scheduled to discuss the future of ACMC. Instead, the meeting was high jacked by the county's agenda to demand repayment of the debt they claim is owed by the medical center. After a dog-and-pony show by Cambio and its admin team, the Supes dropped the bomb that they were setting a $200 million cap on the debt, which they claim is now at $191 million. While there was a show of asking Cambio a lot of questions, in the end the Supes insisted that they couldn't intervene in the actions of the Trustees, who have the final say on ACMC staff cuts. Vote Health countered that the BOS is the final authority and that they should dismantle the BOT, who they appoint, rather than allowing the confusion to continue about who is in charge. We also disputed Cambio's claim that ACMC is overstaffed.

Other "highlights" of this meeting included Cambio bragging about how they got 500 workers laid off in three weeks at another facility they managed. Finally, Sheriff Plummer, sporting dark shades, insisted that the problem at ACMC was too much union involvement! For more details, attend the next Vote Health meeting on Aug. 16!

What took them so long?

A recent AP article quotes the nonpartisan National Coalition on Health Care as saying "incremental changes are not sufficient. We've had 40 years of failure with experiments with that strategy." NCHC is the largest national alliance on health care, including business, labor, religious and civic groups. They stated that Congress should require that everyone have basic health insurance. They even noted that options include a single-payer system.

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