ACMC TRUSTEES CAVE TO CARPETBAGGERS

Conditions at ACMC have taken an alarming turn for the worse this month. Measure A's stunning victory and affirmation of support for ACMC did not fit in with the plans already underway by Cambio Health Solutions consultants: Slash care to patients and reduce the Medical Center's workforce. Therefore, Cambio is moving ahead as if Measure A had never happened.

At the Board of Trustees (BOT) meeting April 26th, Cambio released their proposed cut list of 347 full-time equivalent (FTE) positions. Since many ACMC workers are part-time, the actual body count is higher. Cambio's presentation lacked any justification for the reductions and they were unable to provide specifics on which teaching or public urban hospitals formed thebasis for comparison. Training of the remaining staff to perform the work of their departed co-workers was delayed until a vague time in the future. Nor did Cambio present any plans for how departments would function and services could continue with the decimated workforce.

With an amendment exempting only translation services from the cuts, the Trustees approved a process that will result in approximately 500 workers being cut within 45-60 days. At the end of the meeting, it was also announced that Interim Chief Executive Officer Efton Hall, Jr. was being terminated effective May 10th. Rumors were rampant about the removal of other executive staff by Cambio but nothing further was announced by the Board.

Then, in a turn of events that shocked even the most cynical Medical Center watchers, Cambio returned several days later with a proposed "Amendment A" to their already fat 18-month, $3.2 million consulting contract. This amendment proposed that Cambio take over the day-to-day management of ACMC and replace not only the CEO but also the Chief Operating Officer, Chief Financial Officer, and Personnel Director with Cambio so-called "special employees." Exorbitant additional fees on top of their existing contract were proposed, including higher salaries Cambio proposed to pay their new staffers, a 25% oversight fee and uncapped living expenses for their out-of-state employees!

This amendment seemed too blatant a power grab to win approval. Cambio had been hired insisting their role would be only to advise and support ACMC. After all, weren't they the kinder, gentler slash-and-burn firm? It appears their plan for a palace coup caught ACMC executives by surprise. In a flagrant conflict of interest, Cambio engineered firing of staff that they now would replace at a far greater cost. Even more ominous, there would be no oversight whatsoever on Cambio's destruction of the Medical Center; they were now to be openly in charge, with no checks and balances on their actions.

Anticipating this vote, at least 250 angry workers and community members came out in force for the emergency BOT meeting held May 6th in the Highland Auditorium. The meeting began with another outrageous presentation by Cambio Vice President Jim Braley, who claimed credit for recent successes that Cambio had no involvement with, while brushing off the fact that Cambio's reports with a 90 day deadline were already overdue. The BOT made a motion to accept this ill-conceived amendment to hand the hospital over to Cambio, with only an insignificant change to reduce their 25% surcharge to 20%. Then the public comment period began, with at least three-dozen speakers lined up. Never have workers or community advocates been so eloquent!

A petition with over 600 signatures by ACMC staff was presented, all of which had been gathered in one day, calling for Cambio's ouster. Speakers hammered on every aspect of the new contract and condemned the trustees for their passivity in the face of Cambio's hostile takeover. One nurse said the "BOT is either complicit, corrupt, incompetent, or clueless." The Board seemed unaware of the rich irony in their statement that they had to do this to stop the bleeding at ACMC. Another nurse brought down the house in her response, "If you want to stop the bleeding, you don't put the leeches in charge."

A dietician pointed out the penny wise, pound foolish aspect to the savings Cambio has identified. For example, they ordered ACMC to stop serving bagels and juice to poor pregnant women who came to ACMC for prenatal classes. A Legal Aid attorney spoke about the flaws in the contract, such as no caps on the salaries or expenses Cambio will pay the out of town executives. Vote Health argued that these actions were a betrayal of the voters who agreed to tax themselves to preserve services at ACMC, and that Cambio has squandered the enormous good will generated by the Measure A campaign.

Perhaps the most chilling moment was when one of the physicians pointed out that if the amendment passed, there would be not a single executive at ACMC who was there because of any commitment to our mission or to this community. Dozens of ideas for change and proposed amendments were raised. Cambio's checkered history around the United States had been explored and examples were presented. Cambio had been involved in the closure of DC General Hospital in Washington, D.C., and was removed from a contract in Columbus after they boosted their fee request several months into their contract. Their parent company until recently, Quorum Health Care, has paid the largest fine in history to the federal government for its Medicare and Medicaid fraud.

Concerns about Cambio's performance to date, its history elsewhere, its questionable 'savings', and holes in the contract should have been enough to motivate a responsible leadership to delay the decision for at least a few days. But in the end, the BOT approved the amendment and threw up their hands, with only trustee Floyd Huen dissenting. Now it will fall to the unions and community to watch every move that Cambio makes and provide the only checks and balances left. As we go to press, emergency meetings are taking place to plan future actions - we'll keep you posted!

"Charity Care"??? We Think Not

Another Cambio "contribution" to the welfare of low-income patients is its addition to the new charity care program, which would cover patients not eligible for Medi-Cal or CMSP: if patients earn 200-300% above the federal poverty guideline, they will be billed 25% of total charges! At 301% and above, they will be billed 50% of total charges!

VH has researched the charity care policies of SF General and Santa Clara Valley Memorial Hospital to learn that not only are the ACMC-required deposits higher than their co-pays, but that ACMC fees don't even include labs, xrays, or doctor's charges! The ACMC fee structure has no caps on charges, so the sky is the limit if you are poor and uninsured - despite the passage of Measure A.

This policy will be discussed at a public hearing some time in June, and VH will be vigorously protesting this outlandish proposal. We'll let you know when the hearing is scheduled so that you can join us.

Congratulations to Nancy Friedman...

Congratulations to Nancy Friedman for receiving a Commendation from the Alameda County Board of Supervisors for her contributions to the community through her work with Vote Health and other organizations.

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