More Bad Press for Alta Bates/Summit Medical Center

The Contra Costa Times published a critical article on July 3 regarding patient care issues at our local Sutter Health facilities. After describing shabby treatment of several patients, the reporter notes that many of the complaints investigated by the state's Department of Health Services detail incomplete medical records, communication breakdowns among staff members, and inadequate staffing levels. Hospital management puts the blame on nurses for not adequately documenting patient care, so they introduced a new checklist that nurses claim adds 20 minutes per patient, taking away from patient care.

Alta Bates' total profits in 2003 indicated a profit margin of 6.34%, nearly 3 times the statewide average! At the same time, their level of charity care was only 0.33% of net patient revenue, just 1/3 the statewide average. Going for the bottom line, Sutter proposes further job and service cuts, including the elimination of up to 50 nursing assistant positions at Alta Bates.

It's no coincidence that Sutter, the one hospital corporation in Northern California that refuses to agree to patient care standards accepted by Kaiser Permanente and other major hospitals, is also facing more regulatory problems than any other hospital company. Accreditation is still at risk as the JCAHO panel reviews the requirements for improvement demanded by the hospital industry commission. Vote Health is working with SEIU United Healthcare Workers (formerly 250) and C N A, along with many community allies, to build support for a decent contract and improved accountability to patients and their communities by Sutter Health. SEIU members have approved a strike in the event that negotiations continue to be stalled. If this potential strike occurs, it will be the biggest hospital strike in the U.S. in twenty years! You'll be hearing from us soon, about what you can do to help support this campaign for patient care and workers rights.

Alameda County Medical Center Dodges Layoffs But...

It is hardly surprising, after the Measure A win, that ACMC can finally produce a balanced budget. We're grateful that ACMC didn't cut staff or services in the fiscal year 2005-06 budget. But it took a lot of cooperation between union members, community activists, local politicians and healthcare professionals to pass Measure A, and that lesson seems to have been lost on Cambio and the trustees.

There was virtually no public input from hospital staff, physicians, or the community. Cambio ignored its own schedule to unveil the budget in early May, and when the budget was finally released on June 21, the Board of Trustees' Finance and Human Resources committees couldn't muster quorums to review the proposal.

Not a single budget hearing was scheduled for public input. At their regular meeting on June 28, the trustees scheduled adoption of the budget as the final agenda item and spent less than a hour considering the $390 million proposal. Despite the importance of the subject, speakers were cut off mid-sentence after 3 minutes, a significant change from how meetings have been chaired in the past.

Vote Health is particularly concerned about the ballooning budget for nurse registry, travelers and other temporary staff, an 83% increase over last fiscal year. Yet no significant funds are identified for recruiting permanent staff nor for paying the competitive salaries that such recruitment requires. The ongoing exodus of experienced staff contributes to deteriorating patient care. For example, in May ACMC hired 13 nurses, but 9 left, for a net gain of 4. Guess how long it will take ACMC to replace the 250 temporary nurses with permanent staff?

This reliance on temporary staff is not just a patient care or cost issue. Following its inspection of the Alta Bates/Summit Medical Center, the state Department of Health Services cited the use of temporary staff as a primary reason that medical care is deteriorating at those facilities (see Contra Costa Times article of July 3). The state also noted that nurses were overworked and there were too few support staff, problems that also exist at ACMC. The situation is so serious at Alta Bates/Summit that it is at risk of losing its accreditation. Is that what ACMC could be facing next time there's an inspection?

The failure to budget for staff pay increases exacerbates the recruitment and retention problems not just with nursing but also in lab, pharmacy, imaging and respiratory classifications. Public hospital systems in nearby counties, such as SF General, have recently negotiated nurse increases that put them significantly ahead of ACMC. Even before these raises, SF General had half the number of vacancies as ACMC, with twice the number of nursing positions.

Medi-Cal Largely Spared in State Budget

While Schwarzenegger got much of what he had proposed for the state budget, the legislature largely rejected the Governor's "Medi-Cal redesign" proposals, such as premiums for a half-million adults, and privatizing the processing of some applications. However, the budget imposes a $1,800 cap on dental benefits for the three million adults with Medi-Cal coverage.

On the controversial proposal to force more Medi-Cal patients into managed care plans, the legislature does allow for expanded managed care in more counties. However, the legislature rejected some of the specific proposals for mandatory managed care for seniors and people with disabilities. The issue of federal financing of the state's public hospitals remains unresolved, and will be debated in the legislature this summer. (Thanks to Health Access, www.health-access.org, for this update).

Newsletter committee:
Jan Arnold, Bradley Cleveland, Kay Eisenhower and Jim Forsyth.
Our thanks to CA Nurses Association for their help in producing this newsletter.