County Promotes Flawed Plan to Rebuild the Medical Center

Alameda County needs to rebuild Highland Hospital to meet the state's stringent seismic standards. But the Board of Supervisors may botch the rebuild job, just as it did about 15 years ago, for one simple reason. The supervisors again are following the advice of County Health Care Director Dave Kears.

In the early 1990s, the Board of Supervisors was prepared to rebuild Highland's inpatient tower. The beauty of the plan was that the state would pay half the costs. But Kears convinced the supervisors that the 1960s-era inpatient tower would meet seismic standards for the 21st century. The supervisors killed the inpatient rebuild, and in its place, constructed the Critical Care building, which contains the ER, OR and clinics, but not a single inpatient bed.

Even before the new building opened, the supervisors realized that Highland wouldn't meet the state's new seismic standards, but it was too late to change course. At that point, the wise move would be to squirrel away funds to pay for the inpatient replacement project. Kears could have advised the supervisors to set aside money from the national tobacco settlement or the county's portion of Measure A revenue. But planning for the Medical Center's future was never a priority for Kears.

Now the supervisors are prepared to make another ill-considered decision regarding the Highland rebuild because the board continues to listen to Kears' advice. The health care director is advising the county to construct a building that fails to accommodate today's patients, let alone address the needs of the growing, and aging, county population.

So what does Kears propose? Only 118 beds, plus an empty "shell" that could accommodate an additional 36 beds, but only if the Medical Center could pay for these beds. Even Kears' hand-picked consultant, s2i, said that ACMC needed at least 155 beds, but Kears ignored the consultant.

What's worse, Highland's Labor and Delivery Department would shrink from 22 to 16 beds. Virtually all pregnant women are insured, so ACMC would be forced to turn away paying patients under Kears' plan. Since the Medical Center's insured patients help subsidize the cost of care for the uninsured, Kears' plan would make it more difficult, if not impossible for ACMC to balance its budget, and force it to either seek greater subsidies from the county or cut services.

On an average day, Highland had 118 patients, plus another one or two dozen patients in the ER waiting to be admitted. Since hospitals can only operate at 75% occupancy, in order to accommodate the patient flow of admissions and discharges, Highland would need at least 160 beds just to handle current inpatient demand. At this size, the ER would remain backed up with patients waiting for admission. ACMC hired a consultant, KSA, which concluded ACMC needed at least 166 beds to meet current demand, and 190 beds to accommodate demographic changes and growth in ACMC's services.

At least the county is planning to rebuild Highland; it has no such plans for the Rehabilitation Unit at Fairmont Hospital. Rehab, which averaged 22 patients a day last year, must meet the same seismic standards, and deadlines, as Highland. Neither the county nor the Medical Center has looked at the costs for the various options for rehab: retrofit the existing building, construct a new facility at Fairmont, or add rehab beds to the Highland rebuild plan. Nor have they studied how much it would cost the county and the Medical Center to shift these patients to private rehab facilities, assuming private facilities would be willing to treat ACMC's patient population. And there has been no discussion about who would pick up the multi-million dollar tab for treatment at private facilities-the county or the Medical Center. Without a plan to rebuild rehab-either at Fairmont or Highland-the state will require ACMC to close rehab by January 1, 2008.

Vote Health is working with SEIU, the Medical Center, and health care advocates to ensure the county rebuilds ACMC to meet the needs of residents into the 21st century. For more information, contact Vote Health at 510/832-8683 or email Bradley Cleveland, bcleveland@seiu616.org.

SB 840 down to the wire as local organizing heats up!

SB 840 should hit the Assembly floor some time around Aug. 21, after passing the Appropriations Committee. Health Care for All - CA, CaPA, Health Access and other allies have been vigorously lobbying the Assembly holdouts and have come within one or two votes of the final tally needed for passage. Then SB 840 is off to the governor's desk! He has the month of September to sign or veto the legislation. Supporters will ramp up our public education and organizing, media outreach and grassroots lobbying to make Schwarzenegger sign SB 840!

As part of our local organizing efforts, the League of Women Voters secured the endorsement of SB 840 by the Oakland City Council, introduced by Council President Ignacio de la Fuente. On the same day, July 18, the SF Board of Supervisors gave their endorsement as well. Albany is next up to bat on Sept. 5, thanks to city council member Bob Lieber. The Alameda County Board of Supervisors and the City of Berkeley signed on months ago. Tabling with the OneCareNow petitions is going on regularly in the Berkeley/Oakland and Eden District areas. On Aug. 11 the Tri-City OneCareNow campaign got underway (Fremont, Newark and Union City) with a meeting convened by the League with the assistance of Vote Health.

The opening event of the OneCareNow Campaign in 365 cities for the next 365 days was a picnic party Aug. 12 in Los Osos/Morro Bay featuring live music, a children's dance group, free homemade cookies and speakers including Andrew McGuire and Dan Hodges of HCA-CA. The campaign was also featured at the August 4 meeting of the Progressive Caucus of the California Democratic Party, with McGuire and Hodges speaking again, joined by Don Goldmacher, MD. The Grand Lake Theatre in Oakland has agreed to host a major benefit for the OneCareNow campaign in early October, featuring the new film on SB840 and the healthcare crisis. Entertainment and speakers will complete the benefit program, which is being organized by the SB 840 East Bay Coalition.

To get involved, call Vote Health at (510)832-8683. Stay informed by checking the OneCareNow.org website, as well as healthcareforall.org.

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