Saturday, June 27, 2009

Stark votes against Climate Bill

Forty-four Democrats in the House split with their party in Friday's historic climate change bill. Of those, 15 came from districts that supported President Obama last November, including Rep. Pete Stark.

The venerable lefty, who has represented the East Bay since 1973, called the bill watered down. "We are right to act with urgency to end our nation’s addiction to fossil fuels and combat global warming," said Stark, "But we cannot waste this opportunity by moving a deeply flawed bill that provides too much to special interests and too little to the environment and consumers."

The vote, which now heads to the Senate, narrowly gained passage 219-212. The Congressional Quarterly speculated many in the House who voted against the bill are attempting to either appear to be an adversary to Democrats in 2010 or, like, Stark and Rep. Dennis Kucinich (D-Ohio) positioning themselves to be independent of the president. Others believe Stark voted against the bill since his and other staunch liberals would not have affected its outcome.

Stark says a passage in the bill calling for a new carbon market will be exploited by speculators on Wall Street. The creation of a carbon market, he says, will grow to the largest commodities and derivative market in five years and will foster market volatility that may force energy companies to switch back to coal for their bottom line.

"This is the scenario that has played out in the European Union, where prices have swung wildly and some power plants have actually switched back to coal due to the low cost of emissions permits," Stark said yesterday on the House floor.

Stark also took exception to concessions made by Democrats to coal-producing states like West Virginia and Pennsylvania. "This legislation continues the 'clean coal' myth by providing at least $60 billion for pie in the sky projects that will only continue the destruction of mountains and waterways at the hands of coal mining operations."

Some critics believe various "clean coal" theories such as Carbon Capture and Storage (CCS) is technically feasible but an example of a red herring perpetrated by King Coal. Jeff Goodell, the author of Big Coal: The Dirty Secret Behind America's Energy Future, said "Unfortunately, CCS is more fantasy than reality at the moment." (Read a post from the Commonwealth Club of California on the subject here.)

Friday, June 26, 2009

Waiting for Sutter's Next Move

Sutter Health can begin making definitive plans known to the community about embattled San Leandro Hospital as early as next Wednesday. Their year-long window starting July 1 may not last long, though.

The chief of staff for Supervisor Alice Lai-Bitker said he would not be surprised to hear Sutter make an early announcement on the matter as early as next week--a sentiment also heard from other San Leandro city officials.

The "key to success" for the county and the rescue of the hospital rest with taking Sutter out of the equation, said Lai-Bitker's Chief of Staff Shawn Wilson who added, "We need to get Sutter out of the way."

At a contentious hearing June 15, residents believed the Eden Township Board of Directors would vote on the fate of the hospital only to have the issue removed from the agenda. During the same hearing, Lai-Bitker announced to thunderous applause her intention to pursue a motion to the Board of Supervisors rescinding the county's offer to move acute rehabilitation services from the seismically insufficient Fairmont Hospital to San Leandro, but no action has taken place. Wilson says the supervisor's office is looking at every angle before moving forward.

"We are taking due diligence on this issue," said Wilson, "The residents of San Leandro want, at the very least, an ER. Our goal, however, because of a lot intricacies in this situation is to take time and figure out the best way to get that."

According to Wilson, the supervisor may interject during the July 14 session whether the board has jurisdiction over the hospital's dilemma as time begins to run out on, at the very least, staving off disruption of the hospital's services.

A certain amount of leeway before a possible Sept. 30 closure of the ER is likely needed if any sort of resolution is achieved. Wilson believes answers will be needed by the end of July at the latest to allow for alternatives.

One alternative could be Southern California health care provider Prime Healthcare who have indicated they could quickly obtain a license to run the hospital. Another could be leasing the emergency room services to another vendor, but neither possible solution has received any official consideration.

Future's Not So Bright, I got to wear Blinders

Like the recently approved city-wide fiscal budget, where numerous one-time sources of funds were used to balance the budget, the San Leandro School Board is using the same gambit in the face of an uncertain economic landscape in the future.

The San Leandro Times reported the district assistant superintendent said, "we are deficit spending." According to the article, the bulk of the one-time funds came from the Federal Stimulus bill to the tune of $2.2 million.

The Daily Review painted a bleaker situation for the district if the state goes through with plans to cut education by over $4 billion next year. The Times also said employees are being asked to double up duties while some administrative absences are to be covered by other staff instead of substitutes.

The political crystal ball seems to be saying the day of reckoning for some leaders looking for re-election in the Fall of 2010 may well be tied to the health of the economy and how treacherous local budgets appear to the electorate in the next 16 months. Local officials are betting on taking the hit later rather than sooner.

Tuesday, June 23, 2009

'We're trying to figure this out'

On June 15, Alameda County Board of Supervisors President Alice Lai-Bitker told a jam packed library audience she would recommend a motion to the board rescinding the county's offer to turn San Leandro Hospital into an acute rehabilitation facility. At the time, she told The Citizen "When there was no option, this was a good option. We didn't want to have a hospital become a blight." Things changed when Sutter Health announced the transfer of its purchasing option to the county that same day.

With the possibility of another vendor in the hospital equation, Lai-Bitker believes new options that may keep the hospital's emergency room open should be explored, but no action has been made by the board president.

The Board of Supervisors have been tackling equally excruciating budget decisions the past week with hearings everyday until Thursday. The next regular session of the board is June 30.

Lai-Bitker's Chief of Staff Shawn Wilson, while listening to the online broadcast of today's budget hearing, said the supervisor's staff is still putting together a plan, "We're trying to figure this out," he said, "It's a long story."

Monday, June 22, 2009

The Prem Reddy Reader

Los Angeles Times, July 7, 2007
The most critical news story published about Prime Healthcare and its owner Dr. Prem Reddy was this Los Angeles Times feature. Contained within it is the most damning quote uttered by Reddy that, in essence, says patients deserve the type of health care they can only afford.

"It's an entitlement mentality. Why aren't the same people asking why everybody shouldn't be eating the same foods, or have the same clothes or same homes? Those are as essential services as healthcare," he said.

Victorville Daily Press, July 10, 2007
Reddy took little time to respond to the L.A. Times piece calling the offending quote manufactured, but did not plan to file suit against the newspaper.

SoCal doctor earns millions buying hospitals, cutting insurance
Associated Press, July 9, 2007
An AP riff on the same L.A. Times article but adds more context to the notion the company puts the bottom line ahead of health care for patients

Anaheim not Prime real estate
Modern Physician, July 16, 2007
Prime's $55 million bid for Anaheim Memorial Medical Center was rebuffed by the attorney general. Integrated Healthcare eventually won the bid paying $68 million while pledging $28.8 million in capital. The terms of Prime's bid for Memorial has parallels their possible bid for San Leandro Hospital.

Prospect scouts L.A.'s Alta; Hopes purchase will help keep patients in system
Modern Physician, June 25, 2007
Prospect Medical Holdings planned to buy four managed care hospitals in Southern California. This article illustrates what happens when companies like Prime cancel insurance contracts to keep higher premiums in their own coffers.

BusinessWeek, August 28, 2008
Prime Healthcare has often been accused of balance billing which puts patients in the middle of billing disputes between managed care providers and hospitals. Often, the onus is illegally put on the consumer to pay the contested difference with the threat of wrecked credit ratings. Many consumers simply pay for services they do not owe.

Modern Healthcare, August 18, 2008
States like California and New York are taking steps to curb the use of balance billing on an unsuspecting public. This story features the dispute between Prime and Kaiser over balance billing and begins to show the push-pull nature of doctors, hospitals and managed care providers vying for patient's dollars. Said one doctor, "If I can’t enlist my patient’s help to pay the bill, the health plan won’t pay at all.”

Friday, June 19, 2009

Video: Prime Laid Off 150 Nurses after Buying Redding Hospital

One of Dr. Prem Reddy's most generous offers is his willingness to honor the current collective bargaining agreement with employees at San Leandro Hospital, if he is able to purchase it. Is that bluster or not?

The night of Reddy's triumphant entrance into San Leandro, a labor leader for the California Nurses Association was asked by The Citizen about Prime Healthcare's long list of dubious business practices. With a shrug, he said, "It's an employer."

The union might want to look out for their members and the welfare of the public with less cavalier statements. Many of Prime's critics say one of the first actions the hospital provider executes is to lay-off up to 10 percent of existing employees.

Here's video from KRCR that reveals Prime laid off 150 nurses just days after taking possession of Redding's Shasta Regional Medical Center last November.

Video: Prime's Reddy Interview Reveals Pro-Business Stance

Last November, Dr. Prem Reddy flew to Shasta County in Northern California carrying the same bag of promises to save the nearly bankrupt Shasta Regional Medical Center as he presented two weeks ago to the people of San Leandro. In this interview, Reddy says all hospitals are different, "There is no one cookie-cutter plan we can implement," he told KRCR TV, "Health care is local. You need to understand the local community."

Reddy, who runs a burgeoning billion dollar health care empire in the state, says "making money is not our first priority, or, otherwise we wouldn't be doing this job. It's a long commitment to the health care needs of the community."

The local broadcaster in Redding hemmed Reddy on the question of the company's unwillingness to work with managed care providers (Video of the response starts at the 9:15 mark). The reply appears to be a clever populist move to shift responsibility from providers like Prime Healthcare to Wall Street fat cats with a little garnish of pro-business Republican ethos.

"We believe managed care is not reimbursing the hospitals and providers in general--hospitals and doctors--the rates that meet the costs of health care. The costs are going up and managed care is making a lot of profits. They are increasing the premiums, but they are making profits for Wall Street, themselves and hiking the premiums to the public...Where is that premium going? It's not going to the hospitals and doctors, it's going in the pockets of executives of the health plans, the middle bureaucracy, which is an enormous amount of bureaucracy and wasting the premium dollars rather than in patient care. The patient is really not benefiting from the premium dollars they are paying. I want managed care to pay the providers their fair share."

Reddy also said Prime Healthcare does not have contracts with Medicare, but will still treat those with the benefit including those who are uninsured, but at what cost, he does not say.

Thursday, June 18, 2009

Daily Review has Printed Just 63 words against Possible Hospital Bidder

It is likely the Alameda County Board of Supervisors will force Sutter Health to faithfully negotiate with Prime Healthcare, the owner of 13 hospitals in the state and known for a few shady business operations, itself to purchase San Leandro Hospital. The problem is, nobody except for a few intrepid citizens know anything about the health care provider and its charismatic owner, Dr. Prem Reddy. Even County Board President Alice Lai-Bitker told The Citizen last Monday she did not know anything about Prime.

People work. A construction worker erects buildings, a dentist fixes teeth. These and other occupations when you include family time do not lend themselves to find and construct the news. This is a journalist's job. So, why isn't the local news outlets--namely, the Daily Review and San Leandro Times not doing their job?

The Citizen was born to fill an enormous hole in local news. The San Leandro Times can still tell you which house burned down, who got shot, whose bike was stolen and who recently passed (I check the Times obits every Thursday, myself). The Daily Review is sadly owned by one of the most spendthrift newspaper operators in the country in Singleton. Neither, though, are giving you the information you need to make an informed decision on the fate of your hospital.

As your morning paper shrinks into oblivion, your knowledge of your surroundings quickly dwindles to nothing. That's an obvious equation. Without some sort of guardian for the people like The Citizen, people will invariable become misinformed and ripe for manipulation. This can already be seen at many hearings regarding the San Leandro Hospital story. A mere mention of the anointed hospital savior Prime Healthcare elicits lusty cheers amidst hooting and hollering. My Pavlovian brain now tells me either the Raiders just scored a touchdown or a public official just uttered the words Prime Healthcare.

If the Daily Review would have reported the dark side of this billion dollar company and its wealthy-centric view of healthcare, the exuberance would be rightly dampened. The only positive with the inclusion of Prime Healthcare is the county has at least one possible suitor and one desperately needed additional option.

The June 9 article published in the Daily Review by Karen Holzmeister is one of the most egregious and potentially harmful pieces of journalism that dulls the senses of media consumers in its simplicity. The article's bias is appalling to the point where you don't know whether the author simply did not have ample space to question the other side of all the goodies Reddy was offering or the paper is willingly going along with anything that makes people happy in the short term.

To readers picking up their morning paper, the revelation that Reddy would give San Leandro everything they wanted and needed plus an extra $20 million for our trouble must have felt like not just Christmas in June, but the greatest Christmas ever! There was not a quote, fact or corroborated allegation to dampen our city's unbelievable luck in being chosen by Prime Healthcare. In fact, the Daily Review has published just one mention of the alleged shoddy business policies of Prime Healthcare. In a piece from June 7, Holzmeister included at brief paragraph at the end of the article that notes the California Nurses Association's web site contains links with alternative narratives to the generosity of Prime along with a quote from San Leandro School Board President Mike Katz's blog questioning whether Prime is the type of company the city wants. Here's the paragraph:
Prime has offered to honor current employee contracts, but articles on the association Web site question Prime's billing practices. And, San Leandro community blogger Mike Katz-Lacabe — president of the San Leandro school board — this weekend asked, "Is Prime Healthcare the type of company that Sutter Health critics want" because of insurance contract cancellations and suspension of services such as chemotherapy treatments and mental health care?
The implication is the articles that might describe Prime's unfriendliness with poorer patients, the cancelling of healthcare insurance deals and suspect billing procedures were posted by an entity with an ax to grind against the company.

Subsequently, the Daily Review is setting up the citizens of San Leandro for greater problems than they perceived to have had with Sutter if more information about the recklessness of Prime is not aired. Near daily articles on the closing of San Leandro Hospital by the Daily Review have published a mere 63 words to illustrate the other side of Prime's wonderful offer. Believe me, another deal with the Devil deserves far more inspection. One like this: click here to read about Prime Healthcare's checkered reputation.

Tuesday, June 16, 2009

Unified Public Sentiment is Driving Hospital Issue

At 5:30 p.m. yesterday evening, the San Leandro Library's Dave Karp Room was nearly full. Thirty minutes before the scheduled Eden Township Board meeting, the room with the dividers open to gain the full expanse of the room, was a bundle of chatty energy. By the time, Dr. Rajendra Ratnesar opened the meeting shortly past six, every seat was filled and the perimeter of the large conference room was lined with citizens angry that any government body would dare close a public asset such as their hospital.

One of the most intriguing aspects of the furor over the possible loss of San Leandro Hospital has been the slowly rising tenor of voices from elderly San Leandrans to cocksure doctors and hard-working nurses. The core of the movement has always been there. Followers of this story have listened to a small group of about dozen concerned citizens consistently address nearly every and any government body that will listen. On their backs, the tide of anger has risen precipitously as more people learn the details of Sutter Health's plan to turn over the hospital to the county for a acute rehabilitation facility.

“It's really exploded," said David Brannan, a labor representative for the California Nurses Association, "It's been a community effort with health care workers and doctors. Everybody was just sounding the alarm. At first, it wasn't happening. It was just falling on deaf ears, but obvious now the community is in alert mode.”

There were times in past month, when the San Leandro Hospital story seemed more like a labor issue than a public health concern. Of course, they are both since hundreds of workers could lose their jobs or be transferred to other county hospitals, yet at times the angry voices were mainly doctors and nurses with a few sprinkled senior citizens. The group has growned as of late, highlighted by a nearly capacity crowd for a Thursday afternoon hearing. Monday night's gathering was comprised of residents of every age and color hollering and cheering every applause line delivered by speakers. Sometimes they booed heartily while others shouted catcalls towards the board.

"The response from the public is not unexpected," Eden Medical Center CEO George Bischelaney told The Citizen at the conclusion of last night's meeting, "The public has an interest in keeping their hospital." Bischelaney was literally one man against the entire world last night, while another person became branded the savior of the cause.

“It's a natural thing," said the President of the Alameda County Board of Supervisors Alice Lai-Bitker, who announced she would motion to withdraw the county's offer to Sutter, "Nobody wants to have their hospital close. With more people finding out about it, the more they are speaking out against it." It seems those early voices are beginning to echo through the community. As Brannan observed, in three heavily-attended public meetings in the past week, not a single speaker voiced approval for the transfer of the hospital to an acute rehab facility.

These may be the times we live in. The corporate behavior of Sutter Health may represent everything Americans loath about the current economy and, more importantly, how its entitlement, arrogance and hubris has made the public suffer. Nobody wants to lose a hospital, but maybe the growing avalanche of civic participation for this issues represents something different--the people of San Leandro saying enough is enough.

Monday, June 15, 2009

It's Not Over: In Non-Binding Vote Directors Reject Alameda County

The Citizen
San Leandro Hospital lives to fight another day, for now. Alameda County Board of Supervisors President Alice Lai-Bitker changed the entire dynamic of the fate of San Leandro Hospital last night announcing she will ask her board to rescind the county's offer to move rehabilitation services to the facility.

Lai-Bitker said the impetus for her decision was in response to an announcement earlier in the day Sutter Health would transfer their option to buy the embattled hospital to the Alameda County Medical Center. “We came in because there was no other option, so now there is an option,” she said of an offer from a Southern California company to purchase the hospital, “The directors deserve to have the process go through and explore and evaluate whether it's a viable option.”

Sutter's deal with Alameda County reportedly made over the weekend riled an already angry overflow crowd of over 500 residents who charged the healthcare provider with corruption and accusations of some Eden Township directors presenting instances of a conflict of interest.

The last of three public meetings on the issue was believed to have led to a resolution Monday night until the vote was removed from the board's agenda. Director Dr. Vin Sawhney surprised the crowd when he interrupted Board President Dr. Rajendra Ratnesar with a motion calling for the directors to take a position on the proposal in the absence of an official document. Sawhney's subsequent successful motion set forth a chain of unseen events that may have made things complicated for Sutter Health, the owner of both San Lenadro Hospital and Eden Medical Center in Castro Valley.

“In these cases, somebody has to stand up and do what he did and he did it, to his credit. Otherwise, it's just wishful thinking,” said David Brannan of the California Nurses Association, “Somebody has to actually stop the train and he did.”

A lawyer for the Eden Township advised the board the addition of an amendment without prior consideration would violate the Brown Act that promotes open government and suggested a non-binding straw poll, instead. The move allowed the public to hear the board's opinions on the possible closing of San Leandro Hospital for the first time. Four of the five directors voted against the county's proposal with Dr. Walter Kran saying he “strongly rejected” the proposal along with Sawhney and a tepid response from Dr. Harry Dvorsky. Director Carole Rogers, an employee of the Alameda County Medical Center, jokingly wondered whether she would still have a job before saying the “corporate takeover of San Leandro Hospital is a travesty.”

Board President Ratnesar, while communicating solidarity with the rest of the board said he agreed the community needed emergency room services at San Leandro Hospital, but awkwardly chose to abstain from voting in response to various charges from the public that he represented the interests of Sutter Health. Ratnesar is currently an employee of the company. “I came to these meetings with an open mind,” he told the crowd, “To come here with a predetermined position would have made these meetings a sham and a mockery.” Afterwards, Ratnesar told The Citizen: “In my conscience I have no conflict of interest.”

The surprising turn of events came as a shock to Eden Medical Center CEO George Bischelaney who sat towards the back of the room in a sea of sometimes raucous applause and invectives against his company. When asked his response to the board's actions he said, “Uh, actually I don't know” and believes in the integrity of the Eden Township Board. “I think there are independent," he said, "You saw how they made their decision.”

The developments now put Sutter in a political bind with the possibility of now having to deal with the Alameda County Board of Supervisors to decide the fate of San Leandro Hospital. Critics believe Sutter Health wants to avoid dealing with a competitor at San Leandro Hospital to challenge their planned $300 million rebuild of Eden Medical Center. Bischelaney was ambivalent towards a proposal from rival hospital administrator Prime Healthcare, which owns 13 hospitals in the state.“The proposal was obviously made to the district, so it remains to be seen what they do with it,” Bischelaney said, “Maybe, they will considerate it more. I really don't know. If that's what they choose to do; if it ends up that way, it ends up that way.”

Brannan, a labor leader for the nurses is more pessimistic about Sutter's intentions. “He's got his marching papers from Sutter in Sacramento and that is to do whatever you can to make sure a competitor doesn't get that facility,” he said.

While the hospital may have won a temporary reprieve, the political wranglings last night assure that the issue will continue for weeks and possibly months if the Eden Township Board is given the chance to conduct due diligence on a proposal from Prime Healthcare or another unforeseen party, yet Brannan still believes Sutter's deal with the county could still be revived.

“They are going to try to do this deal with the county despite what you heard here tonight. I really don't think this is over," Brannan said, "There are factions in the county who want that to happen and they are lobbying for that to happen.”

Let's get into the Hospital Business

San Leandro Councilman Michael Gregory loathes the idea of a hospital closing in his district under his watch "for any reason." There really isn't a good occasion for such a critical service to be lost, but during trying economic times like these the moment seems more like another kick in the gut than a jab our community can easily recover.

Unemployment is rising in the Bay Area. An already expensive place to live is only putting a harder pinch on the bottom line and uncertainty is the coin of the realm. It's no wonder the possible closing of emergency services at San Leandro Hospital has hit such a nerve. A paying job and money in your pockets are merely material aspects of our life. Our health and quick access to it is a jarring look at our mortality. 

Hearings and local government meetings in past month has repeatedly featured a band of hardy and tenacious civic-minded citizens who have chastised officials for their lack of transparency and political guts. They have told compelling stories of the hospital saving their lives, extending their time with loved ones and describing the peace of mind that comes with having doctors and nurses at the ready in case their health fails them. 
The behind-the-scenes tug-of-war between the Alameda County Medical Center, Sutter Health and recently Prime Healthcare is a microcosm of the nation's broken medical system where as Bono once wrote, 'the rich stay healthy, the sick stay poor.'
If Americans, in general, are scared, imagine the torment of the woman who told the large crowd at last Monday's Eden Township District meeting she fears having to awake in the middle of the night to rush her elderly husband to the emergency room that she sleeps fully clothed--just in case. The faces of the five-member board apparently translated a look of indifference to her plight, so she chastised them saying, "Don't smile at me like that. You don't live in San Leandro."

With times of pessimism often comes bouts of apathy. They might say, "that's what powerful corporation do, they control the levers of government to their advantage" or feel powerless over the inevitable cadre of slickly-dressed lawyers who arrive making things go the big shot's way. But, during these times, apathy has turned to the type of anger that leads to change. Sutter fears this uprising as evidence to recent shenanigans and possible ringers walking among the the public at last Thursday's healthcare district meeting. They have too much riding on this vote to sit back and let the public determine its outcome.

The behind-the-scenes tug-of-war between the Alameda County Medical Center, Sutter Health and recently Prime Healthcare is a microcosm of the nation's broken medical system where as Bono once wrote, "the rich stay healthy, the sick stay poor," but San Leandrans are mad and ready to fight. With that San Leandro faces the prospect of an ugly catch-22; where a powerful health care provider like Sutter slithers from city to city maximizing profits like a department chain store looking to go upscale or the choice of teaming with an obvious carpetbagging billionaire huckster like Dr. Prem Reddy and Prime Healthcare promising medical nirvana. These are not choices, but the extension of further corruption of government officials and exploitation of this area's underclass. Unfortunately, there is only one option that at least roots out the nefarious actors, but it will costs us.

San Leandro needs to go into the hospital business. Mayor Tony Santos' suggestion to the Eden Township District Board of Directors to draw up a ballot initiative enacting a hospital tax as a last resort, should be the next step in this saga. It will costs citizens of the healthcare district money in extra taxes, but you cannot accept a favorable end to this story without costs. That's the cruel Hobson's Choice our elected officials have condemned us to. The city of Alameda facing a similar dilemma a few years past went this route costing taxpayers $297 a year. Such a tax , though, would likely be far lower and spread over a larger electorate and would keep services open at the hospital. John Kalafatich, the man lovingly known as "Papa John" said, "When the emergency bell rings a couple of dollars doesn't matter."

No matter the outcome of this story, one thing is assured; the people of San Leandro have risen to the occasion all the while fostering a new civic attitude that can stand toe-to-toe with not just one, but three formidable opponents: their government, mighty corporate interests and, most of all, despair.

Sunday, June 14, 2009

With Hospital on the Verge of Closing, Where's Tony Santos?

Hearings have Revealed Sutter's True Intentions

The District Board will end hours of public comment on Monday by voting whether to accept or reject a proposal by Alameda County Medical Center's Fairmont campus to move their rehabilitation unit to the Hospital campus, with an 8 a.m. to 8 p.m. sub-acute urgent care clinic replacing the acute care 24-hour emergency rooms. The intensive care unit, medical floors and surgery would be among the many other services terminated.

The offer represents months of secret negotiations beween Sutter Health and the Alameda County Health Care Services Agency. The Agency is anxious to find a place for Fairmont services, which must be moved from its current site on Foothill Boulevard. Sutter is anxious to eliminate a nearby competitor to its Castro Valley hospital.

The East Bay is only the latest community in Northern California to face down Sutter Health's strong desires to deny needed health care to vulnerable communities when it serves their bottom line. This is a provocative claim, but one must merely look around us to find its truth. The San Francisco Chronicle has done plenty of reporting on Sutter's persistent efforts to close St. Luke's Hospital in San Francisco. In addition, Sutter attempted to close its hospital in Santa Rosa.

The County Boards of Supervisors in San Francisco and Santa Rosa forced Sutter back to the bargaining table in order to prevent an outcome which would have harmed their constituents. In the backlash to Alameda County's secret negotiations with Sutter to take over San Leandro Hospital, the public is wishing to ensure that our Board of Supervisors and the Eden Township Healthcare District Board have all the information they need to do the right thing.

Public meetings at the County and District levels have revealed a number of disturbing details about the County's offer and internal processes of the potential deal:
  • Sutter reported to the County that over 80 percent of the 27,000-plus patients seen in SLH's ER in 2008 had low level of illnesses appropriate for the proposed urgent care clinic. This was refuted by the director of San Leandro Hospital's ER Dr. Gail Hubbell who publicly stated that over half of the patients were too ill to receive urgent care treatment, including over 1,300 patients in critical condition whose lives would be put at risk by delays in care.
  • In order to justify their strained position that there is sufficient capacity in the system to absorb both SLH's ER patients and 20,000 inpatient days, the county and Sutter would force ill people formerly treated in our Healthcare District to seek care at all hospitals from St. Rose and Kaiser in South Hayward to Alta Bates Summit in Berkeley and Oakland, along with the overloaded trauma-designated Eden and Highland Hospitals.
  • SLH's closure would reduce capacity at district hospitals from the current 300 beds and two ER's to 130 beds and one ER by the year 2013. Sutter admits their goal for the new Castro Valley rebuild is for this new hospital to have an average 85 percent inpatient bed occupancy rate, unprecedented in our County and incompatible to safe health care. As a comparison, while its ER has extremely high use, the County's Highland Hospital has had an average 60 percent inpatient occupancy rate in recent years.
  • Sutter presented to the Agency in their negotiations that there were no other organizations interested in continuing current services at San Leandro Hospital, and that Sutter intended to end acute care services by Sept. 30. In reality, earlier this year Prime Healthcare entered into discussion with the Healthcare District about taking over current SLH services, and last week publicly reveal their offer to lease operations of the hospital.
  • There is a perverse imbalance in the quality of the two proposals submitted to the District. The county's proposal not only kills many vital hospital services, it also sees the District hand over the property to the county free of charge, and has Sutter paying the County $6.5 million. The Prime Healthcare proposal preserves current services, guarantees $20 million in prompt acute care improvements, and has Prime paying the Healthcare District throughout a 10-year lease with two 5-year options. This much-needed money for the District could be used to support their hospital and non-hospital health care activities. As mentioned on The Citizen, it would be neccesary to ask Prime hard questions about their practices before a well-crafted agreement addressing community concerns is completed; this would also be needed if any other provider came forward with a competing bid. All the same, with these facts only a corrupt Board would approve the County's proposal.
  • The President of the Healthcare District Board, Dr. Rajendra Ratnesar, was the subject of a story in the Daily Review this week. The story revealed Sutter Health paid Dr. Ratnesar up to $100,000 last year. The story further detailed that he will be allowed to vote on this issue, while the Healthcare District attorney has advised board member Carole Rogers she should not vote on the County proposal due to a specious conflict of interest (Rogers has publicly expressed opposition to the County deal; she has retained an attorney to defend her right to vote).
Monday's action by the Healthcare District to vote on the inferior County proposal to the exclusion of Prime's offer also disrespects a request of our County Supervisor Alice Lai-Bitker to the District Directors. In the Board of Supervisor President's letter of May 11th, the President of the Supervisors said, "To date, neither Sutter nor the Health Care District has been forthcoming with data to reassure the community that health care needs have been considered and all option (sic) pursued in the decision to close San Leandro Hospital. This is simply an outrage!"

Frankly, the Healthcare District Board has let down the citizens of San Leandro, Castro Valley, San Lorenzo and Hayward often, particularly in its approval of a horrendous 2007 agreement which could put the hospital in jeopardy even if Monday's vote goes as it should. One battle at a time, though, and we are hopeful that we will win Monday's battle in the war Sutter Health is waging on our community.

Doug Jones is a resident of San Leandro and a former employee of Eden Medical Center. He is also a member of the San Leandro Community Action Network (SLCAN).

Friday, June 12, 2009

School Board President gets an 'F'

The president of the San Leandro school board, writing a posting on his blog, borrowed portions of the article without citation from a well-know web site.

In an email response, School Board President Mike Katz called the allegation a non-story, but indicated the dearth of online news regarding former Mayor Jack Maltester's death May 1 led him to the Wikipedia page.

Katz notes a citation to his May 3 posting on his blog San Leandro Bytes was posted to Wikipedia, an online encyclopedia that can be updated by anyone and notorious for proffering false information and media hoaxes as proof his article is actually the foundation of the Wikipedia entry. He denies using the site without attribution.

Visitors to the site can add and delete information on any subject without approval. Wikipedia's accuracy, though, has proven just as reliable as a standard encyclopedia and offers a greater number of entries on virtually any topic.

“I'm familiar enough with Wikipedia to not be foolish enough to rely upon it as a sole source of information for pretty much anything,” said Katz, “ I can assure that the information I posted on my blog did not come from Wikipedia.”

Further investigation, though, reveals the entry updated May 3 with a link attributed to Katz's blog is nearly identical to versions of the article as far back as May 2007 edited by an unknown poster not known to be Katz. (Click here to view the Wikipedia page on Maltester, Katz would have viewed before writing his article.)

Katz revealed he has revised the posting on Maltester in the past.

The issue of plagiarism and academic dishonesty regularly plagues all levels of academia and has dragged under the reputations of many notable writers. A charge of plagiarism in the classroom routinely brings a failing grade or even expulsion.

The opening paragraph of the offending posting opens in a similar fashion to the Wikipedia page. Early versions of the page attribute the information to a 2006 posting on Katz's blog—using the the first line verbatim, while condensing the remaining information. In a bizarre twist that highlights the Brave New World of blogging, Katz, in a sense, plagiarizes himself by using similar phrasing from the retooled article for his blog posting.

Subsequent paragraphs of Katz's posting reveal clear similarities namely in structure, content and tone.

Katz follows with similar sentences on Maltester's testimony on May 6, 1967 to a U.S. Commission of Civil Rights and his tenure as president of the U.S. Conference of Mayors.

The last Wikipedia revision before Katz's article in December 2008 reads:
Maltester served as President of the United States Conference of Mayors (USCM) from 1969 to 1970. In 1971, he sponsored a resolution at the annual USCM meeting in Philadelphia, entitled "Withdrawal from Vietnam and Reordering of National Priorities", which called upon then-President of the United States, Richard Nixon, "to do all within his power to bring about a complete withdrawal of all American forces from Vietnam by December 31, 1971." Speaking in support of the resolution, Maltester said,

I might ask you: Have we left anything up until now to the military experts or have we been running a political war in Vietnam? My city, a small city in California with less than 70,000 people, proposed this resolution and it is supported by the citizens of the community. It is not a resolution of condemnation. It is not offered in rancor. It is a positive statement of principle. To support this position, I believe, is an obligation none of us can ignore in the name of humanity. I ask your vote for an end to this war.”
Katz's May 3 posting reads: While he was Mayor, Maltester served as President of the US Conference of Mayors from 1969 to 1970 and introduced a resolution at the 1971 annual conference calling for the US to withdraw from Vietnam. In the resolution, of which he was quite proud, he stated,” which is followed by the exact same quotation from Maltester without attribution or context.

Part of the burgeoning tradition of blogging encourages the author to routinely provide links or journalistic references to other articles, videos or photos. The second half of Katz's article is notable for its original reporting of various past and current local politicians. In blogging circles, it would have been perfectly acceptable to link his article to the Wikipedia page while incorporating his own reporting.

Katz's was elevated to president of the school board following voter discontent that swept three new trustees into office. Upon election to the board in 2006, Katz ran on a platform calling for “transparency and accountability.” The voters call for wholesale change allowed Katz an opening to lead the board in addition to being influential in the election of all three new board members.

While there is no law or reason to expect impropriety from an elected official writing a “journalistic” blog, its presence runs a fine line between breaking the natural barrier between city hall and the newsroom in a traditional or cyberspace sense.

“I have no problem with a trustee having a blog while serving as long as that trustee is very clear to their readership that the blog does not represent the opinion of the school board,” said School Board Trustee Morgan Mack-Rose, “To date, I have never seen any implication of his posts being the opinion of the School Board.”

Thursday, June 11, 2009

Entire Eden Healthcare Board Advised of Conflict of Interest

An already confusing and critical decision making process is taking a turn for the worst in backroom politics.

Eden Township Healthcare Director Dr. Rajendra Ratnesar again refused to answer questions about charges of conflict of interest before the five-member committee votes Monday on Alameda County's proposal to convert San Leandro Hospital to an acute rehabilitation facility.

Before today's second of three hearings at San Leandro Library, Ratnesar said all five of the directors have been briefed on the possible legal ramifications of voting on the plan, not just himself and director Carole Rogers, as reported by other outlets. Rogers is employed by the Alameda County Medical Center, who under the proposal would convert the hospital to an acute care rehab center after the closing of the same operation at Fairmont Hospital, which is seismically deficient.

Ratnesar did not comment on whether he would excuse himself from the vote but expressed exasperation at the well-known makeup of the directors. "There are many members who you could say have a conflict of interest," Ratnesar said, "We all have worked in the medical field." A representative from the California Nurses Association called for Ratnesar to resign from his post.

Ratnesar, a medical director at Eden Medical Center and employed by Sutter Health, chose not to speak to the possibility one or more of the competing sides may have raised the specter of a conflict of interest to scuttle the vote next Monday. "I don't want to accuse anybody unless I have the facts," he said.

Accusations of competing loyalties are common on a board that is typically stocked with members possessing deep connections within the local health care industry. Late last year, Director Dr. Vin Sawhney was accused of having business interest in an endoscopy clinic in Hayward critics said competed against facilities in the Eden Healthcare District he now represents. According to the Castro Valley Forum, current Director Dr. Harry Dvorsky said he believed at the time such an arrangement was a conflict of interest.

With no official presentation on Thursday's agenda, the meeting was again filled with pleas from doctors, nurses and the public for the directors to save the emergency room at San Leandro Hospital.

State Senator Ellen Corbett told the sizable early afternoon crowd she fears the loss of the hospital along with doctors from the area. She also discouraged closing a hospital that is currently seismically retrofitted. "I strongly urge the members not to take any action that would transfer San Leandro Hospital until you have explored every single option," said Corbett.

Wednesday, June 10, 2009

Powerful Lobbyist Enters Hospital Fray

Many things have changed since Dr. Prem Reddy set foot in San Leandro this week. Not only did he capture the imagination of the city with a bevy of solutions the cities problems, but now the make up of the Eden Township District directors has suddenly become very muddled.

A San Leandro city official close to the hospital discussions told The Citizen two votes against the approving the transfer of San Leandro Hospital to the Alameda County Medical Center were assured, meaning a lone vote out of three would be needed to move forward. This official expressed confidence another director could be recruited, but maybe this isn't the case, after all.

Today's Daily Review reveals an interesting scenario brewing where one member is being told to skip the vote by lawyers and another being charged with conflict-of-interest. What is not expressly implied in the article but assuredly is occurring is a concerted effort by Prime to pry the control of the health care district from the hands of Sutter, which has long manipulated the group.

With Reddy's billions comes political acumen and powerful lobbying interests. Evidence of Prime's muscle was in attendance Monday with the presence of former top-ranking Republican State Senator Jim Brulte (pictured above) mingling in the background. Brulte spent 14 years in the state legislature before joining the powerful Southern California lobbying firm California Strategies and has been referred to in many outlets as the most powerful Republican in the state.

Whether or not, Reddy is overtly using his immense political power in San Leandro at this time, it is clear the legal challenges are emananting as a lawyerly gambit to leverage the system. The knowledge of Dr. Rajendra Ratnesar's employment at Sutter is as long-standing as the controversial Sutter plan to close San Leandro Hospital over two years ago. The question becomes, how do you eliminate any conflict when a board formed to oversee health care issues is filled with current and former doctors and nurses? This may be the point, Prime seeks to exploit. Ratnesar, for his part, may have become an important piece that greases the way for Prime in San Leandro. As it stands, the fears of losing San Leandro Hospital are now being gamed by two powerful corporations both attempting to manipulate the system for their own financial gain.

Supes Approve Eden EIR; Miley urges Hospital Owners to Deal

OAKLAND, Calif. - Sutter Health is closer to breaking ground on their new $400 million hospital at Eden Medical Center. The Alameda County Board of Supervisors unanimously approved the long-awaited final environmental impact report (FEIR) Tuesday, but not before Supervisor Nate Miley appealed to a noticeable thawing of intensity from both sides to nudge Sutter and possible bidder Prime Healthcare Services to the bargaining table.

Miley repeatedly asked Eden Medical Center CEO George Bischalaney whether Sutter would negotiate with the late-emerging option to keep San Leandro Hospital's ER and acute care services open. Technically, Sutter has not offered an official decision on San Leandro Hospital, but Bischalany was visibly reluctant to answer the supervisor's question before slightly bowing his head and saying, "sure." Miley announced the county would take its offer off the table if Sutter could make deal with Prime or any other health care entity. "We don't have to have a dog in this hunt," he said.

A day earlier, Prime Health Care's owner Dr. Prem Reddy chastised Sutter officials during the Eden Township District meeting at the San Leandro Library. Reddy implied he could run the operation better and saying the people of San Leandro "deserve better." Some in attendance believe some of Reddy's comments Monday night were the beginning of very public negotiations with Sutter. Reddy also criticized Sutter's option to give the county 90-day current before closing up shop in San Leandro. A few city officials thought he was making overtures to lengthen the time before taking over the hospital.

Approval of the EIR was delayed last month when a flood of new information was received by county staff and whether a crucial aspect of a link between the rebuilding of Eden and the closing of San Leandro Hospital existed. Miley motioned to postpone any decision by the board under the pretext of avoiding any future lawsuits. The county staff returned Tuesday and found nothing new in the late-filed documents nor was there any evidence of any linkage between the fate of the two hospitals. Regarding the EIR, the county staff reiterated their belief that no physical damage would be incurred by the environment, which primarily focused on traffic, air and noise quality.

Many of the same speakers from various rallies and town hall meeting again voiced their opinion--some in anger, some with a tone of melancholy--but the overall tone of the hearing was far more complimentary than others. The board chambers were full, but less of the ubiquitous doctors and nurses were in attendance. One three occasions, speakers hoping to save San Leandro Hospital, turned away from the podium and addressed supporters of Eden saying that "nobody is against building your hospital." Such mutual respect along with many glowing references to the emergence of a possible buyer seem to have lightened the tone quite a bit.

Rogers says State not as rigid on Seismic Retrofit

Eden Township Director Carole Rogers says State Senator Ellen Corbett told her the state-mandate to have all medical facilities seismically retrofitted by 2013 will not be as rigid as once believed. Rogers says nearly half of all facilities have yet to offer up plans for such renovation or will not be drawn up in time. Corbett has told her there is no way the state will indiscriminately close so many hospitals at once.

Tuesday, June 9, 2009

Where in the World is Tony Santos?

Mayor Tony Santos has taken some heat as of late over perceptions he is not providing sufficient leadership during the current hospital saga. Santos has been missing from numerous rallies and town hall meeting on the subject leading San Leandrans to wonder where their mayor is.

He appeared briefly at Monday night's hospital district hearing at the San Leandro Library resplendent in a green shirt and red tie before ducking out early without making a public appeal on the fate of San Leandro Hospital. Instead, the mayor gave a commencement address at a nearby middle school while Councilman Michael Gregory read a prepared statement on his behalf. While the accomplishments of a group of stellar students graduating to high school are of utmost importance, were they really more important than saving the hospital?

Santos, in his statement, did offer a modification to the health care district's proposal calling for a potpourri of downsized services to be located at the hospital and utilizing the vacant fourth floor for the counties desired rehabilitation wing. He also announced support, as a last resort, for a district-wide hospital tax referendum. Neither seem to have gained the imagination of officials in attendance, the those in attendance loved it.

The suggestion to allow voters to decide the efficacy of a hospital tax is a bit strange since Councilman Jim Prola and the mayor, himself, questioned last month, the ability to raise enough support for any tax in the current economic climate.

Ironically, the mayor who seems to instill indifference or outright anger in some citizens and rarely gets rousing approval failed to basked in the revelry of an approving crowd who loudly cheered his proposal.

County Reiterates Proposal; Possible Bidder Wows Crowd

Dr. Prem Reddy knocked them dead. The possible savior-in-waiting for San Leandro Hospital whipped an overflow crowd into a frenzy of hooting and hollering before eliciting a standing ovation during Monday night's hearing to discuss the future of the embattled facility.

The Eden Township health care directors held the meeting to reiterate the counties plan to convert San Leandro Hospital to a 50-bed acute care facility that would make up for the seismically deficient building at Fairmont. Although the Alameda County Medical Center has a detailed proposal, it is still only an “assumption” at this point the county will take over until Sutter Health Care makes an official decision on the hospital's fate.

The addition of Prime Healthcare Services to the agenda by Eden Township Director Dr. Vin Sawnhey added a brief sense of hope to a throng downtrodden over the possible loss of their hospital. With Sutter officials, including Eden Medical Center CEO George Bischalaney in attendance, Reddy, the self-described small town physician from Victorville, Calif. offered to keep the hospital's emergency room open in addition to streamlining its service and offering longer hours.

Prime Healthcare owns 13 hospitals in the state, mostly centered in Southern California and earned $1.2 billion in revenues last year. According to Reddy, all of his acquisitions rehabilitated bankrupt or near bankrupt hospitals. “This is our philosophy,” Reddy said before adding, “I can turn a failed community hospital into a successful community resource." His plan also offers to lease the property for 10 years with an option to buy along with an infusion of, at least, $20 million in working capital during the first year in operation.

Critics of Reddy's previous business plans detail a drive to strip new acquisitions bare to their biggest money-making components while reducing the hospital's workforce. Reddy announced that his proposal will honor the union's current bargaining agreement, but did equivocate on both subjects during his 25-minute presentation. On services he said, “We will keep pretty much all services intact” in addition to offering to keep nearly full employment, “We will keep all of them or substantially all of them.” Many officials in attendance knew next to nothing about Reddy and Prime Health Care, but were willing to listen.

“I know their reputation is almost like Sutter's” said Councilman Jim Prola who also gave an impassioned plea for rejecting the county's proposal, “At this point, we should listen to all and any offers we might get.”

Until Sutter makes a decision, the hospital situation in San Leandro is at a standstill. In the meantime, the county's plan is to fill a need in acute care by using San Leandro Hospital to fill that void. David Kears, the director of the Alameda County Health Care Agency, again noted “the greatest increase in demand is in acute care.” and believes the loss of the emergency room facility could be made up for within the system. Many opponents, though, point to already overflowing emergency rooms that cannot take such a hit. “We believe there is capacity. It's going to be tight. I'm not going to lie to you,” Kears said especially after Eden is rebuilt and expansion of St. Rose Hospital in Hayward.

Despite Article, Meeting goes on without Casualties

There were a few raised voices, a lot of finger pointing and and a couple attempts to induce tears, but NO ONE WAS KILLED. Repeat, there were no casualties at Monday night's Eden Township District hearing. Thank God! You might ask, why would there be any death? According the Karen Holzmeister's Daily Review article last weekend, the scene at the San Leandro Library might have been something out of the film Tombstone without, of course, Val Kilmer. Here's the lede from that article:

Tonight's showdown on the future of San Leandro Hospital could be as gritty and tense as the moments before the legendary gunfight at the OK Corral.

Politics and business concerns drive both proponents and opponents of closing San Leandro Hospital, and the same motives spurred the Oct. 26, 1881, shootout pitting the Earp brothers and Doc Holliday against the Clantons and their cowboy crowd.

I would say that's quite an unfortunate use of hyperbole, but again, nobody was hurt. Besides, you can't carry a loaded weapon in California.

Monday, June 8, 2009

Hayashi did not vote on Similar Hospital Bill

Last week, Assemblywoman Mary Hayashi trumpeted her efforts to save San Leandro Hospital with legislation that would allow for hospital district residents to have more control of the fate of their hospitals, but failed to support a similar bill last year.

California State Senator Denise Moreno Ducheny offered a bill in Sacramento last year that would have given the attorney general authority to withhold the sale of a non-profit hospital to a for-profit or another non-profit health care provider. The bill was a response to the controversy that arose over Prime Healthcare's purchase of Paradise Valley Hospital in her senate district.

The bill won approval in the Assembly Committee on Health, but without member Hayashi, who did not vote. Ironically, another of state politicians willing to join the "Save the Hospital" bandwagon is Assembly Speaker Alberto Torrico, who wrote an impassioned plea to the Alameda County Board of Supervisors last month urging them to acknowledge a link between Sutter's plans in Castro Valley and San Leandro Hospital. Sen. Ducheny's bill eventually languished in the Assembly until Torrico rendered it inactive last August.

Torrico and Hayashi are playing politics with a populist issue. Ducheny may have been doing the same last year when she wrote the piece of legislation in the name of transparency and returning power to her constituency, but talk of action in Sacramento later muddled by political hocus-pocus serves San Leandro and the state little when they truly need their elected officials to stand up to corporate America.

Prime Healthcare is not the Solution to Hospital Woes

The inclusion of Prime Healthcare into the San Leandro Hospital equation may have larger ramification on the sick and infirm than the loss of the hospital.

The for-profit health care provider located in Southern California and owned by an eccentric cardiologist named Dr. Prem Reddy seems intent on following a tried and true pattern of gobbling up small, cash-strapped hospitals and stripping down costs to make them profitable. In the past seven years, Prime has purchased 13 hospitals in the state.

In many ways, Prime is an example of national health care policy gone wild. Reddy told the Los Angeles Times two years ago the medical field is a commodity like any other that is sold to the highest bidder.

"Why is it in health care we expect to have the same?" Reddy said, "It's an entitlement mentality. Why aren't the same people asking why everybody shouldn't be eating the same foods, or have the same clothes or same homes? Those are as essential services as health care."

Prime typically enters a new market portraying itself as the savior willing to keep the existing hospital running. According to the Daily Review, part of Prime's proposal will be to honor the current collective bargaining agreement, but in an era of immense public distrust in corporate greed and honesty, critics say the hospital chain is known to slash up to 10 percent of staff as they vowed last year after purchasing hospitals in Garden Grove and San Dimas.

To make the large profits it seeks, Prime's modus operandi is to strip the new asset of services that fail to make substantial earnings such as chemotherapy and birthing centers. A main source of Prime's profitability is a reputation for nullifying contracts with insurance companies that, in some cases, reduces their profits by 30 percent in return for the insurance carrier to keep the flow of business steady. By voiding this arrangement, a health care provider like Prime can reap larger profits from the carrier and make up the difference by utilizing expanded emergency room hours. Prime has also shown a propensity for favoring patients with problems that may necessitate longer hospital stays which translate into even bigger earnings.

The story of Prime's acquisition of Paradise Valley Hospital last year in National City, near San Diego and 10-miles from the Mexican border, could be instructive to what may happen in San Leandro.

The 100-year-0ld hospital run as a charity by Adventist said the facility was hemorrhaging in debt and would need to be closed if a credible buyer did not reveal itself. Prime Healthcare was that Good Samaritan. What ensued was a roiling debate that pitted doctor against doctor, accusations of the faith-based owner of hiding behind religion and tugging at local fears of losing a hospital.

Not many of these aspects differ from what is occurring in San Leandro. The failure of the county to recognize a link between the building of a new hospital in Castro Valley to the possible closing of one in San Leandro has pitted doctors and nurses against each other while stoking jealousy between neighboring communities. In addition, the anxiety among older residents is high with the window of the next few years having fewer hospital services in the area while Kaiser Permanente constructs a new complex on Merced Street and the likely Sutter Medical Center in Castro Valley is built.

Prime's ability to swoop into a situation and dictate the terms of its perception could be on display tonight when the Eden Township District discloses Sutter's plan to turn over the hospital to Alameda County. The reported presence of officials from Prime, despite not listed on the agenda, raises the possibility the health care provider plans to portray itself as the cure of all that ails San Leandro. In reality, the sick and poor may have to pay more than ever before to line the pockets of a health care provider to retain their hospital. Sadly, that's the cost of doing business.

Tuesday, June 2, 2009

Budget Approved Despite Opposition

San Leandro is placing a big bet the economy shows signs of life in the next year by approving Monday night a $134 million city-wide budget. The adoption of the budget did not go on without a hitch, though, as two councilwomen threw the council for a loop by voting against the proposal after contemplating the possibility of tougher budget cuts in the next year.

Vice Mayor Joyce Starosciak elicited a few raised eyebrows from the normally congenial council when she read a three-page statement calling for more equitable cuts than the proposed budget contained. “I had been quietly supporting the consensus,” said Starosciak, “There were specific things that should have been done in this budget and I wanted to make my last statement about that and it was contrary to what they expected.”

In her statement, Starosciak urged for making the tough decisions now rather than later. “A balanced budget in this economy requires a firm stand and an effort to communicate our dire situation to our citizens. Next year, with no remaining reserve, it will be much, much worse and we must start communicating that message.”

Councilwoman Diana Souza, who also voted against the budget, agreed and said we are “setting ourselves up for a shock next year.”

As Starosciak read her statement, both Mayor Tony Santos and Councilman Jim Prola appeared shocked at the vice mayor's reversal of support. Prola called it an “attack” on the finance committee. “You know, we're a family and we choose to have our disagreements,” said Starosciak.

A breakdown of the budget indicates a presumption that President Barack Obama's Federal stimulus money will recharge the nation's economy by estimating increases in property and sales tax and the recent voter-approved utility and communication taxes.
  • Property taxes are estimated to rise 3 percent or $455,000.
  • Sales taxes are estimated to rise 4 percent or $800,000.
  • Utility tax is estimated to rise 2 percent or $200,000.
  • 911-communication tax will add $700,000 based on historical increases.
Finance Director Perry Carter said an increase in property taxes is based on the housing market stabilizing. The jury is still out on whether the home buyers are keen on taking advantage of record-low mortgage rates just yet, although, recent reports indicate higher end homes are rebounding in the Bay Area. Overall, this is not likely to be the last word on the budget within the next year or two.

The city could find itself in dire straits in a year if the Federal stimulus fails to do anything other than merely stabilize the economy. Without a reserve fund or the ability to trigger insurance funds, San Leandro could be faced with even larger cuts in services. Residents have already voiced strong opinion over closing libraries and keeping swimming pools from the budget ax. According to Starosciak, part of her concern stems from a belief the city council has failed to prepare the public for a grim future.

“I find communication about hard situations makes them less difficult,” said Starosciak, “You have a choice. You can take an easy way or you can take the hard way and communicate that.”

San Leandro's Budget is not Prepared for a Worsening Economy

This budget started out equitable and realistic. It has become political and unrealistic. The 15 percent reductions in all departments but public safety was agreed to be equitable and the Council was fully supportive. However, the community did not fully understand this and when their local services were announced to be cut, they challenged the Council to return their favorite service.

Instead of communicating our desperate situation, the Finance Committee looked for ways to save the services that had the loudest clamoring. The suspension of the Mulford Marina Branch and the South Branch libraries generated a great deal of fervor. Rightfully so, as many people enjoy all of our branch libraries. However, to keep them open, even at reduced hours, we are required to change our 15 percent strategy of reductions to 10 percent for libraries only and utilize almost a quarter of a million dollars of our insurance reserves. This has become a political decision and it is inequitable to all other departments.

It was only three years ago that the Manor Branch library suspended its service for over 18 months to be rebuilt. During that time all of District 4 had to utilize other locations for library services. Then, as now, the suspension of the branch library services was for a better future in San Leandro. We knew that, and survived without out a local library and felt fortunate to have long hours of operation at alternative locations in San Leandro. This year, we should have better communicated to our constituents that the suspension of the branch libraries means long hours of operations and maintenance of the alternative locations. In the future, under this proposed budget, we are destined for drastic reductions in library and other operations.

Our budget has become unrealistic because of the growing number of optimistic projections that have received our quiet consent.

The suspension of Farrelly Pool services brought out a literal flood of protests. Farrelly is well used by the neighboring families and it is right that they work to keep their pool open. Still, in 2005, the Washington Manor Pool was closed for over a year and a half, which meant a season and a half of swimming was completely suspended. And even beyond that, when it reopened, Washington manor was without its diving depth pool. To this day, all parents on the West of town must take their children across town for advanced swimming lessons and teenagers can no longer walk and must be driven across town to enjoy swimming at their level. District 4 has not complained because they knew in 2005 that eventually they would be given all of the services that have been enjoyed by the rest of the city in both shallow and diving depth pools. To do this day, we still don't have a diving depth pool, yet we knew it was for a better San Leandro in the future.

This is the same as we are asking our citizens today. The suspension of the Mulford/Marina Branch and South Branch services and the suspension of Farrelly Pool services are for the betterment of the city's future. By suspending those services, we are maintaining services for long hours in other parts of town. And with this inconvenience, our plan is to have enough revenue to re-open those facilities in future years. We should be communicating that message, not giving in to the clamoring.

Our budget has also become unrealistic because of the growing number of optimistic projections that have received our quiet consent. We are budgeting based upon a number of assumptions that have us collectively crossing our fingers and hoping for the best. Some of the assumptions are:
  • Six police officers will be fully funded by the Federal Recovery Act.
  • Business license fees, property taxes and sales tax revenue will increase in a year of continued recession.
  • The state will not carry out their plan to borrow $1.8 million to balance California's budget.
These are not conservative projections, but have been defined as optimistic projections. When these assumptions fail, it will mean an additional shortfall of millions of dollars and further diving into our emergency reserves. For all of these reasons, I am not in favor of using our $250,000 insurance reserves to save any program this year.

However, in the spirit of consensus, at our last meeting Councilmember Diana Souza, in an effort to balance community needs, suggested, and I supported, a finance committee consideration of using the insurance savings that supported the branch libraries to help fund the Farrelly Pool services.

Instead, the finance committee took a different tact, proposing to double the pool entrance fees and potentially reducing hours at all our other pools. This means we plan to serve the same number of swimmers at twice the cost at up to half the hours. This does not make sense to me.

A balanced budget in this economy requires a firm stand and an effort to communicate our dire situation to our citizens. Although it feels difficult, this budget has been relatively easy due to the use of $3 million in reserves. Next year, with no remaining reserve, it will be much, much worse, and we must start communicating that message. I plan to work with the community to do all we can to weather the coming 2010-11 budget storm.

Vice Mayor Joyce Starosciak has represented San Leandro's 4th District since 2004.

Monday, June 1, 2009

Santos takes Timeout to Speak, Defend Self

The Citizen
The mayor's office may be one of most accessible and welcoming city offices anywhere. Bright light enters the room overlooking East 14th Street and the furnishings are classy yet understated. The man sitting before his computer leads the city with a belief in government as a two-way road of polite discourse, but seemingly cannot help backing down from a challenger.

In an hour-long interview last Wednesday afternoon, Mayor Tony Santos acknowledged the city's precarious money problems, jabbed critics who say their leaders have failed to take ownership of the San Leandro Hospital issue and maintained the city has no bargaining power in the equation. Santos also asserted the possibility of another round of hospital musical chairs occurring by saying Kaiser Permanente has shown interest in moving their acute care facility from Ashland to San Leandro Hospital.

He says the city has used $16 million of a once-plentiful reserve fund during the past three years, which after the upcoming fiscal year could be gone. He lamented the grabby hands of the state government "borrowing" funds from the city and pointedly criticized populist ploys such as Gov. Arnold Schwarzenegger's cutting of the vehicle license fee early in his term.

"If that fee had still been in place during the last five or six years the state would probably not have been as seriously impacted as it now is," Santos said, "As a result the state took approximately $4.1 million from the city."

Well-attended recent council meetings and open forums featuring the hospital situation have recorded a palpable sense among people that their local government is not leading them. It was the only part of the interview where Santos became animated and protested that he has been following the issue for over two years. "I have not been behind the curve, but in front of the curve," he said, "My frustration is that people don't understand the city and the mayor has made every effort to keep this hospital going."

The mayor indicated that Kaiser has made a "cursory inquiry" into moving acute care services out of Ashland to the hospital. He also indicated there were rumors of an additional interested, unknown party. The addition of more options available to the Eden Township board might further gum up the wheels of government rather than help according to Santos as each new proposal takes up precious time to examine. He also predicts the hospital will ultimately lose its emergency room services but will not go unused. "I understand the need is there throughout the county and that will happen. "

Oftentimes, Santos goes out of his way to highlight the need for "respect" among those who might disagree with his policies, but don't peg him as a pushover. Nearly 20 years in local government has toughened his skin quite a bit even if there might be a bit of hypocrisy in his statements. "I believe it becomes counter-productive to have this discussion go back-and-forth. They're blaming us, we're blaming them," he said, "I'm not for that. I wouldn't want them to come to us and tell us to do something." That's not to say, he won't fight back.

For example, he mocked former School Board Trustee Stephen Cassidy, who has been a critic of the mayor's handling of the city's purse strings of late, saying Cassidy was telling him how to balance the budget when he could not achieve the same command of the school board's finances.

When it comes to an issue like the possible loss of San Leandro Hospital and a horrendous national economy, you cannot blame Santos for feeling helpless when surrounded by uncontrollable forces, but he does not seem worried. "What am I going to do?" he said, "People can blame me all they want, but my only defense is that I did my best to keep this hospital open. I couldn't stop it. "

Q&A with Mayor Tony Santos

Here's an excerpt from San Leandro Mayor Tony Santos' interview May 26:

Q: On the budget, it seems the reserves are dwindling. What's the outlook?

A: Budgets for local government have always been a test any way. Cities just don't have the wherewithal to raise revenues as can the state or the Federal government....If there is one thing [Gov. Arnold Schwarzenegger] did that was absolutely ridiculous, in my opinion, was cutting the vehicle license fee. If that fee had still been in place during the last five or six years the state would probably not have been as seriously impacted as it now is. As a result the state took approximately $4.1 million from the city. Our reserves are pretty well gone. In the past three years, we've used approximately $16 million to balance our budget and to keep services at a fairly decent level. If the economy does not pick up, we're going to be further constrained.

Q: Most economists say the economy won't pick up until, maybe, the end of 2010. How worried are you the budget will become even more problematic in the future?
A: I will say that we have an excellent interim finance director in Perry Carter and a knowledgeable city manager. By the way, the staff has been a lot more stronger on budget cuts than has the city council. The staff has recommended cuts that we have restored.

Q: Is it surprising that the city council would buckle under over a budget staff that is faceless and not accountable to voters?

A: The staff doesn't respond to the political will of the people. We do. We have to consider our constituents and their feelings.

Q: Like Farrelly Pool?
A: Yes, we just restored partial operations of the pool. We were going to cut it. Well, people came and said they wanted to restore it. So, we're going to do that, but, in order to do that we're going to have to almost double the fees for swimming in town. Other pools such as the Boy's and Girl's Club and the Aquatics Center will need to contribute to keep Farrelly open. And we'll see too, because the public out there that wants to keep Farelly open said they will go and hold fundraisers keep it open. We'll see if that occurs.

Q: As a matter of precedent, how do you feel about raising fees on city services in the short term that will likely never be reduced.
A: Just yesterday at the Shoreline Marina committee, we were talking about charging a fee for berthing. You know, this is the problem when you have a financial situation. We're in a crisis, not only nationally, but locally. Last Sunday, I noticed there were a lot of cars parked at Walmart. So obviously, they're looking for discounts and for the cheapest place to spend money, but what they don't understand, in my view, what you are doing is subsidizing China, Vietnam, the Philippines or wherever because the goods are not manufactured in the United States, but offshore.

Q: Let's talk about the hospital. Some people are saying there's no leadership from the city about saving San Leandro Hospital.
A: I've been involved in the issues before it was even before the public. I was elected mayor in 2006 and February of 2007, the head of the physician's association sat in the same chair you're sitting and asked, “Can the city take over operation of the hospital? Would the city be interested in a hospital tax and how can the city get involved?” Over the period of over two years I've had all of these discussions with two county supervisors, chiefs of staff, hospital district presidents, board members.

I've been telling these people for two years they need to work on saving this hospital. I have not been behind the curve, but in front of the curve, but my frustration is that people don't understand the city and the mayor has made every effort to keep this hospital going. I'm as concerned as anybody else that 20,000-30,000 people use the ER yearly. I've asked Sutter and the Township District to do what is necessary to keep the ER open. This has happened before the public has organized.

Here's what is missing. Neither the city or the county has jurisdiction over the hospital. It rest with the Eden Township District Board of Directors and I've been involved with them for the past year. I have told them repeatedly, look, you folks need to come up with some alternative plan to keep this facility operating. It's up to you. They've asked us to take it over. In my view, we don't have the means to do that. They're talking about startup costs of $35-$40 million. You've got this deficit, where are we going get $40 million? And we don't have the expertise or the license to operate a hospital.

Q: But, this loss of control wasn't always like that in the past? Right?
A: Well, like everything there is a history. Sutter reached an agreement with the hospital district and there is no question Sutter stacked the board for awhile there. Somehow, Sutter put six non-elected members on the board and created an 11-member board. In that arrangement, Sutter oblviously controlled any action for operating both hospitals...Then Sutter decides to put all of their eggs in the Castro Valley basket and build a new hospital there. With that Sutter now looks at extricating itself from San Leandro because the operation is a drain on their finances to $15 million a year and they didn't want to pay for that subsidy even though a lot of people in the public want them to do it. There's nothing that forcing them to do that.

Q: Do you agree with opponents charging Sutter is red-lining affluent patients from low-income, possibly non-paying, patients?

A: In all honesty, I'm not here to speak from anybody's perspective. Somebody else will have to look into that. The thing I want to do is speak from a realistic position. I will add that only 33 percent of the ER patients come from San Leandro.

Q: What do you think may happen with this hospital?
A: The options are [Sutter] can purchase the building or the property or extend the lease. Sutter has an option to do those things. I've heard on the grapevine, not from Sutter, that they are not going to do that. They want out of there.

Q: But, what are the odds of keeping this hospital open?
A: I understand from the district that they may have two possible vendor who may be interested in operating the facility.

Q: Do you know the names of those two vendors?
A: I heard that one is Kaiser and they don't know who the second one is .

Q: Do you think the addition of Kaiser in this equation is plausible?
A: I've had discussions with Kaiser and they suggest that they need to move their acute care unit out of Ashland. So they have made a cursory inquiry to whether it is possible to move that over to San Leandro. What it means to me is that the district has many options.

Q: Alameda County Supervisor Scott Haggerty said the city should put forth a city-only ballot measure on the hospital during a recent board meeting. Do you think he was just passing the buck to you and the city council? A few of them were a bit harsh.
A: I heard they were very harsh on the city, but myself, I'm not into getting in a fight with the Board of Supervisors. I'm here to be the mayor of San Leandro. I just think there is so much misinformation that is out there. Nobody, not the board, maybe, not even us, really have come to grips with what the true issues are. Look, go back to what I just said, neither the board nor the city have jurisdiction over the hospital which happens to be within the borders of San Leandro. We just don't. Any possible options should come from the [Eden Township District] not from us.

Q: This issue is not within your jurisdiction, therefore, politically nothing could happen to you or the council if they rattle the cages. Little could happen politically if it fails and the possibilities are boundless if there's success. Why do councilmen like Jim Prola and Michael Gregory only speak on the record as citizens and not as elected officials?
A: Because, number one, we have a charter and the political spokesperson for the city is the mayor. So, the mayor has the right to speak on the behalf of the city. Those two individuals don't speak for the city council, Technically, the council does not have a position.

Q: But, the council passed a non-binding resolution in favor of keeping the hospital open, right?
A: And what did it say? It said the same thing, I think, I'm telling you. Save the ER, Save the hospital. Personally I don't think it's a good idea to go to another body and tell them what to do and how to do it. I believe it becomes counter-productive to have this discussion go back-and-forth. They're blaming us, we're blaming them. I'm not for that. I wouldn't want them to come to us and tell us to do something. I wasn't there.

I don't have anything to base this on, just an opinion. What's going to happen is someone is going to come into San Leandro and operate it as a rehab unit. I understand the need is there throughout the county and that will happen. I think the county board of supervisors are in a bind. I cannot see them rejecting Sutter's EIR to build a new hospital. I think if they do, they are placing that hospital in jeopardy. I think right now, Sutter holds the cards.

Q: If the hospital closes, though, the public perception is going to be you and others dropped the ball. How do you think voters are going to react to that premise?
A: I represent 85,880 people. I represent the city of San Leandro. I have to do what is right for the city. I can't force the hospital board to take the action I would like to see them take. What am I going to do? People can blame me all they want, but my only defense is that I did my best to keep this hospital open. I couldn't stop it.

Q: You mentioned that you once worked for AIG. When was that?
A: Back in 1985. I only worked for them two years.

Q: So, we shouldn't expect to hear the mayor being indicted or anything?
A: [laughing] no.