Tuesday, September 29, 2009

Crossing Guard Solutions: Bubble Wrap Kids and Run Fast!

San Leandro City Councilmembers come in two flavors: some have a desire to sit and listen and to engage speakers with profuse thanks and softball questions. Others just talk like 21st Century versions of William Jennings Bryan. San Leandro Councilman Bill Stephens is the latter.

It is common for the council's lone conservative to launch a measured, somewhat folksy soliloquy on the city's affairs. Monday night's finance meeting once again put the city's once-robust budget and currently mildly troublesome situation (as opposed to other Bay Area cities) in the spotlight.

Residents were not happy earlier this spring when word traveled one of the their popular public swimming pools would close for the summer. Within the same vein, the safety of children crossing the city's street before and after school has only heightened concerns to the extent the ubiquitous, but ominous phrase "quality of life issues" has again been loudly raised by families in San Leandro.

To judge the council and Mayor Tony Santos' comments Monday night, the solution is for everyone to do their part. Pulling one up by your bootstraps in a conservative canard not usually linked to the clearly liberal council, Stephens excluded. The consensus was so thorough that some heard the faint sound of Whitney Houston singing her 1986 hit "The Greatest Love of All", the part when she says:
I believe the children are our are future
Teach them well and let them lead the way
Show them all the beauty they possess inside
Give them a sense of pride to make it easier
Aside from wrapping your child in bubble wrap to blunt the force of a speeding car or simply telling them to run, REALLY fast, blaming those who are unable to help is just about as plausible a solution as the others. The question becomes how did this mayor and council become so blind to such simple solutions and pitfalls? How do you put yourself in the position to be susceptible to charges of being lax on saving a local hospital, nearly closing a popular recreation spot for chintzy reasons and now allowing critics to portray you as putting the city's school children in harms way?

You may be surprised that Stephens' response also calls for you to do more and used the word "prioritize" on three occasion without being clear on whether the safety of children is paramount over pruning the city's trees and filling in potholes. The public seems to be saying we can put off trimming the Bougainvillea's on East 14th before cutting crossing guards. Here is Stephens' entire speech Monday night:
It's been a long evening and some of you have been busy with your children since this morning. It's not easy being a parent. Most of us know and we're concerned about your children. We're concerned about all the children in the community. We're concerned about all the community members and their safety. That being said, we recognize that we're in for very difficult fiscal times ahead of us. We have to take out about, I estimate, $6 million—8 percent of our budget—and we need to do that this year. We cannot continue to deficit spend and it's going to require us to prioritize and I'm not saying anything any of you have not said.

The major costs to the city are safety—police and fire. That has always been the priority of the city. We're going to have to look at their compensation because that's where the biggest money is. Once we get that solved that might help us sort out some of the other problems. We have various employee groups that are working with us and we're going to have to continue to work together.

We have infrastructure needs—some we cannot ignore. We can't allow our street lights to go out. We can't allow our signage to deteriorate. We have to try and maintain our roads, somewhat, and we haven't been funding that to the degree we should. We have to look at the sidewalks. We have to maintain cleaning up after the trees lest they start jamming up our sewer lines. So, we have a number of things that are pressed against us and are hard for us to avoid.

We have wonderful libraries we do not want to have closed or days and hours reduced. We have wonderful park and recreation programs. We're going to have to curtail those. We have our community-based organizations that help support the indigent, the poor and the needy. We're going to have to look at curtailing that maybe by a half. We're going to have to look at everything. We're all going to have to work together. We're going to have to volunteer more. There are some of you who are volunteering to max right now and putting forth a great deal of effort and there are some who are doing virtually nothing. We see that everyday. I appreciate your comments. This has not been an easy year for any of us, but we're listening and we're trying to make sure we have the best that we can for our community and prioritize along with what the community desires.
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The Citizen
Eden Township Healthcare District Director Dr. Walter Kran offered his resignation Monday evening.

According to a District spokesperson, Kran's resignation was effective at noon, Sept. 23.

The board member's abrupt resignation further complicates an already topsy-turvy narrative involving Sutter Health and the Alameda County Medical Center's plan to close San Leandro Hospital and convert it to a rehabilitation

Kran, who retired from medicine in 1994, had struck some as disinterested during public appearances in the past month leading up to a string of strange behavior reported by The Citizen last week.

Fellow Director Carole Rogers revealed Kran had instructed another board member to meet him at his home and follow him to a "secret location" where a mediation conference between Sutter and the District was scheduled to take place.

Last Thursday, both Rogers and Director Dr. Vin Sawhney both told a group gathering at Eden Medical Center that Kran indicated a willingness to attend the district board meeting which was eventually cancelled due to a lack of a quorum. When ask by Rogers if Kran would attend the meeting, he said he would ask the CEO Dev Mahadevan.

In August, Kran oddly abstained from voting on the board's action to make a decision on Sutter's desire to initiate its option to purchase the hospital. The board voted 3-1 against the plan, as Kran said he did not have enough information to vote.

What this means in the short term is unclear. As word of the resignation leaked out at a finance meeting attended Monday night by San Leandro Mayor Tony Santos and the city council, prevailing wisdom sensed a battle could erupt over the important seat on the board between forces connected to Sutter and labor organizers for both the doctors and nurses.

According the Eden Township by-laws (Article III, Section 4) Any vacancy upon the Board of Directors shall be filled by appointment by the remaining members of the Board of Directors, for such term and under such conditions as may be specified by law. With the chance of a board evenly split at two any appointment could raise the ire of either side and further draw out the hospital's murky future.

(PHOTO CAPTION: Dr. Walter Kran.)

This article has been updated since its initial posting.

Check back for more on this story along with coverage of San Leandro's budget forecast and the controversy over funding for school crossing guards.

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Monday, September 28, 2009

Effort to Recall Eden Board Member is Brewing

The Citizen
If you can't get someone to do what you want, just find another who will. At least that's the sentiment expressed by a few San Leandro residents who figure if they cannot get their elected leaders in the health care district to hear their demands to keep their hospital functioning, then they will just ask voters to recall them.

Rumors of recalling Eden Township Healthcare District Chair Dr. Rajendra Ratnesar have been circulating for weeks and came to light last week as fellow Director Carole Rogers and state Sen. Ellen Corbett discussed its pros and cons to a gathering of doctors and nurses in Castro Valley.

Members of various groups representing doctors and nurses at San Leandro Hospital have long charged Ratnesar with a conflict of interest for his role in the 2004 agreement between Sutter and the District that effectively offered up San Leandro Hospital's demise in return for a rebuilt Eden Medical Center in Castro Valley. Ratnesar's presence on the contentious 2007 Memorandum of Understanding as an employee of Sutter Health has also been a point of suspicion for many opponents of the possible closing of the hospital.

While proponents of a recall effort against Ratnesar are convinced of his alleged indiscretion, what it would accomplish in terms of saving San Leandro Hospital in the near term is unclear.

"It would be a shot across the bow of Sutter that would speak volumes," said San Leandro vascular surgeon Dr. Robert Gingery.

According to the California Secretary of State's office, the recall effort to unseat Ratnesar would need to accumulate the signatures of over 10,000 registered voters in the health care district. Proponents says the amount of people and the work involved in a short time frame is possible. "You would get enough signatures that you wouldn't know what to do with," joked Gingery.

Corbett, while agreeing with the benefits of a recall, urged caution in using short-term resources to keep the hospital open for a recall election that would likely take place next spring or during the June primary season and questioned if the remaining board members would have the authority to appoint a successor in lieu of running another candidate for the board concurrent with the recall.

District health care officers were recalled in Marin in the 1990s dealing with similar conflict of interests allegations that involved Sutter's earlier involvement with Marin General Hospital. While two board member were successfully recalled, the downside to any movement to remove an officer is the likelihood forces in the opposition of the recall may be able to offer up their own replacement candidate at great cost. No names have been attached to any election of a new director should Ratnesar be successfully removed.

Rogers said the threat of recalling Ratnesar could possibly embarrass him into resigning before the full force of a recall gains traction. "It don't think he would want to hear his name attached to any recall or having his name in the papers," Rogers said.

Brian Tseng of the Physicians Organizing Committee also believes in the power of the community speaking out against the board with the machinations of a recall hovering over the board. "When you have this huge community saying you've got this massive conflict of interest, possible civil and criminal violations of the law--stealing a hospital--that's a conflict of interest when you have a board member in the pay of a corporation that is going to benefit with the closing of another hospital," he said.

Time is of the essence for any recall. Opponents of Ratnesar would have 160 days to collect the requisite number of signatures leading to a vote no longer than 125 days afterwards. Such a vote would likely not occur until June when it is unclear what the political landscape of the city, county and San Leandro Hospital will look like.

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Thursday, September 24, 2009

District Director Asks CEO Will I Attend Meeting?

The Citizen
CASTRO VALLEY, Calif. - Welcome to the Great Hospital Caper.

Two Eden Township Healthcare District members continued to question the bizarre set of events Wednesday which led to the cancellation of a pair of scheduled mediation and board meetings this week, while shedding more light on an emerging tale of comic intrigue Director Carole Rogers mocked as "The Sutter Follies."

Directors Dr. Vin Sawhney and Rogers along with over 75 participants arrived at Eden Medical Center for what they thought was an opportunity to voice concern over the possible closure of San Leandro Hospital by Sutter Health, which leases the facility from the District. Instead, they learned the scheduled meeting was cancelled by Board Chair Dr. Rajendra Ratnesar due to a lack of a quorum. Sawhney and Rogers questioned the legality of one member cancelling a meeting and at such haste. Sawhney told the group he learned of the cancellation by email at 9:30 the night before and did not understand how Ratnesar assumed at least three of the five members would not attend without asking.

"I'm not sure how he concluded there was not enough for a quorum if I did not receive a call and [Carole] did not receive a call."

Rogers said she spoke to another board member Dr. Walter Kran early Wednesday who said he was "in town and available" for the meeting. Eden Township Healthcare District CEO Dev Mahadevan yesterday had given no reason to The Citizen for the absence of Kran. When Rogers inquired whether Kran planned on attending the regularly scheduled board meeting he said, "let me ask Dev."

It was reported yesterday that Kran told Sawhney, who was appointed to take Rogers place on the mediation committee, to meet him at his home and follow him to the "secret location" for mediation concerning the District's dispute over Sutter's option to purchase San Leandro Hospital and subsequent closing as a full-service facility.

Rogers said she believes Ratnesar's actions are the result of fears the District could lose both San Leandro Hospital and the future rebuilt Eden Medical Center by her actions. "Dr. Ratnesar believes that if we strike down the Memorandum of Understanding (MOU) that will cancel out the rebuild of Eden Hospital. I don't think Sutter is going to back down from Eden Hospital," Rogers said. "They already have too much invested, but that is the danger of striking down the MOU." She also added the concern was unfounded since the preceding 2004 agreement held Sutter accountable to rebuild Eden.

The strange set of occurrences in the past week clearly irked many who attended the unofficial meeting in Castro Valley with one making a connection between the alleged actions and that of a television series. "Working with Sutter and some elements of this health care district is sort of like Patton Place," said Mia Ousley of the San Leandro Community Action Network. "I feel like I'm in the television show Lost where everything is so mysterious and bizarre. This is the stuff that movies are made of. It's not the way real people are supposed to act in real life."

State Sen. Ellen Corbett, who earlier in the meeting announced the attorney general's office is looking into allegations faulting Sutter for improper business practices of which she requested last month, questioned possible improprieties by District administrators in regards to recent attempts to circumvent the board through mediation and closed session meetings.

"I'm very suspicious that the executive director has not pushed the auditor to go forward and is pushing harder for mediation," said Corbett. During the same meeting last month when the District blocked Sutter purchase option for San Leandro Hospital, they also approved a motion by Sawhney to hire an outside auditor to peruse the hospital's books. No action has yet been taken.

Corbett also expressed concern with an agenda item which attempted to pursue action in closed session of the infamous missing 2007 minutes the board decided last month to not vote upon. "It is very inappropriate to discuss minutes in closed session," Corbett said.

Labor Representative Mike Brannan of the California Nurses Association took exception over what he believes is corrupt behavior by some members of the District and Sutter.

"When you think about removing people who were appointed through board action, closing meetings to public access, lying to cancel a meeting; it is outrageous behavior. Every time I think they have done something that 'Wow, they can't top this one,' then they always find something else. I don't know that we can say there wasn't a mediation meeting or there won't be one that nobody knows about. Who knows what they will try to get away with?"

Brannan says Sutter is apprehensive to confront charges made by Rogers and others that the MOU they signed with the District may be legally problematic. "They want this mediation to go through without the conflict of interest issue. It is obvious that is what they are afraid of," said Brannan. "When we think about it, Ratnesar, who is one of the people alleged to have the conflict of interest is the person who removed Carole Rogers from the mediation committee. It's like Nixon trying to fire the special prosecutor. I think they are getting so deep into this thing that they are willing to go for broke and willing to expose themselves legally."

While a few doctors and nurses were lamenting the fact certain board members were not in attendance to lambaste or calculating a plan to recall one of the directors, others expressed concern over the cost to the community if the hospital ceases operation and troubled by the lack of funding available for an important public asset.

Doug Jones, a community activist and former Eden Medical Center employee says over 1,300 patients with critical care illnesses are treated every year at San Leandro Hospital's emergency room. "We know San Leandro Hospital's closure would hurt any future medical care in Castro Valley. It's unavoidable. The five to twenty minutes they would spend in transport from near San Leandro Hospital to whatever hospital would kill a lot of patients, no doubt about it."

One of the main sticking points attached to any possible working arrangement without Sutter's involvement has been a lack of subsidies most agree will be needed. Alameda County Health Services estimate permanent yearly funding of between $3-5 million is needed. To this date, none of the plans put forth for saving the hospital have come attached with a price tag. Brian Tseng of the Physicians Organizing Committee, though, believes even cash-strapped Sacramento can come through with the money.

"If the state can give $1.5 billion away in subsidies to the largest corporations in California for this state budget alone-well, they've got the money--$5-10 million to keep San Leandro Hospital open is really just a red herring."

Sawhney concluded the nearly 90 minute meeting by addressing rumors among nurses and hospital employees of administrators encouraging them to begin looking for new jobs in advance of the hospital's possible closure.

"I think they want you to be discouraged. They want you believing the hospital will close and you don't have any options," Sawhney said. "I think it is part of a strategy so that you do not become active, you do not fight and you do not make any effort to keep it. We have so far proven that we can do it by coming together."

I believe that Sutter does listen to some of what's going on. We don't know what they may or may not do, but I think you should not be discouraged just because you get told by the administration that the hospital is going to close. We should keep fighting until the last day, even if we go down, we must fight."

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AG Office Opens Investigation into Sutter's Business Practices

The Citizen
State Sen. Ellen Corbett told an impromptu gathering of the Eden Township Healthcare District Wednesday the state attorney general's office has sent a letter of acknowledgment to claims Sutter Health has manipulated various Northern California hospitals for their benefit at the expense of the communities they serve.

"This letter is confirming that they are responding to the letter legislators sent them and definitely looking into the issue," said Corbett.

She noted the receipt of the letter from the chief deputy attorney general was a positive for efforts to save San Leandro Hospital. "You don't always receive a letter of acknowledgment," Corbett said, "They have started an investigation."

Corbett, along with Marin Assemblyman Jared Huffman and 11 other legislators, sent a letter Aug. 28 to the Attorney General's office asking for an investigation into allegations the Sacramento-based hospital chain has displayed a pattern of misrepresentation toward communities around the state. When announcing her intention to draft the letter, Corbett told San Leandro residents last month, "We are trying to show to the attorney general that there is this pattern of abuse," and adding, "This is just not San Leandro. This is an ongoing historic pattern."

The letter detailed alleged wrong-doings by Sutter at hospitals in San Francisco, Santa Rosa, Marin and San Leandro.
The Citizen FILE on Ellen Corbett, Sutter, attorney general
>>>>The Letter to Attorney General, Aug. 28, 2009.
>>>>Corbett to ask AG Jerry Brown to Investigate Sutter Practices, Aug. 27, 2009.

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Wednesday, September 23, 2009

District Chair Cancels Meeting; Lack of Quorum Cited

The Citizen
Eden Township Healthcare District CEO Dev Mahadevan told The Citizen today's scheduled meeting of the board was cancelled due to a lack of a quorum.

Mahadevan said District Chair Rajendra Ratnesar would not attend due to “personal reasons” along with Dr. Walter Kran. No reasons was given for Kran's absence. In addition, Dr. Harry Dvorsky notified the board last week he would be in Los Angeles and could not attend, according to Mahadevan.

The District by-laws state the board needs a majority of the five members to be present for any action to be approved. Despite the cancellation, Directors Carole Rogers and Dr. Vin Sawhney plan to conduct an informal meeting at the same location at Eden Medical Center at 5:30 p.m. today.

The meeting's agenda, since pulled down, featured a laundry list of actions to be taken by the board—none Sutter and San Leandro Hospital related—although, an executive session was listed referring to the on-going dispute resolution over Sutter's desire to purchase the hospital. Mahadevan refuted the assertion a quorum could not be called without an actually meeting occurring by saying it was done as a “courtesy to people who might have planned to attend." Mahadevan said he had the District remove the agenda from its website last night when notified of its cancellation.

The next scheduled meeting of the District is slated for the end of October. Mahadevan indicated that meeting may be pushed up a week along with the possibility of an additional special session being called.

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Rogers: How I was Railroaded by the District

The Citizen
Carole Rogers says she was removed from the group attempting to mediate a solution to the board's conflict with Sutter Health over the fate of San Leandro Hospital because of a private document brought to the attention of the board's chair.

Rogers, in an interview this morning, told The Citizen the mediation meeting scheduled for Tuesday was held in a "secret location." There has been no confirmation whether the meeting was actually cancelled, although sources say another Director Dr. Vin Sawhney planned to protest the meeting because of Rogers' removal last week by Board Chair Dr. Rajendra Ratnesar. Eden Township Healthcare District CEO Dev Mahadevan said he was notified Monday night of the meeting's cancellation to be held in Oakland--the same location featured in the video posted on The Citizen.

According to Rogers, Dr. Walter Kran--another appointed director to the mediation team--told Sawhney the meeting was moved from an office building in downtown Oakland to an unspecified location. Kran told Sawhney to meet him at his home at 8:30 a.m.--thirty minutes before the planned hearing--and to follow him.

Rogers' appointment and removal began after the infamous "non-meeting" Sept. 3 where the public was not allowed to make public comments before the District board entered into a closed meeting. That night, Rogers told those remaining in the lobby of Eden Medical Center she had accepted a role in the mediation of Sutter's wish to purchase San Leandro Hospital. Things went sour afterwards, according to Rogers.

All members of the mediation team were offered the opportunity to submit documents they believed would help the mediator make a decision. A day after her appointment, Rogers submitted documentation renewing previous concerns over the validity of the memorandum of understanding (MOU) signed by Sutter and the District in 2007. She had claimed during a board meeting the month before her belief the document had no legal standing since two of the board members--Ratnesar and former Director Dr. Francisco Rico were employees of Sutter. The MOU is regarded as the main document allowing Sutter to close San Leandro Hospital and reformulate it as a rehabilitation facility under the auspices of the Alameda County Medical Center.

Rogers received an email from Mahadevan that night saying Ratnesar had removed her from the mediation committee because of the document he reportedly called "inappropriate." Rogers protested and consulted with her lawyer because "we don't trust advice we're getting from the our legal counsel." It is unclear how Ratnesar was alerted to any information given by Rogers or any member to the mediator. "So much for a fair and impartial mediator," Rogers said.

On Monday, Rogers sent a demand to Ratnesar to be reinstated on the committee, of which Sawhney also supported. According to Rogers, Sawhney planned to protest yesterday's mediation hearing. In response to a question whether Tuesday's hearing was rescheduled because of Sawhney's protest, Mahadevan said today, "you could put it that way."

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Opinion: Health Care Director Attempts to Save Hospital; How you can help

Some things—like mushrooms growing—only happen in the dark. Add to the list Sutter Health’s efforts to steal San Leandro Hospital from an elected public board, and shut it down.

Tuesday was supposed to be a big day for Sutter Health. It had a mediation scheduled with the Eden District Township Health Board. Sutter hoped the result of that mediation would be that it be awarded San Leandro Hospital for the grand sum of $1.

Fortunately a little bit of sunshine shone on the situation and San Leandro Hospital lives to heal another day. In a comedy of errors, Sutter first tried to stack the votes in this committee, then tried to move this public meeting to a secret location, which is probably illegal. Finally, unable to get a quorum, Sutter seems to have cancelled the meeting and San Leandro Hospital was saved—for today.

The heroine in this story remains Carole Rogers, RN, who is a nurse at Highland Hospital as well as a board member of the Eden Board, which owns San Leandro Hospital (and leases it to Sutter).

Rogers first sounded the alarm about Sutter’s efforts to take over San Leandro Hospital. As a result of her efforts, the entire Eden board recently voted down Sutter’s claim to ownership of the hospital. To add emphasis, she also filed a motion that the whole memorandum of understanding (MOU) that is the basis of Sutter’s claim is illegal, because some of the board members were employees of Sutter’s, and thus had a conflict of interest when they agreed to the MOU.

Sutter responded in two ways to Rogers’ efforts. First it announced an intention to move ahead with purchasing the facility—despite the board’s rejection of their bid. Then it attempted to remove Rogers from the committee that will mediate this dispute. She showed up anyway, and ultimately the meeting got cancelled.

Sutter is relentless, and committed to closing down San Leandro Hospital. East Bay patients are still in danger of losing a major portion of their public healthcare safety net. We can not give up.

The public is outraged and frequently asks nurses how they can help. Here are two things you can do:

1. Call Wright Lassiter, CEO, Alameda County Medical Center
Sutter Health is basically at war with the community of San Leandro, and their hospital. The public is outraged that Sutter continues try and shut down San Leandro as a fully functioning 122-bed acute-care facility with a 24-hour emergency department.

Wright Lassiter is working with Sutter to close down the hospital, so that Alameda County can turn it into a 50-bed rehab facility. While that’s important, it does not justify closing a facility that serves 27,000 ER patients a year.

Call Wright Lassiter at 510-437-4800 and tell to let San Leandro Hospital—and the patients it serves—live!

2. Attend the next district board meeting.
Hundreds of angry San Leandro residents have made the difference in keeping our facility open, and we need you again!

Liz Jacobs is a registered nurse and commuincations specialist for the California Nurses Association.

Tuesday, September 22, 2009

VIDEO: Health District Director crashes Mediation Meeting

Eden Township Board Director Carole Rogers, who was recently replaced on the mediation committee hoping to settle Sutter Health's claim to purchase San Leandro Hospital, attended the meeting anyway Tuesday morning only to learn it was cancelled.

With legal counsel in tow, Rogers was turned away by an employee for the mediation firm and eventually told to leave. Evoking shades of Michael Moore, the video shows attorney Jim Eggleston charging the mediator with being complicit with Sutter's alleged power play to gain control of San Leandro Hospital. The video, shot by representatives from the California Nurses Association, assert Sutter had hoped to settle the dispute by paying $1 for the facility.

A full story to follow shortly.

Mediation Merry-Go-Round

The Citizen
As Sutter Health and the Eden Township Healthcare District meet in mediation starting today, one participant is no longer on the team.

Eden Township Director Carole Rogers was removed as one of the two members from the mediation committee. She has been replaced by another director Dr. Vin Sawhney.

According to Sawhney and other sources, Rogers was stripped of her duties by the District Chair Dr. Rajendra Ratnesar because of "inappropriate" documents presented by her to the mediator.

It is unclear how Ratnesar was privy to such documents or what they contained. Rogers was unable to be contacted for this story. Concern on the side of those who seek to keep San Leandro Hospital open was lessened by the appointment of Sawhney. The move, in those circles, is viewed as exchanging one director who is pro-San Leandro Hospital with another.

Generally, correspondences to the mediator are sent independently by each side of the conflict. Sawhney said each participant was invited to supply the mediator with information they felt pertinent to the case. It is also unclear whether Ratnesar, who had been accused by the nurses union last June as being less than impartial, had the authority to make the switch.

Dr. Walter Kran, another District director is the other member of the mediation committee attempting to resolve Sutter's claim on the hospital.

The news of Rogers' removal comes at a possibly pivotal week for the fate of San Leandro Hospital. In addition, to today's mediation meeting, the District will hold its monthly meeting tomorrow in Castro Valley where Sawhney believes the subject of their dispute over Sutter's decision to pursue its purchase option for the hospital and the subsequent mediation will be discussed.

More ominously, there are rumors swirling that Sutter may soon announce their intention to pull the plug on San Leandro Hospital as early as this week. The Citizen previously reported comments made by San Leandro Mayor Tony Santos in city council chambers that Sutter would keep the hospital open until the end of January 2010 because of pandemic fears, but those prospects may have since changed.

According to their agreement with the District, any announcement by Sutter to close the hospital would call for its to cease its current configuration 90 days later. Such an announcement would have the facility closed just after Christmas.

In the past, Sutter has made astonishing announcements twice on the day proceeding a move against them by the District or county. Sutter followed a decision by the District Aug. 18 to block the proposed sale of the hospital by shocking most everyone the next day by announcing the signing of a lease with the Alameda County Medical Center to run the facility as a rehabilitation center.

In late July, Sutter quashed efforts by Alameda County Supervisor Alice Lai-Bitker to obtain assurances the emergency room at San Leandro could be subsidized in the short term by the District and city of San Leandro when they revealed July 28 they were seeking the purchase of the facility.

A major sticking point may be the fact the mediation Sutter and the District agreed upon Sept. 3 is non-binding, meaning whatever is decided or not has no legal teeth for either side to abide with. Some believe by going the mediation route Sutter can effectively run out the clock on the process and return to its stated goal of turning the hospital over to ACMC and transfer rehab services from Fairmont Hospital.

"I'm sure this is something they will try, but I don't this is a done deal yet," said Sawhney. "I still think there are things that can be done." Some of the possible remedies according to Sawhney are following through with mediation, possibly entering into arbitration and, if needed, pursuing other legal avenues.

"I wouldn't be surprised if they say this is our decision and this is what we are going to do," said Sawhney, "I don't believe this is something they can legally do."

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Stark says Blue Dogs lap up Insurance Money; Meet Mike Ross

Arkansas Rep. Mike Ross -- a Blue Dog Democrat playing a key role in the health care debate -- sold a piece of commercial property in 2007 for substantially more than a county assessment and an independent appraisal say it was worth.

The buyer: an Arkansas-based pharmacy chain with a keen interest in how the debate plays out.

Ross sold the real estate in Prescott, Ark., to USA Drug for $420,000 -- an eye-popping number for real estate in the tiny train and lumber town about 100 miles southwest of Little Rock.

"You can buy half the town for $420,000," said Adam Guthrie, chairman of the county Board of Equalization and the only licensed real estate appraiser in Prescott.

But the $420,000 was just the beginning of what Ross and his pharmacist wife, Holly, made from the sale of Holly's Health Mart. The owner of USA Drug, Stephen L. LaFrance Sr., also paid the Rosses $500,000 to $1 million for the pharmacy's assets and paid Holly Ross another $100,001 to $250,000 for signing a non-compete agreement. Those numbers, which Ross listed on the financial disclosure reports he files as a member of Congress, bring the total value of the transaction to between $1 million and $1.67 million.

And that's not counting the $2,300 campaign contribution Ross received from LaFrance two weeks after the sale closed.

Holly Ross remains the pharmacist at Holly's Health Mart under USA Drug. Neither she nor her husband agreed to speak with ProPublica for this story.

At the time of the 2007 sale, the county assessor's office valued the pharmacy's building and the land on which it sits at $263,000 -- nearly $160,000 less than the Rosses got for it. Because assessors' valuations don't always reflect true market value, ProPublica hired Guthrie to appraise the property. He placed the current value of the lot and building at $198,000, substantially lower than the county's assessment, which was raised from $263,000 to $269,000 this year. Guthrie explained the difference between his appraisal and the county assessment by saying that county assessments have been running higher than actual market value.

Mike Ross frequently speaks for a coalition of House moderates known as the Blue Dog Democrats, a group that helped force changes to the version of the health care reform bill drafted by the House Energy and Commerce Committee. The role has lifted him to national prominence in recent months.

Ross, a member of the committee, told reporters on Aug. 5 in Little Rock: “We held the bill hostage in committee for 10 days to make it better. ... We protected small businesses. ... And we ensured that if there is a government option, it will be just that, an option. It will not be mandated on anybody."

Ross bristled at suggestions he was trying to kill the bill.

"I wasn't trying to kill health care reform," he said. "If I was, I wouldn't have been in negotiations for 10 days."

LaFrance has amassed a privately held chain of more than 150 pharmacies operating in five Southern and Midwestern states under a variety of names, including USA Drug. It was the 15th largest drug chain in the country in 2008 with an estimated $906 million in sales, according to Racher Press, which publishes business intelligence reports.

The pharmacy industry is aggressively lobbying Congress in an effort to protect its interests in the health care debate. Ross, who belongs to the 52-member Congressional Community Pharmacy Coalition, has introduced and supported legislation backed by pharmacy trade groups.

On Aug. 1, the National Community Pharmacists Association issued a news release thanking Ross for an amendment to the health care reform bill that would create greater transparency in the operations of pharmacy benefit managers, who act as clearinghouses for insurance company reimbursements for pharmaceuticals.

In June, the National Association of Chain Drug Stores issued a news release thanking Ross for introducing legislation authorizing payments to pharmacists to train patients in how to manage their medications.

Health-related interests have donated $342,475 to Ross since 2007, according to federal campaign data maintained by the nonprofit Center for Responsive Politics. No other business sector has given Ross as much.

LaFrance declined to be interviewed for this story. His son, Stephen L. LaFrance Jr., who helps run the chain, asked for questions to be submitted in writing but didn't respond to them.

Ross's spokesman, Brad Howard, said the real estate deal was "open, honest and by-the-books." He described Ross and LaFrance as "acquaintances" but declined to say whether they have discussed the pending legislation, adding that Ross has discussed health care reform with many of his constituents.

The $157,000 gap between the property's assessed value and the price LaFrance paid wasn't unusual, Howard said, because assessments are done for tax purposes and typically don't reflect the full market value of the real estate.

"The appraisal always differs from the assessment, and you can't really compare the two," Howard said.

In that initial interview on Sept. 2, Howard told ProPublica that the appraised value of the real estate at the time of the sale "was somewhere around where the purchase price was, which was, you know, I think was like $420,000." He said he didn't have a copy of any such appraisal and suggested obtaining it from LaFrance, who did not respond to requests for a copy. On Friday, however, Howard said he could "only assume there was an appraisal done on the property by the buyer in 2007" and that he "never said" the property was appraised at $420,000.

Nevada County, which includes Prescott, hires an outside firm -- Arkansas CAMA Technology Inc. -- to update its assessments every five years. After LaFrance bought Holly's Health Mart in 2007, someone from CAMA called the headquarters of LaFrance's pharmacy chain to verify the sale price for the lot and building, in part because "it was such an expensive sale for that area," CAMA employee Mike Shepherd told ProPublica.

Commercial property values in Nevada County "have stayed flat" in recent years, Shepherd said, adding, "I would say flat or a slight increase, maybe. That would be pretty slight, though."

Brenda Williams of Nevada County Real Estate in Prescott said county property assessments tend to be slightly below market value, but usually "no more than 5 percent."

"Being in the real estate business, I know that I see the tax card every time, and it's usually assessed a little bit less than the actual value or sales price, a little bit less but not that much less," she said. Asked about the value of the lot and building housing Holly's Health Mart, she said: "It might cost $250,000 to build it. I wouldn't have a problem with that two hundred and something thousand. But not over 400."

The Rosses bought the lot in 1999 for $10,000, then constructed a building that the county assessed at $225,000.

Two months after the 2007 sale, LaFrance's concerns about health care reform were spelled out in an article in the Arkansas Democrat-Gazette.

"Universal health care will ruin our health care in America," LaFrance told the reporter. "There'll be long lines, they won't be able to get treated, potential doctors will be afraid to go into medical school, there will be an outflux of doctors -- in my opinion. It's not broke and don't fix it."

Describing the drug industry as "very big business," he said the high prices charged for prescription drugs are possible only because insurance companies and the government underwrite about 95 percent of the cost.

"So when the customer pays $7, $10, $15, $20" for a prescription co-pay, "it doesn't hurt him. They don't realize that the insurance company is paying the other $125. That's kind of a double-edged sword; if it wasn't for insurance, the American pharmaceutical industry wouldn't be able to charge the prices it charges today, because the public wouldn't put up with it," LaFrance told the Democrat-Gazette.

"Our sales are higher, because it affects the top line of sales," he added. If the government doesn't interfere, there's "nothing but good days ahead."

ProPublica research director Lisa Schwartz and researcher Kitty Bennett contributed to this report

© Copyright 2009 Pro Publica Inc. ProPublica is an independent, non-profit newsroom that produces investigative journalism in the public interest.

Saturday, September 19, 2009


The Citizen FEATURE
John Kalafatich is a big man. He doesn't use his size to intimidate, nor does he raise his voice very often. His face is ruggedly ringed with a white beard and topped by a thick mane of gray hair. He conveys a point without a word said, but the man known as Papa John cannot stay quiet any longer; not when his entire livelihood is dependent on the fate of San Leandro Hospital. It's the source of the food in his pantry and the health of the heart beating in his chest. If Papa John can save the hospital, he figures, he can save lives, including his own.

The story of how San Leandro Hospital has reached the precipice of closure is a long and complicated tale of government secrecy, corporate deceit and community apathy. When you couple that triumvirate of evil, you have a recipe for disaster and Papa John is on a crusade to do what he thinks is the only right thing to do; speak up.

Aside from hurling a few choice barbs at a television set, Papa John had never been involved in a cause and his first foray into public speaking nearly fell flat. He meticulously wrote out notes to address the Eden Township Health District for a meeting in May, but mistakenly left them at home. He spoke extemporaneously only to see a camera crew from a local television station capturing his speech for the 10 o'clock news. Everybody told him he was great.

Since then, Papa John has spoken at nearly every hearing on behalf on saving the hospital. Once, Papa John, with his large frame ambled to the microphone during a meeting one afternoon in June and addressed the cocksure Alameda County Supervisor Scott Haggerty. He punctuated his allotted time by pointing at the supervisor and saying, “Remember my name. I'm Papa John.” His visage and moniker has become so popular that there is no longer any need to utter it. Just last month when addressing a panel brought together by state Sen. Ellen Corbett, Papa John merely rose to the podium, twisted his body towards the group of 300 behind him with outstretched arms like a prophet leading his flock and said, “What's my name?” There were cheers among a cascade of nurses, yelling “Papa John!” But, that's where the fun ends.

These are not good times for Papa John. He has been to the emergency room at San Leandro Hospital twice in the past month. He had heart bypass surgery five years and clearly remembers the job paramedics and staff at San Leandro Hospital treating his busted ticker in their the emergency room. For Papa John, saving the hospital is payback for saving his own life. Ironically, the same institution that saved him five years ago, is also the one exerting enormous pressure on his life today. His doctors think this 71-year-old man is crumbling solely from stress that emanates from a single focal point: the fate of San Leandro Hopsital.

Papa John derives his income from the hospital along with his health insurance and the doctors who care for him. He's been a pharmacy technician there for over a decade. His long strolls through the corridors of the facility while he visits patients and an endearing propensity for calling nurses “kid” earned him the loving nickname of Papa John. He says the only positive about this situation is he loves his job, but if Sutter Health, the medical behemoth that runs both the hospital in San Leandro and Eden Medical Center in Castro Valley, has its way, Papa John and his adopted children in the nurses ward will likely be out of job.

If that weren't enough, his wife of 51 years lies in an Hayward nursing home with severe osteoarthritis in both her knees and painful lymphedema that restricts the flow of fluid to her legs. The insurance company that handles Papa John's health claim is refusing to pay. Two weeks ago, he received a bill for over $7,000 to pay for his wife's care.

“I fight with the hospital, fight with the insurance company and I fight to keep my health,” he said. “I'm so afraid if the hospital and the emergency room close, I'll not only lose my job, my health insurance, I may lose my life and I don't think I deserve that.”

As Washington faces an uphill battle to reform the way health care is offered in this country, people like Papa John are forced to fight a battle for their lives. Two weeks ago, Papa John's wife, Mary, finally received approval for surgery on her weary legs. The insurance company stepped in and felt a second opinion was needed from Mary's primary doctor. Papa John believes the insurance company thinks they will be wasting their money on his wife's legs. “I'm thinking, they're looking at the bottom line again and not looking at the patient,” he said.

“This insurance company doesn't seemed to want to pay for anything and you wonder why the government is pushing for some sort of insurance reform and health care for everybody. You wonder why, huh? You don't wonder no more.”
“I'm very lonely,” he admits. “I'm at home sometimes and I'm thinking, I don't know how much more I can take. I talk to the man upstairs and I say, 'What am I going to do?' I'm running out of ideas. I get these emails saying, 'If he got you to it, he'll get you through it.' Well, where the hell is he right now?”
He says the contract drawn up by the insurance company ensures payment for his wife until discharge. Mary has been in a nursing home since the middle of May. “They say now that they only pay until 30 days,” he says an anything after that costs him $131 a day. “No honest working man can afford that.” It's funny how things turn out.

Papa John never thought his life would be like this. He never had a taste for school as a child. His father died young and he saw the armed forces as a way to help his mother get through the tough times by sending home a monthly check. The military took him to the U.S. base in Morocco where he worked in an Air Force hospital. As fate would have it, an infirmed soldier called for his girlfriend to visit him, but she would eventually leave with Papa John and become the love of his life. “Big mistake,” Papa John said of the soldier's decision. “When you're in the hospital, don't ever send for your girlfriend when Papa John is around.”

Today, though, he can't retire and enjoy the last years of his life like his friends and family. He wasn't always a pharmacy tech, either. He spent the majority of his working life as a warehouseman for a pharmaceutical company until severely injuring his back in 1994. He didn't work for an entire year and says the company viewed him as “damaged goods” and got rid of him. He sued to get his job back and failed.

Papa John must continue to work because he has no other choice. He says his Social Security check would only cover his mortgage and nothing else. During that tumultuous year, he says, he drained his savings, his pension and the IRAs of both he and his wife to make it through the year. In hindsight, he should have taken people's advice and filed for bankruptcy, but that wasn't how Papa John was raised. You pay for what you get and get what you pay for. “This is why I would like to save the hospital and the ER, because the hospital and the ER saved me. So, I would like to pay them back.”

At a time when many Americans are gearing up for retirement, he began a new career at age 57. Papa John enrolled in Western Career College and earned a certificate on his way to becoming a pharmacy tech. Before long he passed up far younger graduates for a full-time position at San Leandro Hospital. It is that tenacious dynamic that now is a significant road block to his future employment if the hospital closes. “I'll be a 71-year-old man out competing with 21-year-old recently graduated pharmacy technicians,” he said, “and having a wife in a nursing home will probably not go in my favor.”

Most signs point to a less than tidy solution for San Leandro Hospital. It is likely Sutter Health will soon announce the hospital's definite closure as a full-service facility. Ninety days later, the hospital built in 1960 will shutter its doors. Whether those doors stay permanently close, though, may be just the beginning of a political nightmare for the city and a public-relations fiasco for Sutter Health. For Papa John and hundreds of nurses and doctors, though, anything less than the hospital's current configuration will not suffice.

The much-talked about hybrid plan pushed by Alameda County Supervisor Alice Lai-Bitker and San Leandro Mayor Tony Santos would marry acute care services and rehabilitation facilities under one roof. While the plan's potpourri of services is viewed as better than no hospital at all, it will likely shake up the staff at San Leandro Hospital who are primarily represented by the California Nurses Association. A hybrid plan, in its current iteration, would put the hospital under the county's control, which is predominately staffed with nurses from the Service Employees International Union.

“The hybrid model is not a good idea,” said Papa John. “It might be good for a car, but not for a hospital. You're either a hospital or you're not. If the county takes over, they're going to bring their pharmacy people here.”

Papa John faith in saving the hospital has not been hastened by what he sees as ineffectual local leadership and politicians shifting the blame to one another. He was appalled by the inattentiveness of Alameda County Board of Supervisors Scott Haggerty, Nate Miley and Gail Steele during another meeting in June when a few ducked out and one tuned out.

“Haggerty and Miley kept leaving the podium,” recalls Papa John. “They must have been going to the back room to get a toot or something, I don't know. The only ones who stayed out there the whole time was Alice [Lai-Bitker] and Gail. The reason Gail stayed was because she was asleep.”

Last month, outside of a heavily-attended town hall meeting with Rep. Pete Stark, Papa John confronted Mayor Santos and questioned his desire to save the city's only hospital. “His coming around has been minimal and his participation has been less. He said this is really not a city issue,” Papa John recounted. “What the hell do you mean? We're not talking about Hayward. We're not talking about St. Rose. We're talking about San-LEE-andro Hospital. This is your city and I told him that.” Papa John said the mayor protested that perception.

Don't blame Papa John for telling it like it is. He says don't ask for his opinion, if you're not going to appreciate what he has to say, but his life outside of work and attending hospital meetings, has become achingly solitary since his wife's convalescence. He's become handy cooking meals with the microwave and visits her when he's not working.

“I'm very lonely,” he admits. “I'm at home sometimes and I'm thinking, I don't know how much more I can take. I talk to the man upstairs and I say, 'What am I going to do?' I'm running out of ideas. I get these emails saying, 'If he got you to it, he'll get you through it.' Well, where the hell is he right now?”

In the meantime, Papa John is plotting his next speech, whenever that occurs. He says he's been working on a newly crafted rejoinder that goes something like this: “If you people decide to go against what everybody wants, I'll just ask you to do one favor, every time you hear an ambulance siren in San Leandro, say a prayer for the person in the back, will you? Because he might not be able to make it to the next ER.”

Theatrics aside, when it comes down to the real stakes involved in losing San Leandro Hospital, Papa John's best line is his worst nightmare. “People are going to die,” Papa John says as his head slowly bobs and repeats, “People are going to die and I don't want to be one of them.”

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Thursday, September 17, 2009

Sutter Nixes Hybrid Model with SoCal Health Provider

The Citizen
Earlier this month, Sutter Health, which operates San Leandro Hospital, refused an offer allowing the Southern California-based Prime Healthcare to run the beleaguered hospital as an hybrid acute care and rehab facility proposed by some in the county.

"Sutter has told us that Prime is a non-starter, period," said Alex Briscoe, the acting director of Alameda County Health Services.

Last month, The Citizen reported Sutter also refused to entertain Prime's offer to purchase San Leandro Hospital and operate it in its current configuration as a full-service facility.

Sutter is not be opposed to hospital hybrid plan if it is run by the Alameda County Medical Center, according to Briscoe, but they are not keen on Prime or any other outside provider at San Leandro Hospital.

Briscoe reiterated the county's desire to keep the hospital open while realizing the potential danger of closing the emergency room. "We don't want to lose the hospital and they are difficult to bring back," said Briscoe. "You know, it doesn't matter if 1,000 people die because one is too many, to me."

The hybrid model--a sort of conglomeration of all plans under one roof--has been offered as a solution by San Leandro Mayor Tony Santos and the President of the Alameda County Board of Supervisors Alice Lai-Bitker. Under the proposal, the bottom two floors of the hospital would encompass emergency room and surgical facilities while rehab services would be moved from the seismically-deficient Fairmont Hospital and would occupy the top two floors, one of which is currently empty.

Such a plan, though, carries the need for a significant annual subsidy according to Briscoe. Health Services calculates the hybrid plans will necessitate a permanent subsidies between $4-7 million. The ACMC now says the plan will cost even more, at between $6-10 million a year.

According to Briscoe, Health Services believes the now-unlikely possibility of Prime operating the hospital under a hybrid plan would also need some sort of subsidy.

To this date, there has not been a public official or entity that has brought forth a plan involving funding to keep the hospital's emergency room functioning nor offered money to run the hybrid plan. Santos indicated he had brief conversations with Sen. Barbara Boxer and Rep. Pete Stark, but no specifics were offered.

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Health District Violated the Brown Act; Sen. Corbett File a Complaint

In 1953, Assemblyman Ralph Brown sought to return the business of government to the perusal of the people. The Brown Act was created to force every molecule within the light of democracy to shine on the business of legislative bodies, city council and public commissions. When it is flouted, the confidence of the people within the levers of powers becomes sullied, whether any wrongdoing occurred or not.

A simple reading of the Brown Act regarding special meetings clearly shows the controversial Sept. 3 meeting of the Eden Township Healthcare District Board of Directors was illegal. Here's a rundown of the law and the actions that followed that night:
  • Under the Act, the presiding officer or a majority of the body may call a special meeting - YES. Eden Township CEO Dev Mahadevan called the special meeting.
  • Notice of a special meeting must be provided 24 hours in advance of the meeting to all the legislative body members and to all media outlets who have requested notification. YES. By most accounts, the Eden Township Board posted the agenda for the special meeting just hours before the time frame allowed the Act.
  • The notice also must be posted at least 24 hours prior to the meeting in a location freely accessible to the public. YES - Again, notice was posted in a timely matter and the meeting was scheduled to be held at the Eden Medical Center Board Conference Room.
  • The notice should indicate that the meeting is being called as a special meeting, and shall state the time, place and business to be transacted at the meeting. YES - The posted agenda does indicate a special meeting and includes a date, time and place. Listed under agenda item #2 is "Executive Session: Conference with legal counsel re: anticipated litigation: Sutter Health exercise of purchase option under San Leandro Hospital Amended Lease and Hospital Operations Agreement (Government Code Sec. 54956.9(b))"
  • At every special meeting, the legislative body shall provide the public with an opportunity to address the body on an item described in the notice before or during consideration of that item. The special meeting notice shall describe the public's rights to so comment. NO - This is the crux of the violation. While the agenda notice describes how an audience member may address the board by receiving recognition from the Chair, the notice also clearly states "NO PUBLIC SESSION."
What occurred, in fact, was the denial of over 30 people to address their concerns to the District board. Resident were never allowed to come closer than 20 feet from the conference room doors. To make a formal complaint, the filer must prove whether any action was taken by the board regardless of any possible violations. It is known that the District discussed entering into non-binding mediation to resolve the issue of Sutter Health exercising its purchase option of San Leandro Hospital and approved such measure. Board member Carole Rogers indicated such to those who remained after the conclusion of the meeting, Sept. 3.

A complaint must be filed within 30 days of the possible violation. As of today, we are halfway through that period. State Senator Ellen Corbett's office voiced concern that night over what transpired and a few San Leandro council members angrily charged the Distict with a violation of the Brown Act, as did representatives from the California Nurses Association; yet nothing has been done.

As a First Amendment issue, conducting government business under the cloak of deception is a very scary proposition. During the last two District meetings, The Citizen has been provoked by the questioning of using an audio recording device to cover meetings. The use of video recorders has also been questioned by representatives from Sutter Health.

Conducting government business in secret is unfortunately quite common. Within just the past month, various government bodies in Long Beach, Clearlake, Gilroy, Los Angeles and San Diego County have been accused of violating the Brown Act. In Alameda County, the recent quick hire of a district attorney to replace retiring Tom Orloff without any public scrutiny also has raised the ire of many who support open government.

Whether significant action was taken Sept. 3 is not the point, but it continues a rather long line of deliberate obfuscation by Sutter Health and its surrogates on the District board. Many believe the City of San Leandro and Alameda County face the very real possibility of losing San Leandro Hospital because of a string of similar secret meetings in the past. The public is no longer naive to this tactic and The Citizen on behalf of the community is calling for state Sen. Corbett to file a specific complaint calling for the District to reveal what was discussed Sept. 3 and demand that these clandestine meeting cease immediately. Not only do we need to maintain the physical and mental health of our community, but we also must care for our delicate democracy at the same time.

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Wednesday, September 16, 2009

He's #1! The Champion of Outside Interests

When it comes to getting his campaign nourishment in Alameda County, Rep. Pete Stark prefers the big dollars in Washington. According to the web site, MAPLight.org, he ranks number one among those in Congress for receiving the highest percentage (99.6 percent) of fundraising dollars received from outside of his district. Stark was also ranked second in contribution received from outside his state (95 percent). (See the graphic below.)

Despite representing one of the more wealthy districts in the country, Stark has tapped the medical and pharmaceutical lobby's of Washington dry over the years. The long-time congressman from the 13th district, is often a target of health care dollars as chairman of the House Ways and Means Health Subcommittee. Stark is also a firm supporter of health care reform, yet in the past, according to MAPLight.org, he has received tens of thousands of dollars from the health care field just days before voting on a House bill and on two occasions receiving $10,000 for two contributions the same day as a vote in their favor.

The American Society of Plastic Surgeons contributed $20,000 to Stark's coffers in a three day period when four House bills involving the medical industry were set to be voted upon. H.R. 1014 and H.R. 758 were approved by Stark on Sept. 25, 2008 and coinciding with $10,000 in campaign funds received. Another bill, H.R. 6983 was preceded by $5,000 by the same group and H.R. 2994 was voted in the affirmative by Stark and followed by another $5,000 donation the next day. None of the four bills that Stark receiving campaign donations were of any controversial matter and fell in line with other votes on health care, but perception of the medical lobbyist having a hand in his votes seems evident.

In total, Stark received over a $1 million in a three-year period ending in 2007 from various medical fields and organizations. The number is quite high for a congressman who routinely runs unopposed and regularly garners more than 70 percent of the vote in his district.

Stark's predilection towards receiving campaign donations from the medical industry comes in conflict with his now-infamous "Brain Dead" comment last August where he charged moderate Democrats with hampering health care reform legislation by doing the insurance companies bidding in exchange for campaign dollars. "They're for the most part, I hate to say brain dead, but they're just looking to raise money from insurance companies and promote a right-wing agenda that is not really very useful in this whole process," Stark told a group of reporters during a conference call on the issue.

Stark's comments towards his Blue Dog colleagues in the House also mirrored that of The Nation and giving some semblance of solid left wing support on the charge, but the work of MAPlight.org shows the congressman who is standing fervently in attempting to enact a health care bill featuring the public option, is also lavished with an inordinate amount of money from outside groups, in addition, to lobbyists with no discernible interests in the people, infrastructure and ideology of the inhabitants of the East Bay.
The Citizen FILE on Pete Stark, campaign finance
>>>>Questions over Stark's $3500 Health Care Fundraiser, July 20, 2009.

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Tuesday, September 15, 2009

The Bad Boys of Capitol Hill

A funny thing happened after Rep. Joe Wilson rudely yelled "you lie!" at the president last week. The Congressman from the Palmetto State oddly became synonymous with our own Rep. Pete Stark as poster boys for crude behavior in Washington.

Try Googling Stark and Wilson and you will arrive at a treasure trove of articles where journalists provided background to the South Carolina Republican's antics with past Congressmen Behaving Badly. Front and center, unfortunately is the representative from the 13th District. Here's a sampling:
  • CNN.com's Julian E. Zelizer, in a rundown of not-so-great moments in Capitol Hill history, remembers Stark calling Colorado Republican Scott McInnis a "fruitcake" when the chairman of the Ways and Means Committee attempted to have capitol police escort Democrats from a meeting.
  • The conservative blogger Michelle Malkin adds to the tale by saying Stark also called McInnis a "c--ksucker" and said, “Oh, you think you are big enough to make me, you little wimp? Come on. Come over here and make me. I dare you."
  • Victor Davis Hanson at the National Review pointed out Stark called President George W. Bush a "liar" and said he was sending troops to Iraq to "get their heads blown off for his amusement" on the House floor (Watch the video here) . Stark was nearly censured for the comment by Rep. John Boehner and Republicans if not for the Democratic majority in the House narrowly stifling the resolution.
It should be noted unlike Wilson, Stark eventually apologized to the president and Congress.

After a video surfaced two weeks ago of a younger Stark cussing out an documentarian after a sitdown interview and saying, "Get the f--k out or I'll throw you out the window," (Watch the video here.) you would think that one would be hard to follow up on the YouTube cavalcade of infamous videos from the Congressman, but you would be wrong.

Clearly Stark has little taste for hearing his constituents spout their loopy takes on how their country should work; just watch the clips of his Sept. 12 town hall meeting in Fremont. His face is sour and his body language suggest he would rather be preparing for his yearly colonoscopy than listen to these people. If you can get through the obvious conservative rhetoric (the video was posted by The Minutemen, citizens who believe in Draconian anti-immigration policies) and put up with the outrageous misinformation (when in the world did a valid drivers license ever prove citizenship?) then watch the video below.

It's curious that people believe Stark should have stood at the podium and allow people to call him a liar so in many different ways. Unfortunately, Stark's response to the man who says, "Don't pee on my leg and tell it's raining" may be his most bizarre yet. One blogger hilariously mocked the retort by referencing it as Stark's "anointed urine."

(PHOTO CAPTION) Rep. Pete Stark (D-Calif.), left, Rep. Joe Wilson (R-S.C.), right.
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Monday, September 14, 2009

City Manager Recently Moved to Castro Valley

No offense, but why would anybody want to live in Castro Valley? There is no there in Castro Valley where residents feel more comfortable siphoning support from the county rather than taking the initiative to create their own unique community, but a few San Leandro leaders think otherwise. The San Leandro Times, in a gallant display of tabloid journalism, reported both San Leandro City Manager Stephen Hollister and the newly-minted Police Chief Ian Willis live in Castro Valley rather than the vaunted land of cherries.

The front-page article was real pie-in-the-face stuff that elicited a chuckle. Castro Valley is only a few miles away and Hollister fairly told the Times he could do the job from there. Willis' response was typical of law enforcement, straight forward with a slight hint of so what? There's no law that says department heads must live in the city they serve. It's just a good idea if they do. End of story, right? Wrong.

Here's what the otherwise fine article from The Times failed to report: Hollister just moved to Castro Valley in June with a bit of consternation from the city council, according to sources. According to Hollister, some were adamant and some were ambivalent. Sources say Councilman Bill Stephens was one member who advised Hollister against moving out of the city.
Voters will not look kindly towards making a sacrifice when their leaders have no skin in the game.
Hollister told The Citizen he moved Castro Valley because, at the time, he was unable to find a home in San Leandro that suited his families needs. You might remember, a dust-up a few months ago over the expanding number of city employees earning six-figures. According to city records, Hollister pulls down exactly $200,000, which makes it difficult to believe Hollister's housing choices were severely limited in this buyer's market.

But, here's where it gets politically shaky for Hollister in a city that continually offers raising taxes as a remedy to budget probems; how will he justify any future parcel tax initiatives when he, himself, will not pay his share of the burden? Hollister says, because he was a renter, he would not have paid a parcel tax anyway, but that is not the point. At a time when the city needs all possible remedies to its economic woes, the elusive parcel tax is now as dead as the skunk splayed out on Williams Street. Voters will not look kindly towards making a sacrifice when their leaders have no skin in the game.

It is inexcusable for a singular option to be torpedoed because of personal choices. The Times article made a sly stab at the fact a non-resident hired another non-resident to be the police chief. Harsh stuff, but true. Hollister is not going to overrun the city's department with outsiders, but he did say something very telling last week when he insinuated the modern role of city manager's across the country is to be more transient than in the past, meaning it is not uncommon anymore for a person in his position to not live in the city he works. That sort of thinking makes one wonder if Hollister is more like a free-agent in baseball with more loyalties to his contract than the home team.

For full disclosure, I was born at Eden Hospital in Castro Valley raised just around the corner under the shadow of the Three Crosses Church. It's not a bad place, but it's no San Leandro.
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Sunday, September 13, 2009

The Race to Unseat Santos Begins

The race for mayor is still over nine months away, yet the incumbent and his possible challengers are already gearing up for what may prove to be an interesting race centering on two of the nation's hot button issues--the economy and health care.

For those hoping to unseat the one-term San Leandro Mayor Tony Santos, the early strategy is taking a cue from James Carville's famous campaign maxim, "It's the econmony, stupid." Officially, only current Councilwoman Joyce Starosciak has announced her candidacy, but former School Board Trustee Stephen Cassidy interest in the job is probably the worst kept secret in the city.

As with all political races, the incumbent holds a significant advantage--well-kept connections, access to networks of fundraising in addition to valuable name recognition. Santos is a well-known local pol as opposed to Starosciak and Cassidy, who are far less known outside the inner circle of San Leandro politics. Santos indicated last week an aversion to fundraising, but not enough to forego a potentially lucrative pot of campaign funds next Thursday. The scheduled event, to be attended by enough local heavyweights to make you wonder, "who died?", will likely illustrate to opponents just how great a mountain their candidacies may face. Some believe Santos could be able to raise close $75,000 for next June's election, likely to handily dwarf the others.

Santos' climb to re-election, though, could be hampered by external factors, namely, a languishing economy coupled with the likelihood of further distressing budget cuts next year. Starosciak and Cassidy both seem intent on portraying themselves as proponents of budget restraint.

During a speech two months ago, Starosciak appeared to be foreshadowing her campaign themes, while voting against the city's proposed budget. Hoping to show leadership during tough times ahead, she was one of the first to alert the community of the possibility of far worse cuts next year. The clear stand seemed to have been a shot across the mayor's bow as public comments on the budget by Santos shortly after began to contain specific talking points that, he too, is the candidate of budget restraint. Within San Leandro's electorate, it is not clear whether the real problem Starosciak poses to Santos is the possibility she may peel away voters from the same pool of voters Santos hopes to gain or leaving the possibility of a strong third candidate sweeping up the leftovers.

While Santos has the support of most the city's leadership past and present, Starosciak has the support of Assemblywoman Mary Hayashi. Starosciak's campaign site, electjoyce.org, at first glance, imparts the impression she is running in tandem with Hayashi. A prominent photo of the two adorns the top of the site.

The wildcard of course, may be Cassidy, who if anything may insure the focus of the campaign stays squarely on the the city's hemorrhaging coffers. Through his blog, Go San Leandro, and numerous Letters to the Editor, Cassidy has written extensively on San Leandro's budget problems and how the current leadership led the city to this predicament. Cassidy believes the city will be bankrupt by 2015 "if significant action is not taken."

It is well-known that Cassidy has been a thorn in Santos' side for some time. In response, Santos repeatedly mocks Cassidy's comments on balancing the budget, saying he failed to balance the book when he served on the school board, "He wants to tell me how to balance my budget when he didn't even balance the school's budget?" Many believe Cassidy has the tenacity to seek the job, but there are concerns his heavy-handed approach is less than conciliatory and may fall flat with voters despite being the candidate thus far declaring the most solutions to the city's problems.

The fate of San Leandro Hospital may also be a major campaign topic. At the moment, a betting man would accept the hospital will close, but the more protracted the battle to keep it open lasts, the more it could hamper Santos. While the city has little power over the hospital's fate, many in the community have been critical of Santos' leadership on the issue. Some of his detractors also say his public comments too often mirror the talking points of Sutter Health. Santos, though, says he has been working on the issue for over two years, yet there is simmering discontent in the electorate that may well blame the mayor if the hospital's emergency room closes its doors anytime before June.

Like all elections, the aura of unpredictable events must be written into the equation. While Santos is somewhat vulnerable to those realities than the other candidates, they both have much work to show the people of San Leandro why they should boot their mayor out. But as they say, it's still way too early.

This article has been edited since its initial posting.
The Citizen FEATURE: Papa John's Crusade
When it comes to the closing of San Leandro Hospital, 71-year-old John Kalafatich has more to lose than most of us--his job, his health insurance and his life. Never before an activist, the man called Papa John vows to save the hospital while saving the lives of others, including his own.

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Saturday, September 12, 2009

Everything you need to know about Saving San Leandro Hospital


STATE SEN. ELLEN CORBETT The former assemblywowan and mayor of San Leandro is widely regarded as the most high profile politician on this issue and the go-to person powerful enough to counter Sutter's corporate power. Critics will note the absence of any political solution with dollars attached, but Corbett's move along with 13 other local pols to reach out to the attorney general's office is the most significant gambit against
Sutter to date. The AG is currently looking into launching an official investigation into Sutter's alleged pattern of wrongful business dealings at its Northern California hospitals. A bill that would lengthen the time a hospital provider must give notice of closing a hospital from 90 to 120 days currently sits on Gov. Schwarzenegger's desk. In addition, Corbett is the leading proponent of forcing the issue of San Leandro Hospital to a vote under a state health and safety code which says a health care district may not sell assets worth more than half of its holdings without a vote of the people. QUOTABLE "[Sutter] has a tax break because they are suppose to be serving the people who are the most needy. That's why we are starting to ask people what is really happening?"

ASSEMBLYWOMAN MARY HAYASHI The two-term assemblywoman has been notably absent from the issue in recent months. Known as one of the most petulant politicians in the East Bay, Hayashi was active on the issue as earlier this spring, but seemed to lose interest after an odd blow-up with Sen. Corbett in June. Dueling terse press releases highlighted Hayashi's deciding no vote in committee. Hayashi co-sponsored the bill with Corbett raising eyebrows as to why she torpedoed her own piece of legislation. At the time she called it a good bill that needed work. The incident between two Democrats working on the same local issue still confuses many officials around town. Many believe Hayashi is girding up for a Titanic tilt for Corbett's senate seat. Her only public statement on this issue came in June when she sent a representative to play a pre-recorded speech. Her rep told the large gathering at the San Leandro Library the assemblywoman could not attend because of budget crisis in Sacramento, even though Corbett was sitting at the back of the room. QUOTABLE "Saving San Leandro Hospital is my top priority." Watch the video here.

MAYOR TONY SANTOS Aside from the health of potential patients in the community, no one has more at stake by San Leandro Hospital closing than Santos, yet many believe he has shown indifference over the issue. A hearing does not pass without one resident criticizing the mayor's lack of involvemnet. He has repeatedly called the issue out of his control, but says he has been dealing with the problem for over two years—way before anyone else--he will add. Numerous insiders, brand the mayor as being pro-Sutter in his talking points when he says Sutter, as a business, has no obligation to subsidize a money-losing hospital and charging doctors with hastening San Leandro's financial demise by outsourcing procedures and tests to outside vendors. Being seen at the July 1 groundbreaking of Sutter's new hospital in Castro Valley hardened that perception. If the mayor, indeed, tended to lean towards Sutter in the past, the future may be different. Sutter officials were reportedly livid over Santos' comments in The Citizen when he said the hospital would stay open because of pandemic concerns until the end of January 2010. Political wisdom says the longer the hospital's fate is up in the air come the June mayoral primary, the easier opponents will be able to pin the loss of a public asset on him. QUOTABLE "They have private practices and I hope they try to do things for the common good, but many send their patients to facilities other than San Leandro Hospital."

SAN LEANDRO CITY COUNCIL The six-member council has primarily been the punching bag of the Alameda County Board of Supervisors, while offering very little pushback. Supervisors Scott Haggerty and Nate Miley have both viciously excoriated the group for offering, what they contend, is no leadership on the issue. Haggerty even infamously crumpled a letter from the council during a meeting and threw it into a trash can calling it a “piece of crap.” Like Mayor Santos, the majority of the council believe the issue belongs under the jurisdiction of the county, not the city since a majority of the patients at San Leandro Hospital arrive from Oakland and other cities. Councilman Jim Prola has been the loudest voice consistently charging Sutter with medical redlining and saying he does not trust them. Councilman Michael Gregory, whose district the hospital resides in, faces re-election in 2010. Gregory was one of the earliest politicians putting out the clarion call for action to save the hospital when he organized a series of town hall meetings on the subject in May, but has been absent since. Despite certain vulnerability, no candidate has emerged to challenge him next year. The rest of the council has been virtually mute on the hospital with some rarely attending public meetings. The most notable wallflower is Vice Mayor Joyce Starosciak, who will run against Santos next year. Sources say Starosciak's strong support of Assemblywoman Mary Hayashi will dictate her agenda (Hayashi has been quiet on the hospital) with Sutter and the hospital. The Santos/Sutter brouhaha and Hayashi/Starosciak duo may link the mayor's race and the fate of the hospital in an unlikely way. QUOTABLE "[Former Director of the Alameda County Health Services] Dave Kears is trying to shift responsibility on to us," said Prola, "I believe it's the county's responsibility not just San Leandro's because only a third of our residents use the hospital."

SUPERVISOR ALICE LAI-BITKER If one politician is stuck between a proverbial rock and a hard place it's Lai-Bitker. She has consistently juggled the agenda of the county with her conscience to varied results. Many of her proposals have misfired including announcing to great fanfare in June her intention to have the county rescind its offer to the Alameda County Medical Center to move rehabilitation services to San Leandro Hospital as the prospect of another health care vendor briefly arose. Nothing came of the action, when a decisive third vote on the board of supervisors could not be cajoled out of Supervisor Keith Carson. Although her plan to create a hybrid hospital of emergency room services, surgery and rehab facilities at San Leandro Hospital is still kicked around, it is now viewed as the best case scenario if all else fails. Lai-Bitker's bipartisan proposals stem from an aversion to having the county possibly having a shuttered hospital in San Leandro without a tenant if Sutter and the Alameda County Medical Center walk away. There is a school of thought that Lai-Bitker, whose mother passed away last week, will find a second wind in saving the hospital after facing first-hand the real life stakes losing a hospital has on patients and survivors. QUOTABLE "[The Board of Supervisors] 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.”

REP. PETE STARK Where's Pete? The long time practicioner of liberal East Bay politics has certainly been busy on the national stage as he tries to enact universal health care, but without question he's been absent on this health care issue. You can try asking him his thoughts, but you won't get an answer from him or his people. While Fremont's Nummi and its 4,700 autoworkers stood on the chopping block, Stark and others were there, yet an equally distressing situation where over 1,000 people could die annually due to the loss of a key emergency room, the congressmen is silent. Many note that local health care is typically a state issue, but with Federal stimulus dollars floating in the wind, the stated $4-7 million subsidy for San Leandro Hospital is a mere pittance. Cynics will say you cannot obtain Stark's chairmanship on the Ways and Means Health Committee without sizable support from the health care lobby QUOTABLE No comment.


DR. RAJENDRA RATNESAR No other member of the Eden Township board has weathered more calls for potential conflict of interest charges than Ratnesar. As an employee of Sutter, he reportedly earns over $100,000 a year while serving as the board's chair. Various groups led by the Calfornia Nurses Association charged Ratnesar with being on the take last June when reports surfaced alleging other members of the board not including Ratnesar faced potential conflict of interests suits. To the uproar of many nurses and doctors, he recently removed member Carole Rogers from a mediation committee for distributing “inappropriate” materials to the mediator. Soft-spoken and slight, Ratnesar does not appear to hold a strong grip over the board's action and shows a tendency to flub simple rules of order during meetings. A recall effort is currently in its infancy to remove Ratnesar, but such a move may not have time to affect the near-term effort to save the hospital. QUOTABLE "There are many members who you could say have a conflict of interest. We all have worked in the medical field."

DEV MAHADEVAN The CEO of the Eden Township District is alleged to be the board's tether to Sutter corporate. Behind the scenes, some contend he is difficult to work with, but keeps a somewhat low profile. During a meeting in August when the board rescinded Sutter's plan to purchase the hospital, the turn of events had a few board members glancing towards Mahadevan for direction. Mahadevan's role may grow larger in coming week's as the board looks to replace Dr. Walter Kran. QUOTABLE In response to a question whether the abruptly cancelled mediation hearing was rescheduled because of Sawhney's protest, Mahadevan said, "you could put it that way."

The new kid on the block, Sawhney is the most forceful voice on the board. He has consistently led the way in blocking various proposals likely to have grease the skids towards the closing of San Leandro Hospital. It was Sawhney's motion in June that killed the county's plan to move rehabilitation facilities from Fairmont to San Leandro Hospital. He followed with leading the way in blocking Sutter's option to purchase the hospital along with forcing the board to seek a second legal opinion (underway) and launching an independent review of the hospital's financial records (not underway). Sawhney is the board's most passionate supporter of saving the hospital. QUOTABLE "We should keep fighting until the last day, even if we go down, we must fight."

CAROL ROGERS, RN Along with Sawhney, no other board member is more trusted by doctors and nurses and likely the community than Rogers. The current nurse at Highland Hospital is the least removed from witnessing the realities of closing a hospital. In recent weeks, her patience with the board's dealings and relationship to Sutter has grown non-existent after Ratnesar removed her from the board's mediation committee with Sutter. The controversial move may have been illegal. Undeterred, Rogers showed up at the site of the meeting anyhow and found it cancelled. More telling, Rogers have been very candid about her dealings with Dr. Walter Kran, telling The Citizen and later a group at Eden Medical Center about conversations with him about the whereabouts of a “secret location” and saying Kran needed to ask Mahadevan whether he would attend the last board meeting. The hearing was eventually cancelled at the last minute. Rogers has said she will not run for another term in 2010. QUOTABLE "I don't think Sutter is going to back down from Eden Hospital. They already have too much invested."

The health of the once noted San Leandro physician is far less than it once was. Dvorsky has uttered very few words in various meetings since May and The Citizen reported widespread concern on the board and local politicians about his mental capacity to make all-important decisions regarding the fate of the hospital. Various sources say he has stated a desire to keep the doors open at San Leandro Hospital, but his voting record shows inconsistency. Many say his wife, who also serves on the Chabot College/Las Positas board is calling the shots, yet Dvorsky's propensity to blurting out indecipherable statements and inability to follow the course of debate during meetings is the 800-pound gorilla at the Eden Healthcare District. One source with knowledge of Sutter's dealings, say Dvorsky was told to vote against the motion halting Sutter's plan to purchase the hospital along with Kran's decision to abstain; turning a 2-2 deadlock into a 3-1 victory for the community. QUOTABLE When a doctor representing physicians read a statement to the board, Dvorsky harshly said, ""What the hell are you trying to say?"

DR. WALTER KRAN In a story known for being supremely unpredictable, Kran's sudden resignation Sept. 28 left mouth's agape. Little is known yet about his departure, but it did follow a string of erratic behavior more similar to a bad espionage thriller than ho-hum healthcare issues. Along with Dvorsky, Kran says very little although he tended to exhibit exaggerated facial expressions which sometimes gave a window into what he was thinking. Although, elected as a bulwark against Sutter, many believe he was in their camp, although possibly half-heartily. Sources say Kran and other members may have been threatened with legal jeopardy by their actions (or inactions) by Sutter. How the board replaces a pivotal vote is likely to be the next front in the battle between the community and Sutter. QUOTABLE Not much. During a vote to block Sutter's purchase option he abstained and said, "I don't have enough information."


EDEN CEO GEORGE BISCHALANEY The mercurial executive has been relatively quiet recently. Most believe he is merely Sutter Health's foot soldier receiving orders from headquarters in Sacramento. At an Alameda County Board of Supervisors meeting in June, he was pressured by Supervisor Nate Miley to negotiate turning over operations of San Leandro Hospital to another health care vendor. Bischalaney reluctantly agreed, but reports in The Citizen say they flat out refused Prime's advances in person and one with a hybrid model in mind. One of the more comedic moments of this entire story occurred at the Sept. 3 Eden Township meeting where residents were shutout of the meeting and Bischalaney reportedly threatened to call the sheriff on the group. QUOTABLE On approving the environmental impact report, he struck an ominous tone. “Any delay is a problem. Candidly, who knows beyond that. I cannot assure you [the rebuild of Eden Hospital] will pull through.”

DR. MILES ADLER Sources say the former chief of staff of Eden Medical Center and San Leandro Hospital was burned by Sutter's stated intention to keep the hospital open if it could turn a profit. Once a backer of Sutter, Adler is now one of the more vociferous voices charging the hospital chain with cooking the books at San Leandro Hospital and facilitating its financial demise. Adler is no friend of the powers at City Hall, either. He called San Leandro Mayor Tony Santos "clueless" over accusations doctors outsource medical procedures to outside vendors. Adler also criticized the absence of some members of the city council during a recent forum on the hospital hosted by state Sen. Ellen Corbett and wondered aloud why five of six members believed the hospital was not an important enough topic to attend the meeting. QUOTABLE "It is very disappointing when one thinks there are five city council people who don't think it's important enough to come to a forum of this nature with their own constituents sitting in the audience."

DAVID KEARS The recently retired director of Alameda County Health Services still casts a long shadow over the possible future of San Leandro Hospital. It is Kears' analysis the county needs an influx of rehabilitation beds to be a fully functioning hospital system. When one of the current such facilities at Farimont Hospital proved too costly to seismically upgrade, the possibility of converting San Leandro Hospital became a tantalizing option. Universally recognized as one of the most knowledgeable people on the subject, the Alameda County Board of Supervisors welcomed the plan absent any other offers to operate what was believed to be a hospital swimming in the red. Critics now question the plan since data supplied by Sutter on the hospital's finances and usage revealed more of a need for its emergency room services than initially believed. Kears has also been critical of San Leandro's lack of a plan for their hospital similar to the takeover by the city of Alameda and their facility which was financed with an annual $300 parcel tax. QUOTABLE "We need a firm commitment, not a we'll explore it or not anything. Go to the city council. Ask to take an action--make a decision. Go to the district. Have the district look at their resources. Put real money on the table. Take actions that result in actually saving hospitals as oppose to shifting responsibility onto someone else."

ALEX BRISCOE As the current interim director of Alameda County Health Services, the youthful Briscoe quickly changed the tenor of the agency's beliefs after Kears' retirement. Sources say moving rehabilitation services from Fairmont to San Leandro Hospital was conceived under Briscoe's watch. Insiders say he was reluctant to stand by the plan's merits under Kears because of the political ramifications which eventually flared to this day. As acting director, Briscoe's comments at the Alameda County Board of Supervisor meeting in July corroborated the widespread belief Sutter's numbers regarding the usage of the hospital's emergency room was understated and touched off a debate among supporters of saving the hospital that its financial numbers were also faulty. QUOTABLE "Sutter has told us that Prime is a non-starter, period,"

CALIFORNIA NURSES ASSOCIATION In an age, where the attention of the local press is perfunctory, the nurses union has been a catalyst for drumming up community support for saving its member's jobs and a community asset. Always good for a biting quote, representatives for the union have screamed for the resignation of health care directors at meetings, organized chanting picket lines in front of the Board of Supervisors chambers and distributed literature across the city. It is hard to imagine local politicians having enough cache to fight for the hospital without the presence of the union and its members making their voices consistently heard. QUOTABLE "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,” said labor rep Mike Brannan.

The maverick Southern California hospital baron arrived on the scene in June with much fanfare and exited without ever being heard again. His company, Prime Healthcare has gobbled up 13 failing hospitals in the state and claims to have quickly turned around the financial prospects. Prime's business model of funneling patients through its ER concerns many in the industry who feel the state will eventually clamp down on the company. Some believe its penchant for cancelling existing insurance agreements will further cripple the state's failing health system. The addition of Prime to the San Leandro Hospital question, in hindsight, may have given supporters of the hospital valuable ammunition in the following months showing another company wanted to operate the hospital and gave the county pause for backing a plan to move rehab to the hospital when another plan existed. Twice in the past months, Prime has attempted to negotiate with Sutter to a resounding no, but still sends a representative to nearly every public meeting. QUOTABLE “I can turn a failed community hospital into a successful community resource."

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