Healthcare District Hires Lawyer for Second Opinion

WALNUT CREEK LAW FIRM HAS DEALT WITH SUTTER IN THE PAST
The Eden Township Healthcare District has retained the legal services of Archer Norris of Walnut Creek, according to Board Director Dr. Vin Sawhney.

The law firm specializes in representing the many sides of the complex health care industry and has experience litigating against Sutter Health. Archer Norris represented the Marin Healthcare District's fight against Sutter over the transfer of Marin General Hospital. Recently, legislators in the area have accused Sutter of moving $88 million from the hospital without the knowledge of the health care district.

The move by the District was necessitated Aug. 18 when the Eden Board of Directors voted to hire legal experts to explore additional options to keep San Leandro Hospital and its emergency room services open after blocking the purchase option of Sutter to buy the facility. That vote was seen as a move by the District in anticipation of an announcement by the Alameda County Medical Center it had signed a lease agreement with Sutter to run the hospital as an acute rehab center while closing the emergency room. Sawhney said the District hopes to have a report from Archer Norris in the coming weeks.

On the same night, the District also approved seeking an independent auditor to scour San Leandro Hopsital's finances, which had claimed excessive losses at the community hospital. Sawhney said no action will be taken on hiring an auditor until the board considers their lawyers forthcoming opinion.

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Letter to Attorney General

LEGISLATORS CALL FOR 'IMMEDIATE INVESTIGATION' OF SUTTER
Click here to view the letter signed by 13 California legislators, including state Sen. Ellen Corbett and Assemblywoman Mary Hayashi, to State Attorney General Jerry Brown calling for an investigation into Sutter Health's business practices.

The letter, sent today, calls for an "immediate investigation" into a host of allegations against the health care corporation, spotlighting controversies in Santa Rosa, Marin, San Francisco and the current situation at San Leandro Hospital.

"Access to quality and affordable health care in California communities is too important and too precarious to allow this alleged misconduct to go unchecked. We implore you to immediately launch an investigation of Sutter Health, Affiliates and its subsidiaries and its business practices on a statewide level. We ask that you take immediate steps to intervene to determine whether Sutter has acted improperly," the letter concludes.

The 13 legislators who signed the document include, state Sens. Loni Hancock, Mark Leno, Patricia Wiggins, Leland Yee, along with Corbett. Assemblymembers Tom Ammiano, Jim Beall, Jr., Wesley Chesbro, Joe Coto, Noreen Evans, Jared Huffman, Nancy Skinner and Hayashi.

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The Slowly Disappearing City Council

DOCTOR LASHES OUT AT ABSENT COUNCIL MEMBERS
Dr. Miles Adler is not afraid to tell you how he feels. His manner can be brusque and pointed. In the past he has reserved both qualities for San Leandro's elected officials. While discussing the hospital situation at Sen. Ellen Corbett's town hall meeting, Adler angrily called out members of the council for their absence.

"There are six elected city council members in San Leandro--the mayor is here and one of their city council members is here," said Adler. "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."

Only Councilman Michael Gregory attended the nearly three-hour meeting at the San Leandro Hospital. Councilman Jim Prola, who has attended many of the meetings and hearings during the past few months, is on vacation and out of the country. In an interview with the former chief of staff at San Leandro Hospital earlier this month, Adler called the city council "weak" and the mayor "clueless."

At times, the meeting inadvertently set some politicians up as a large target of criticism. By the time Dr. Robert Gingery had the chance to speak during the public comment session of the meeting, Santos had left the meeting before he could address him. Gingery also motioned towards an unidentified local politician in the front row, either Assemblywoman Mary Hayashi or Alameda County Board of Supervisor President Alice Lai-Bitker, saying they looked "disinterested and couldn't be bothered." Hayashi was also seen exiting the meeting before the end of public comments.

This is the second time, Santos has left a major gathering on the subject. In June, he slipped out of a health care district hearing shortly after 7 p.m. to address graduating middle school students.

An email from The Citizen to all council members and the mayor asking for a brief statement for a story exploring ways to save the hospital this week was returned only by Gregory.

One member, Bill Stephens, who is termed-out in 2010, has never attended any informal meeting or public hearing since disapproval with the county's plan to end emergency room services at San Leandro Hospital began to grow louder. Councilwomen Diana Souza and Ursula Reed were seen at meetings in June along with Joyce Starosciak, who announced this month she will oppose Santos for mayor next year. Starosciak has not made a specific comment on the issue.

Not all of the council has been ineffectual. Gregory held an early series of town hall meetings at the city council chambers and Prola has frequently addressed both the Alameda County Board of Supervisors and numerous public meetings.

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Corbett to Ask AG Jerry Brown to Investigate Sutter's Practices

STATE SENATOR TELLS LARGE AUDIENCE IN SAN LEANDRO SHE WOULD EXPLORE USING SUBPOENA POWERS TO BRING SUTTER OFFICIALS TO TESTIFY......SOME DOCTORS CALL ON HEALTH DISTRICT AND BOARD OF SUPERVISORS TO 'STEP UP TO THE PLATE'.....FORMER SLH CHIEF OF STAFF QUESTIONS SL CITY COUNCIL: 'THIS ISSUE ISN'T IMPORTANT ENOUGH FOR FIVE OF SIX COUNCIL MEMBERS TO ATTEND?'.....MAYOR SANTOS AND ASSEMBLYWOMAN HAYASHI DUCK OUT OF MEETING DURING PUBLIC COMMENT SESSION

By Steven Tavares
The Citizen

State Sen. Ellen Corbett is taking the battle to keep San Leandro Hospital and its emergency room open higher up the political food chain.

Speaking at a town hall meeting Thursday night in San Leandro, Corbett said she will ask the state's attorney general to investigate claims Sutter Health has engaged in a continual pattern of misrepresentation involving various hospitals in the state.

"This is just not San Leandro," Corbett told another large crowd at the San Leandro Library, "This is an ongoing historic pattern."

The letter to Attorney Jerry Brown's office currently circulating around Bay Area legislators, according to Corbett, will charge Sutter with a host of indiscretions which are grounded in the current fight to keep Sutter from leasing the hospital to the Alameda County Medical Center and becoming an acute rehabilitation facility while closing the hospital's emergency room services to an estimated 27,000 patients a year.

Corbett will ask the attorney general's office to investigate the following:

• Sutter-run hospital finances.
• Practices of economic and medical redlining.
• Abuse of non-profit status.
• Misallocation of public assets
• Execution of contracts in conflict of existing law

A spokesperson for Sutter Health could not be reached for comment.

Corbett said there is interest among various committee chairs to invite or possibly subpoena Sutter officials to answer legislators questions in Sacramento. The idea stems from a conversation with Assemblyman Jared Huffman (D-Marin), who is himself is dealing with Sutter's planned extrication from Marin General Hospital and charges it funneled $88 million dollars from the facility. According to Corbett, the idea is being explored and is in the preliminary stages.

After tumultuous week when the Eden Township District Board of Directors voted Aug. 18 to block Sutter's purchase option for San Leandro Hospital, only to be one-upped the next day by Alameda County Medical Center's announcement of a lease agreement with Sutter to run the hospital as an acute rehabilitation center, Thursday's discussion may have laid the groundwork for a legal strategy to keep the community hospital open.

"We are trying to show to the attorney general that there is this pattern of abuse," said Corbett, "and if you have legislators saying, 'hey, this happened in my community and this happened in my community,' I think it will help them to understand that this is a big issue that has to be addressed by our chief law enforcement officer and I think he will investigate."

Dr. Miles Adler, who was once chief of staff for both San Leandro Hospital and Eden Medical Center in Castro Valley, said Sutter only believes in the bottom line, ""We need to remember that Sutter's motto of community based and not-for-profit operations is bogus because as everybody has talked about today, Sutter is all about profit."

Adler then charged Sutter with choosing insured patients over those on assistance or non-paying. "What Sutter is trying to do is basically medically redlining this community. Government payers are not particularly lucrative. By eliminating San Leandro Hospital and taking the paying patients over to Eden this will enhance their revenue. This is what they are doing."

"Should a non-profit be doing this?" asked Corbett. "They have 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?"

San Leandro Councilman Michael Gregory, who represents the district San Leandro Hospital resides, also found fault with Sutter's non-profit status. "I would question them being a non-profit corporation, but I would say everything they do is legal, but is it ethical?"

"This plan was set two years ago," said Gregory, "and [Sutter] has done a masterful job of taking power over the hospital away from the district. This case is a little more airtight than other situations, but this is not a real estate deal. This is about the community and it's about Sutter not playing fair in the sandbox."

Additions to this article have been made since its initial posting.

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Brain Dead, Bed Wetters, Believers of Unicorns; Stark Goes Off

STARK HOLDS FIRM IN QUEST FOR HEALTH CARE REFORM WITH PUBLIC OPTION
In the latest sign Democrats in Washington are easing away from achieving bipartisan support for health care reform, Rep. Pete Stark had pointed remarks reserved for opponents of various plans in the House, especially those backing the latest nouveau plan--health co-ops.

During a teleconference with reporters, Stark harshly questioned the viability of medical co-ops recently discussed by various Senate Democrats, equating the proposal with belief in a mythical medieval creature, according the Huffington Post.

"But, as I say, there is no real example of either the regulation, or how you would establish them, or where they would get enough people to have a purchasing base. So you might as well talk about unicorns." Stark said, "You know, what is a medical unicorn? My kids all know what a unicorn is. But you don't. You have never seen one. So I think this co-op is just a way of ducking the issue of having the public plan."

He also questioned one of the backers of the plan and his political gravitas representing what Stark said "less than three percent of the rural constituency." At a town hall meeting before the Alameda Democratic Club Aug. 12, Stark also challenged another of the co-ops supporters, Sen. Max Baucus (D-Mont.).

"I would debate Max Baucus on the issue of health care any day, anytime, anywhere and bet money before the debate--my money," Stark said to applause from the decidedly progressive audience.

During the same conference, the AP reported Stark called Blue Dog moderates in his own party "brain dead." He recently referred to them as "bed-wetters" and questioned whether their intentions were genuine. "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."

In recent days, Democrats have quietly discussed the notion of passing a health care reform bill without help from Republicans. The loss of Sen. Edward Kennedy this week to brain cancer may make reaching 60 votes without bipartisan support from Republicans may be difficult, but not untenable.

The issue of medical co-ops is in some ways a relic of the Great Depression where local communities banded together to create affordable services where none previously existed. Two notable health care versions still exist in Minnesota and the Puget Sound area near Seattle.

Stark recently called the Group Health Cooperative of Puget Sound "not very successful" and mocked its rural roots by describing it as "all our neighbors getting together like a barn-raising. We're all going to get together, hold hands and sing 'Kumbaya' and give everybody health care," he said, "I don't think they are the end-all and be-all for the way to deliver medical care."

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Toyota says NUMMI to close in March 2010

PLANT CLOSURE WILL AFFECT MORE THAN 4,700 OUT-OF-WORK AUTO WORKERS
Toyota announced earlier today it will close the NUMMI plant by March of next year. The decision, which became increasingly likely after Toyota said earlier this week it would ratchet down global production of its vehicles, will put over 4,700 unionized auto workers out of work in the Bay Area.

“I was very disappointed to hear that Toyota has made this announcement." state Sen. Ellen Corbett said in a statement, "I, along with other state lawmakers and the Governor’s office, have been working very hard to create a package of incentives to keep the NUMMI plant open.”

Assembly Majority Leader Alberto Torrico of Fremont undaunted by the news expressed hope in keeping the last auto plant in the Western United States open when he told The New York Times, “There are great costs in shutting down a plant and moving to a different location, and we think there are still some cards to be played.”

The economic impact to area could be devastating. According to estimates reported by the Los Angeles Times 30,000 jobs which depend on NUMMI could be cut and over 1,000 companies concentrated in Alameda County will be affected.

In many ways, the death of NUMMI evokes similar times that eventually led to its unique cooperation between competing car companies. The crippling recession of 1981-82 led General Motors to close the sprawling auto plant leading to its rebirth two years later as way for GM to learn more efficient Japanese manufacturing models and allow Toyota to experiment with its operations in North America. Corbett, in her statement, hopes to attract another auto manufacturer if all possibilities with Toyota are exhausted. She estimates over 5,000 workers in her district will be affected by the closure.

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GM was Too Big to Fail, but is NUMMI?

SWEETHEART DEAL TO WORLD'S #1 CAR MAKER NEEDS TO BE EXAMINED
When John Garamendi attached the phrase "too big to fail" withthe rescue of NUMMI, the words conjure not unemployed auto workers by the thousands, but car manufacturers reaping the benefits of their own mismanagement.

The sentiment is now so ubiquitous that it's used to describe every industry in dire financial straits. The thing is, though, if General Motors is a hulking dinosaur of a bygone era of manufacturing in America, then why is saving NUMMI any different, other than this time, it is our backyard and not Flint, Michigan?

This is a difficult question for many in the Bay Area and the state where mismanagement and a virulent strain of a bad economy is crippling California's ability to thrive and compete. Early this year, many urged the Obama Administration to let the rickety-old patient in Detroit die a honorable death. Some concluded propping GM and Chrysler is nothing more than putting a billion dollar band-aid on a terminally-ill patient. Both companies eventually filed for bankruptcy (GM's leading directly to their decision to pull out of the NUMMI partnership with Toyota) and now see a future as a smaller, hopefully innovative auto company.

But, what about other companies and employee that halo around the auto industry? The argument was made in Michigan and adjoining rust belt states where the business of building cars extends far from the assembly plant. Peripheral companies that make leather seats, carburetors and steel companies among others would also fail. Politicians in the East Bay are saying the same thing and both sides are correct. Over 4,700 highly-skilled wage earners and linked businesses will falter greatly, but the difficult question is how long will these companies and worker skills be useful in California's future economy anyway? A vast majority of those painters, middle managers and line workers will not fit the state's creative and high-tech industries without a vast training initiative.

Even when the recession ends and companies actually start hiring, the future of auto companies still look tenuous, at least, without some sort of "Cash for Clunkers" type program. Banks will not be lending as they once were. Interest rates will be high, home equity loans will become scarce and in NUMMI's case, the rush for environmentally-friendly cars does not extend to Corollas and Tacoma trucks. Even with the help of Sacramento, there is a good chance some of these workers will be laid off.

Sacramento's typical response has been to obsess over the future, before eventually giving in to the present quagmire prolonging the state's recovery. The budget passed last month did precisely this by gutting education and health care for those most needy and borrowing billions from already reeling cities and counties. Now, we want to bail out Toyota or as state Sen. Ellen Corbett told the San Francisco Chronicle last Friday, "to let Toyota know that we love them and we want them to stay in Fremont."

Giving the world's largest automaker tax breaks, offsetting losses for up to 15 years and lending up to $30 million to retool the plant is more than love, it's a torrid sex scandal. Thousands of jobs would be lost that may be cut eventually. The economy of California is not geared towards manufacturing any longer. It's difficult to believe such a massive reduction of employment is good, it's not, but it illustrates clearly how the once Golden State has no plans for returning to those halcyon days when we were the envy of the industrialized world and leader in so many areas. Washington couldn't fully face this fact earlier this year with GM and apparently California, too, would like to worry about today rather than tomorrow.

-STEVEN TAVARES

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Sutter Train Keeps on Rolling

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Respectfully, this Bill is Bad; Don't Hurt Me

OP-ED PIECE SHOWS HAYASHI'S PROPENSITY TO ATTACK
Assemblywoman Mary Hayashi will cut you.

The recent side-by-side Op-Ed pieces in the San Francisco Chronicle shows how Hayashi can praise you, then before you can say thank you, will rip you to shreds.

Rep. Jackie Speier, who authored legislation six years ago that stopped insurance companies from steering customers to preferred repair shops, dared to criticized Hayashi's bill that attempts to roll back some of those consumer protections by giving companies a final chance to make the hard sell.

"But that's all about to change," Speier wrote, "because of an industry-sponsored bill and a recent legal ruling that are conspiring to make consumers the least important person involved in car repair decisions."

That's alright, 'I like you,' Hayashi seemed to be saying. "Like so many in the Bay Area, I highly respect Rep. Jackie Speier. She has been a champion for consumers, and established California's anti-steering law to protect our right to select the auto body repair shop used in an insurance claim."

But wait. Before Speier could begin to think about an invitation to Hayashi's Labor Day BBQ (if she has one), the snipping began:

Unfortunately, AB1200 has been subject to a disinformation campaign led by those who have a vested interest in not allowing insurers to discuss these options with their claimants. These include trial lawyers who sometimes file questionable or frivolous lawsuits related to auto body shop repair.

Additionally, one opposition leader, Richard Steffen, who served as Speier's chief of staff during her time in the state Legislature, is now employed by and is representing auto body shop organizations that have an interest in maintaining inflated auto repair prices for consumers.

Making not nice with opponents is nothing new for Hayashi. Many will remember the two-term assemblywoman's flap with state Sen. Ellen Corbett that raised many eyebrows across the East Bay. Hayashi failed to cast a vote in committee that would have approved Corbett's bill. The bill, since passed, (actually passed the Assembly Appropriations Committee last week) set off fireworks between the two camps as Hayashi called the bill she co-authored "a work in progress."

Former Alameda County Fire Chief Bill McCammon who was defeated by Hayashi for the assembly in 2006 also faced her wrath after a round of hard-hitting mailers. Hayashi narrowly defeated McCammon, who won the endorsement of the San Francisco Chronicle, but did not allow the scars of the battle to heal and continued to punish McCammon well after the primaries.

As written in an Citizen editorial two weeks ago, Hayashi's talking points like to feature the reasonable notion that more information is always to the benefit of consumers, but in this case, all information is not created equal. If Hayashi is asking for the public to believe the word of multi-billion dollar corporations in the era of Madoff, AIG and 11 percent unemployment, she's not going to get it. She ends her piece with a curious bit of elitism when she notes the Assembly passed her bill 78-0. Are we to infer the best interests of Californians are being sought by Sacramento or rather the insurance lobby has reached everyone in the Assembly?

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Q&A with Sutter VP of Communication Bill Gleeson

The lease between Sutter and the Alameda County Medical Center was signed Aug. 3, why wait until Aug. 19 to announce it? There is a perception in the community that Sutter is not being transparent about its actions. How does Sutter respond?
It wouldn’t have been appropriate for Sutter Health to announce the lease while the other public entities, including Alameda County Medical Center, were conducting their internal processes.

If Sutter believes the Eden Township Healthcare District no longer has authority over your plans for San Leandro Hospital, why does Sutter continue to participate in their dealings?
We haven’t. The District board has yet to convey the hospital to us following our exercise of the option to purchase. We continue to abide by the requirements in all of the agreements; if this involves a mediation process, we will do so.

In regards to the Health & Safety code 32123 cited by Sen. Corbett, could you explain Sutter's position, apparently, that the transaction is less than 50 percent of ETHD assets?
The option for Sutter Health to purchase San Leandro Hospital was agreed to by the District in 2008. We believe that the District complied with applicable law with regard to this agreement.

The plan laid out by ACMC for SLH is exactly the same as 6 months ago. This plan has been Sutter, ACMC and Health Services favored option. In a sense, we are at square one. The community has been vehement in its desire to keep the ER open. Is Sutter disregarding the wishes of the community?
We have determined, as have the District and Alameda County Medical Center, independently of Sutter Health and Eden Medical Center, that continuation of the current services including the Emergency Department would require an annual subsidy exceeding $5 million. Our investment now exceeds $30 million over five years. The status quo is not sustainable without a subsidy.

Perhaps the best and most accurate gauge of the community’s wishes is the actual utilization of San Leandro Hospital’s services. San Leandro Hospital is under-utilized by the San Leandro community, and the majority of visits to the San Leandro Hospital ER can be accommodated by urgent care services. Eden Medical Center maintains a full-service ER just a few miles away. Sutter Health considered public input as well as the community’s actual hospital utilization.

Legality aside, how do you explain to the public Sutter has leased a community asset to another entity when it is unclear whether they own said property. I'm not looking for a legal answer such as Article V of the Memorandum of Understanding gives you the authority.
Our lease of the property to Alameda County Medical Center is conditioned upon its acquisition from the District. The lease with Alameda County Medical Center does not begin until we have acquired the property from the District.

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The Power of the Well-Written Press Release...

....OR THE TRAGEDY OF A BARREN MEDIA LANDSCAPE
When the Alameda County Medical Center sent a press release late Wednesday afternoon, it attained the status of gospel most students of public relations dream about. Its talking points dominated the few articles written about San Leandro Hopsital last week.

The release was well-written, stringing together, in modest tones, every fact the county and Sutter has consistently offered. Make no mistake, this is precisely the job any PR department is designed to perform. It is not, however, the role of news organization to pass that information along unfettered without questioning its content. (Read the ACMC press release announcing its lease with Sutter Health here.)

The standard press release is intended to attract attention. It can become a cheat sheet for reporters, too. If for instance, the Lupus Foundation sends a press release announcing a fundraiser, give it to an intern and rewrite it. Yet as the traditional news media continues their slow slide into oblivion where staff is cut and resources dwindle, the power of the press release when it touts something more important and becomes the basis of a story bad things can happen, like, say, losing a hospital.

The tragedy is old news media outlets are going by the wayside, while public relations firms continue to churn out information in their favor.
___________________

An article on the web site of local CBS affiliate KPIX must have had PR people high-fiving. The ACMC press release trumpeted the idea San Leandro Hospital would remain open. "Alameda County Medical Center officials say they have signed a lease agreement that will ensure San Leandro Hospital remains open to the public," the article said. While it is true the hospital would technically remain open, the argument is quite specious, since while it would remain a hospital, it would not continue as an acute care facility with emergency room services.

The San Francisco Business Times even allowed ACMC's equivocation of "most likely" to creep into their lede paragraph. "Alameda County Medical Center said Wednesday it’s worked out a new lease deal to keep San Leandro Hospital open, but that 'most likely' that hospital will lose its emergency room and change into a physical rehabilitation and urgent care facility." This is kind of like persuading someone you're not going to hurt them while you hanging them out a 12-story building by the ankles.

Even further, both articles include the seemingly off-handed inclusion the deal would simply send emergency room patients to nearby hospitals such as Eden Medical Center in Castro Valley, Highland Hospital in Oakland or St. Rose Hospital in Hayward. In fact, this is the primary reason for the uproar in the community. The residents of San Leandro have spoken clearly in repeated public hearing they want access to ER services close to their home. This is an important fact omitted from every published article. The public does not want to travel for emergency room care and believe the consequences of doing so to be dire. This is what this story is about!

After a full month without publishing one story on the hospital situation, the Daily Review's Jason Sweeney plan to purchase San did his best to create an amalgam of the two hospital stories that broke last Tuesday and Wednesday, but to the layman the story does more to confuse the reader than illuminate. (By the way, did the Daily Review really need to include the exact address of San Leandro Hospital in the article? Where's the Oakland Coliseum? Oh, it's the giant concrete bowl next to 880. Thanks.)

According to the article, the Eden Township District voted against Sutter'sLeandro Hospital, but Sutter also leased the same hospital to ACMC. Are they buying the hospital, or not? Of course, this is what happened, but without explanation, it only makes the reader scratch their head and turn to the page to the Macy's advertisement. Call it the triumph of the press release or merely the reporters failing to do their jobs.

Unfortunately, San Leandro is becoming a very unwelcome experiment in what may occur when newspapers either fail to exist or drop the ball covering a region in the public's best interest. The deep complexities and contradictions of the San Leandro Hospital story is far too much for one reporter or a even a few to quickly digest. The tragedy is old news media outlets are going by the wayside, while public relations firms continue to churn out information in their favor. Even though, the public has turned out by the hundreds to voice their opinion at various public meetings, the pitch of their anger is small in comparison to the overwhelming majority of people who do not understand the issue or are not sufficiently alerted to its implications. If San Leandro Hospital is closed, you can easily make the argument its demise rests squarely on the shoulders of a hapless local news media.

-STEVEN TAVARES

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Starosciak Running for Mayor; Hires High-Profile Consultant

OAKLAND'S LARRY TRAMUTOLA TO ADVISE CAMPAIGN AGAINST SANTOS

San Leandro Councilwoman Joyce Starosciak has hired noted Bay Area political consultant Larry Tramutola to run her campaign for mayor next year.

Starosciak, who represents District 4, filed with the city's clerk office Aug. 10. She will likely face incumbent Mayor Tony Santos and possibly former school board trustee Stephen Cassidy.

The addition of Tramutola is seen as a coup by some. Tramutola is one of the state's top political strategist, but is primarily recognized as a go-to-guy for tax measures. He helped Starosciak win previous campaigns for the school board and her current seat on the city council.

Like most in the rough and tumble arena of politics, Tramutola is known for his controversial campaign literature. Such a gambit could backfire in San Leandro where the electorate is typically wary of negative campaigns. Nevertheless, Tramutola is expensive and it could take serious money to introduce the virtually unknown Starosciak to the community.

TRAMUTOLA PHOTO: FULLCIRCLEFUND

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Questioning a Eden Board Member's Mental Fitness

STRANGE BEHAVIOR OF DR. DVORSKY CONCERNS EDEN HEALTH CARE BOARD
The five members of the Eden Township Board of Directors sat around a small conference table Tuesday night. The CEO of the District Dev Mahadevan joined the group along with a lawyer from Sutter. About 50 dedicated supporters for saving San Leandro Hospital crowded into the room. The scene was intimate those inside. For others, the sounds of muffled voices struggled to reach the adjoining reception area.

When the discussion of lost minutes was raised, the board spent nearly 15 minutes both learning of the hastily reconstructed two-year-old minutes and devising a path to proceed. Member Dr. Vin Sawhney proposed the board take no action until a subsequent meeting, while another member Carole Rodgers felt she could not approve an entirely different board's minutes. The discussion, while not heated, went back and forth until the motion was put to a vote. All said "aye" except one member. The members stopped for a moment, realizing the 86-year-old member, Dr. Harry S. Dvorsky, did not vote. "How do you vote?" said the president of the board Dr. Rajendra Ratnesar.

"I didn't hear a motion," said Dvorsky, a retired thoracic surgeon who practiced at San Leandro Hospital.

"Ok, Harry," said Sawhney as he calmly gave Dvorsky the short version, "There are minutes here from 2007 that we are being asked to take an action to approve or not approve." Dvorsky nodded his approval and the meeting continued, but some with knowledge of the board's inner workings have quietly voiced concern over the mental health of the longest-serving board member.

"It's been on the minds of all the board members," said a person who declined to have their name mentioned because of their relationship with the board.

Dvorsky's capacity to perform his duties comes at a time when the fate of San Leandro Hospital hangs in the balance. In addition, the board has developed a split between those who tend to favor keeping the hospital and emergency room functioning (Sawhney and Rodgers) and those who have consistently voted with Sutter (Dr. Walter Kran and Ratnesar). It is conceivable that Dvorsky could be the wildcard in any future vote.

During Tuesday's meeting, Dvorsky, who rarely speaks during meetings, appeared detached and agitated, frequently blurting out sentences. When a doctor representing physicians read a statement to the board, Dvorsky harshly said, ""What the hell are you trying to say?"

On another occasion when state Sen. Ellen Corbett addressed the group he interrupted her saying, "You're going to have to speak louder." Corbett, who stood only a few feet away from Dvorsky, smiled and proceeded to speak louder.

The apparent inability to function within the board has become the proverbial 800-pound gorilla in the corner, yet despite the concern no action has been made to remove Dvorsky. Another official, who because of the sensitivity of the subject declined to be named, feared for Dvorsky safety after the meeting. When they witnessed him driving himself home they said, "He seemed a little bit out of it tonight."

One source described a first-hand account of a meeting about six months ago when Dvorsky turned to another board member and quizzically asked, "They're going to close San Leandro Hospital?"

In the meantime, the competence of Dvorsky is treated with a knowing smile and a shrug. As the meeting concluded, Dvorsky finally spoke as the crowd stood and a quiet commotion took over the room. "Thank you all for coming!" he said.

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Sutter Signs Lease with Alameda County Medical Center

SUTTER ATTEMPTS TO RAM DEAL THROUGH DESPITE BOARD ACTION
ALAMEDA COUNTY MEDICAL CENTER CEO ANNOUNCES SIGNING OF LEASE WITH SUTTER TO MOVE ACUTE REHAB TO SAN LEANDRO HOSPITAL.....LETTER SAYS E.R. AT SLH WILL BE CLOSED.....SUTTER SIGNED DEAL WITH ACMC AUG. 3......COMES DAY AFTER EDEN TOWNSHIP BOARD VOTES AGAINST SUTTER'S PURCHASE OPTION.....BOARD MEMBER DR. SAWHNEY: "I DON'T BELIEVE THE DISTRICT HAS NO RIGHTS."

By Steven Tavares

The Citizen

A day after the Eden Township Healthcare District board told Sutter Health they would not accept their bid to purchase San Leandro Hospital, the Alameda County Medical Center announced it had already negotiated a deal with the rebuffed health provider to lease the hospital as an acute rehabilitation facility.

According to a press release issued late Wednesday afternoon, the Alameda County Medical Center (ACMC) says it hopes to begin operations of the hospital without emergency room services beginning in early 2010.

“Alameda County Medical Center is pleased that this agreement will allow San Leandro Hospital to remain open and continue to serve residents in the surrounding communities, ensuring local residents have access to quality, affordable health care," said Wright Lassiter III, Chief Executive Officer of Alameda County Medical Center, "something that many in the communities we serve desperately need.”

In fact, most in San Leandro have waged a concerted effort to stop the plan to move rehab services from the seismically-deficient Fairmont Hospital to San Leandro. Doctors, nurses and hundreds of residents turned out for a series of hearings in late June voicing overwhelming opposition for the plan Sutter and ACMC now hope to resuscitate.

"Sutter believes they have the right to buy. That's their perspective," said Eden Township Board Member Dr. Vin Sawhney. "I don't believe the district has no rights. But, that's what they are claiming by signing this lease." Phone calls to both ACMC and Sutter were not returned.

A separate internal letter also sent Wednesday afternoon by ACMC to stakeholders reveals more insight into the lease agreement. Sutter and ACMC reached the lease agreement Aug. 3, less than a week after notifying the District of its intention to exercise its option to purchase.

The Eden Township Board of Directors were not aware of the transaction until recently according to Sawhney. Knowledge of the deal was the impetus for the motion brought forth by Sawhney and approved allowing the District to hire a second opinion lawyer to explore legal strategies to keep the hospital and emergency room open.

The letter continues to lay out San Leandro Hospital's possible future. "Our current plan is to operate San Leandro Hospital as an acute physical rehabilitation and urgent care facility and we are committed to exploring with community physicians the feasibility of continuing outpatient surgical and diagnostic procedures."

The plan is identical to the original blueprint created by Alameda County Health Services earlier this year which triggered numerous town hall meetings in San Leandro, sign-waving protesters at the Alameda County Board of Supervisors chambers and overflow crowds at the San Leandro Library and received the scrutiny of the area's elected officials in Sacramento.

The surprising announcement leaves the quest to save San Leandro Hospital at a crossroads. There is question as to whether the vote to block the purchase of the hospital by the District Tuesday night has legal merit under the memorandum of understanding signed last year. There is also uncertainty whether the health and safety code cited by state Sen. Ellen Corbett calling for a voter referendum when over 50 percent of a health district assets are transferred actually reaches that threshold.

Some believe the best possible strategy to keep hospital services intact entails suing Sutter for breach of contract. Under 2008 memorandum of understanding, Sutter agreed to remodel two floors of San Leandro Hospital for rehab services which have not be satisfied. As reported earlier, though, legal counsel for the Alameda County Health Services believes such a lawsuit does not have merit.

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Shades of Watergate; Missing Minutes, Blame the Secretary

BOARD ASKED TO APPROVE IMPORTANT RECONSTRUCTED MINUTES FROM 2008 HEARINGS
During Tuesday night's Eden Township Healthcare District board meeting there was no smoking gun, no deep throat or bumbling burglars, but there is suspicious evidence of missing information.

It was revealed minutes from hearings in 2008 detailing the Memorandum of Understanding (M.O.U.) between the District and Sutter do not exist and blamed the previous secretary. Many believe the agreement armed the health care provider with enormous power over the future of San Leandro.

During Watergate, investigators found the infamous 18 1/2 minutes of silence causing an uproar over White House malfeasance and corruption. The Nixon administration blamed the president's secretary Rose Mary Woods for the gap. Later, she testified to inadvertently erasing Nixon's conversation with his chief of staff.

Eden Township CEO Dev Mahadevan said the minutes did not exist and therefore never presented to the board for approval. The former secretary attempted to reconstruct the nearly two year old minutes from her notes, said Mahadevan, yet board members Dr. Vin Sawhney and Carole Rodgers along with state Sen. Ellen Corbett balked at the documents validity. "I find quite a few inaccuracies,"said Sawhney. "Even I spoke at these meetings and was not mentioned."

Further complicating the board's attempt to approve dated minutes is the current board is different than the group which presided over the signing of the M.O.U. "It isn't proper for me to sign minutes for a meeting that happened before this present board," said Rodgers.

Corbett told the board she read the minutes the night before and remembered many people who spoke at the hearings that were not recorded in the current version of the minutes.

The question becomes what exactly is missing from the piecemeal version of the minutes? Some believe the missing information may contain either motions or public comments not in the best interests of Sutter, while others speculate the faulty minutes as constructed would not be approved by the current board therefore allowing the M.O.U. as written and tilted towards Sutter's favor to stand.

"It's an indication of Sutter's manipulation of this board," said Mike Brannan of the California Nurses Association. "It's apparent they will get it what they want one way or another."

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Healthcare District Blocks Sutter's Plan to Purchase SLH

BOARD RECOMMENDS HIRING SECOND LEGAL OPINION TO EXPLORE OPTIONS TO KEEP HOSPITAL OPEN....MINUTES FROM DISCUSSION OF 2007 M.O.U. FOUND INCOMPLETE....SEN. ELLEN CORBETT URGES BOARD NOT TO MAKE DECISION WITHOUT ALL THE INFORMATION.....MEMBER DR. VIN SAWHNEY'S MOTIONS HELP BLOCK SUTTER'S PLAN.....SAWHNEY QUESTIONS RECENT TRANSFER OF $88m BY SUTTER FROM MARIN HOSPITAL.....BOARD MEETING HELD IN CRAMPED CONFERENCE ROOM

By Steven Tavares
The Citizen

CASTRO VALLEY, Calif. - In a cramped, unadorned conference room tucked between a local watery hole and a nondescript sushi restaurant the Eden Township Board of Directors voted to block the planned purchase of San Leandro Hospital by Sutter Health.

The vote as with many stops and starts in this slow-moving process hardly gives supporters of keeping the community hospital open a clear vision of the road ahead, but may create more options in the near future.

"I'm happy that we will be able to look for more options to save the hospital," said state Sen. Ellen Corbett. "Like it told them, I believe they don't have all the information they need to make a decision."

Corbett and others alluded to a section of the health and safety code that limits the ability of a hospital provider to transfer the assets of more than 50 percent of a hospital without a voter referendum. In addition to calling for a vote on the sale of the hospital, Corbett urged the board to seek an independent auditor to examine Sutter's claim of losing over a half million dollars a month at the facility.

The hastily planned board meeting held at the district office across the street from Eden Medical Center forced over 50 attendees to cram into a small conference room and its adjoining reception area. Previous hearings in June drew hundreds of residents and dozens of speakers.

"Just the fact that we are having this meeting when you knew the public would be turning out we're in this tiny conference room with limited access." said Mike Brannan, a labor leader for the California Nurses Association, told the board. "I'm sure the board didn't want it to be that way, but that's the kind of manipulation that we've seen on this board and it's Sutter trying to control what happens." During a closed session midway through the hearing which lasted over an hour, attendees, including Corbett, were forced to stand outside in the breezy Castro Valley evening. "I'm irritated. This is disrespectful," said Brannan.

As with the board's vote against the Alameda County Medical Center's bid to move acute rehab care from Fairmont Hospital to San Leandro, Board member Dr. Vin Sawhney again steered the board towards approving Corbett's calls to action and had pointed remarks for Sutter and an agenda item that sought to approve minutes from discussions of the 2008 memorandum of understanding. Sawhney and Corbett both characterized the minutes as inaccurate. According to Sawhney he recollected speaking at the hearings yet found his remarks missing from the recently pieced together document.

Eden Township CEO Dev Mahadevan explained there was no evidence the minutes were ever presented to the board. The secretary at the time was able to recently create a version of the lost minutes from notes, he said, but the document were found to be rife with omissions.

"I'm very concerned how you can place minutes on the agenda two years after, with a board that is seated that is different from the board at the time," said Corbett. "I think it really impacts the authentication of those minutes."

Sawhney also raised the issue charged recently by Assemblyman Jared Huffman (D-San Rafael) that Sutter transferred over $120 million in profits since 1995 from Marin General Hospital without the knowledge of that area's health district. Critics of Sutter in San Leandro have questioned why the Sacramento-based health care provider is not able to subsidize losses at the hospital from the profits of more successful facilities. "This is the track record that Sutter has," said Sawhney. "I do not want to take the numbers they give us."

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San Leandro's Donaire Wins Super Flyweight Title

NEW CHAMP INJURES HAND IN SECOND, WINS BY UNANIMOUS DECISION
By Steven Tavares
The Citizen
LAS VEGAS - San Leandro's Nonito Donaire won the vacant WBA super flyweight title Saturday night by unanimous decision over Panama's Rafael Concepcion despite injuring his left hand early in the fight.

Donaire (22-1) says he suffered the injury during the second round of the fight but continued to land heavy blows on his opponent who stood three inches shorter but weighed-in over four pounds heavy at 119.5. Sources estimated Concepcion had a ten pound weight advantage by the opening bell.

During the post-fight interview, Donaire said Concepcion's weight advantage played some part in his injury and took offense to Concepcion calling him a "coward" after the fight. "He's the coward," said Donaire in the press room. "He came in overweight."

Donaire said he believes the injury, which will be examined later, occurred in the second round when he opened a large cut under Concepcion's left eye.

Donaire, who grew up in San Leandro and attended San Lorenzo High School, controlled much of the fight, but the injury to his hand, which was visibly swollen and bruised over the middle knuckles, changed his game plan quite a bit.

Throughout the middle rounds, Donaire ran much and backpedalled around the ring, to which irked Concepcion and elicited derogatory comments from the Panamanian. The injured hand may have played a large part in Concepcion keeping the fight close. Donaire never was able to exploit Concepcion's cut, in addition, to difficulty defending his own head and body.

Donaire is expected to jump in weight class in the near future, despite saying he felt comfortable in the division and may fight again in December. Donaire noted his well-known spat with his father and former trainer weighed on his mind throughout the fight. "I kept hearing my family cheering for me. It bothered me. I kept thinking they were there in the crowd." said Donaire.

PHOTO: Matt Santos/www.msantosphotographer.com

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Main Event: Donaire vs. Concepcion LiveBlogging

WBA Interim World Super Flyweight Title
Hard Rock Casino & Hotel, Las Vegas, NV
Nonito Donaire (21-1, 14 KOs) 25, 5'8", 68", 115 lbs.) vs. Rafael Concepcion (13-3-1, 8 KOs) 27, 5'4", 119.5 lbs.)

Round 1
Concepcion opened with a few left blows to the Donaire's head, but Donaire controlled the first round highlighted with a a vicious low-slung left to Concepcion's head. Donaire is wearing yellow trunks in honor of Corazon Aquino, who recently passed.

Round 2
Action continues. Concepcion caught Donaire with a brisk combo, but Donaire ended it, cutting the opponents eye in the process. Bloodied. Concepcion though may have won the round with a blow that shocked Donaire late.

Round 3
Pace has slowed down from the second. Concepcion slips throwing a punch. Blood flow has ceased a bit. Yellow belt is quite red, chest splattered with blood.

Concepcion did not make weight--four pounds over.

Round 4
Concepcion's swelling eye is becoming a factor. With 30 seconds in round, Donaire lands a nice right Concepcion probably didn't see. Concepcion gives some attittude to Donaire after the bell. A bit of dancing, but last 10 seconds end in a flurry of punches from both fighters.

Round 5
Concepcion's mom behind press row is giving louder, more cogent advice than his corner. Midway, Donaire slips , Concepcion nearly lands a blow. Donaire is beginning to lose his form--getting sloppy. Concepcion head butts Donaire in last 30 seconds.

Round 6
Donaire is doing a lot of running, backing up in the sixth. Concepcion had Donaire in the corner before Donaire lands a heavy right to the head. Donaire has let up on hitting the swollen left eye of Concepcion. Concepcion corner doing a good job of keeping cut in check.

Round 7
Donaire continues to use the ropes and run corner to corner and landing consistent blows. Not much defense near end of 7th.

Round 8
Pace slows after frenetic seventh. Donaire lands of vicious straight armed right jab that stunned Concepcion. It remains to be scene is if Concepcion can stand muuch longer. Donaire leaving his head open to hits yet it's not fazing him.

Round 9
Fatigue setting in. Donaire taps Concepcion on the trunks, turns and smile and cheeckily hangs tongue out. For having as bad a cut as Concepcion has, the injury has not been a factor

Round 10
Much like the ninth. Despite, many blows and a hard upper cut, Concepcion doesn't look like he's going down--a tree. Some hard punching from Donaire. Concepcion nearly landed a blow to Donaire's face after the bell.

Round 11
Donaire's Ace Ventura-looking hairdo is mussed. Second round where Donaire has done some quick dodging of big Concepcion punches land his own offensive. Donaire lands three big, crowd-pleasing blows, but his theatrics put him vulnerable to a big Concepcion right with 30 sec.

Round 12
Final Round. At this point, Donaire should be way ahead on points. Donaire has landed 74 percent of punches to 22. Donaire slips and jumps up from the canvas. Ref and other crack a smile. Donaire dodging back and forth, running the clock out with 45 sec. to go. Donaire lulls Concepcion into running then returns and lands one of the biggest blows of the night. Flurry of punches in the end. Donaire should have this. just too much athleticism for the shorter, stocky Concepcion. The results....

DECISION
Nonito Donaire beats Rafael Concepcion by unanimous decision. Post-fight, Concepcion and his corner call Donaire "coward". Donaire says he broke his left hand in the second round. Sources say Concepcion may have weighed as much as 130 pounds. Donaire says he could feel the weight.

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With Twitter, Learning more than you Expected

The prevalence of Twitter is undeniable. Aside, from the insanity of announcing to the world how much you love Pop Tarts or comically musing about the evils of dolphins, the micro-blogging site when applied by insiders reveals a unique view of events.

The Twitter account of Nonito Donaire, the San Leandro born and bred super flyweight fighting tonight for the WBA title is just about as close to the players as you could be. You might argue it harkens back to a time when children sent fan letter to their favorite ballplayers and actually received a handwritten reply.

If you check out twitter.com/filipinoflash you'll find photos of himself being taped in the dressing room, but anybody could do that. Instead, you have Donaire responding to fans just over two hours before he fights Rafael Concepcion. Donaire asked Lawrence 88, "send me a pic of your PPV party dude!" and revealing the winner of the night's second bout, Diego Magdaleno, asked to use Donaire's shower. The 115-pounder Donaire said, "Sure it's 20 bucks LOL."

To be fair, it's not actually Donaire tweeting, at least, at the moment unless he has a computer with keys large enough to type with boxing gloves. Nevertheless, if you can't sit three rows from the ring, Donaire is giving fans an impressive peak at what most of us never see.

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San Leandro's Donaire Fights for the Title

The Citizen opens its local weekend sports coverage with coverage of the San Leandro's Nonito Donaire as he fights Rafael Concepcion for the WBA Interim World Super Flyweight Title in Las Vegas.

As with other local stories the local mainstream media misses; hospital closures, the inner-workings of our elected representatives, and news before it happens, the press has forgotten about the highly-touted flyweight from San Leandro and graduate of San Lorenzo High School.

Keep up with the bout tonight and this weekend at The Citizen.

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Stark: 'We're going to have a Bill, I'm quite sure'

CONGRESSMAN HEARS IT FROM PROGRESSIVES IN ALAMEDA

By Steven Tavares
The Citizen

ALAMEDA, Calif. - "Nobody wants to disrupt?" Rep. Pete Stark playfully asked members of the Alameda Democratic Club Wednesday in what may be a preview of his remarks this weekend.

In contrast to the wild scenes of livid protesters and politicians being drowned out by the commotion, Stark, instead, had to deal with a somewhat irked progressive mob urging for more health care reform than he wants to deliver.

Anti-tax protesters may be girding themselves for Saturday's trio of town hall meetings in Alameda, San Leandro and Fremont. Protesters from the Tea Party Patriots, among others, are expected to "counterprotest" the monthly meetings, but Stark is circumspect about their participation in what is a normally quiet, lightly attended affair.

"I'm uncertain and ambivalent if the town meetings are so disruptive that we can't hold them--I'll be back in September," he said. "I just don't choose to get into any beef with them. If they want to shout and scream, I'm just inclined to let them shout and scream." Stark added he has been meeting with his constituents in this manner for over 38 years. "I just wasn't about to quit having them now," he said. Stark also believes the voracious opposition of the health care reform by some is rooted in misinformation being offered by some high-profile conservative pundits.

"Many of the disrupters are scared and they're scared that they may lose the right to select their own doctor--which is not true, but somebody scared them. If they came and discussed it or listened maybe you could take that fear away," said Stark. "They have every right to come and discuss those issues and hope they would."

The bill that comes will be a bill that I won't like and none of you will like," said Stark. "You'll all dislike it for different reasons, but if I can be reasonably assured that in five years, north of 95 percent will have access to a health payment plan--I'll support it.
__________________________

For differing reasons, some people are beginning to sour on health care reform the president believes will ultimately give health insurance to over 97 percent Americans and is part of Stark and other Democrat's plan to use the town hall format to educate the public of their plan, yet the group in Alameda appeared far more savvy than those witnesses on cable TV and Youtube.

One member grilled Stark on his decision to back the public option plan instead of the more popular progressive desire to enact a single-payer program. Stark agreed a large portion of the 13th District want the single-payer plan, but he says it is political inconceivable and too much, too fast for the appetite of most voters. "The American public doesn't make these kind of radical changes rapidly," he said.

The liberal lion of the Congress and chairman of the House Ways and Means Committee on Health, is normally sensitive to the left-leaning populace of Alameda County, but has become a pragmatist on this possible landmark legislation on the minds of Democrats since the days of the Franklin Roosevelt's New Deal.

"The bill that comes will be a bill that I won't like and none of you will like," said Stark. "You'll all dislike it for different reasons, but if I can be reasonably assured that in five years, north of 95 percent will have access to a health payment plan--I'll support it."

At one point, Stark appeared to be stoking the same high-voltage rhetoric recently attributed to the likes of Lou Dobbs and Glenn Beck when he asked how many in the audience, many of whom already carried Kaiser as their primary health insurance, would like to switch to a new plan.

"How many here have Kaiser?" asked Stark. "Alright guys, on Jan. 1, 2010 all your plans end--Kaiser, Aetna, Blue Cross--they're all gone and I'm going to bring you a plan from Washington that you're going to love! There were three million people on The Mall cheering for Obama, there will be three million people burning me in effigy."

Despite more questions challenging his position, Stark said his bill would allow those happy with their coverage to keep it while also incorporating the benefits of the single-payer plan. "Single payer would disrupt about 90 percent of what people have and we have a commitment from our president that if you like what you have, you can keep it," he said. "Under single-payer you could not. I think we can accomplish all of the benefit of single-payer in our bill."

Now, it's on to a less formidable opponent for Stark this weekend--the teabaggers.

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Stark says Bill views Same-Sex Couples as a 'Family'

TEXT OF HEALTH REFORM BILL PROPOSES CONFUSING DEFINITIONS
ALAMEDA, Calif. - A gay couple asked Rep. Pete Stark Wednesday night how the bill he co-sponsored with many in the House Democratic leadership defined a family.

Stark said, "A family is more than one person."

"How about the two of us," the man asked. "Are we a family?"

"Under our bill, you are a family," Stark replied, but cautioned, "Whether that will stay or not is anybody's guess."

A look at HR 3200, America's Affordable Health Choices Act of 2009, defines a family as "an individual and includes the individual's dependents." Going further, the term "dependent" is defined as the "meaning given such term by the Commissioner and includes a spouse."

As if health care reform was not controversial enough, the president and the authors of the bill would hardly welcome the political hot potato of same-sex marriage into the equation. Stark's response seems aimed at the definition of family outlined in the bill. The wording sounds similar to benefits one might receive from employer-based health insurance covering a married couple, common law partners or same-sex unions, yet the subsequent definition of dependents confuses rather than clarifies.

If passed, could the bill already possibly diminishing the rights of same-sex couples to affordable health insurance also be open to hostile interpretation in the future? It also raises the question if this is the best liberal step forward, what would a compromise with Blue Dog Dems and Republicans look like?

--STEVEN TAVARES

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'What exactly is the public option?'

Rather than blaming conservative commentators for the diminishing support of the current health care reform bills in Congress, maybe it's the fault of supporting Democrats for failing to explain it in an easily digestible sound bite. One of authors of the public option plan, Rep. Pete Stark, responded to the basic question Wednesday night from a member of the Alameda Democratic Club who asked, "What exactly is the public option?" The following is Stark's part incoherent ramble, part enlightening response measuring just under 400 words:

"The public option we have in our bill is an insurance program that benefits, well, go back. Private insurance companies will be regulated and the standard benefits will be set, probably similar to Medicare, which is pretty broad in what it covers and then there would be add-ons, sort of like supplemental those of you already buy. We specify what exactly will be in those plans. Then there will be a plan that will be designed by Health and Human Services that will be what's referred to as the public option. It will be not-for-profit. It will be self-sustaining. It will receive no taxpayers subsidy. It will charge a premium that will be sufficient to pay the benefits.

For the start-ups, unlike private insurance companies, it will have no beneficiaries and no reserves. We will advance it a couple of billion dollars to get it started. We will repay the federal government out of premiums, not out of taxpayer money so that the public plan will be as financial independent as any other public company. You must spend 85 percent of what you take-in in terms of benefits just as other private insurers. The public plan will negotiate with hospitals, doctors just like the private companies do. Hopefully with our experience, it will have very low overhead. We like to think we can do it for less than 10 percent and there aren't many private insurance companies that can get that close. So, it is just there to set rates and standards by which the private companies will have to compete.

Our theory is we can sell you a family program or your employer for $10,000 for the standard benefit and you have to make the case you want to go to Aetna and pay them 12. I can't think of a particular reason for you to do that unless they came up with something we can't think of, which I doubt. It is there for us to hold down the costs and provide an option. We have many areas of the country--I think it's 30-odd states--where there are only one insurer. Talk about competition? If you go to South Dakota, it's Blue Cross and nobody else. In these communities, the public plan becomes the competition."

Got that?

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Covering the Health Care Debate as Wrestling Match

TEAPARTY-PATRIOTS.COM

ANTI-TAX PROTESTERS TARGET STARK'S TOWN HALL MEETINGS
It's Rep. Pete Stark's turn to navigate the wrath of "counterprotests". Whether the protests are artificially created opposition as House Speaker Nancy Pelosi calls them, AstroTurf or genuine right wing exasperation with the President's growing deficit, the congressman's public appearances this week should be present quite a stark difference over the normally austere, quiet gatherings he is accustomed.

Stark is quite a large target for opponents of the President's desire to provide affordable health care to nearly all Americans. As one of the authors of the House health care reform bill floating around hospital and a reputation as one of the Capitol's most liberal legislators his appearance almost makes anti-tax groups in the Central Valley and South Bay froth at the mouth (you need medication for that ailment). If they are poised to jump on Republican Rep. Dan Lungren at his town hall meetings, what will they have in store for Stark?

A quick look at a few of the web sites belonging to these "counterprotest" groups provides very
limited snapshots of how they were formed. For instance, the site for the Tea Party Patriots merely provides links to other groups, which in turn provide very little information or give a sense of any central authority. This raises the question whether they are indeed empty organizations built primarily to cause a ruckus or a growing organic group solely about the cause and not personalities.

Earlier today, the San Leandro Community Action Network (SLCAN), sent followers an email alerting them to the high probability of protesters attempting to drown out Stark's monthly series of town hall meetings this Saturday. Could you call them "counter-counterprotesters"? SLCAN advises their members to get there earlier and occupy the front rows , bring signs and don't entice the protesters. The Tea Party Patriots say don't act foolish, download their signs, talk cogently to the press and don't be belligerent. Although, everyone is advised to play nice, somehow the scene across the country has been dotted with deafening voices drowning out civil and civic discourse. Earlier this week, protesters baited Sen. Arlen Specter to stray from his remarks ("Wait a minute!" Here's the video) and Rep. Susan Davis (D-Calif.) had a mob of protesters cat-calling departing visitors of her town hall meeting hollering, "go home to your mamas, faggots!"

Obviously, many of these protesters are not veterans of the local political scene. Apparently, pulled from surrounding rural areas without a personal stand to draw from, these protesters amount to little but loud-mouth filibusters, but can we fault the mainstream media? Yes and maybe yes. Conservative media mouths like Glenn Beck, Michelle Malkin and Lou Dobbs have stoked the furor with misinformation and straddle the borderline between stoking a genuine anger in the populace to inflaming violent action. The television and print media, by focusing on the protests, may also be doing journalism an injustice by shamelessly spotlighting the WWE antics of these groups rather than debating the bill's strengths and weaknesses. Is this about yelling and screaming or health care for more Americans?

• STARK THIS WEEK
• Wednesday, Aug. 12, 7 p.m. Speech at the Alameda Democratic Club, Alameda Hospital.
• Thursday, Aug. 13, 3:45 p.m. "Fireside Chat", Hilton Hotel, Newark, Calif.
• Saturday, Aug. 15, 9 a.m. Town hall meeting, Fremont, Calif.
• Saturday, Aug. 15, 10:30 a.m. Town hall meeting, San Leandro, Calif.
• Saturday, Aug. 15, noon, Town hall meeting, Alameda, Calif.

About a year ago, I covered a similar dynamic within the protesters of Code Pink who desired to force out the Army recruitment center in Berkeley. Clad in their trademark pink-hued t-shirts and creative costumes, they camped in front of the old Berkeley Library, sang protest songs from the Golden Era of protest and snacked on organic cupcakes. Veterans supposedly aligned with nondescript groups counterprotested the protesters the next morning. I spoke with aging, disaffected Vietnam vets who teased Code Pink as "hippies around the campfire" and wondered how men dressing in pink dresses was going to help the United States win the war against terrorism. The next morning, these same vets yelled, chanted and angrily tossed epithets of every persuasion at the Code Pink protesters. The story that day along with photos of angry faces screaming at each other led the newscasts and topped the first pages of newspapers. The story was about the conflict, not about whether the war was justified.

This week, the story will be some right wing lunatic taunting the irascible Stark into a fork-tongued retort to be plastered all over YouTube. Stark, already has a few web hits from the House. In the end, the protesters win because every day that passes without discussion of how to enact and pay for health care will allow another person to fall into debt because of injury and illness and allow the status quo to stand for at least another decade or more.

-STEVEN TAVARES

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California’s Hidden Deficit: Unemployment Insurance Fund Owes $2.6 Billion

By Olga Pierce
ProPublica

Seventeen states have been forced to borrow federal money because their unemployment insurance trust funds have run dry — but even among this group one state stands out from the rest.

California, which now owes $2.6 billion, has the most indebted trust fund in the nation. For the last month, the state has been borrowing at a rate of about $30 million per day.

Source: California Employment Development Department

State workforce department officials estimate that by the end of 2010, the state’s fund will owe a jaw-dropping $18 billion.

A historical compromise left the U.S. with a patchwork system [3] of 53 different trust funds operated by states and territories, which are able to decide their levels of financing and benefits provided they comply with federal guidelines that have not been updated for more than 25 years. The result is a system where some states have ample funds for unemployment insurance, and some run out. Workers in the most generous states get benefits twice as high as those in the stingiest states.

(How is your state’s unemployment insurance trust fund faring? See an updated chart here [4].)

As is the case with most of the other states whose trust funds are empty, the funds coming into California’s trust fund have barely kept pace with the money being paid out in benefits. In times of recession, unemployment benefits function both as a helping hand for workers in need and an automatic form of economic stimulus by keeping people spending and businesses open.

When the unemployment insurance system was created, the intent was for states to accumulate reserves during good years and then let that money flow into the economy to ease economic rough patches.

Instead, as we reported earlier this year, many states let their reserves dwindle [5] to nothing and have been forced to either cut benefits or raise taxes at the worst possible time—the middle of a deep recession.

California’s recent problems date back to 2001 when Democrats in the state legislature had the simple majority required to increase benefits, but not the two-thirds majority required to raise taxes to a rate that would make those benefits sustainable.

Ever since then, the state has barely been able to break even, let alone accumulate trust fund reserves required to weather a recession like the current one. Even in 2004, a relatively good year, the state found itself borrowing federal funds.

The stimulus bill provides for interest-free loans to states until 2011, but if California can’t pay off the bulk of its loans before then, it faces interest bills of more than $500 million per year. And according to federal borrowing rules, that money must come out of the state’s general fund, which means less money for other priorities.

The legislature is debating several proposals to stop the bleeding, including a provision similar to other states’ that would automatically adjust tax revenue upward as wages increase, thus ensuring sufficient funding each year with no need for the legislature to take action.

But all of the proposals yield to harsh economic reality: For the trust fund to regain solvency, businesses will have to pay higher tax rates, and benefits may have to be cut.

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

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Hayashi's Green Building Bill signed by Governor

BILL TOUTED AS 'GREEN' INCLUDES ALL TYPES OF CONSTRUCTION
California cities can now build green to their hearts content because of a bill authored by Assemblywoman Mary Hayashi's signed into law Thursday by Governor Arnold Schwarzenegger.

The bill, AB 210, allows for stricter building codes than currently set by State's Building Code. According to a statement from Hayashi's office, many cities are unable to enact green building designs due to the requirements.

While the bill is highlighted as a progressive advance in green building, it makes no distinction between environmentally-conscience construction and conventional building outlined by the state. "This bill would specify that the requirements and regulations that a city or county is authorized to change or modify includes, but is not limited to, green building standards," according to the language of the legislation.

While the bill may remove oversight away from the state to communities and developers, it also comes at a time when the state's unemployment hovers over 11 percent and a stagnant, but slowly reemerging housing market seems poised to reignite. The state may also benefit from the allotment of Federal stimulus money earmarked for what the Administration believes is a resurgent economy based upon green jobs and technology.

“AB 210 goes one step further by giving cities and counties the legal authority to surpass the state’s standards in the fight against global greenhouse gases," Hayashi said in a statement. "State law should set the minimum criteria for buildings but not limit a municipality from becoming the greenest city in the world.” (Click here to listen to Hayashi speak in January about the the future of green technology and jobs.)

The bill sailed through the Legislature without much opposition and was one of 128 bills signed by Schwarzenegger.

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Santos: Hosptial's losses partly from Doctor's Private Practices

DOCTOR: HE DOESN'T HAVE A CLUE

By Steven Tavares

The Citizen

In late 2007, Sutter Health signed a deal with the Eden Township Healthcare District which, barring the continued collapse of San Leandro Hospital's finances, would keep the facility open past 2010. Some, though, continue to charge Sutter with accounting shenanigans hastening the hospital's demise.

The Memorandum of Understanding (MOU) signed by the health district and Sutter implied the hospital's future was pinned to hopes it could turnaround losses Sutter says amounted to between $300,000-$500,000-a-month. Many doctors and nurses and community leaders, though, assert Sutter applied accounting gimmicks and stymied the hospital's ability to succeed, in effect, stacking the deck against the city's lone medical facility.

"They gave lip service saying they were trying to increase services and revenue," said Dr. Miles Adler, the former chief of staff for both San Leandro Hospital and Eden Medical Center, "I've always felt the desire, although stated differently, was to close San Leandro Hospital."

Critics have long accused Sutter with cooking the books, but the charge has gained new attention since Sutter's surprise announcement to purchase San Leandro Hospital last week. According to the terms of purchase outlined in the MOU, when reported losses by the hospital are deducted from the net book price of the hospital (estimated at $25 million), the facility purchased by the District for $35 million in 2004, effectively belongs to Sutter.

Adler characterized Sutter's accounting method of cost accounting rather than cash accounting as a primary culprit of the incongruity between ravaging losses on accounting ledgers and emergency rooms teeming with patients. "If you go to 7-Eleven, put $1 on the table for a lottery ticket possibly worth $13 million and you lose," he said, "then according to Sutter's accounting they would say they lost $13 million."

In an interview today with San Leandro Mayor Tony Santos, he believes the policy by some doctors to send patients for diagnostic testing outside of San Leandro Hospital is one reason why the hopsital is in the red. "I do believe Dr. Adler is disingenuous as are some other doctors," Santos said, "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."

"The mayor does not know what goes on in the medical field," said Adler, "He has no clue and never has had one. Because of a weak mayor and weak city council, we are in this position."

Santos recounted an instance when his son--a patient of Adler's--was referred for diagnostic tests in Hayward rather at San Leandro Hospital. "I asked my son, 'why don't they send you to San Leandro?,'" said Santos.

According to Adler, on occasion, doctors send patients outside the district for tests not available in San Leandro. "We send certain work out," said Adler, "This isn't something that just happened. It has always been this way."

Adler says sending patients to other facilities is not the problem and oftentimes attempts to save patients money in this tight economy. "Dr. Adler saving patients money is not the problem," he said "I have a responsibility to save money for patients when I can. Would you rather have a colonoscopy at another place for $500 or pay $4,500 at San Leandro Hospital?"

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Sutter's Desire to Purchase SLH Surprised Mayor

SANTOS: SUTTER SAID THEY WANTED OUT
San Leandro Mayor Tony Santos said he was led to believe Sutter Health was planning to transfer its option to purchase San Leandro Hospital to the Alameda County Medical Center last Tuesday. Instead, the Sacramento-based health provider choose to purchase the hospital.

"I was stunned," Santos said. "I was led to believe the [hybrid] option was possible. That's why I have been pushing it lately and I had been told Sutter wanted out." Santos later said the identity of his sources were "people close to Sutter."

He also hopes Sutter reveals its intentions sooner rather than later. "I would hope they would make a public statement to what their intent is then we can react," he said. A spokesperson for Sutter was not available for comment.

Santos also reiterated his backing for a district-wide parcel tax to be put on the ballot next year at the earliest, but because of the timing of the next election cycle and the latest possible date for the closing of the hospital roughly occurring simultaneously in June 2010, it's doubtful such a measure would help.

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Hayashi's bill allows Insurance Companies to Crash the Party

THE EDITORIAL
Steering, the customer service art used by car insurance companies to spotlight the benefits of having your automobile repaired at a sponsored garage, is quite ironic word usage since, presumably, if you steered your car differently you wouldn't be in this predicament in the first place. The same could be said of consumers if AB 1200 is allowed to pass later this year.

The bill proposed by Assemblywoman Mary Hayashi and supported by nearly all of the big players in the insurance industry believe consumers would be better off with more information, rather than less as they claim current California law prescribes. On the face of it this sounds noble, but there's more to it.

Currently, it is against the law for auto insurance companies to explain the benefits or "steer" customers towards a repair shop of their own choosing. Hayashi's bill would allow companies the opportunity to "hard sell" customers even after they state their desire to have their car fixed by another garage. The bill cleverly frames the argument as a panacea of additional information flowing towards the consumers hands. Unfortunately, it merely switches the preponderance of information from the consumer and spotlights the information in the hands of the insurance companies.

In practice, after smashing your brand new Altima, who really cares about where your car is fixed? This is the psychological frame of mind insurance companies hope to exploit by making it "easier" for you to have your car repaired at the insurance company's choice of auto garage. Consumer groups says steering gives garages incentive to do less-than-satisfactory work and leads to cost-cutting procedures (or lack thereof) by garages yearning to secure inclusion on the insurance company's lucrative preferred list.

What exactly is the genesis of this bill? Were constituents of Hayashi's district clamoring for more information from a highly profitable industry in these times of sky-high public distrust of corporate America or is she doing the likes of Allstate, State Farm and Progressive's bidding?

Just five years have passed since legislation passed through Sacramento severely limiting the type of steering this bill aim to breathe life back into. According to Hayashi's fact sheet on AB 1200, the thrust of the bill really favors the strengthening of "commercial free speech" and allows insurance companies to bundle warranties and car rentals along with the repair work. These options will only mean higher profits and larger monthly premiums for customers. Sadly, many feel Assemblywoman Hayashi plays to special interests too often, we can't speculate on those other occurrences, but with this bill, it seems like Hayashi has told the insurance companies, "you're in good hands."

Click here for the Senate analysis of AB 1200

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