Wednesday, November 25, 2009

Happy Thanksgiving

From left to right: Alameda County Medical Center CEO Wright Lassiter, Sutter Health CEO Pat Fry, Eden Medical Center CEO George Bischalaney. On the right, Dean Singleton, CEO of MediaNews. The newspaper chain known for cost-cutting has run exactly two stories since July on San Leandro Hospital's struggle to remain open. Sutter is an advertiser. Below right, Mayor Tony Santos peeks into the shot.

Tuesday, November 24, 2009

Different Views of Prime from One End of the State To Another

One year ago, the tranquil city of Redding was facing the likelihood of losing Shasta Regional Medical Center (SRMC), one of its two local hospitals. The facility was in bankruptcy until Prem Reddy, the brash and outspoken owner of the Southern California-base Prime Healthcare swooped in to save the hospital.

According to an article in the Record Searchlight (Redding, Calif.), SRMC has emerged from bankruptcy after Prime purchased the hospital to a remarkable $38 million in net patient revenue in just one year. Net patient revenue is not viewed as profit but operating revenue, but a steep reversal of fortune for the once-struggling operation. Randall Hempling, the CEO of SRMC, who has been seen at nearly every public meeting regarding San Leandro Hospital told the paper, "We've turned the corner."

Travel to the opposite end of the state and the folks of San Jacinto and Hemet will not speak of Prime in the same miraculous tones. In fact, local politicians in the area are, ironically, in a battle with Prime somewhat similar to San Leandro's current situation with another corporate behemoth, Sutter Health.

A special election Dec. 15 will allow residents of the Southern California outpost to decide whether its two bankrupt hospitals will be purchased by a physicians group of over 130 doctors or face closing. Prime, whose business model is based on gobbling up bankrupt and underperforming hospitals, has bitterly fought the sale with five lawsuits, four of which have been unsuccessful. Supporters of the sale to the physicians group successfully forced the change of elections materials when it was found Prime used the name of fictitious group in literature to rebut the Dec. 15 measure.

At times, Alameda County officials and state Sen. Ellen Corbett have voiced unease with the possibility of Prime fully entering the equation to keep the hospital and emergency room services open. When Dr. Bill West was appointed to the Eden Township Healthcare District last week, he briefly spoke of Prime in the same two-sided terms before abruptly stopping mid-sentence before giving his full opinion of the profitable, yet controversial corporation. Local pols, from Mayor Tony Santos to the city council have been far more keen in giving Prime a chance to revamp the hospital, which Sutter says loses up to $500,000 a month. San Leandro residents have also voiced displeasure of Prime's exclusion from the debate as proof Sutter has it in for the community hospital.

In the past three months, Sutter has rebuffed Prime's offer to both purchase San Leandro Hospital and to be part of proposed "hybrid" plan that would house rehabiliation, surgical and emergency services at the hospital. Undaunted, Prime has quietly stayed on the sidelines as spectators of the situation. Hempling told The Citizen in September, Prime could take over San Leandro Hospital at a moments notice, but apparently over Sutter's dead body. Alex Briscoe, the Director of Alameda County Health Services, recently summed up the prevailing wisdom saying Sutter would rather fall on their sword before it allowed Prime to set up shop within miles of the soon-to-be rebuilt Eden Medical Center.

While the shocking turnaround by Prime in Redding could be a blueprint for San Leandro Hospital, it did not come without costs which explains the trepidation by some in Alameda County. Prime took over SRMC just weeks after filing for Chapter 11 bankruptcy last year. It immediately laid-off 150 employees and cancelled the existing health insurance contracts. As SRMC transformed into a more sleek business model for Prime, the city's other hospital Mercy Medical Center was overwhelmed. Since Prime claimed the pre-existing insurance contracts deprived them of additional profits, Blue Cross fought back and labeled SRMC an out-of-network provider. What subsequently occurred is Mercy became overwhelmed with patients and was eventually cited by the state for health violations. The hosptial says the violations stemmed from the precipitous increase in the volume of patients.

Health officials in the area, have told The Citizen, Prime's business model of funneling patients through its emergency room doors makes an end around insurance providers thereby spiking health insurance premiums for everyone. One county official said Prime's tactics are not sustainable and could bust an even bigger hole in the state's heatlhcare system. Sutter has successfully shielded Prime from San Leandro Hospital, but while many are far from head over heels about Reddy taking over the hospital, an overwhelming number of residence want to, at the very least, have the conversation.
>>>County Reiterates Proposal; Possible Bidder Wows Crowd, June 9.
>>>A Prime Example of Healthcare Havoc, July 27.
>>>Potential Hospital Buyer Met with Sutter Last Month, Sept. 1
>>>Sutter Nixes Hybrid Model SoCal Health Provider, Sept. 17.

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How the F@*% Does a Candidate Get Attention?

Salon asked its readers if New Orleans mayoral candidate James Perry's irreverently blunt political ad was the greatest ever? It's not anywhere close to the same league as Lyndon Johnson daisy ad, Bush the Elder's Willie Horton spot or even Hillary Clinton's 3 a.m. commercial, but it could be useful to two San Leandro candidates looking to catch the city's attention.

Vice Mayor Joyce Starosciak and former School Board Trustee Stephen Cassidy both pale in name recongnition against current Mayor Tony Santos. Everybody knows Santos as a long-time councilmember and current mayor. Many have met the man through the years and that's a problem for his competitors. Not only do residents know Santos but they can recite some part of his biography.

Perry has less than three months to introduce himself to the people of New Orleans before they vote for mayor in February. Within a 30-second spot, the little-known Perry is getting impressive attention on his $60,000 investment. It's doubtful any Bay Area candidate would dare use bleeped out curse words in a political ad. This is the P.C. capital of the world, you know, but both candidates will eventually need to grab the city's attention unfortunately greater than just laying out a thoughtful vision of the future.
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Friday, November 20, 2009

San Leandro in Need of a Caped Crusader?

Did Starosciak make the campaign's first blunder? | Santos' speech: like a bad actor who won't end his death scene | It's the hospital, stupid! | Corbett gives Dr. West her blessing | Can Cassidy be the next Lincecum?
What if political consulting, like news on the Internet, became free?.....In any race, it is never too early to make a glaring mistake, but fortuitous to make it as far away from election day as possible. Mayoral candidate Joyce Starosciak may have made the campaign's first flub this week when she told both the Daily Review and The Citizen the city was in "decay". Whether it is true or not or justifiably the collective opinion of the hundreds she claims to have spoken, such dystopian views of your own city is quite a perilous tack and opens herself up to questions of what she has done to cause the dysfunction as a city council member. Instead, it now becomes harder for her to highlight what she intends to do to fix the problems. We will have to wait to see whether San Leandrans feel comfortable with a description of their city that conjures up images of Batman's Gotham City as a dark, crumbling place rife with crime and filth and not to mention The Joker and The Penguin running loose on East 14th Street.

It is no wonder the 20-year veteran of San Leandro politics, Mayor Tony Santos, jumped on the dark imagery hours after Starosciak's comments hit the newsstand with the raw exuberance of a child on Christmas morning. Santos was firm when he said anyone claiming the city was "deteriorating" to be "out of line". The passive aggressive references to Starosciak's comments, who was sitting just a few feet away definitely made the rest of the council a bit uneasy since their allegiances to the two candidates may end up split down the middle. As months go by, we will have to see if lightning quick political responses will become a hallmark of Santos and his political consultant Charlie Gilcrest. Both told The Citizen the speech was not prepared, but a source says the gambit to fight back came from Gilcrest. In fact, the dean of San Leandro political history sat knowingly in the council chambers as Santos' rambling speech rolled on.

Santos gets a bad rap around town, but as a political animal his instincts are very underestimated. He may not have nailed the rebuttal to Starosciak's dark comments very well. In fact, one reader of The Citizen said it sounded like a bad actor who doesn't know how to end his death scene since he made three separate, but identical points with various burst of intensity. He did though manage to set the tone for the next couple of months by acting quickly and snatching the mantle of the candidate who paints the city in rainbows and unicorns, which should be the natural position of the incumbent. On a more subtle tone, Santos is apparently trying to portray his other mayoral opponent, the progressive Stephen Cassidy as a conservative. Cassidy said he is not adverse to tax revenue enhancement but has implied a way to balance the budget is to cut city staff pay and jobs. Santos has done excellent job of using his jab to highlight this talking point. The assertion may be outrageous, but Santos has made an astute observation in Cassidy's rhetoric by exploiting its populist deficiencies. Santos went as far as to compare Cassidy to local Republican pariah Lou Filipovich on three occasions. That one may have missed the mark, but was humorous nonetheless. Saying, though, progressives don't take money and jobs away from workers is spot on in this current economy.


To be fair, Cassidy's call for everyone in the city to make sacrifices starts with himself. One of his main campaign talking points, if elected, is to not draw a paycheck until the city balances its budget. The leading by example ploy appears to be gaining traction. We're hearing an awful lot of positive reaction to the plan ranging from lauding his leadership acumen to "it's the right thing to do." Cassidy has used variations of this idea the last couple of months by calling for the city council and mayor to do the same. He did get the council to forego their pre-council meeting dinners, but the downside now is you have council members chomping on cashews and drinking caffeine-free Coke during hearings.


One real political consultant in the area says the keys to victory in any San Leandro race is a three-ring circus featuring (1) labor, (2) the police and fire departments and (3) older voters who are more likely to vote. He says you can win with two of the three. Right now, Santos has all three with labor in a vice, police and fire content and being of full Portuguese descent (although he speaks German and not Portuguese) surely helps him with older voters. There could be a new paradigm in this race that has the potential to change this equation. It's the hospital, stupid! If talk of a settlement between Sutter, the District and the Alameda County Medical Center comes to fruition in coming weeks, it will neutralize any chance this issue can be successfully used against Santos. The Mayor says he's been in the middle of saving San Leandro Hospital far longer than anyone else, but there are zero results to show for us supposed work. The problem for Starosciak is she has done nothing on the issue as a council member, leaving Cassidy as the candidate who can put a huge dent in Santos' cause. If a deal is announced that keeps, at a minimum, emergency room services at the hospital for the short term, Santos will quickly claim credit and any argument that he, in fact, did very little, will evaporate. Voters won't care he has the perception of doing nothing if they still have their ER. Time is ticking for those who need to whittle away at one of Santos' constituencies.


At Wednesday's anti-climatic Eden Township Healthcare meeting, there was widespread worry among nurses in attendance that a candidate hostile to saving San Leandro Hospital would be appointed to the board. In fact, there really was never much chance any of the seven candidates other than the eventually winner, Dr. Bill West, would be picked. Truthfully, if there was just a small adversarial group on the Sutter side, there is an argument to be made the appointment was tilted toward West from the beginning and the others had no fair shot. But, supporters of saving San Leandro Hospital should rest easy after state Sen. Ellen Corbett sent a press release yesterday congratulating West on his appointment. As the politician who has done by far the most to keep the hospital from closing, Corbett's statement is pretty much like the Pope given you his blessing.


Debate on whether the city should adopt Instant Runoff Voting (IRV) is due to heat up in December. The female bloc of councilmembers appear opposed to the method of electing leaders where voters rank their choices to determine a consensus winner rather than through a plurality. There is evidence IRV hurts minorities and female candidates along with those outside of the local power structure. IRV sometimes produces odd anomalies and if approved in San Leandro voters would fill out two ballots since IRV only determines elections for offices and not initiatives. Look no further than yesterday's vote for the National League Cy Young voting which uses a variant of IRV to see how the best person may not always win. The difference, though, is Major League Baseball writers use a point system to rank their choices. Pot-smoking San Francisco Giants dynamo Tim Lincecum narrowly won his second consecutive Cy Young award despite not receiving the most first or second place votes. The Oscars will also choose the winner of the year's Best Picture in 2010 using ranked choice voting. If Star Trek somehow wins, then Stephen Cassidy has a chance for mayor. -S.T.

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Wednesday, November 18, 2009


Breaking News--Read it Here First
The Citizen
HAYWARD, Calif. - The Save San Leandro Hospital constituency got a shot in the arm Wednesday night with the appointment of Dr. Bill West to the Eden Township Healthcare District Board of Directors. Like a nurse administering a menacingly long needle, the ordeal was over before you knew it.

The embattled board unanimously named West to replace Dr. Walter Kran who resigned Sept. 28, but the semi-retired orthopedic doctor, who worked the early morning hours and admitted he was exhausted, left the meeting before knowing of his appointment.

West's lack of sleep Wednesday night may have accounted for his hasty opening statement to the board which last barely over two minutes, but colleagues describe him as a man of few words and more than capable. What West communicated to the board, though, was a new member intent on facilitating compromise between Sutter and the District.

Director Dr. Harry Dvorsky asked him how he would find a resolution to Sutter's lawsuit against the District over the purchase of San Leandro Hospital, West said, "Through compromise. I think there are compromises." He added little to the statement in regards to the Nov. 2 complaint against the District and told the board he had only learned of the suit yesterday.

Rumors continue to persist that Sutter, the District and the Alameda County Medical Center are working on a deal that would turn San Leandro Hospital into an urgent care facility with emergency room services. The board entered closed session talks after the appointment of West to discuss the pending litigation. Eden Medical Center CEO George Bischalaney was in attendance, but did not participate in the closed session meeting.

West was believed to be the front-runner to replace Kran because of his familiarity to Directors Dr. Vin Sawhney, Carole Rogers and Dvorsky. West raised a few eyebrows when he gave the impression he was selected to run rather than on his own aspirations. "I've been encouraged to apply for the vacant position on the board, so I'm here tonight doing that," said West.

The question heading into Wednesday's meeting was which direction Dvorsky would use his powerful swing vote facilitated by the departure of Kran. In a display of slick parliamentary maneuvering Sawhney asked first for Dvorsky's opinion as the board's senior member before proceeding.

The move allowed the board's two most secure votes for saving San Leandro Hospital--Sawhney and Rogers--to react to the swing vote's direction. Dvorsky quickly moved to support West citing a familiarity with his work over the years. Sawhney and Rogers concurred with Dvorsky, but Ratnesar did not verbalize a vote until asked by Eden Township CEO Dev Mahadevan. Once appointed, though, West comically could not be found.

Depending if he's ever found, West said he has not considered whether he would run for re-election after the remainder of Kran's term next year. "I have not seriously considered it," he said. "During the course of the year, if I'm on the board, I certainly will learn what the function of the board is, what the challenges are and whether I can contribute anything."

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Council Approves $61,000 Mailing Campaign

The Citizen

Coming soon to a mailbox near you three educational mailers from the city saying, in effect, "Brother, can you spare a dime?" or three glossy pieces of paper to be quickly recycled. Ultimately, the city wants the latter, but only after it states it case for possible increases in tax revenue.

The San Leandro City Council voted 6-1 Monday night giving the go ahead to spend $61,000 on mailers and consulting fees in anticipation of a tax measure on the 2010 ballot. Councilman Bill Stephens registered the only dissent.

City Manager Stephen Hollister told the council the three mailers, one of which will be sent in early December, will cost $41,000 for printing and postage, while consulting fees will run up to $20,000. On Nov. 2, Hollister told the council, $34,000 would be paid to the Oakland consulting firm Lew Edwards Group, but told the council Monday night the fees were now only $20,000. When asked afterwards for the reason for the decrease, Hollister said he had over-calculated how many months the firm would be needed. He also said "budgets are complicated" and pushed the need to educate the public.

"This is an extremely serious financial situation," said Hollister. "I feel that it is very important citizens and particular voters know as much as they can about our financial situation and are informed and give informed feedback to the council."

When Hollister made reference to a ballot measure in describing the mailers, Stephens interrupted him and asked, "Why are discussing a ballot measure?" As Catherine Lew, the president of the Lew Edwards Group, attempted to quell Stephens' discontent he shifted in his seat, furrowed his brow and took off his glasses. Lew said the mailers would both provide facts about the city's financial situation and reference a possible ballot measure.

In a brief moment of pique, though, Stephens moved for the council to prematurely approve the yet-to-be conceived ballot measure. City Attorney Jayne Williams called it "inappropriate" and advised the council, instead, to direct the city staff to draft legislation for approval in the future. Moments later, Stephens admitted his motion was only half-hearted, but pointed.

"Obviously, I'm being a stinker tonight," said Stephens. "I have no intent on moving forward on this, but I want to confront everybody on the reality of it. I just don't want to send a message to the community that we are prepping them for a ballot measure and that to me is what we are doing."

Lew told Stephens. "No one, however, will want anything shoved down their throat. There is nothing disingenuous about this program. It is not a foregone conclusion there will be a ballot measure."

With laughter from some council member, Stephens shot back saying, "I'm still not convinced. I'm willing to wager that there will a ballot measure. Anybody else like to wager?" There were no takers.

Aside from Stephens, the council voiced approval with the notion of increasing tax revenue with an eye towards a more tumultuous budget situation next year. In addition, there was solid consensus for the need to make the city's case to residents through the mailing. Councilman Michael Gregory said it is an expense to the city worth taking. "I'm stunned by how we can keep a government running with less taxes and higher costs," he said.

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House Healthcare Reformers React to Times Story

In an instance of dynamic journalism Monday, The New York Times blew the cover on Big Pharma's price-gouging gambit in the face of health care reform. The piece was so harrowing to the pharmaceutical companies that the Big Three in the House Ways and Means Committee, including Rep. Pete Stark took immediate notice.

Along with Rep. Charles Rangel (D-NY), Rep. John Lewis (D-GA) and House Energy and Commerce Chair Rep. Henry Waxman (D-Calif.) fired off this letter yesterday to the acting comptroller of the General Accounting Office which called for an analysis of the Times' claims that pharmaceutical companies are raising drug prices in anticipation of losses from health care reform legislation passed last week by the House and waiting for debate in the Senate.
The pharmaceutical industry has been monitoring this legislation closely, and recent studies have indicated that the industry may be artificially raising prices for certain pharmaceutical products in expectation of new reforms that could otherwise reduce prescription drug prices or price growth by encouraging patients and the government to be more efficient purchasers. Any price gouging is unacceptable, but anticipatory price gouging is especially offensive. We request that the GAO prepare on an expedited basis a report that analyzes recent trends in prescription drug pricing.
According to the Times, drug companies have raised prices on wholesale brand name medications by nine percent and could add more than $10 billion to the nation's expenditures for drugs. They also cite two professors who say their analysis of drug prices prior to past legislation show price increases are common. The article also mentions the existence of the inflated prices may be why Big Pharma was so amendable to the Obama administration's demands to cut drug prices by $80 billion over the next 10 years.

Today, Sen. Harry Reid (D-Nev.) announced a Senate bill similar in price to the House that would cost $894 billion over 10 years. According to reports, the bill includes a public option, but allows states an option to opt-out.
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Santos Slams Opponents in Council Chambers

The Citizen
Oftentimes, the only useful news from a San Leandro City Council meeting happens at the very end. A dirty little trick that forces reporters to stay for the entire hearing. Monday night wasn't exactly one of those nights, but it was close. There was a spirited debate on the city's plan to "educate" the community on its budget crisis for a likely ballot initiative next year and the council approved a state of emergency regarding the H1N1 virus. Don't worry. The resolution is more of a mechanism for the city to recoup any money spent fighting the burgeoning pandemic than an admission of impending microbial pandemonium. Nevertheless, remember to cough into your sleeves.

It was the final seven minutes of the two-hour meeting that was one of those "what just happened" moments when people look around and sheepishly smile and shrug their shoulders at one another. When it was Mayor Tony Santos' turn to make a public comment he took the opportunity to rip into his two mayoral opponents.

"This city is not deteriorating. Anyone who says that is out of line," Santos forcefully said from the chambers dais. Santos never mentioned his mayoral opponents by name in the sometimes rambling argument which was a response to comments made this week by Vice Mayor Joyce Starosciak, but the references were crystal clear.

Strarosciak told the Daily Review Monday the state of the city was in disarray. She reiterated her stance to The Citizen after Monday's council meeting saying, ""I'm talking to hundreds of voters. I'm not giving speeches. I'm asking people people in San Leandro and they are saying we are not moving fast forward. We are in a state of decay. The city is not only impacted by the state of the economy, it's spiraling out of control. People want someone who is going to listening and that's not happening right now."

The mayor and councilmembers are free to riff on any subject during the comments period, typically at the end of the meeting. Starosciak agreed and said Santos can speak about anything during his time even if it could be contrued as political in nature. Her demeanor during the address was far different. As Santos told the small group of remaining attendees to "look into the future" and see the rise of new Kaiser campus on the corner of Fairway and Merced, Starosciak turned towards fellow Councilwoman Ursula Reed and chatted in hush tones. What she said could not be heard and lips are hard to read, but the comfort level of the entire council was noticeably and comically low.

The council had the look of discomfort similar to spending the night at your friends house as a teenager as the kid's parents started fighting right in front of you. Councilwoman Diana Souza had a forlorn look that seemed to evoke the old bath soap commercial with the famous tagline, "Calgon. Take me away!" Another member suddenly had a newfound interest in the chamber's ceiling architecture.

At various points, Santos seemed to lose his train of thought and returned to various areas of the city that are, according to him are growing and then he returned to his favorite whipping boy, mayoral challenger Stephen Cassidy. Santos, while motioning to a few city staff members to his left, again criticized Cassidy for implying he would cut city staff wages and cut jobs to balance the budget.

This reporter was also put in the middle of the spat in the council foyer afterwards while chatting with Santos. Starosciak approached me and the two combatants were forced to make small talk like nothing had just occurred. Santos asked her if she wanted to attend a meeting in his place and, while she never directly answered, she did not seem too keen about it.

Neither Santos nor one of his campaign consultants would cop to the speech being more than impromptu and the lack of crispness in the arguments may suggest this to be true, but the point was made. This was more than an opportunity to rebut a critical point made by Starosciak, but a political warning shot that says the mayor will run on his record next year and do it quite forcefully.

So, what that, the battle lines are beginning to emerge. Santos: an East Bay John Winthrop channeling a vibrant, shining city upon the hill. Starosciak: the Cassandra showing us San Leandro as a decrepit Gotham City and Cassidy, the idea man, hoping to conjure the spirit of de Tocqueville favoring the best way to see the city's problems is from the outside, rather than in. However way you view it, it's on!

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Saturday, November 14, 2009

San Leandro Rapper/Activist Appears on Sacto Program

San Leandro rapper and community activist Sara Mestas is known to the parents and schoolchildren at Corvallis Elementary as simply Mo Wiley. The budding local music talent has a new album and appeared Thursday on the Sacramento morning news program "Sacramento & Co." to talk about her music and her role in bringing back the crossing guards program initially cut by the city of San Leandro this summer. Mestas was one of the more vocal parents who volunteered to for morning and afternoon guard duty while the city council and school district hammered out a cost-sharing deal for the school year. You can still see her working her shift on school days.

WATCH Mestas on "Sacramento & Co." here and checkout her web site here.

Cassidy Is In It To Win It

Former San Leandro School Trustee Stephen Cassidy addresses supporters during his mayoral kick-off party Thursday night at Zocalo Coffeehouse. Cassidy asked voters to imagine their city five years from now as a safe, growing, economically-viable community, if he is elected. Cassidy and Vice Mayor Joyce Starosciak will face incumbent Tony Santos, who has already raised over $20,000 for the 2010 race.

PHOTO: Tim Holmes

Friday, November 13, 2009

City May Be Moving Along Without Controversial Transit Plan

The Citizen
It does not take very long to figure out San Leandro city leaders dislike AC Transit's proposal to remodel the city's stretch of E. 14th Street with a dedicated bus lane. Through recent actions, the city may be quietly distancing itself from the $234 million project.

AC Transit's Bus Rapid Transit system (BRT) has been kicked around since 2001. The city acquiesced to the transportation agency in 2006 when it tacitly stated its position to have the bus line end its southern route at San Leandro's downtown, which in itself will be transformed into what the city hopes will be a point of destination for shoppers and urban city dwellers. The newest version of the plan moves the ending point further down E. 14th to Bayfair and removes two portions of dedicated lanes along the route.

San Leandro Mayor Tony Santos has reiterated the city's official stance on BRT on countless occasions but the city council unanimously voted Sept. 8 to award a contract to the construction firm Joseph J. Albanese, Inc. for over $600,000 to beautify eight blocks of medians on E. 14th Street--the same path which AC Transit would eventually remodel the pathway. The approval sheds some light on the city's lack of enthusiasm for the project.

"They got their answer five years ago," said a former city official who dealt with early versions of the BRT plan. "They can't take no for an answer." The proposal from AC Transit needs the approval of the cities of Berkeley, Oakland and San Leandro, of which the bus lane will cut through. AC Transit says over 22,000 passengers use the line which is laden with shops and points of employment.

While the city and AC Transit say they have worked together to mesh the plans of both entities, the approval of construction between 136th and 144th Avenues near the nearly constructed ninth grade high school campus reveals a rift in public comments and actual procedures. "If the city is for BRT," said the official, "then why did they approve $600,000 for landscaping?"

After a council meeting Nov. 2, Santos accepted the notion the city may be moving forward without BRT with the approval of the median project, but also said AC Transit would have to pay for any changes done to the reconstructed work if the city approves the BRT.

City Engineer Ken Joseph said, "This is not a statement as to whether the city is for or against the BRT." He says future work on the medians by AC Transit could be easily adapted by filing in sections of the median to remove left hand turns, which is hallmark of the BRT proposal. He also noted most of the median project deals with landscaping, which is also a feature of the BRT proposal.

The AC Transit plan would dramatically transform significant parts of E. 14th by removing the median and replacing it with trees and landscaping along with center-boarding bus stations. The main point of contention within the plan is the formation of a bus-only center lane the agency says will increase efficiency up to 15 minutes from one end of the line to the other. AC Transit officials say the plan will include level boarding for passengers, an off-bus fare payment station, real-time arrival signs and traffic signal priority for their buses. The plan also has an element of green planning which many of the council's more progressive members support.

AC Transit readily admits the plan has drawbacks. The city will lose parking spaces on stretches of the route and the flow of traffic will be decrease, something the city's noted transportation plan already hopes to create. One city official who recently visited similar transportation strategies in the Bay Area told The Citizen the city needs to encourage people to get out of their cars. "They don't like it at first, but I believe they will get used to it and see its benefits." But, for the time being, there has been a chorus of detractors who believe the construction of a median down the sometimes narrow thoroughfare will disrupt business and travel.

During a public discussion of the proposal Oct. 22, one resident of Sunnyside Drive, which abuts E. 14th, said trucks making deliveries to the numerous businesses on that stretch of route would disrupt the flow of traffic. According to the woman, trucks already double park on the two lane street and wondered how it would be alleviated with only one lane and a left turn. The representative had no answer, but said the agency would explore the problem. For their part, AC Transit has been aggressive in publicizing the plan with seven meetings in the past month, some heavily attended and some basically officials staring at each other.

AC Transit hopes to have the three city councils approve the BRT in the Spring of 2010. The city of Berkeley has also provided stiff opposition to plan. If approved, the project would begin construction in 2012 and completed three years later, but there is still question as to how the project will be funded. "They keep pushing this plan that will cost $243 million but there's not really any money behind it. Is this really going to happen?" said San Leandro Councilwoman Ursula Reed during a recent council meeting. Transit officials say funding will come from bridge tolls, the federal government, AC Transit sales tax and state funds. Reed, whose business-centric district lies on E. 14th said AC Transit officials told her the project could be funded in the future with loans or bonds. With a shaky economy the inclusion of state and federal funds have been a cause for concern. To further make some skeptics weary, the agency is attempting to shift $35 million to alleviate local bus routes along with the sudden resignation of its general manger, Rick Fernandez. "Each time we asked the same questions the answers came out differently. It didn't make me feel confident with the presenters," Reed said.

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Thursday, November 12, 2009

Talk of Settlement Enters Hospital Equation

The Citizen
A legal compliant is always a good way to coax a settlement. That's what Sutter Health is bargaining after filing suit in Alameda County Superior Court for the transfer of San Leandro Hospital from the Eden Township Healthcare District. Sutter is also seeking damages in excess of $5 million.

Sources tell The Citizen, Sutter, the District and the Alameda County Medical Center (ACMC) are exploring a three-way deal that would keep San Leandro Hospital open as an urgent care facility with emergency room services. Sources also say there is the possibility of another local hospital running San Leandro Hospital. It is unclear, though, the length of any possible deal.

Most agree any future plan for San Leandro Hospital would entail an annual subsidy of between $4-7 million. According to a person with knowledge of the negotiations, each entity would contribute up to $1.5 million. In past months, similar proposals have been made through Alameda County Health Services (ACHS) and Alameda County Supervisor Alice Lai-Bitker. The missing part of the equation is how long such a plan would run.

Critics have long charged the District with making a poor agreement with Sutter in 2007 which only kept the hospital open for another two years. A similar deal to continue ER operations in the short term may only extend the inevitable closing of the hospital in the near future.

Alameda County Health Services Director Alex Briscoe has long maintained the hospital needs a long-term solution that includes a subsidy annually-adjusted for inflation but said, "We have yet to see a plan to keep acute care services at the hospital."

Briscoe said the District should divest itself of its undeveloped property in Dublin to fund San Leandro Hospital. "The District has assets of $120 million," he said. "Why do you need a health care district if you don't have a hospital?" San Leandro Mayor Tony Santos also told The Citizen he agrees with such a plan to fund the hospital.

According to sources, the current vacancy on the District Board of Directors is making negotiations with Sutter and ACMC difficult without a clear consensus from the board on a direction to proceed. The current board of four is believed to be split with those wanting to keep San Leandro Hospital open with emergency room services and those who support Sutter and ACMC's plan to convert it to a acute rehabilitation facility.

Briscoe said he was aware of Sutter's complaint against the District and said the health agency is concerned about the suit and the possibility it could become a drawn out affair. "I haven't read the lawsuit, but I know Sutter's position," said Briscoe. "They believe they signed a deal that gave them the right to a purchase option and they acted upon it and they think the District is breaking the law."

"The District signed a bad deal to keep it open for a couple of more years," he said. According to Briscoe, the District's own legal counsel Frank Cannizzo told ACHS any legal challenge to the 2007 Memorandum of Understanding was slim, although some members of the board have privately expressed uncertainty over some of his previous legal opinions.

As to suggestions Sutter would pull up stakes at Eden Hospital, Briscoe would not rule it out, but believes it is highly unlikely given the Board of Supervisors approved the Environmental Impact Report in June. "I can't speak for Sutter, but I don't see any reason for them to leave Eden," he said. "There's no impediment stopping them now from building."

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Wednesday, November 11, 2009

Sutter Sues District for San Leandro Hospital

Citizen Exclusive
The Citizen
Sutter Health, the operator of both San Leandro Hospital and Eden Medical Center, has filed suit in Alameda County Superior Court against the Eden Township Healthcare District seeking damages of $5 million. The Sacramento-based health care provider alleges in court documents, the District failed to transfer ownership of the the beleaguered San Leandro Hospital after Sutter exercised its purchase option July 27.

The lawsuit, filed Nov. 2, accuses the District of refusing to transfer and close escrow on the property located on East 14th Street. Sutter is seeking $5 million to cover attorney fees, interest lost and arbitration costs. The suit also maintains the right to include specific board members. Rumors have floated for months certain board members had been threatened with legal action. Chatter only increased when former member Dr. Walter Kran abruptly resigned Sept. 28 from the board citing stress. During the Aug. 18 board meeting when the District voted against approving Sutter's bid to purchase San Leandro Hospital and close its emergency room services, Kran oddly abstained from the decision that stands front and center in the current lawsuit.

Shortly after, Sutter exercised its option to buy San Leandro Hospital, which is spelled out in the 2007 Memorandum of Understanding (MOU), it signed a lease July 31 with the Alameda County Medical Center to convert the hospital to an acute rehabilitation facility. Sutter offered $6.5 million to assist with its remodel. The quick transaction by Sutter created a stir among some board members who openly questioned how a lease was possible without the facility being legally transferred. The subsequent special meeting held in Castro Valley may have been the first indication a stern activist bloc of members was beginning to form. The District blocked Sutter's purchase option by a 3-1 margin and moved to explore San Leandro Hospital's financial records while seeking a second opinion attorney, which was a response to the yet-unreported news of a lease between Sutter and ACMC.
The defendants have realized considerable benefits under the MOU and lease...Eden Medical Center and Sutter proceeded in good faith to build the replacement hospital.

In court documents, Sutter claims the inclusion of a purchase option for San Leandro Hospital was concession from the District to rebuild Eden Medical Center. "The District's grant of an option to Sutter for the purchase of SLH was a material inducement for Sutter's agreement to construct the replacement hospital on the Eden Hospital campus," the lawsuit says.

According to the lawsuit, Sutter asserts the it has held its own end of the agreement and the District has been well compensated. "The defendants have realized considerable benefits under the MOU and lease...Eden Medical Center and Sutter proceeded in good faith to build the replacement hospital, and construction began in July 2009."

In the past week, there have been signals of trepidation from some close to Sutter about their willingness to complete the rebuild of Eden Medical Center despite obvious signs of construction on the Castro Valley site. In an interview with The Citizen, former District member Suzanne Barba expressed some doubt Sutter would finish the project and cut its losses. Another former member Dr. Francisco Rico indicated the same sentiment along with Eden Townhip CEO Dev Mahadevan. During interviews for candidates to replace Kran on the board Tuesday night, Mahadevan reacted to a question by Steven Ree Worley on what other problems the District faces by saying, "One is that we need to keep an eye on Eden Medical Center to make sure they don't stop."

It is not confirmed whether board members were aware of the pending lawsuit before Tuesday's meeting, but it is likely. Board member Carole Rogers' peculiar grilling of Rico may have been in response to the lawsuit when she asked if he recalled whether the 2004 agreement legally obligated Sutter to rebuild Eden. Rico answered, "This is correct," to which Rogers replied, "That's the point I wanted to make."

The lawsuit filed by Sutter makes no mention of the 2004 agreement, but alludes to the 1998 agreement that lead to Sutter entering the District and the 2007 MOU which Rogers has long maintained has no legal standing. Critics say the MOU was signed after Sutter refused to rebuild Eden and forced the District to renegotiate the 2004 agreement with a deadline to seismically upgrade state hospitals by 2008 looming. The deadline was later pushed back to 2013. Rico, who is often critical of those attempting to save San Leandro Hospital amidst alleged unprofitablility, corroborated this view Tuesday night during his interview saying the District sent Sutter a letter in anticipation of a breach of contract.

News of legal action by Sutter against the District diminishes rampant speculation of who will replace Kran on the board and what may occur if the decision moves to the Alameda County Board of Supervisors. By filing suit, Sutter is reiterating a similar stance taken in August when it deemed the District had no authority to block the purchase option of San Leandro Hospital.

>>>Healthcare District Block Sutter's Plan to Purchase SLH, Aug. 18
>>>Sutter Signs Lease with Alameda County Medical Center, Aug. 19
>>>Mediation Merry-Go-Round, Sept. 22
>>>VIDEO: Healthcare Director Crashes Mediation Meeting, Sept. 22
>>>Q&A with Former Healthcare Director Suzanne Barba, Nov. 6
>>>Rogers Grills Rico on Past Agreements with Sutter, Nov. 10
>>>The History of San Leandro Hospital According to Rico, Nov. 11

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The History of San Leandro Hospital According to Rico

Former Eden Township Healthcare District Director Dr. Francisco Rico has been one the most polarizing figure over the possible loss of San Leandro Hospital. Critics have labeled him pro-Sutter by his numerous public comments and fear his return to the board a year after losing re-election could be the final nail in the hospital's coffin. Tuesday night, his interview with the District Board of Directors became a referendum on his tenure on the board when he was one of the key negotiators who essentially traded the stability of San Leandro Hospital for a new Eden Medical Center in Castro Valley. Here are highlights from Rico's opening statement and questions from the board:

For a period of 10 years the relationship between the District, Eden Hospital and Sutter was amicable. One of the major problems we were grappling with was SB 1953, which required that hospitals in California meet certain seismic requirements. There was a deadline for 2008, but they actually pushed it back to 2013 because many hospitals were having difficulty complying...A number of architectural studies were done, proposals were made even showing pictures and models and so forth. The big shocker came when Sutter announced publicly that they were not going to rebuild Eden and they would turn it into an urgent care facility and their primary interest was east of here in the 580/680 corridor in the Pleasanton area. All of us on the Eden board, which included all of you on the District board, were unanimous that we were not satisfied with that and quite unhappy about that and would do whatever we could to reverse that decision. After a long sequence of negotiations between the District board and Sutter Health where Dr. [Rajendra] Ratnesar was member of the negotiating committee as was I. Eventually, we were able to get Sutter to agree to rebuild Eden Hospital and after looking at a number of alternative sites within the District they determined even though the space on the current campus was limited it still made more sense to do it there. Some of the other sites they were looking at could not be purchased...As a part of those negotiations we also got a concession from them to continue to support San Leandro Hospital for an additional two years and work with the medical staff there to try and turn things around which unfortunately has not been successful...It pains me to see that it has declined fiscally that its existence is in jeopardy and the hybrid concept that Carole [Rogers] mentioned is very appealing. I would say that if that could be managed, it probably worth a look. However, it would have to be in such a way that it could be fiscally sustained.

DIRECTOR DR. HARRY DVORSKY: Would you run again in 2010?

RICO: I'm reluctant to say yes or no at this point. The reason being is that I don't know what is going to be happening in 2010. I'm not getting younger.

DVORSKY: When you say you don't know what's going to happen if you're on the board, what will happen will be in part from your contribution.

RICO: One would hope so.

DVORSKY: Again, so that is the question, why do you want to be on the board?

RICO: There were a couple of things of which I very much involved in the last six years that are still in a stage of not being completed and one of the things is the Dublin-Gateway property. We put a lot resources into it and it has the potential of developing into a very worthwhile enterprise. Hopefully, it generates enough revenue so the District can do more things for our community here. As you know, the new hospital in Castro Valley will not have psychiatry. Our policy on the District board has been to use resources to serve underserved segments of the community.

DIRECTOR CAROLE ROGERS: I know one of your mantras is a hospital has to be profitable to survive. Seeing Sutter Health, Eden Hospital and San Leandro Hospital are combined, their financial statements are one so they are one hospital system--a sister hospital--not competing. Together, they made a $20 million profit. Can you address how we can convince Sutter that San Leandro Hospital and Eden is one hospital and how can we bring some profitability to the negotiating table?

RICO: Hospital. When you say I supported the concept of a hospital generating profit. The word profit is actually inappropriate when you're talking about a non-profit organization. The better word would be surplus because profit suggests some way or another profits are distributed to shareholders. In a non-profit profits are distributed within the business entity...I can't promise that I have any magic formula to cause I'm not sure I can convince Sutter Health because that's one of the things we argued with them about a couple years ago when we were negotiating for the replacement of this hospital. Incidentally, if they did not replace it, it would not continue as an acute care hospital. Our first priority was to make sure that we had a hospital that was compliant with the earthquake recommendation. At the time, we argued quite a bit with them about sustaining San Leandro...

My main reluctance as far as Dublin is concern I go back to a meeting the Eden Board of Directors had where after Sutter had announced they would not be rebuilding the hospital in our district, we had the CEO and CFO of Sutter to come to our board meeting. All of the members questioned them and stated our objections, you know, that this hospital has been here 50 years serving this community and you're telling us you're going to close this hospital and build one on the other side of the hills. The community that is here is not going away. It's still going to need hospital services and you're telling us we're going to have to go over the hill. Dublin is not our community and his response was 'Well, you should start thinking of it as your community.' The property in Dublin was primarily a bargaining chip against Sutter moving to that area.

ROGERS: Let's see if you can remember, in 2003 you were on the board at the time. San Leandro Hospital was making at profit when Sutter leased it from the District and at that time in 2004 there was an MOU that I understand Sutter promised to rebuild Eden Hospital.

RICO: That is correct.

ROGERS: That's the point I wanted to make.

RICO: Several times over the years [Triad] had approached the administration at Eden Medical Center with proposals to sell it, but their asking price was always considered excessive. When it turned out they were willing to negotiate a reasonable purchase price, those of us on the district board said, 'Do we really want to buy San Leandro Hospital?' Our response was we weren't enthusiastic about doing this so we had to get some concession for us to sweeten the deal for us to shell out over $30 million, which was a sizable segment of our total assets. At the time, if we purchased San Leandro Hospital, Eden Medical Center with Sutter's backing would build a new hospital. Not necessarily on the same site, but in district, serving the district and they agreed to that. Afterwards it become evident as the deadline for compliance with SB 1953 approached that we were running out of time, At that point, with Dr. Ratnesar as the chair, he sent a letter to Sutter saying you haven't done anything. We anticipated they were going to be in breach of contract which would make them liable to legal action. The problem was there was a deadline for SB 1953 and legal action takes time. We might not be able to get through the legal action and still be within the deadline for SB 1953. All the time, understand the state might extend the deadline, but prudence dictates that we can't depend on the them to extend it and apply the law and get it done. We negotiated a settlement to get what we wanted.

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Tuesday, November 10, 2009

Rogers Grills Rico on Past Agreements with Sutter

The Citizen
CASTRO VALLEY, Calif. - The conference tables at meeting room of the new Castro Valley Library were set up with the remaining four members of the Eden Township Healthcare District facing one of three candidates to replace departed member Dr. Walter Kran like a image often seen on Capitol Hill.

The scene took on all the accoutrements of someone testifying before Congress as Director Carole Rogers attempted to grill former board member and rival Dr. Francisco Rico for his role in negotiating disputed agreements with Sutter Health--the operator of San Leandro Hospital--in 2004 and 2007.

The board gathered Tuesday evening for a second round of interviews to replace Kran, who resigned Sept. 28. A seventh candidate, Dr. William West, will meet the group during their monthly meeting, Nov. 18, when he District will likely appoint one of the seven applicants. If not, it risks a Nov. 27 deadline to appoint a successor or send the decision to the Alameda County Board of Supervisors.

Rico's interview was anticipated to be an opportunity for supporters of keeping San Leandro Hospital to have a chance to hear from one of its biggest detractors. Rico has publicly criticized Rogers handling of the hospital and believes her board actions against Sutter will put the rebuild of Eden Medical Center (already underway) in jeopardy. Director Dr. Vin Sawhney, who replaced Rico on the board last year, has also been criticized by the San Leandro anesthesiologist for allegedly sending patients to a Hayward clinic of which he has financial ties. Sawhney politely declined to ask Rico any questions.

When it came for Rogers to pose questions to Rico it appeared she had greater interest in pinning down testimony on his role in two contentious agreements the District made with Sutter in 2004 to rebuild Eden Medical Center and the 2007 Memorandum of Understanding (MOU) that eventually upheld Sutter's decision to rebuild Eden. It also put at risk the closing of San Leandro Hospital if its financial condition, as stated by Sutter, did not improve. Rogers has repeatedly charged the 2007 MOU has no legal standing. She also contends the 2004 agreement to rebuild Eden should stand on its own.

Rico equivocated his answers to Rogers' questions on his role, but communicated an extensive history of the last six years of negotiations with Sutter that, according to Rico, were sometimes bitter. Rico admitted Sutter had agreed to rebuild Eden in 2004, but was met with resistance afterwards amidst a looming 2008 deadline for hospitals in the state to seismically retrofit. The law was subsequently pushed back to 2013 and still weighs as a large factor in the predicament the county and district face with both facilities and Fairmont Hospital, also in San Leandro. Rico said he and current chair Dr. Rajendra Ratnesar anticipated Sutter might be in breach of contract over the deal as the deadline neared, which led to the 2007 MOU.

In response to a question from Rogers on how to make San Leandro Hospital profitable, Rico said, "I'm not sure I know how to convince Sutter because that's one of the things we negotiated to replace Eden Medical Center," he said. "I don't know if I can promise any magic formula for Sutter to change their position at this time."

Medical supplies owner Steven Ree Worley portrayed himself as an outsider to the politics of the District, but also expressed remorse for the plight of the hospital. "When I talk to my customers they tell me they use this hospital," said Worley. "If everybody think there's a need, I think we should find a way."

He says he would bring a different perspective to the board, which is entirely comprised of medical professionals, since he works with patients as customers every day. "We should put them first. It's the reason why we have a business. I don't know if anybody sees it that way, but I do." Worley also told the board he hoped San Leandro Hospital could be saved and said it would do well to improve its marketing of the 50-year-old facility.

A third applicant, Dr. Ronald Hull, is well-known to the board after two unsuccessful campaigns for the job in 2002 and 2006. Hull said he decided for a third run at the position as way to give back to the community he has served. He indicated he was in favor of keeping San Leandro Hospital since his parents, who he said have been married 58 years, still live in the city. Hull offered his backing for the hybrid proposal at the hospital and thinks obtaining sponsorships from San Leandro corporations could help fund the plan.

The final applicant slated to be interviewed Nov. 18 could be the most anticipated of the seven. West is out of the country which necessitated pushing back his interview until next week. Many figure West as the front runner favored by pro-hospital supporters with Director Dr. Harry Dvorsky being the deciding vote. If the board does not make a decision Nov. 18, it can still call a special meeting before the Nov. 27 deadline. If the previous voting bloc maintained at the county board of supervisors holds from earlier this summer when the issue was briefly discussed, supporters of keeping the hospital open would likely have only two votes out the five-member body The Board of Supervisor are currently pursuing a plan to have the Alameda County Medical Center take over San Leandro Hospital and convert it to a acute rehabilitation facility.

Aside from Rico, Worley, Hull and West, the board will also choose among previous applicants interviewed Nov. 5, Dr. Norbert Ralph, Lester Friedman and John Chin.
One Question on their Minds: What will you do for SLH?, Nov. 5

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Monday, November 9, 2009

This One's for the Children

"Today's vote will be the most important of our careers," Rep. Pete Stark said Saturday before the House narrowly passed a health care reform bill. "History will mark which side we were on; providing quality, affordable coverage for all Americans or the status quo." Using the unknown threat of the future's perception of today, Stark said former Sen. Bob Dole's refusal to support Medicare in 1964 "probably preventing him from being president." He was not the only congressman throwing the weight of the history books around. The Washington Post reported numerous legislators using similar imagery like Rep. John Lewis (D-GA). "If we fail to act on health care, history will not be kind to any of us," he said.

The bill now goes to the Senate for debate with two competing plans. According to The New York Times, the possibility of enacting healthcare reform by the end of the year is in jeopardy as the Senate awaits a cost analysis from the Congressional Budget Office that may delay debate until after Thanksgiving.

Stark, with grandchildren in tow, appeared energized by the historic moment which would be the defining moment of his three decades on Capitol Hill. It also renews speculation Stark could hang up his legislative gloves if health reform is passed by the end of the year. Most East Bay politicians are obsessively tight-lipped on any water cooler talk about Stark's future, but a combination of age and his high-profile involvement in the landmark legislation could be the perfect final bow.

It was also notable that Stark appeared on the House floor with his grandchildren. Of course, they were there to illustrate a point; young Americans will not live without medical care if this bill passes or were they also at his side to remind Grandpa Pete to behave before the cameras? Calling a congressmen a "fruitcake" and insinuating the President is motivated by getting soldiers "heads blown off" as he had done in the past would not make mommy and daddy happy.

Speaking of children and health care. Stark ran through a litany of groups supporting health care reform in his speech. They were the usual suspects: seniors, the poor and the medical profession, but he also added children. Do children have a lobbying group, now? Of course, there are numerous activists groups who lobby on behalf of children, but no known group of mini-lobbyists (if they did they would reside in a world similar to this: watch the video.)

If you think about it, if children had a lobby they would likely not support health care reform. Have you ever met a kid who likes going to the doctor?

Sunday, November 8, 2009

Lockyer Not Running for Governor, but has Ideas to fix State

The Citizen

SAN LORENZO, Calif. - San Francisco Mayor Gavin Newsom is out of the race for governor leaving Attorney General Jerry Brown as the only current choice for state Democrats. So, what about Treasurer Bill Lockyer?

At a League of Women's Voter luncheon Friday in San Lorenzo, Lockyer said "I looked into it. Sure, I looked at the polling and nobody can beat Jerry Brown right now, whether that's good or not."

Progressive bloggers have been urging Lockyer to enter the race for months and the sudden departure of Newsom due to tepid fundraising success and poll numbers that showed the telegenic mayor even trailing Brown in his own city, only heightened parlor chatter about who if anyone would challenge the former governor next year.

Strategists may conclude a similar fate for Lockyer, but he sounded like a candidate with a plan Friday afternoon to reform the state's woeful fiscal structure.

Lockyer described himself as centrist on taxes and thinks the legislature needs to craft creative solutions instead of raising tax revenues, "As a practical matter, I don't think tax increases are going to occur and Democrats go back to that solution for every problem too readily," Lockyer said. "My own view is that we need to spend a decade working on governmental efficiency and spend the money we have well, if for no other reason to convince people that they are getting a dollars worth of value for dollars worth of tax."

The inefficiencies in state government can be alleviate according to Lockyer and cited two examples where more bang can be squeezed out of every tax dollar. Even though the state was collecting DNA samples of felons a decade before his tenure as attorney general, most of the data was not computerized. He also mocked the failure of the Department of Motor Vehicles to streamline its service because of computer program incompatibility issues. He joked about his wish to launch tactical nuclear weapons on the DMV.

Lockyer says the last "traditional" balanced budget--where both sides of the ledger could be reconciled--was in 1997 and has been followed by reckless borrowing. "We spent money we did not have that was made up for by internal borrowing against everything that moves and external borrowing in public markets." But, Lockyer also cautions against the perception of a deep unending California's budget crisis by citing a structural deficit of only 3-4 percent. "Grown ups should be able to figure this out," he said. "There is a need for adult supervision in Sacramento."

Much of the state's problems are structural, said Lockyer, and are attributed to the requirement of a two-thirds majority to pass nearly anything of importance. "It's hard to get a two-thirds agreement on very divisive, controversial, expensive, so part is those requirements," he said. The rule of two-thirds was initially designed to reduce the urge to spend, but the opposite has occurred in practice when the need to line up 67 votes has led to excessive spending and pork to entice legislators, Lockyer says.

Propositions in California, which only need a simple majority to pass, have allowed, he said, other interests to bypass the legislature and enact spending measures without saying where the money will come from. Believes reforms will be push forward in the next year to remedy such problems.
"It's hard to get a two-thirds agreement on very divisive, controversial, expensive, so part is those requirements." Representatives from activists groups Repair California, who favor forming a Constitutional Convention, and California Forwards both laid out visions to reform the business of state government that are likely to be both on the November 2010 ballot.

On the subject of San Leandro Hospital, Lockyer said, "I'm with those who agree with keeping services at the hospital," but the man elected to hold the state's purse strings did not see subsidies for it in the near future and punctuated it with a simple, "no."

PHOTO: California State Treasurer Bill Lockyer speaks to the League of Women Voters Friday afternoon in San Lorenzo.

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Saturday, November 7, 2009

Mayor Attacks Cassidy's Liberal Cred

San Leandro Mayor Tony Santos and his opponent former School Board Trustee Stephen Cassidy are probably not friends and the long slog of campaigning for mayor will not alleviate their constant backbiting.

During a council meeting Monday night Cassidy sternly criticized the mayor and city council twice for allegedly positioning the newly-created Budget Task Force Committee to follow the city's agenda to raise revenue through taxes. Cassidy also charged the city with failing to fund school crossing guards while preparing to spend $75,000 on an informational tax campaign. Santos used the opportunity to further ratchet up his rhetoric this week against Cassidy, likely signaling the beginning of a vicious political fistfight.

Santos, at times, looked on with exasperation, but made no public comment to Cassidy's charges. Afterwards, he said "Cassidy, in my mind, is becoming the new Lou Filipovich." The reference to Filipovich, who was the Republican challenger to Assemblywoman Mary Hayashi last year, in San Leandro terms, is akin to Hillary Clinton calling Barack Obama, the next Newt Gingrich.

Filipovich is known for speaking on numerous topics during council meetings. At one hearing earlier this year, he turned in four separate public comment cards and was the only person to speak that night. The scene of the elderly Filipovich repeatedly shuffling back and forth from his seat to the podium four consecutive times to lecture the council on taxes is one of the funniest moments of the year.

On Thursday, Santos again compared Cassidy to Filipovich, but added a scathing attack on Cassidy's liberal credentials. "You want to call yourself a progressive like Cassidy does and then support cutting jobs and taking funds out of the hands of employees. Progressives don't go against employees. Like I said the other day, he's no different than Lou Filipovich."

In recent months, Cassidy has honed his message around the city's growing budgetary problems and attempts to alleviate its demise by increasing tax revenues. He has also publicly shined a light on the mayor's terse email messages to himslef and other constituents, saying Santos "praises me in public and puts me down in private."

Their tit-for-tat began this spring when Cassidy criticized Santos' handling of the city's finances. Santos countered with "Here's a guy, when he was on the school board, who couldn't balance his own budget and he wants to tell me how to balance mine?" Subsequently, every mention of Cassidy to Santos elicits the same talking point and the war of words continues.

PHOTOS: San Leandro mayoral candidate Stephen Cassidy; Lou Filipovich, a two-time Republican candidate for State Senate, was defeated last year by Mary Hayashi for Assembly.

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Friday, November 6, 2009

When Mad Men meets Madoff

Before Pacific National Bank suffered the ignominy of being a victim of financial hubris, it was a stable, family-owned community bank called California Savings Bank. The failure of the 100 year old institution illustrates how lenders, once the bedrock of trust became bloodthirsty vipers in a psychotic rampage for greed and power and nearly knocked the country off its hinges.

I worked for California Savings Bank for the last four years of its existence before the Symon family uprooted its century long interest in the bank and sold it to the First Bank of Oak Park (FBOP) in 2004. It's easy to describe California Savings today. Think of the 1960s drama "Mad Men" and delete the image of men in pomade-slicked hairstyles. The main office on Fourth and Market in San Francisco, which I worked and is now a Diesel store, still had garish orange carpet and the wallpaper still reeked of smoke from a bygone era when workers smoked at their desk at ate lunch leftovers straight out of the Betty Crocker cookbook. The decor of the office had not change since the Johnson administration, but its attention to financial fairness rooted in good business acumen and a foothold in the success of the community had also not changed.Today this anachronism speaks to how Wall Street bankers become godless purveyors of excessive usury and reckless financial motives nearly ruined the American Dream for a generation.

When the Symon family announced its attention to sell the bank to the Illinois-based FBOP in 2004, there was a palpable belief extensive change was about to occur. Many of the office workers had been with the company for decades. The company did not dabble on the investment side of banking beginning to thrive thanks to the repeal of the Glass-Steagall Act in 1999, which tore down the regulatory wall between retail banking and investments that would eventually spew toxins all over the world of finance. At times, people in the loan department were amazed anyone could survive the bank's stringent lending standards. They didn't even make construction loans.

FBOP, which had been slowly increasing its presence in the lucrative California market by purchasing small banks in Southern California looked at California Savings and its then-22 branches in Northern California as a potential asset ready to pour money like a broken ATM machine. The 21st century hit California Savings hard one day in early 2004, when a president of FBOP visited his newly-conquered inhabitants. Stern and cocky, but a bit undersized, the executive openly mocked the former owners for how they operated the bank. "Did they not want to make money," he said in a nicely-tailored suit and shiny black loafers that starkly contrasted the ubiquitous orange carpet. "There was a job here for everybody," he said, "if you wanted to work for it." The sentence was ominous. In time, those deemed "dead wood" were slowly laid off. Gone were worker with over 30 years invested in the bank. In hindsight, workers due to be let go were given little to do while being told they were not working hard enough.

California Savings moved its San Leandro branch from Bayfair shortly after to new digs on Parrott and E. 14th and renamed itself Pacific National Bank. Reports say regulators had been looking at the failing bank for over two months. The cause, the Treasury Department, says was a load of poor investments in the nearly worthless Fannie Mae. The true cause is symptomatic of everything that is wrong with banking, the morality of Wall Street and the predicament we have been placed where unemployment sits in double-digits and the poor get poorer and, if you're Goldman Sachs, the excessively rich get obscenely rich.

There was a time when being a neighborhood banker was viewed as a friendly face. The fate of the bank was intertwined with your own. Bankers were not out to put your livelihood at risk. If you could not pay back a loan you were not given it to begin with. The banks were still a business with an eye on the bottom line, but its aim was not to strip mine the community of all its money to impress their managers and pad their own personal portfolios. "Did this bank want to make money?" is the problem. Undoubtedly, FBOP made millions from transforming California Savings into a "modern" institution, but in the end, like Bernie Madoff, AIG, Bear Stearn, Lehman Brothers and millions of displaced former homeowners, we all paid in the end.

PHOTOS: Above, the male cast of the television drama Mad Men. Below, Bernie Madoff.

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Q&A with Former Healthcare Director Suzanne Barba

Suzanne Barba was a Eden Township Healthcare District Director from 1990-2006. She was replaced by current member Carole Rogers. During the last half of her tenure she sat on the board as Sutter Health entered the District and helped negotiate contentious agreements with the hospital provider in 2004 and 2007. She sat down Friday afternoon with The Citizen in San Lorenzo.

Sutter Health, at one time, had great interest in building a facility in the lucrative Dublin/Pleasanton market. Is it fair to say the District was trying to cut its loses by keeping Eden Medical Center over San Leandro Hospital or risk have no hospital at all?
When the board sat down with the other Sutter boards to look at where the business would be going, when you're doing strategic planning, of course, the eastern section looked really ripe because that's where the growth is. Castro Valley isn't growing very large. San Leandro isn't growing very large. Hayward is pretty static. Yeah, that was one of things we were afraid of. We were wondering whether they were going to retrofit [Eden] because they would rather be in Dublin. Well, as it turns out, they stayed with Eden and they're going to build us a new hospital.

When you negotiated the Memorandum of Understanding in 2007 with Sutter was there any worry about the sections allowing San Leandro Hospital to be closed if it did not turn a profit and whether that could actually happen or was that not a concern at the time but subsequently became a huge factor in where the hospital's fate stands today?
We really thought it was going to be okay because of the kind of effort we were putting into it. We tried to make the employees happy by raising their benefits and salaries and I think you can look at the seniority at a hospital and know whether they love their hospital. San Leandro is a good hospital, but it has changed hands and I don't think this Prime Healthcare is a good deal for San Leandro. It's a for-profit. [Owner Prem Reddy] has a history, but some people in San Leandro think its worth it. He's promising the world and you know he's not going to be able to deliver because the hospital is not making money. If he's making money, it's because he's cutting corners.

When you talk about stars aligning, the county needed a place to put their rehabilitation facility, so here was a hospital losing a lot of its services anyway. So it seemed that we were doing good for the county. They don't have to worry about retrofitting [Fairmont Hospital]. It's good for Eden and the hospital stays in San Leandro.

There has been rumors that Sutter is using cost-shifting maneuvers to make it appear San Leandro Hospital is losing money when it is not. One story is Eden donates a large piece of medical equipment to San Leandro Hospital but is listed on San Leandro's books as a severely overpriced expenditure for installation. Do you believe San Leandro Hospital is losing money despite doctors and nurses who describe a bustling facility?

I think it's losing money. [District Director] Carole Rogers had an auditor look at the hospital's book. They spent $40,000 and when they did the audit it came out the same way.

Why is San Leandro Hospital losing money?
One of the problems is doctors like Vin Sawhney are part owners of a surgery center that is in competition with hospital and that's what a lot of the doctors did. They either have a surgery center or started doing some of the stuff in their offices.

What do you believe the outcome of this will be? Will it stay as a fully-functioning hospital with emergency room services or become rehab for the county?
I don't see how it can stay open. It's losing money. Nobody can really stay in business like that. That's the bottom line whether you want it to stay open or not.

Despite enormous pressure from doctors, nurses and the public, it is still likely San Leandro Hospital will become a rehab facility. Do you any remorse or regrets for your part of negotiating the agreement if this happens?
I regret all those things that came together as a perfect storm had happened and then got worse. The doctors got mad and a mad doctor is not a cooperative doctor and they're not working from the same agenda. The outrage I hear from San Leandro is the hospital being built in Castro Valley is too small. Well, the trend now is to outpatient surgery. The new hospital will have about 100 rooms that can be converted when needed. They're not staffed, so you don't have to staff those rooms that are empty, but if a pandemic occurs, they can convert those rooms into a larger hospital for all those people. You can look around, nobody is building monster-size hospitals anymore.

Critics say without an emergency room in San Leandro people are going to die. Is Castro Valley really too far for someone in San Leandro to get care?
It's ten minutes and if it was a trauma situation they would be helicoptered over no matter where they are. If they're talking about screwing up the building of the new hospital, they're talking about losing the trauma service, so they better not wish for something or the they're liable to get it. If they mess up Eden's plans then they don't have a trauma center in this area.

Wouldn't you say it's too late to use the "we might lose Eden, too" scenario when Sutter is already tearing up the earth in Castro Valley?
[Former District Director] Frank Rico is of the opinion that Sutter is just waiting to leave. No matter how much money they have put in so far, it's nothing compared to what it is going to cost to build the whole thing. They are just looking for an excuse to back out and maybe go to Dublin.

And, you know, poor San Leandro, they are going to have a beautiful Kaiser there and I don't think people realize you can go to the emergency room at Kaiser even if you're not a member--it's state law. I went to Kaiser emergency once. They stabilize you and then they send you, if they have to, to your regular hospital and then they bill. I remember at Eden, they had over a million dollars in money owed by Kaiser for patients they treated. They are so slow to pay.

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Thursday, November 5, 2009

One Question on their Minds: What will you do for SLH?

The Citizen
CASTRO VALLEY, Calif. - Every question the remaining members of the Eden Township Healthcare District posed seemed superfluous except for one. What are your thoughts on San Leandro Hospital? All the answers appeared to suit member Dr. Harry Dvorsky. He refrained from questioning the first round of three candidates to replace Dr. Walter Kran, who resigned in late September. The Board will reconvene again Nov. 10 to interview three more applicants.

One candidate who will have to wait is Dr. William West, who some believe is the front-runner to replace Kran. West will not face the board until their regularly scheduled Nov. 18 meeting. The announcement, made by Board Chair Dr. Rajendra Ratnesar signals Kran's successor will not be named after the second round of interviews next week as some suggested, but just nine days from the deadline to make decision or risk handing jurisdiction over to the Alameda County Board of Supervisors.

Three applicants introduced themselves to the board Thursday evening at the newly-opened Castro Valley Library. Lester Friedman, the only applicant from outside the medical field; John Chin, a controller for Nightengale Nursing and Dr. Norbert Ralph faced the board with Director Carole Rogers on speakerphone.

Friedman portrayed himself as outside the lines of the District's battles with Eden Hospital and San Leandro Hospital saying, "I have no conflicts with the hospital or anything that should occur." He told the board he has witnessed firsthand the specter of two overflowing emergency rooms when he was transferred to San Leandro Hospital on diversion from Eden. "Any closure would be catastrophic," Friedman said, "If you take away one facility, it's obvious what will happen."

Chin told the group he was uninterested in running for re-election. He said he only learned of the opening while reading the paper at a coffee shop a day before the Oct. 16 deadline. He jokingly wondered what was in his latte that day. Chin said his current position on the turmoil at the District is "neutral" but later struck an opposite chord after reading the board's bylaws in regard to San Leandro Hospital's alleged money-losing operations. "Are we asking the right questions?" he said. "Do thinking about profits fit the needs of the community?" In response to the answer, Ratnesar appeared to wince. When asked by Rogers, the unabashed supporter of keeping San Leandro Hospital's emergency room in operation, about his opinion of alleged cost-shifting by Sutter Health in the District and among the corporation's multiple subsidiaries, Chin called cost-shifting "legitimate according to Medicare."

The board appeared to have a problem with the proximity of Dr. Norbert Ralph's practice to the District. Ralph said he spends four days a week in San Francisco along with a work in Modesto. He also maintains a small practice in San Leandro, but both Directors Dr. Vin Sawhney and Ratnesar came back to the question on separate occasions. Ralph also offered no specifics on any of the questions posed while admitting he was "generally aware of the District's situation" and could offer an "open mind."

The bulk of the questions emanated from either Sawhney or Ratnesar with Rogers, who is out of the area, offering one question to each of the three candidates via conference call. Conversely, Dvorsky, whose mentally acuity has become a looming issue since his vote is likely to appoint a new member, looked dazed and disoriented throughout the process. He declined to ask questions to any of the candidate and appeared to be moving his pen above a piece of paper feigning to write notes. Other moments, he stared blankly at each applicant, which oddly may have significant ramifications for the next two weeks. Some believe Dvorsky's familiarity with West, who is believed to be favored by Rogers, could help gain the director's decisive third vote thereby stacking the board with a solid majority of member interested in keeping San Leandro Hospital open.

Three more applicants will stand before the board Nov. 10 at 5:30 p.m. at the Castro Valley Library; former Director Dr. Francisco Rico, medical supply owner Steven Ree Worley and two-time board candidate Dr. Ronald Hull.

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