Councilmember Rebecca Kaplan become the 18th person to challenge Jean Quan for Oakland mayor and she just might be her toughest opponent this fall.


Assemblymember Rob Bonta casts his ballot Tuesday morning in Alameda.


Election Day is Tuesday and the East Bay Citizen has the big races covered in this handy guide along with the predicted winners and losers.


On a hot day in Fremont, we shadowed 17th Congressional District candidate Ro Khanna and some voters found themselves quietly starstruck.

Showing posts with label Sutter. Show all posts
Showing posts with label Sutter. Show all posts

Friday, February 14, 2014

Boardmember Who May Have Unwittingly Saved San Leandro Hospital Has Died

Dr. Harry Dvorsky
EDEN TOWNSHIP HEALTHCARE DISTRICT | Dr. Harry Dvorsky, a former chief of staff at Castro Valley's Eden Hospital and elected member of the Eden Township Healthcare District Board of Directors, died Feb.10. He was 90.

The kind thoracic surgeon was known to attend board meetings with his trademark bow tie and served three terms on the health care district board of directors before not seeking re-election in 2010.

Much of his service on the board coincided with tumult arising from the attempt by Sutter Health to take control of San Leandro Hospital. The community hospital was transferred from Sutter Health to Alameda Health System last year, ending over five years of political and legal disputes.

In hindsight, Dvorsky may have unwittingly cast the initial vote that would eventually save the hospital years later.

In February 2010, Dvorsky inadvertently cast the deciding vote directing district lawyers to file suit against Sutter alleging conflicts of interest among participants of a controversial 2008 memorandum of understanding essentially giving away San Leandro Hospital to Sutter.

However, some claim Dvorsky made it clear beforehand he intended to vote against the risky legal gambit. When the vote was taken, Dvorsky surprised everyone by voting yes.

A day later, Dvorsky attempted to rescind his vote, but to no avail. By the time the board met again, the lawsuit had already been filed. The district would eventually lose the case and subsequent appeals, which came with great financial costs. Yet, the protracted dispute went a long way toward exerting significant public and political pressure on Sutter to not close San Leandro Hospital. It worked and the community may have Dvorsky to thank, even if he might not have know exactly what he did that day.

Friday, January 17, 2014

Study: Hospitals will be Hampered by Legislation Asking Non-Profits for Tax-Exempt Accountability

ASSEMBLY | HEALTH CARE | A state legislative audit two years ago found non-profit hospitals receiving lucrative tax-exemptions lack accounting for the amount of charity care they provide. Last year, East Bay Assemblymembers Bob Wieckowski and Rob Bonta authored a bill based on the audit's recommendations. Wieckowski pulled the bill last May.

However, a study released Thursday by the California Hospital Association, authored by former South Bay Rep. Tom Campbell, says any future legislation would make it increasingly difficult for providers to offer care to the poor and uninsured. It may also inadvertently affect the success of Covered California, the state’s version of the Affordable Care Act, it says.

“The sponsors of such public policy base their recommendations on the assumption that non-profit hospitals do not provide sufficient public benefit to justify their non-taxed status,” said the report issued in conjunction with the Berkeley Research Group.

Despite AB 975 not being currently debated in the State Legislature, Wieckowski defended the bill in a statement Thursday. “These important medical facilities receive millions of dollars in favorable tax treatment by Californians and in return are expected to provide lower-income residents in their communities free or reduced-cost medical care," said Wieckowski.

“However, as reports have repeatedly noted, there is no statutory standard or methodology to calculate the level of charity care currently provided and each hospital organization calculates their levels differently. Audits have also found that some non-profit hospitals do not submit their community benefit plans as required.”

In many ways the debate whether non-profit health care providers offer enough charity care to the communities they reside, at least, commensurate with the tax breaks they receive began, in San Leandro. The threat of examining the non-profit status of large non-profits like Sutter Health, was used by local officials, in part, as a negotiating tactic to end a nearly five-year saga to keep San Leandro Hospital from closure.

An audit requested by State Sen. Ellen Corbett and Alameda County Supervisor Wilma Chan found no mechanism for the state to calculate whether taxpayers were getting much in return for tax-exemptions given to non-profit hospitals. "We saw that each hospital had its own method to calculate its costs to provide health care services for which it did not receive compensation (costs of uncompensated care)," said the report, released in August 2012. "Indeed, no statutory standard or methodology for calculating these amounts exists."

Tuesday, August 27, 2013

Sutter Health’s Epic Fail

HEALTH CARE | It seems San Leandro Hospital got out from under the thumb of Sutter Health in the nick of time. The California Nurses Association on Tuesday harshly criticized the hospital provider for potentially putting patients at risk when its $1 billion records keeping computer program went dark for most of the day on Monday.

Doctors and nurses were unable to access or input patient information such as types of medication and dosage from 8 a.m. Monday morning to late in the afternoon, the nurses union said, and affected Sutter facilities in Northern California, including East Bay hospitals in Berkeley, Oakland and Castro Valley. The inability to access the computer program, named Epic, forced hospital employees to “work blind,” the union added.

A scheduled system upgrade last Friday allowed doctors and nurses to view patient’s file, but not input new data. However, it is not clear whether Sutter’s problems with the computer system are related to Friday’s upgrade. Last July, Sutter encountered trouble with the Epic program and the hospital provider has struggled recently with breaches to its computer security. Over the past year Sutter and the California Nurses Association have also encountered numerous skirmishes on the labor front all over Northern California.

Stacey Wells, a Sutter spokesperson acknowledged Monday’s problem “caused intermittent access challenges in some locations.” She noted specific backup procedures are available and were followed during the time timeframe the system was down and the confidentiality of the patient’s records were “secure and intact.”

“CNA’s allegations should come as no surprise to anyone given their protracted labor dispute with us,” said Wells. “It is interesting that CNA nurses use the same platform at Kaiser and have not challenged the Kaiser system.”

CNA claims the Epic system is not only for keeping track of patient’s record, but also to maximize the amount of profit it can squeeze from each customer. In a statement, Tuesday, the nurses union says Sutter Health management reportedly kept track of every dime. Even a total loss of $6,332 was detailed in an internal memo. “This department will not survive if we continue to operate this way,” said the email. “If you do something that is chargeable, charge for it!!!”

At Alta Bates Summit in Oakland, because of computer problems, patient’s histories were 2-3 days old, said a nurse there. At Alta Bates in Berkeley, nurses reported delays in surgeries and the delivery of babies. “We did not have information on the history of our patients. Nurses could not determine or administer proper meds when the system failed and the pharmacy backup system failed. If it were not for the nurses going above and beyond, it could have been disastrous,” said Beth Sherry, a registered nurse in the labor and delivery department.

As the hospitals in the Bay Area and the state at-large consolidate into big players such as Sutter Health and Kaiser Permanente, the business practices of these non-profits, some of which generate over $1 billion annually, have elicited greater scrutinizing by local and state officials and often at the behest of the powerful nurses union.

A report last year found the charitable benefits provider’s like Sutter give back to the community are far less than the tax breaks it receives with its non-profit status. The seemingly successful bid this year to keep San Leandro Hospital open despite Sutter’s protestations since 2009, put into question whether Sutter valued profits over the welfare of the community. In the past month, control of San Leandro Hospital was passed on to Alameda Health System.

Friday, June 28, 2013

How Alameda Health System Is Going All-In With Deals In Alameda, San Leandro

ALAMEDA COUNTY//HEALTH CARE | The fall and potential renaissance of two East Bay health care facilities in San Leandro and Alameda share similar qualities, they reportedly bleed money and struggle to compete in a market dominated by big players in the health care industry. However, while Alameda resident’s took control of their stand-alone hospital years ago with a annual $297 parcel tax, San Leandro put the onus on the local health care district and Sutter Health. Ironically, in the end, either gambit has led both into the arms of the county’s safety net health care provider, Alameda Health Systems.

This month, the formerly named Alameda County Medical Center, signed a letter of intent with the Alameda Healthcare District to operate Alameda Hospital. All sides were careful how they labeled the deal after a healthcare district’s board members recently resigned citing concerns the pact with AHS should be posed to voters. A state law exists requiring a vote of the people when the assets of more than 50 percent of the health care district is transferred to another entity. “This is not a sale, not a merger,” said Debbie Stebbins, the Alameda Healthcare District's CEO. “It’s an affiliation.”

The proposed deal includes maintaining Alameda Hospital’s emergency room, no reduction of services or loss of jobs, said Stebbins. It also extends a $3 million line-of-credit from AHS to the hospital, of which half can be immediately accessed upon signing the non-binding letter of intent. In addition, medical staff at Alameda Hospital will be autonomous from AHS, said Stebbins. “We have met these people. We have sat across the room from them,” said Alameda Healthcare District board member Dr. Robert Deutsch. “We’ve made eye contact and I think we’ve created a trust.“

Behind the novel realignment of the health care safety net in Alameda County is Wright Lassiter, the long-time CEO of Alameda Health Systems, who says, “Health care is definitely about consolidation. It’s about scale, to some extent, because we all have fixed costs.

Wright Lassiter
“There is a requirement for some level of scale for you to be able to spread your costs and that is what this is about to some extent. Every market is a little bit different. We have two well-run health care systems that cover a lot of the community. Unless you can do something similar to what Kaiser and Sutter, then it is very difficult to compete. So this conundrum is, do you stay small and cover a local community like Alameda and San Leandro has tried to do, or do you try to become more regional?”

While Alameda Health System is currently constructing an addition to its Highland Hospital in Oakland, Lassiter says his recent moves is “not about going big because big is better, necessarily. It’s about doing things to be sustainable.” He adds public-private partnerships like those with hospitals in San Leandro and Alameda “is the future” of public health care systems. “Often times you don’t see public entities doing this. You see private not-for-profit systems doing this.”

However, like the situation in San Leandro, AHS was not willing to take on the risk of an underperforming facility without some financial backing in some form. While San Leandro’s potential renaissance will be boosted by $22 million in short-term subsidies from Sutter Health, another $20 million from the Eden Township Healthcare and $3 million from both the city of San Leandro and Alameda County, Alameda Hospital will continue to rely on proceeds from its parcel tax.

Over a decade ago, Alamedans, fearful of being without an emergency room in this island city, overwhelmingly chose to tax itself through a parcel tax that contribute over $6 million to the hospital’s operations. However, the amount is still not enough. A decision by Kaiser Permanente two years ago to pull out of a partnership with Alameda Hospital hastened an already worsening financial outlook. The health care district maintains control of the hospital and its assets and will also oversee distribution of parcel tax monies, Stebbins said this week, while AHS will gain a seat on the district board.

Lassiter says the deals with San Leandro Hospital and Alameda Hospital are independent of each other. “They are really completely independent. One deal is not dependent on the other. Frankly, we look at them as some of the same reasons for us from a strategic perspective for trying to serve areas we don’t serve well today.”

The main difference, says Lassiter, is Alameda Hospital’s closer proximity to Highland Hospital’s perpetually stretched emergency room. The plan is to alleviate some of the burden on Highland’s ER to Alameda Hospital, he says. “The difference is we are not really looking at shifting volume from Highland Hospital to San Leandro like we’re looking at here.”

But like many hospitals all over the state, both Alameda and San Leandro Hospital have little recourse at this point other than to explore novel new approaches for competing on a regional basis. It is for many, either adapt or die. Added Alameda Board Director Deutsch last week, “The impossible can no longer be pulled off.”

Thursday, June 20, 2013

San Leandro Hospital Deal May Not Be Done By Deadline, But Don't Worry

SAN LEANDRO HOSPITAL | The letter of intent between Sutter Health and Alameda Health System (AHS) to keep San Leandro Hospital open expires July 1. However, if July 2 comes around without a deal in place, don’t worry; says Wright Lassiter, the head of AHS, it’s not the end of the world.

Lassiter told The Citizen this week talks between AHS and Sutter are doing well, but a deal may not be signed by the July 1 deadline oulined in the letter of intent. However, it is not cause for concern, he says.

“I can’t give you a prediction of July 1 or not, but what I can tell you is both parties are working really hard to get it done,” said Lassiter. “So, even if it’s not July 1, we’re working on getting that deal done.”

Last month, Sutter Health, which now owns San Leandro Hospital, offered to transfer title of the facility to AHS at no cost, along with a short-term $22 million subsidy. Under the plan, AHS would keep the hospital’s emergency room open and honor the existing labor agreements. The building’s vacant top floor would also be converted to an acute rehabilitation center.

Also on Wednesday, the Eden Township Healthcare District approved an additional one-time $20 million subsidy which should greatly clarify the situation at the negotiating table.

“We continue to make progress with Sutter on the letter of intent,” added Lassiter. “Our team is working really hard to get through all the details. There’s still a lot more work to be done.”

A Sutter spokesperson declined to speak on the progress of negotiations, but Lassiter assured both parties are “100 percent committed to make it work.”

“As long if we both agree sufficient progress is being made, then that will continue,” Lassiter continued.

Lassiter should be busy over the next few weeks as AHS makes a move in the East Bay to consolidate the area’s underperforming facilities amid the changing healthcare landscape in the dawn before Obamacare more fully comes online next January.

In addition, to the potential San Leandro deal, AHS has a somewhat similar offer to operate Alameda Hospital with a letter of intent that expires July 13. If all goes as planned, both facilities could be operating the umbrella of AHS by year’s end.

Wednesday, June 5, 2013

Letter Of Intent Makes No Mention Of Keeping ER In San Leandro Open

SAN LEANDRO HOSPITAL | The letter of intent signed two weeks ago by Sutter Health and Alameda Health System does not include language assuring the emergency room at San Leandro Hospital stays open.

The proposed deal to transfer title of the facility to the former Alameda County Medical Center along with a $22 million subsidy from Sutter must be finalized by July 1, according to county officials, or risk closure of the hospital.

Keeping the emergency room in continued service has been a pivotal issue for many members of the community and the impetus for over four years of bitter opposition against Sutter’s initial plan to shutter the facility in late 2009.

The five-page letter of intent signed May 14 contains no mention of what happens to the emergency room once a deal is struck. However, a side letter offered by Alameda County Supervisor Wilma Chan to Alameda Health System’s (AHS) 15-person Board of Directors briefly outlines her desire to keep the emergency open for three more years.

Funding for operation of the emergency room would come from the Eden Township Healthcare District, according to the county, but that group expressed doubt during a special meeting last week they could afford such an expenditure without bankrupting the publicly-elected body.

District Board Director Les Friedman and its attorney were especially confused by a section of the letter of intent dealing with Sutter’s claim damages following their protracted legal battle with the District ultimately leading to the transfer last year of the hospital to Sutter.

In the letter, Sutter offers to “release the District from any obligation to pay damages…so long as District provides financial assistance to support the ongoing operations of the Hospital in an amount that Sutter reasonably deems to be sufficient support in light of the District’s financial condition.” Colin Coffey, the District’s attorney, admitted last week not having a clue over the passage’s meaning, while focusing on the word "reasonably."

The letter of intent, which is non-binding, also asks Alameda County Healthcare Services to release nearly $2 million in trauma funds slated for the new Sutter Medical Center Castro Valley (formerly Eden Hospital), which can be doubled in value through federal matching funds. Chan held up release of the funds earlier this year. On Tuesday, the Alameda County Board of Supervisors approved releasing the trauma funds to Sutter.

Curiously, Sutter also attached specific language to the letter of intent insuring those involved represented the proposed deal by portraying Sutter in a positive light. The Sacramento-based health care provider is notoriously sensitive to even the slightest negative publicity.

It suggests public officials labeling the potential transfer as a “donation” by Sutter that “will allow for the continued operations of the Hospital. The section is the only legally-binding part of the letter of intent.

Several news outlets, including the San Francisco Business Times, KPIX and Patch followed by the request. In an op-ed piece, Chan also characterized the deal as a donation.

Sunday, June 2, 2013

The Lengths Non-Profit Hospitals Go To Scam Taxpayers On Charity Care

SUNDAY COLUMN | As the Legislature made a mad dash this week to clear its calendar of bills from its houses of origin, one specific floor debate in the Assembly showed why many distrust government and unfortunately assume their hands are tied by the sheer volume of corruption to do anything about it.

Non-profit hospitals, which are laughably only so by definition and not by any sense of logic, do not provide anywhere near the amount of charity care due to their communities in exchange for highly sought after and lucrative tax exemptions. The game is rigged like so much in the corporate world. A state audit ordered by the State Senate Joint Legislative Audit Committee clearly revealed the racket non-profit healthcare providers like Sutter Health and Kaiser Permanente have perpetrated on taxpayers.

Testimony at a State Senate select committee convened by State Sen. Ellen Corbett on the subject last year claimed providers reaped almost $2 billion more in government benefits than their expenditures for community benefits. In addition, half provide less than 2.5 percent of their operating expenses on charity care.

In short, there are no regulations for accurately accounting how much aid these non-profit hospitals are actually providing. In addition, there are no rules for what exactly is charity care. Assemblyman Bob Wieckowski this week used a canvas shopping bag given by a local non-profit hospital as an example of what can be counted as “charity care”—a shopping bag (really?).

What these corporations get away with is akin to a high school teacher allowing their students to submit their final grades for the semester. Would you give yourself the C+ you rightly deserve or would you be like Sutter Health and grossly inflate their false, yet amazing generosity?

When this audit was presented in San Leandro last August, Sutter Health, which now operates San Leandro Hospital, ran an ad in the consistently complicit San Leandro Times claiming over the years it had offered $756 million in charity care. I won’t waste another column inch on the claim, it’s all bullshit.

In addition, Assemblyman Allen Mansoor (R-Costa Mesa) defied credulity Thursday in the Aasembly when he and others claimed forcing non-profit hospitals to accurately report the value of community benefits would actually hurt the poor and decrease the level of charity care they might receive.

What Republicans in the Assembly presented (they weren't only to blame, Democrats ultimately defeated the bill) was a laughably obtuse and lame argument against Wieckowski’s AB 975, which would have merely placed accounting rules for how much or how little non-profit hospitals provide in community benefits. That’s all. In fact, Sutter and Kaiser had already brought the wheels of government to a screeching halt by gutting the bill of any teeth while in committee.

However, even in its final state, Assemblymembers Wieckowski, Rob Bonta, Bill Quirk and Nancy Skinner should be praised for pushing this important issue even if it failed last Friday. This imbalance between the level of tax exemptions non-profits receive from taxpayers and what they actually give back to the struggling local safety net is not fair. To be clear, it’s a bait and switch hatched long ago that borders on stealing from the people of this state.

“If this deal is not cut, we will be getting a closure notice. I truly believe that letter is written.”
-Alex Briscoe, the director of Alameda County Healthcare Services, May 29, urging the Eden Township Healthcare District to approve a $20 million subsidy to keep San Leandro Hospital. The proposed deal offered by Sutter Health to turn over the facility expires July 1.

The Week That Was
Gov. Jerry Brown in San Leandro Thursday.
PHOTO/Steven Tavares
-Brown out in the East Bay: Gov. Jerry Brown came to San Leandro this week for the grand opening of the Zero Net Energy Center, a energy neutral building that now houses training facilities for union electricians. Brown made his laudatory comments, said he enjoys a good drink and espoused the threat of global warming. However, during the past few weeks, environmentalists have pounded his rhetoric, noting it differs from his actual policies.

-Deadline week in the Legislature: Over 700 bills were decided this week in the Assembly alone. While a bevy of bills from the East Bay’s delegation now head to the State Senate, there were some notable local defeats. Despite unanimous support from the East Bay, a procedural bill that could grease the skids for a waterfront arena in San Francisco for the Warriors easily passed. In addition, a bill centered on the region’s fight with Sutter Health over non-profit tax exemptions failed miserably despite its good intentions. Legislation regulating medical cannabis dispensaries also failed, but a bill raising the state’s minimum wage was successful.

-Debarment moves forward: The goal of symbolically handing Goldman Sachs a slap in the face in Oakland for its egregious corporate behavior leading to the Great Recession once again comes before the City Council next week. Amendments made by Councilmembers Desley Brooks asserting greater control for the council over the debarment process to potentially prohibit Goldman Sachs from bidding on city contracts in Oakland again passed committee this week. Over the past few months the issue has met resistance from city administration.

-A's Demolish Giants: The hometown Athletics took three of four games from the Giants this week in a fashion not seen since the victorious 1989 World Series. However, a controversy erupted when reporter Jon Heyman tweeted it was a shame "ATandT" Park sat empty while Monday's game was played across the Bay at the Oakland Coliseum. A's fans and some players were angered by the perceived slight and unmercifully belittled Heyman online. A wave of civic and team pride flipped the conversation, though, putting Oakland in a position it seems to relish as the scrappy underdog.

Tweet of the Week
“Interesting dynamics with #Athletics players showing love for Coliseum while Lew Wolff argues for new ballpark in San Jose.”
-@hangingsliders, tweeting May 31 on the controversy started by a New York-based sports reporter who tweeted a lament this week that San Francisco’s AT&T Park was unused while the Bay Area rivals played an interleague game in Oakland.

Best Reads
>>>A piece in The Atlantic on Jerry Brown in this space last week portrayed the governor in a positive light, now here comes the critics. First, Robert Gammon lays out how Brown’s record on the climate is faulty. (East Bay Express, May 29.)

>>>Others have pegged the beginnings of California’s renaissance not on Brown, but on the groundswell of liberalism being currently fostered in the state Legislature. This piece lays out the specifics behind this school of thought. (Salon, May 31.)

>>>Not every school district in Alameda County has a crummy superintendent. Oakland’s Tony Smith had begun to turn around OUSD before abruptly leaving earlier this year. However, there’s reason its next leader can continue what Smith started. (EdSource, May 27.)

Voice of the People
“Ha! Ha! Ha! All of Oakland’s thugs and gangbangers will have guns and the innocent citizens will be disarmed. Stupid is as stupid does.”
-Kalifornia Kafir, commenting May 28 on Assemblyman Rob Bonta’s AB 180 would allow the Oakland City Council to enact stronger gun control law than the rest of the state on “Oakland Gun Bill Passes Assembly.”

Friday, May 31, 2013

Wieckowski’s Bill Adding Accountability To Non-Profit Charity Care Falls Short

ASSEMBLY//HEALTH CARE | An Assembly bill steeped in the long-running fight to save one East Bay hospital failed passage Friday morning after several attempts. The bill authored by Fremont Assemblyman Bob Wieckowski and co-sponsored by Assemblyman Rob Bonta would have standardized the reporting of charity care dollars by the state’s non-profit hospital providers.

The Legislature’s lower house voted down the bill, 36-26, on Thursday after three unsuccessful votes. It was also allowed reconsideration, but Wieckowski requested Friday morning to move the bill to the Assembly's inactive file. The entire East Bay delegation voted in favor of the bill.

AB 975 was inspired by a 2012 legislative audit that found no discernible standard for non-profit hospitals reporting the amount of charity care they provide the community. In exchange for highly-beneficial non-profit tax status for hospital providers, they must offer charity care to the uninsured and indigent. However, there are no rules over how much or how little they must give.

Although Wieckowski’s bill was gutted in committee to remove any teeth for penalizing hospitals if their levels of care is found to be deficient, on Thursday, he was critical of the hospital lobby and whispers among the opposing assembly members the proposed law would revoke provider’s non-profit status.

“What this bill does is provide guidance for standardizing the reporting of care that is provided without expectation of reimbursement,” Wieckowski said Thursday on the Assembly floor. Some Republican assembly members contend existing law already hold hospitals to reporting standards.

“That’s not what the auditor’s report said,” added Bonta, whose district includes San Leandro Hospital. “That’s not helpful. That’s fear-mongering. This [bill] does not do that. This is simply a reporting mechanism that requires hospital to report what their charity care is.”

In fact, a report released last year, which was requested by State Senate Majority Leader Ellen Corbett and Alameda County Supervisor Wilma Chan found a glaring lack of accountability and transparency over the precise amount of charity care hospitals provide the community. The auditor’s report slammed some providers for including promotional materials in their accounting of community benefits.

To make this point, Wieckowski displayed a beige canvas shopping bag offered by a health care provider in his south county district at a local farmers’ market. “This is a very nice bag, indeed,” he said, “but it does not improve the health of my community, or I guess the question is, does it? I don’t know?”

The report was also seen as an avenue to attain leverage over Sutter Health with a veiled threat by Corbett and Chan to question its non-profit status. Although the audit focused on the issue state-wide, three of the four hospitals reviewed in the report were operated by Sutter Health.

In Alameda County, Hayward’s St. Rose Hospital is impacted greatly by some of the largest influxes of charity care patients in the region. While St. Rose’s economic health is somewhat stable after years of staggering losses, Assemblyman Bill Quirk said not all providers in his district are as charitable.

“In my district two of those non-profits take all-comers, do all the charity care and are a damn close to going out of business," said Quirk. "We have three non-profits doing very well and not doing their share. This is a bill to find out who is doing their share.”

Republicans, however, maintained Wieckowski’s bill would decrease care for the poor in the state and posed an opportunity for labor unions to undermine their health care employers.

Assemblyman Allen Mansoor (R-Costa Mesa) called the bill a “power grab” by the nurses union and Assembly Minority Leader Connie Conway (R-Tulare) was perturbed by a claim certain members, without backgrounds in health care, were pushing the bill with ulterior motives. Conway did not elaborate, but was so upset that she abruptly finished her remarks while hastily brushing away her mic.

“We didn’t just make this up,” said Wieckowski before the bill’s ultimate demise. “We didn’t just decide to go after all the non-profits to try to make them look bad. We’re not allowing accountants to make up figures that look good.”

Thursday, May 30, 2013

'This Is It' Says County Official Asking Healthcare District For $20M Subsidy To Save San Leandro Hospital

SAVE SAN LEANDRO HOSPITAL | Asking for a $1,000 loan from skeptical parents is one thing, urging a struggling health care district to pony up $20 million to save a hospital’s emergency room is another.

Sitting astride a lone office chair before the Eden Township Healthcare District Wednesday evening, the Director of Alameda County Healthcare Services Alex Briscoe did just that as time ticks away for various public entities to hash out a deal with Sutter Health allowing for transfer of San Leandro Hospital to Alameda Health System by a hard July 1 deadline. The deal reported two weeks ago, also includes a $22 million subsidy from Sutter Health to operate the hospital for one year.

Briscoe addressed the District’s skeptical Board of Directors urging them to contribute their own one-year, $20 million subsidy he and other county officials say will allow San Leandro Hospital’s emergency room to remain open, at least, another three years.

After years of legal wrangling and acrimony between the District and Sutter Health some of its board directors remain leery of returning to the bargaining table after so many false starts and breaches of trust among the groups now urging for a positive resolution to the hospital controversy.

District Board Director Lester Friedman was the most skeptical of the plan brought forth by Briscoe. In recent months, the District has grappled with a growing identity crisis following a court judgment that forced it to transfer title of the hospital to Sutter Health last year leaving the health care district without a facility to oversee. The District also provides millions in health-related subsidies to local non-profits. The struggling St. Rose Hospital in Hayward also rest within its jurisdiction. In one exchange Wednesday, Friedman said the proposal to contribute such a large expenditure would hinder its aid to both needy groups. “It would be over,” Friedman said of the District’s future.

“This is it. This is the moment to cut the deal,” said Briscoe adding, “I’m not sure they are there yet.”

The attorney for the District noted the request for subsidy from officials is far bigger than any other proposed deal over the past three years. “It’s a big, huge jump from where we were 6-8 months ago,” said Colin Coffey, the District’s attorney. Previous requests entailed a subsidy between $6-9 million annually to operate the hospital to a more amendable plan just six months ago calling for a 3-year, $3 million subsidy. Alameda County and the city of San Leandro also agreed to similar subsidy plans.

Briscoe, however, reiterated his concern the deal offered by Sutter is the best and last proposal remaining for the county and the community surrounding the hospital. “If this deal is not cut, we will be getting a closure notice,” Briscoe assured the board. “I truly believe that letter is written.”

When pressed by the board directors, Briscoe said the District is not part of the potential hospital deal and if they decline to contribute the $20 million subsidy, it could still be conceivably approved by Sutter Health and Alameda Health Systems. However, it also puts the likelihood of keeping open the emergency room in doubt. Alameda Health Systems also proposes using San Leandro Hospital as an acute rehabilitation center to replace the seismically-deficient Fairmont Hospital.

Later, while the District board was in closed session, Briscoe said of the deal, “This is it. This is the moment to cut the deal,” he said, but added, “I’m not sure they are there yet.”

Aside from Friedman, the other board directors were relatively silent (Board Director Dr. Vin Sawhney was absent). Board Chair Carole Rogers, however, queried Briscoe over the possibility of various stipulations, including the District offering the money contingent on need. Briscoe said he could not negotiate on behalf of Alameda Health Systems, formerly named the Alameda County Medical Center, but added after viewing Sutter's financials, he believes the contention it lost $24 million over the past 2 years at San Leandro Hospital is “inflated.”

Just how the District could fund such a large, one-time subsidy is not clear. Briscoe offered three suggestions, including the liquidation of assets, sloughing off revenues from its real estate holdings or issuing additional debt. The first two appear untenable, said Briscoe. Selling off more than half of the District’s assets would trigger a state law placing the issue before voters. Ironically, this same issue was raised by Senate Majority Leader Ellen Corbett in the past against Sutter Health as a threat to block the transfer of the hospital. Briscoe said using future revenue streams from the District’s holdings is insufficient, but issuing debt on its three real estate properties would suffice.

Although the District’s three properties became financial albatrosses during the Great Recession, there is reason to believe the real estate market is improving. The Dublin Gateway Medical Center, according to the District, is its biggest asset worth $51.5 million. The San Leandro Medical Arts Building, located near San Leandro Hospital, is worth $5.5 million and its brand new medical office building in Castro Valley is a $6.5 million asset.

During a District meeting earlier this month, its CEO Dev Mahadevan noted the appraised value of the properties is on the uptick as are the number tenants signing leases at its medical offices. However, the District has borrowed against its assets in the past. Dublin Gateway has a loan value of $35 million, according to Mahadevan, while the Castro Valley medical office building is $45 million.

Tuesday, May 21, 2013

Chan Says Sutter Health Made First Move On San Leandro Hospital Negotiations

ALCO Supervisor Wilma Chan
SAN LEANDRO HOSPITAL | After years of ambivalence by Sutter Health to even negotiate with Alameda County or the Eden Township Healthcare District over San Leandro Hospital, it approached Supervisor Wilma Chan on its own last February, she said Monday.

Chan was in San Leandro Monday night to update the council on details of a plan to save San Leandro Hospital from closure, whereby Sutter Health transfers title of the facility to Alameda Health Systems along with a one-time $22 million subsidy for operations.

“They called and said we’re ready to talk,” Chan told The Citizen. In the subsequent months, Chan said the community was able to get a far better deal than one offered late last year that included Sutter leasing the hospital to AHS, but without any money for operation.

A letter of intent to begin negotiations between Sutter and AHS through July 1 was signed last week. If the framework of the current proposal is agreed to, the transfer of the facility could occur as early as this October.

Following over four years of uncertainty whether the hospital and its emergency room would stave off closure, Chan, who was elected back to the Alameda County Board of Supervisors in the middle of the controversy, admitted she wasn’t always confident it could be saved.

Chan said sometimes the battle felt like a “hopeless cause.” She added, “I didn’t necessarily feel like it was going to work.”

Nonetheless, members of the San Leandro City Council praised Chan for her efforts. “You have taken a situation thought to be impossible and made it possible,“ said Councilmember Benny Lee. Councilmember Jim Prola was more pointed. “Without Wilma this would not have happened.”

Despite any unforeseen problems hampering the current proposal from being approved, how multiple entities continue to fund operations at the hospital is still unknown. Sutter Health says it lost up to $2 million on a monthly basis over the past two years at San Leandro Hospital. In addition, a second prong of the current proposal includes the Eden Township Healthcare District pitching in a one-time $20 million subsidy to fund the second year of operations.

Already low on revenue, the District, which no longer has a hospital to run, may have to sell off some of its real estate assets. Chan said San Leandro city officials met with a few members of the District’s elected board of directors early Monday.

A parcel tax, either led by the District or the city, has also long been a possibility for funding the hospital. Chan says the county is also looking to offer a ballot measure reauthorizing Measure sometime in the near future. However, she said, last year’s foundering performance by a county-wide zoo parcel tax, gives them pause for concern.

Sunday, May 19, 2013

Saving San Leandro Hospital Is A Rare Populist Success Story

SUNDAY COLUMN | After four years of uncertainty, San Leandro Hospital appears to have been saved, at least, for the next few years. However, the fits and starts that have been a hallmark of this community-fueled uprising to save its hospital, is far different than at any time in the last few years. The main difference: this deal excludes Sutter Health from the equation.

It is this single attribute that is entirely unique to the long struggle led by residents, politicians and the nurses union. The plan offered this week by Sutter Health hands over title to the facility to Alameda Health Systems (formerly Alameda County Medical Center) along with up to $22 million in subsidies to run the first year of operations. The plan keeps the emergency room open and expands the vacant fourth floor for acute rehabilitation services.

Eden Township Healthcare District Board
Director Dr. Vin Sawhney advocating for
keeping San Leandro Hospital open. 
It is the same plan that fell to the wayside earlier this year, except Sutter Health had only offered to lease the hospital to Alameda Health Systems and without the lucrative subsidy.

However, there is still work to be done. It is unclear whether we should put much trust in Alameda Health Systems CEO Wright Lassiter, a former Sutter co-conspirator. If San Leandro Hospital’s finances should go sideways in the next two years and its ER faces another round of uncertainty, don’t worry. Whereas, the threat to the ER used to mean facing down a cold, faceless corporation, it may entail in the future screaming at the Alameda County Board of Supervisors for safety net funding.

Despite what your complacent neighborhood news organization said this week, the saintly Sutter Health did not “donate” the hospital. Instead, Sutter Health capitulated. They laid down their arms and walked away. They finally viewed the headache associated with San Leandro Hospital, in terms of public relations, was less important than its entirely prosperous empire.

In times when Americans feel like they are powerless against immense financial and political interests, the people of sleepy San Leandro (of all places!) showed if we band together, the bad guys will scamper. The rich and powerful, in the back of their minds, are always aware there are way more of us than there are of them.

“You can’t shoot people if you don’t have ammunition,”
-Assemblyman Bill Quirk, May 17 in Oakland, extolling the virtues of Assemblywoman Nancy Skinner’s bill to tax ammunition in the state, at an Assembly hearing on gun violence in the East Bay.

The Week That Was
>>>Haggerty Gets Dirty: Closed sessions at Alameda County Board of Supervisor’s meetings just got more intense. From the fallout of a lawsuit against Supervisor Scott Haggerty by his former chief of staff comes allegations he routinely objectified women and asked male staffers, “Who would you fuck? Wilma Chan or Gail Steele?”

>>>Oakland Looks Away: On second thought, the Oakland City Council will not discuss the contents of an explosive audit offered last March charging Councilmembers Desley Brooks and Larry Reid with repeatedly violating the city’s charter against council members interfering with the business of city staff. Council President Pat Kernighan, in effect, said there is other more pressing matters to deal with. Earlier, the council also put off debarment of city contracts with Goldman Sachs for another two weeks.

>>>Disconnect: Assemblymembers Rob Bonta, Nancy Skinner and Bill Quirk, along with State Sen. Loni Hancock all posed for news cameras Friday advocating for tougher gun control measures following a three-hour hearing on the subject inside the State Building in Oakland. However, community leaders, instead, continually pressed for more funding to help the lives of the youth before they turn to solving problems with firearms.

>>>Zermeno First In For Hayward Mayor: In a surprise move, Councilmember Francisco Zermeno announced he will run for mayor in 2014. Mayor Michael Sweeney is said to be uncertain whether he will run for a third term. Zermeno nearly lost his seat on the council last June and if Sweeney runs, things could get caliente. Sweeney, Zermeno and former school trustee Jesus Armas all play on a basketball team named “Los Chilones.”

>>>Quan’s 2014 Opponents: Port of Oakland Commissioners Bryan Parker and Gilda Gonzales are looking at possibly running against Oakland Mayor Jean Quan. So is City Auditor Courtney Ruby and professor and community activist Joe Tuman. More names are likely to show interest in the next few weeks.

>>>’It’s News To Us’: Although the long San Leandro Hospital saga is nearing a positive conclusion, nobody bothered to tell the Eden Township Healthcare District they may have to commit institutional suicide in order to make the deal work. Supervisor’s Wilma Chan’s plan asks the District to pay $20 million in subsidies for the second year of operations at the hospital. The District, though, knew nothing about the plan and say their assets are worth $29 million; largely from one asset that conversely generates the most revenue.

Tweet of the Week
“Jean Quan shared a bunch of photos from a roller derby match on FB. That means they're probably going to move to the South Bay too.”
-@OakScott, making light May 12 of Oakland Mayor Jean Quan’s perennial problem with keeping its sports teams content.

Best Reads
>>>Sometimes the best way to understand what is around you is through the lens of someone outside looking in. Here is an article describing the bare bones Oakland Police Department. (Los Angeles Times, May 18).

>>>In a progressive city like Oakland, it seems more cops are never the answer. But, over the years, with a rapidly shrinking police force, even progressives are sheepishly rethinking this argument, but should they? (East Bay Express, May 15).

Voice of the People
“Is a gang member really going to say, "Oh darn, that bullet costs 10% more, I guess I won’t do my drive-by shooting now"? Less guns do not mean less guns for criminals...”
-Anonymous, commenting May 18 on “East Bay Legislators Call For Stringent Gun Control Laws.”

Wednesday, May 15, 2013

Healthcare District: $20M Subsidy For San Leandro Hospital Is News To Them

SAN LEANDRO HOSPITAL | On Tuesday morning, Alameda County Supervisor Wilma Chan was trying to get ahead of news reports detailing an impending deal to save San Leandro Hospital leaked to a business reporter the night before.

However, while the report laying out the framework of proposed deal allowing Sutter Health to transfer title of the health care facility to Alameda Health Systems along with a $22 million one-time subsidy hit the airwaves, very few local public officials were aware of its imminent execution. Not fellow Supervisors Nate Miley, Keith Carson and Scott Haggerty.

Curiously, not even the Eden Township Healthcare District, which Chan said Tuesday may be on the hook for funding the second year of the hospital’s operation with its own one-time $20 million subsidy.

“It’s news to us,” said Carole Rogers, the chair of the district’s Board of Directors. “You know more than us.”

Dev Mahadevan, the district’s CEO, said no official representative has formally brought the proposal to the District for discussion. In essence, Mahadevan added, good luck in getting the money. The District doesn’t have it.

In the aftermath of the protracted legal fight that ended with the District losing title to San Leandro Hospital to Sutter Health, the government body founded in 1948, has been forced to tighten its financial belt just as its real estate holdings suffer in the current economy and while it fights for tenants at its newly-constructed medical office building in Castro Valley.

Since the healthcare district has not been a tax-collecting body since 1975, it’s inability recently to generate cash flow forced it to reduce the amount of grants it gives out to various health-related entities within its district. And, without a hospital to oversee, its basically functions as a charity organization.

The issue of the District’s viability as a health care district has been raised in the past by Chan, who angered its board of directors last year when she hung the specter of dissolution over the body if it did not contribute to a multi-entity proposal similar to the deal announced Tuesday requiring Alameda County, the city of San Leandro and the District to pay a 3-year/$3 million subsidy to help offset costs for Alameda Health Systems to run the hospital.

But, the District countered by pledging to contribute its expected cash revenue in the next two years, topping out next year at over $1 million to the pool of money. That deal fell apart after Wright Lassiter, the CEO of Alameda Health Systems, pulled the plug on the proposal.

Although, the District may be cash poor, it also owns potentially lucrative real estate in Dublin with the Gateway Medical Center, along with its medical office in Castro Valley. Ironically, the District bought the property less than a decade ago to block a threat by Sutter Health to close Eden Medical Center in Castro Valley for potential greater returns in the Tri Valley.

Chan, however, may be again using the threat of leveraging the District’s future to obtain what she called a “sizable” subsidy. In fact, the Alameda County Local Agency Formation Commission (LAFCO), which Chan is a member, has raised the possibility of determining the district’s efficacy as a government body over the past few months. On Tuesday, Chan again raised the issue of LAFCO and the District at a Board of Supervisors meeting in Oakland.

The District isn’t taking the threat lightly. Mahadevan reiterated previous statement any attempt by LAFCO to strip the District of its authority would meet stiff opposition from health care district’s across the state who are in a similar situation; existing without a traditional hospital facility to oversee. Mahadevan said such a move by LAFCO would be unprecedented and could be met by a stiff legal challenge.

Tuesday, May 14, 2013


SAN LEANDRO//HEALTH CARE | Sutter Health and the Alameda Health System are set to sign a letter of intent to begin negotiation terms of an agreement that will keep San Leandro Hospital open for, at least, the next two years.

Under the proposed deal, Alameda Health System (AHS), formerly known as the Alameda County Medical Center, would gain title to the entire facility, estimated to be worth between $30-40 million, along with a one-year subsidy from Sutter in the neighborhood of $18-20 million, said Alameda County Supervisor Wilma Chan.

Sutter, would, in essence, wipe its hands clear of San Leandro Hospital, which would maintain emergency room services, in addition, to remodeling its vacant fourth floor with up to 30 beds set aside for acute rehabilitation services. Sutter would also walk away from an operation it estimates is bleeding monthly losses of $2 million.

Under the proposed terms of the non-binding letter of intent, which will run through July 1, Chan said, there is no covenant for how AHS will run San Leandro Hospital in its current configuration, nor how long. If a deal is struck the facility could be turned over to AHS as early as this October, said Chan.

The proposal is similar to one that broke down earlier this year calling for the county, city of San Leandro and Eden Township Healthcare District to each contribute a 3-year/$3 million subsidy to cover the hospital’s operations under AHS. That framework is also part of this deal, said Chan.

The Eden Township Healthcare District, though, balked at the terms of the previous deal and charged Chan was deliberately threatening the body with dissolution. After losing San Leandro Hospital in a lengthy legal case to Sutter, the District no longer possesses a hospital to oversee.

Those terms appear to be again on the table for the District. Part of the deal involves asking the health care district to contribute a one-time $20 million subsidy to cover the hospital’s second year of operations. The District’s Board of Directors meets for their monthly meeting on Wednesday.

Alex Briscoe, the director of Alameda County Healthcare Services, says the deal on the table today is nearly identical to those discussed in 2009 when Sutter first announced its intention to close the hospital and turned it over the Alameda County Medical Center for acute rehab services. Those beds were lost with the closure of nearby Fairmont Hospital, which the county deemed too costly to undergo seismic upgrading.

One key difference this time around may be Chan’s decision in April to withhold a nearly $2 million county subsidy earmarked for Sutter’s rebuilt Castro Valley Medical Center for trauma services. The subsidy is matched by federal funding doubling its value to Sutter. Chan pulled the item from the board’s consent agenda in what now appears to be a move to leverage the trauma subsidy against Sutter. Under terms of the letter intent, said Briscoe, the county would release the trauma funding to Sutter by May 21.

Chan lauded the deal for its ability to keep San Leandro Hospital in operation while gaining a valuable asset for the community at no cost to taxpayers. “Worst-case scenario, said Chan of AHS, “they own a building and have to decide about other services.”

There is still room for great caution, though, says Briscoe. “I have deep concerns,” he said. “It’s not a done deal.” While this may be the facility’s last great hope for staving off closure after four years of tumult, great uncertainty still remains. “If the deal goes under,” Briscoe added, “Sutter will close the facility.”

Friday, March 22, 2013

Miley: A Lack Of Leadership In Oakland Is Hastening Crime Problem

ALCO BOARD OF SUPERVISORS//ROUNDUP | A multi-agency proposal that would add up to 90 public safety officers for high crime areas in Alameda County has some federal and local hoops to jump through before receiving the $67 million grant.

This week, the Alameda County Board of Supervisors, often on the periphery of rising crime in Oakland and routinely critical of City Hall mixed their approval for the proposal to hire 90 officers split equally among the Oakland Police Department, Alameda County Sheriff’s Department and California Highway Patrol, with skepticism and regionalism.

Alameda County Supervisor Scott Haggerty, who represents parts of the Tri Valley and Fremont, voiced support for the plan designed, in part, to put more officers on the ground in Oakland, but also questioned the message it sends to other parts of the county. Haggerty said helping Oakland with gang problem, for instance, may make other cities like Fremont, which is the second-largest in the county, feel left out. “Fremont has gangs, too” Haggerty said, “and let me tell you Hayward is no Shangri-La.”

A lack of leadership is Oakland’s main problem, said Alameda County Supervisor Nate Miley. “I think Rome is burning,” says Miley. “I’ve seen it go down the tubes over the years.”

In the past, whenever other agencies or city beckon the Board of Supervisors for help, Miley regularly portrays their aid in gallant terms. Last Tuesday, he called the board, “knights in shining armor.”

Although, Miley agrees the lack of resources for hiring additional police officers in Oakland is also an obstacle to tamping down crime and homicide rates, he says “It’s an issue of leadership.” He also noted turnover at the chief of police’s office as contributing to the lack of continuity.

COUNTY HEALTH CARE STILL IN STITCHES St. Rose is still losing money, but not as much, says Alex Briscoe, director of Alameda County Healthcare Services. The hospital now run by a new operator has lowered its losses from around $16 million to between $6-8 million, Briscoe said Tuesday. “The problem isn’t going away,” he said, “and we’re not out of the woods.”

Sutter Health, the Alameda County Medical Center and the Eden Township Healthcare were characterized as still in talks over the fate of San Leandro Hospital and a skilled nursing facility at Alameda Hospital was recently approved, said Briscoe. However, like nearly every stand-alone hospital in the East Bay, Alameda Hospital’s poor pay-mix continues to make it difficult to sustain its operations on the island.

Saturday, March 16, 2013

As A Local Health Care District Faces An Identity Crisis, Its Long-Term Future Remains Cloudy

Last Supper? Eden Township Healthcare District Board, Mar. 13, in Castro Valley.
Left-right: Les Friedman, Dr. Bill West, Carole Rogers, Dr. Vin Sawhney, Dr. Ronald Hull.
 HEALTH CARE | The Eden Township Healthcare District, a local government agency facing the possibility of having no hospitals to oversee and dwindling revenues, is facing an identity crisis. Should it reorganize and move forward or cease to exist, as some county officials have intimated recently? On Wednesday, the publicly-elected board of directors attempted to plot a course for the district’s future, despite its tenuous current situation.

“We need to have a convincing story to tell. Why should we need to exist?” said Eden Township District CEO Dev Mahadevan. Ironically, the district’s greatest accomplishment over the past years may also be the reason for its demise. A three-year legal dispute with Sutter Health over title to San Leandro Hospital starting in 2009 drained the District of revenues previously reserved for allocating millions of dollars in health care-related grants to the community.

The District reaches from the southern portion of Oakland to Hayward, including San Leandro, Castro Valley and parts of the Tri Valley.

Although, the District ultimately lost its bid to retain San Leandro Hospital in a state appellate decision last year, the protracted legal battle is viewed by many as a success in it kept the hospital from certain closure. Sutter Health proposed closing the facility in late 2009 and advocated leasing it to the Alameda County Medical Center as a reconfigured acute rehabilitation center. The hospital’s future as a general acute facility with around-the-clock emergency room services is still unclear as the community awaits Sutter Health’s next move.

At issue is whether the District, presently without a hospital to oversee, is worth keeping. Last year, Alameda County Supervisor Wilma threatened the District with dissolution if it did not financially contribution more to a since-failed proposal to subsidize San Leandro Hospital with $1 million each annually from the county, City of San Leandro and health care district.

Mahadevan says the Alameda County Local Agency Formation Commission (LAFCO), of which Chan is a member, is currently performing a limited review of the District’s viability as a government body. Mahadevan insists the review is periodic, but political pressure clearly exists from the county-level. However, Mahadevan say shutting down the District, approved by voters in 1948, is “untested legal ground.” Of the 70 health care districts in the state, 22-24 operate without a hospital and those which do, he said. can range from a few hospital beds to hundreds. He believes most will strongly support the District if dissolution is ever attempted. “’Eden today, tomorrow us,’ they say.”

A district survey last year found nearly three-fourths of residents were either unaware of the District’s existence or its function. In the same report, some county officials said the District’s current state is their own fault for wasting money on the Sutter lawsuit. “I’m not even going to go into the question of how they can say that because some of them encouraged us to sue Sutter. I won’t get into that,” said Mahadevan. “Simply, that’s what they feel. It’s not unusual for public officials to change sides when something fails.”

Nevertheless, declining revenues amid a poor economy have cut into the District’s ability to offer grants to local non-profits to aid residents in a wide-ranging number of health care-related causes. Over the past decade, it has handed out over $8.6 million, but none in the past tthree years because of its legal battle with Sutter. The District has not been supported by taxpayers since 1977 and has recently relied on its real estate assets to generate positive cash flow. Because of a poor market, its holding at the Dublin Gateway medical office is only now begin to retain its lost value incurred during the Great Recession. And a recently constructed medical building across the street from Sutter Health’s new Castro Valley hospital is slowly attracting new tenants.

“Right now we’re functioning as an investment management firm—a real estate management firm—and we’re not doing it very well,” said Les Friedman, a member of the District board of director, who also characterize it as the District’s “worst weakness.”

Friedman and others, like board director Dr. Vin Sawhney believe a way out of doldrums currently facing the Distirct is through servicing a niche in the market for lower cost urgent care centers in the East Bay. “The most ideal case would be to open urgent care centers right across the emergency rooms of every hospital which is run independently and not by the hospital and by their interests,” said Sawhney. “This, I see as a significant opportunity, if we’re not going to be running a hospital, is to get into urgent care centers in critically situated locations across the district.” For instance, said Sawhney, a patient with a laceration could be billed up to $15,000 at a hospital, while a more cost-efficient urgent care center could profitably charge just $1,500.

Although the District’s demise does not appear imminent, Mahdevan hypothetically said, if the board were to vote to dissolve it today, it would still take between 12-18 months to be finalized. “Like the fall of the Roman empire,” he said, “things don’t happen that quickly.”

Sunday, February 17, 2013

A Lack of Trust in Local Goverment Grows Amid Oblivious Elected Officials

PHOTO/Shane Bond ILLUSTRATION/Steven Tavares
THE SUNDAY COLUMN | Oakland Civil Rights Attorney Michael Siegel stood before the Alameda County Board of Supervisors' Public Protection Committee last Valentine’s Day and told them what he thought about a proposal by the Sheriff’s Department to purchase a drone (now, apparently, two, says Sheriff Gregory Ahern). The gray-haired sheriff in a civilian's suit and tie listened, leaning slightly forward, his head positioned angrily with eyes peering at Siegel as the lawyer said, “The sheriff is saying trust us and we’re saying we don’t trust you.”

Just one sentence summed up the real controversy in Alameda County and drones and while very real concerns of public privacy are very worrisome, they stem from one clear channel of belief. After Occupy Oakland, the Oscar Grant protests and decades-long distrust of the Oakland Police Department, it is clear, no matter the substance of the argument—well-reasoned or poorly thought out---we don’t trust law enforcement. And why should we?

Even though, Ahern went out of his way last Thursday to assure the public his drone(s) would only be used for search and rescue emergencies. It is not difficult to understand for those of you that have been kettled in the streets of Oakland and injured by sheriff’s deputies to envision all those protocols for ensuring our privacy will be thrown out the window the moment law enforcement deems the expression of political speech too intense for the status quo to accept and begin violently cracking down. At that moment you can imagine the drone hovering nearby and their use only to be later denied.

Remember when Iraq War vet Scott Olson was blasted with a exploding can of tear gas? It didn’t happen, according to law enforcement, until it was proven to be true, ironically, with the citizens’ own use of personal drones with an eye on the action (i.e. smart phones).

When near-historic crowds of Oakland residents flooded City Hall last month in protest of the city hiring famed crime stopper William Bratton for a consulting contract, the same cries of “we don’t trust you” cascaded from the chambers’ galleries. In the same vein as Sheriff Ahern saying he won’t infringe on your privacy, the city denied Bratton’s infamous use of “stop-and-frisk” would ever be part of the equation for fixing Oakland’s crime problem. Passionate screams of “bullshit!” could be heard from West to East Oakland.

Yet, they move forward without listening to the voice of so many people, largely discounted because they seem to sound and look like the protesters once ensconced in tents at Frank Ogawa Plaza, and, as the local media so masterfully achieved in making them appear less desirable than rabies and gonorrhea, their legitimate concerns and anger don’t mean much to those elected by the people.

This lack of trust in government in Alameda County is not just a police thing, but pervasive at the intersection of  Corporate America and the mayor's office. Since covering government in the East Bay in 2009, I have noticed quite a correlation between corporate interests, particularly rich land developers, and a lack of trustworthiness. Whether it be home builders looking for a quick buck by saturating the Tri Valley with housing or 49ers great Joe Montana fucking over the people of Hayward by slowly shifting a once-gleaming transit-friendly development surrounding the South Hayward BART station into a no-frills run-of-the-mill project meant to pad his bottom line, but leaving one of the least desirable parts of Hayward left holding the bag, too good to be true is always the case.

When Sutter Health, the worst offender of corporate greed in this region makes a deal with a local entity, watch out. Sutter, however, plays no act of remorse, however, when it gobbles up a competing hospital and shutters its doors while leaving the county to pay for the welfare of the least fortunate looking for health care. In the past six months, a deal to keep San Leandro Hospital open for three more years by way of a Sutter ally, the Alameda County Medical Center (ACMC) operating the facility fell through. Sutter has been trying to close San Leandro since 2009 so it can attract patients to its new building in nearby Castro Valley. When the San Leandro City Council asked the CEO Wright Lassiter of ACMC what assurances would they have the hospital would remain open in 2015, he said he could give none. In reality, following past history, the deal would have meant the hospital would be closed far sooner than later and for that answer, give Lassiter credit, his half-truth is a rare occasion when an Alameda County public official kind of told the truth.

“The court finds that under the circumstances presented, there was no moral blame attendant to the conduct of responding officers and firefighters.”
– Alameda County Superior Court Judge George C. Hernandez in a five-page opinion Feb. 11 finding Alameda police and fire were not in the wrong for doing nothing while a man ultimately drowned himself at Crown Beach in May 2011.

The Week That Was
The issue of the tragic drowning of Alameda resident Raymond Zack in 2011 is finally put to rest. The Memorial Day death of Zack who waded into the bay water at Crown Beach hoping for someone to save him in the waist-deep surf as police and fire stood by seemingly paralyzed by the island’s bureaucracy brought unwanted national attention to Alameda and bruised its sense of itself. This week, an Alameda County Superior Court judge found public safety has no moral or legal obligation to help someone like Zack. It’s hardly the ending Alamedans were looking for.

Asm. Rob Bonta
Oakland Assemblyman Rob Bonta continued his rise in Sacramento after being named by Speaker John Perez to chair a special select committee on gun violence in the East Bay. Rep. Barbara Lee offered a bill in Congress to establish a cabinet-level office named the “Department of Peacekeeping.” It’s no secret Lee is looking to expand her power in the Democratic Party and the Beltway. Maybe creating your own bureaucracy is the best way for advancement?

The slow burn toward San Leandro becoming a safe harbor for medical cannabis dispensaries moved forward last week when a full-house of residents attending a special city council meeting to discuss the proposed ordinance allowing up to two permits within city limits. On the whole, those in favor and those against were fairly even. However, the naysayers all seemed to belong to the congregation of a predominantly Asian American Baptist church in San Leandro.

Another packed public meeting occurred at the Alameda County Board of Supervisors’ chambers Thursday for what became an informational hearing on drones in the county. Sheriff Ahern made news by stating he would like not one, but two drones, depending on the vendor the department chooses. But Alameda County counsel Donna Ziegler said the Board really has no legal authority to tell Ahern how to do his job as sheriff. As the coordinator handling mutual aid in the region, Ahern said, his drones could be used from Monterey to the Oregon border. Watch out, Humboldt County!

Tweet of the Week
“Would everybody stop tipping off the Sheriff about how they're gonna hack his #drones? Jeez. Security culture, people! #alcomtg.” – Oakland resident @GonzoOakland responds, Feb. 14, to questioning of the Sheriff Ahern’s comments that the drones he plans to purchase cannot be hacked.

Thursday, January 24, 2013

Alameda County Official Says Sutter Will Not Close San Leandro Hospital Until 2014, At Earliest

HEALTH CARE | Sutter Health's long-held intention to shut down San Leandro Hospital will not happen this year, says the director of the Alameda County Health Care Services Agency, but as early as spring 2014.

The reason for the delay, says Alex Briscoe, is not due to Sutter’s indecision over shuttering the hospital and its much-needed emergency room, but because of the timing of a crucial assessment report compiled by the county and presented to the state Dept of Health Services that will highlight any impacts the closure of San Leandro Hospital will have on the region’s health care delivery system.

“That report will look better for Sutter when Kaiser San Leandro numbers are added,” says Briscoe, referring to the new Kaiser Permanente hospital currently in construction in San Leandro near Marina Boulevard and due to open sometime in the first quarter of 2014.

Without the presence of Kaiser San Leandro in the report, says Briscoe, the area’s emergency medical services and general acute care statistics might shed questions about the impact of closing an emergency room also within a hospital already seismically safe.

An impact assessment report would not be prepared until triggered by Sutter officially announcing its intent to close San Leandro Hospital and due to the state within 60-90 days, says Briscoe. The contents of such report would also come before the Alameda County Board of Supervisors, which could become the last bright flashpoint for community leaders and supporters of keeping the facility open to express their views.

Such a report, however, would not so much delve into questions of whether new hospitals, such as Sutter’s Castro Valley facility and Kaiser’s San Leandro building, have smaller capacities for emergency room beds, says Briscoe, citing an industry-wide move towards shorter stays. Aside from the business aspect of maintaining efficiency, the smaller number of beds, however, will impact the county greatly in the face of a natural disaster. “In terms of disaster preparedness, the county is already short on ER beds,” said Briscoe. It is another reason, he says, why the county greatly focused on propping up operations at Hayward’s St. Rose Hospital with subsidies over the past year.

Stacey Wells, Sutter Health’s spokesperson, said Thursday, “We understand process and capacity issues. As Alex well knows from our discussions with him, we share his concerns, which is why we are looking at all options.”

Regarding, the collapse of a plan put forth by the Alameda County Medical Center to take over San Leandro Hospital and operate it in its current form as an acute general care facility with round-the-clock ER services with $3 million subsidies from three different government bodies, Briscoe says he is flummoxed by Sutter’s disinterest.

“For reasons I don’t understand, they didn’t accept it,” he says of Sutter, and adding the ACMC was the only viable option for the ER at San Leandro Hospital. “They are largely concerned with general acute care at San Leandro and that it could negatively impact Sutter Castro Valley.”

Briscoe says he doesn’t agree with the assessment for many reasons, chief among them, that the new Sutter Castro Valley (formerly Eden Hospital) will not draw from the same pool of patients as San Leandro Hospital, which feature a high number of people with Medicare and the uninsured.

Sutter, however, has never publicly admitted having competition in San Leandro while its constructs its $320 million facility in Castro Valley is the reason for its intention to close San Leandro Hospital. Instead, it has long maintained the hospital, which it purchased from the Eden Township Healthcare District last year, is losing money.

If all goes as planned for Sutter, San Leandro Hospital will not lay idle, but continue as an acute rehabilitation facility. It is plan once backed by county as late as 2010 to cure a lack of rehab beds following the closing of the seismically-deficient Fairmont Hospital.

Friday, January 18, 2013

Health Care CEO Flirts With Another Job While Steering Defunct San Leandro Deal

ACMC CEO Wright Lassiter
HEALTH CARE NOTES | Just as Alameda County Medical Center CEO Wright Lassiter was making the rounds in an attempt to cajole three local government bodies to subsidize his acquisition of San Leandro Hospital, he was also planning to jump ship. Lassiter told a trade Web site covering the health care industry he applied for a position in Dallas, but did not seek the job, he said.

"That was particularly difficult because I'm not unhappy and I'm not looking [for a job]," Lassiter told Health Leaders Media. "My board chair knew about it, but I'm still not talking broadly about it. The fact is, it does create some instability and the last thing I'd like is to create that. I'm haven't been comfortable sharing about it, but I have talked openly with medical staff and leadership team."

Lassiter is a Dallas native, who previously worked for the same entity he has applied to, Parkland Health & Hospital System. Although the article speculates a decision on the job could be made in December, a county source says Lassiter’s future at ACMC is, today, still in doubt.

In the lengthy profile of Lassiter and his work and vision for ACMC, he notes interest in San Leandro Hospital rests solely on transforming it into an acute rehabilitation facility and shutting down its emergency room. The timing corroborates letters sent by Sutter Health to Alameda County Supervisor Wilma Chan and San Leandro Mayor Stephen Cassidy that the proposed “hybrid model” for San Leandro Hospital to be subsidized by the city, county and Eden Township Healthcare District was dead on the vine earlier in the month. The correspondence revealed ACMC’s interest in the hospital soured when Sutter offered new financial information stating the facility needed a subsidy 3-4 times larger than previously speculated.

However, news of Lassiter’s possible departure during a time when ACMC is moving to expand comes as a surprise to some in the county, but also raises questions over how forthright Lassiter’s comments to the various boards and council he sought to fund his enterprise at San Leandro Hospital actually were, especially since the plan involved a proposed three year window to test if the subsidy would indeed by successful going forward. It's not clear whether members of the three entities were aware of Lassiter's flirtation for another job at the same time in late October he was passing the hat at cassh-strapped boards for a $3 million outlay.

PAY YOUR BILLS The Eden Township Healthcare District is apparently getting the silent treatment from the new operator of St. Rose Hospital, Alecto Healthcare. You may recall the District gave St. Rose and its former management team a short-term emergency $3 million loan in August 2011 to cover its payroll. St. Rose immediately had trouble making its monthly payments and in December 2011 the District sent a notice of default. A deal was struck, but St. Rose still owes the District $1.1 million and St. Rose’s new operator does not want to pay back the loan.

However, the transfer of St. Rose to Alecto is still up in the air. The state attorney general must approve the deal and Alecto’s proposal, which excludes payment of the District’s loan, could muddle the deal. On Jan. 4, lawyers for the District sent a notice of default to Alecto for payment of the $1.1 million plus over $30,000 in unpaid interest and legal fees.

“The District was distressed to learn that despite its long and determined effort to assist St. Rose over the past two years, and despite its conceptual support of the Alecto acquisition and extension of the loan, St. Rose and Alecto have apparently opted to avoid the debt and District’s security by transferring the District’s collateral with no intent to pay the debt,” the District wrote. It also says Alecto misled the District into believing it would repay the loan after acquiring the hospital.

At the health care district’s monthly meeting last Wednesday, its elected Board of Directors made no official move regarding the issue with Alecto and St. Rose, said its chair, Carole Rogers.

Friday, January 11, 2013

Inside The Collapse Of The Latest Proposal To Save San Leandro Hospital

HEALTH CARE | Even as the public was led to believe a three-pronged plan to keep San Leandro Hospital open as a acute care general facility with a 24-hour emergency room had great potential, letters between Sutter Health, the Alameda County Medical Center, Alameda County Supervisor Wilma Chan and San Leandro’s mayor show the deal has been off the table since late November, at the earliest. The correspondence obtained this week by The Citizen also show local leaders in the dark and bereft of time and ideas over the nearly four-year long fight to keep Sutter from closing the facility and reconfiguring it into an acute rehabilitation specialty hospital.

It is an open secret Sutter is not on very good speaking terms with either the Alameda County Board of Supervisors, specifically Supervisor Chan, its health services agency, nor their rival at the Eden Township Healthcare District, Carole Rogers, the chair of the elected Board of Directors. But, according to a letter dated, Dec. 20, 2012, Chan and San Leandro Mayor Stephen Cassidy met with Sutter’s legal counsel sometime during last month. On the table for discussion that day was ACMC’s plan to cobble together three, $3 million subsidies from the county, city of San Leandro and healthcare district to help fund current operations at the hospital for, at least, three years. Sutter, however, told Chan and Cassidy, it had never received such a proposal despite ACMC’s CEO Wright Lassiter publicly touting the plan all over the county. Each entity officially approved the subsidy with the healthcare district pledging half of its revenue over the next two years, or, around $1.25 million.

“It is disappointing that ACMC has publicly stated in hearings that its proposal to Sutter Health was to maintain SLH as an acute care facility,” Sutter’s legal counsel wrote Dec. 20. “Sutter Health has received no such proposal from ACMC, and we were surprised to learn that you were not aware of that fact.”

Chan believes the letter was intended to undermine ACMC's efforts. “The main thing they’re looking for is a scapegoat,” she said Wednesday. “They’ve already stated they’re not looking for someone to run the hospital.”

Later, Sutter notes a letter, dated Nov. 7, 2012, where ACMC says the subsidies, only approved a week earlier, were “insufficient” and rejected by ACMC as “economically untenable.” The Sutter letter then quotes ACMC as saying; it “was no longer pursuing the option of providing ongoing acute care services.” The only deal offered to ACMC, according to Sutter, was the option to lease the hospital as an acute rehab center—long Sutter’s desired plan and, in some ways, the county’s original plan—but, not the will of the community, which has clearly urged officials to maintain San Leandro Hospital’s emergency room.

Chan’s contention that the true aim of Sutter’s Dec. 20 to them was to undercut ACMC may hold water. In a subsequent letter to Chan and Cassidy, dated Jan. 7, from Lassiter; he references an exclusive non-disclosure agreement between ACMC and Sutter, which limits what he can reveal to them. However, much of the information withheld is contained in the Sutter letter sent two weeks earlier to Chan and Cassidy.

In the latest Lassiter letter, he is under the impression information of the collapsed hospital deal is new to Chan and Cassidy. “I regret to inform you that the negotiations between ACMC and Sutter have stalled, and at present, I am not hopeful that any agreement will be reached whereby ACMC would either operate SLH as a general acute,” wrote Lassiter.

Later, Lassiter adds Sutter, in effect, moved the goalposts on ACMC after it had procured the subsidies it believed would keep the hospital running under its auspices. However, Lassiter writes new financial information provided by Sutter on Dec. 2, 2012 to ACMC showed the hospital performance is, according to Lassiter, “significantly more unfavorable (by several factors) than had been previously disclosed.” He adds, the new estimates now call for a subsidy 3-4 times larger than prior estimates—outlays likely far too large for any of the willing county investors to cough up.

In the absence of deal, Lassiter says ACMC will return to emphasizing acute rehab, the proposed plan from the start and the deal Sutter has discussed since winning title to the hospital in early 2012 following a long legal fight with the Eden Township Healthcare District. “ACMC’s negotiations with Sutter focused in this direction throughout the balance of 2012,” Lassiter writes. But, those discussions only included Sutter entering a long-term lease for the hospital as an acute rehab center, according to Lassiter. However, since ACMC’s estimate of an initial investment of $25-$30 million in upgrades to be profitable, they believe this sort of expenditure necessitated more control of the asset than afforded to a lessee. Negotiations broke down, wrote Lassiter, when Sutter refused to consider any arrangement giving control of the asset to ACMC.

Chan said she never hopeful about the deal to begin with, but viewed it as the only possible deal on the table. “My viewpoint is Sutter has rejected every offer—viable or not,” but, added, Sutter, at least, was willing to talk to ACMC. “There was never any indication Sutter would go along,” said Chan. “I believe it’s a win-win for all, but all they talk about is losing money at San Leandro Hospital.”

Chan also admitted the somewhat surprising call in December for the Eden Township Healthcare District to pay more into the subsidy pot or risk dissolution was solely an attempt to salvage the proposed plan quickly falling apart and assuage some concern by the San Leandro City Council that the District was not paying their equal share of the future burden to run the hospital. District officials were clearly caught flat-footed by the threat and reacted harshly.

“The burden is on Sutter,” said Chan, who denied Sutter has the unfettered ability to do whatever they please with San Leandro Hospital. “They have turned down every option for the hospital and the responsibility is on them if they care if there is an ER in that area.” In the meantime, Chan says various efforts in Sacramento to look into Sutter’s non-profit status and its desire to become a HMO under the Affordable Care Act, will continue. Last Tuesday, Chan pulled an agenda item off consent dealing with the Board of Supervisors reauthorizing a 3-year, $6 million subsidy for trauma services at Sutter’s rebuilt Eden Hospital in Castro Valley. “I want to take a look at it. I want to see if the county should be doing this because their action in that part of the county is unconscionable.”