Wednesday, January 26, 2011

My Views on the Board Majority (and Hospital Management)

It may seem unusual that I, the newest member of the Hospital Board, do not trust the judgment of those who have served longer.  Another thing that should cause me pause in the great deal of confidence I have in my views is the fact that I am in the distinct minority of those who have a say (not necessarily of Alamedans).  There is a reason that I do not give much currency to these opposing views.  In most of the circumstances where I have bothered to pay attention, the Board and Management have been wrong.

1.  The Board and Management were objectively wrong about their chance of retaining the Kaiser contract.  Kaiser was clear upon entering into the agreement that they planned to take back those services when the contract term ended.  Throughout the term of the contract, they pursued a program of building and renovation at Kaiser Oakland that supported the goal of taking back those services.  Kaiser's policy and practice has always been to retain services in-house where possible.  What possible hope did the Board and management think they had to extend or renew the Kaiser contract? I can only assume that they felt it was inappropriate to tell the truth about the prospects of retention until the last possible moment.  That misrepresentation of what anyone who paid attention could easily conclude either speaks to a lack of awareness or a lack of transparency (or some fantastic, last-minute change of mind by Kaiser - first in considering staying at the Hospital in contravention to every public indication that they would not and then a reversal to leave after all).

2.  The Board and Management were objectively wrong about care for acute stroke.  When the situation was first brought to the attention of the public by Denise Lai, both Debbi Stebbins and Jordan Battani strenuously defended the Hospital and argued for a continuation of a dangerous policy.  It took less than 60 days and only one meeting for Alameda County to change the EMS manual.  Anyone familiar with the pace that these changes are generally made will understand that this change was done emergently because the current policy was simply indefensible.  Yet every member of the Board endorsed the view that the exception policy should have continued.  This shows a real lack of good sense as well as a lack of concern for the health of Alamedans.

3. The Board and Management have been objectively wrong about the Hospital's financial capacity.  That is most important in the context of meeting the state mandated seismic retrofit requirements.  I still am not sure why the OSHPD has decided not to enforce the clearly stated 1/1/2002 deadline for NPC-2 or higher certification, but it is clear that Alameda Hospital is in technical violation of the law and, theoretically, is subject to being shut down at any moment.   Regardless, the Hospital will not be able to meet the 1/1/2013 requirement without obtaining financing which they have finally admitted is not likely to materialize.  Over a million dollars has already been spent on this plan while it was obvious that financing was not a viable option to anyone who was paying attention.  Technically, in its recent report to the state where the Hospital acknowledged its inability to meet the 2013 deadline, it created a default condition on any extensions offered to the original 1/1/2008 deadline.  In other words, the Hospital is in double jeopardy of being shut down for being non-compliant with clearly written regulations.  Only the forbearance of the State of California keeps the doors open and it is questionable whether that forbearance is, in itself, a violation of the law.  It seems wrong to me for me to trust those who have maintained faith in what I consider a misguided plan for so long.

4.  The Board and Management on several occasions played fast and loose with Brown Act notice requirements.  They continue to offer, in my opinion, too little information about closed session agenda items in the short description.  On several occasions, verifiably untrue statements were made to me by CEO Stebbins.  Others are free to interpret this as unintentional, but I am of the opinion that there was more to it than that and would have to label those statements as lies.  In addition, the failure to attempt to avoid violation of at least the spirit if not the letter of the Brown Act (which they may have been able to do since I never actually called for formal correction of the issues I raised)  seems to me to be another reason it is good policy to be weary of placing trust in my fellow Board members and Hospital management.

5.  Finally, I have to mention the most compelling argument, for me personally, against trusting the majority of my fellow Board members and that is their support of Leah Williams.  They chose her to be appointed in 2009.  They endorsed her in the November, 2010 election.  And they said nothing when she acted so detestably after the election - not even private sympathy, much less any kind of condemnation of her personal attacks on me.  They continue to say nothing when someone, in the course of a discussion about changing the tone, actually resurrects and endorses those claims (although Lauren Do would have handled it differently? doubtful given how loathsomely she acted when she took offense at being called out for simply being termed cliquish).  I certainly cannot trust people (Leah Williams) who declare through their actions that their aim is to destroy me and I will be very weary of those who stand silent in the face of such actions.

I think there are positive things a healthcare district can offer Alameda, but I have not seen evidence to my satisfaction that the current Board majority and management have the skills to chart that course.  So it may seem arrogant to many that I maintain my own counsel versus deferring to the more experienced majority, but I think it would be foolish to trust the collective judgment of the Board/management given the above.

 

1 comment:

  1. There is so much that is interesting in your post. But I'll just comment on item 2 for now. Last week, a friend at the Alameda ER presenting with stroke symptoms had to wait 4.5 hours after arrival before getting a neurologist's telemed opinion (!). When she asked to be transferred to a stroke center, the doctor and staff repeatedly said that Alameda Hospital could provide everything she needed and that any medical need to seek a stroke center for stroke care was pure politics. Huh?

    Why do Alameda Hospital ER physicians continue to promote Alameda Hospital for stroke care?

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