Quo Vadis?

So if the Hospital is going to close (only my opinion), what happens to the Healthcare District?

First, the District is not just the acute care services at the hospital although that is its most visible piece.  There is a community clinic at South Shore, outpatient surgery, lab and imaging services, skilled nursing, and sub-acute beds.  Also, keep in mind that rightly or wrongly the political will of Alamedans is tilted towards keeping the Hospital open.  Whether that is an informed opinion or not is another discussion, but clearly Alamedans (even if they hardly pay attention) have a default position in favor.  On the other hand, people more informed regarding healthcare policy are probably more likely to be open to closing/restructuring the Hospital despite their lack of public comment.*

Some ideas that make sense to me (and not fully developed):

1.  An urgent care center with comprehensive lab and imaging.  This would satisfy the need of non-Kaiser residents of the District to have a place to go to provide immediate medical care.  Many people do not want to go out of Alameda for their relatively minor issues.  I don't know where the line between emergency and urgent gets crossed so I don't know what could or could not be treated here.  A lot probably depends regulations and liability issues.  An additional advantage of this approach is such a place could serve as the focal point for emergency services should the "big one" hit that isolates the Island.

2.  Non-acute care beds.  Alameda already has more of these patients than acute care patients so this is already part of the business model.  Where it makes financial sense (that is, adds to the bottom line so as to reduce or eliminate the need for the parcel tax subsidy), these should be investigated.  There are certainly opportunities for rehab beds, complex discharges (such as IV antibiotics), or wound care.  The main driver here, in my mind, is finances (looking for a profit), but there might be some benefit for Alamedans to have these beds available closer to their homes.

3.  New services such as the wound care clinic that is being developed.  The argument here is very similar to the argument for non-acute care beds:  financial sense + some convenience for District residents who desire these services.

4.  Outpatient services such as surgery, dialysis, infusion. 

5.   Finally, some number of acute care beds could be retained if it made sense financially.  A drastic reduction from 30-40 beds down to 5 or 6 to serve the nursing homes on the Island (and possibly the patients of existing and potential District services 1-4 above).  Another alternative might be a partnership with some entity, but I have no idea what form that might take.  The idea of the VA has intrigued me and others, but the Board consensus seems to be that the VA's plans are nebulous and too far out in time to consider any action at this time.

Well, I will not be able to update meeting notes for some time due to my other life, but I thought I should put this out here given the prediction of hospital closure I made in my last post.

*Of course, I think I also have support from those with an anti-tax philosophy.  I'm actually very pro-tax in general (go Measure A!) but I want my taxes to buy something of value.  I voted for the District's parcel tax, but have concluded that I have got less than nothing for my family's $2980 (paid so far, 2002-2011).