May 9 - Board Meeting

I apologize but I have been busy so have not had a chance to regularly update, but this week I should be able to do both a pre and a post commentary on the Regular Board Meeting

1.  The closed session agenda is opaque as usual.  I have exchanged several emails with Jordan Battani about this and I really have not got a clear idea as to why she maintains that this is the best approach.

2.  I will pull the finance statements from the consent agenda to put some things on record.  a.  I'd like to understand how the operating loss was so large if the census numbers were favorable.  b.  Friday, April 1  was a payroll day so the cash balance would have been more in line with previous statements.  April will have an extra payroll day in it.  c.  Discussion of IGT (again).

3.  I will also pull the Bank of Alameda loan mod.  This is a big deal.  This is the first time that the tax revenue will be securitized.  In the campaign 10 years ago for the District, it was explicitly promised that this would not happen.  For those who insist that this original vote represents the current will of the voters and that the District continue even though it provides no benefit in terms of health outcomes, they should be a little wary of breaking this promise.

4.  I will vote against the goals and objectives presented.  I am not trying to deliberately offend people with my stance, but   the Hospital needs to close and, in my opinion, the only arguments in favor of keeping it open are some combination of:
  -ignorance. somewhat defensible when being misled by people you trust and when the naysayers are people you don't trust.
  -self-interest. nothing wrong with a desire to protect an income stream as long as it does not blind you to the truth.
  -interest in having what is perceived as a safer place to go in the event of medical need.  Many in Alameda are leery of going to Oakland for medical care and, I admit, the waiting rooms of most of the surrounding hospitals are somewhat "grittier" than Alameda Hospital's ER.
  -a misguided faith that the desire of Alamedans is to keep the Hospital open.  This is where the cliquishness of Alameda's politics is most at play.  Certainly, most Alamedans would be in favor of a local hospital but they are unlikely to fully understand the issues at play.  Of the people who actually understand healthcare policy, the majority would be happy with the Hospital closing.  I asked a leader in health policy at UCSF to point me to someone in favor of keeping the Hospital open; that person said they could not think of anyone they respected who would be able to engage in that discussion.

5.  There is a nice letter in the packet about care at Alameda Hospital.  It seems cruel but germane to the discussion of health outcomes to note that the person described was not able to be medically helped.  Also, the thrust of the letter is mainly to criticize the other hospital.  Finally, we don't have the other hospital's side of the story.  I am uncomfortable with publishing this type of correspondence in the official Board packet.  After all, much less complimentary material is not published (one such letter I received just last week). I am reminded of the tragic case of Nataline Sarkisyan who should have been denied a liver transplant and was.  The California Nursing Association decided to use this as propaganda and got a lot of good this type press out of misleading statements.  Bottom line, when it comes to healthcare, making policy on the basis of anecdotes is stupid.

6.  NPC-2 requirements.  News flash:  Alameda is still out of compliance with the 1/1/2002 deadline requirements and will continue to be.  The documentation is clear, "No acute care services shall be provided." I guess OSHPD has full discretion on whether to enforce the law (maybe it's only a regulation) or not.


Notes to follow.

(I want to compliment staff on getting the meeting materials posted Thursday.  The goal is Wednesday, but, my understanding, is that vacation schedules made even Thursday a challenge this month.  Thank you for the additional time to review and I look forward to even more time next month.)