The District Board will end hours of public comment on Monday by voting whether to accept or reject a proposal by Alameda County Medical Center’s Fairmont campus to move their rehabilitation unit to the Hospital campus, with an 8 a.m. to 8 p.m. sub-acute urgent care clinic replacing the acute care 24-hour emergency rooms. The intensive care unit, medical floors and surgery would be among the many other services terminated.
The offer represents months of secret negotiations beween Sutter Health and the Alameda County Health Care Services Agency. The Agency is anxious to find a place for Fairmont services, which must be moved from its current site on Foothill Boulevard. Sutter is anxious to eliminate a nearby competitor to its Castro Valley hospital.
The East Bay is only the latest community in Northern California to face down Sutter Health’s strong desires to deny needed health care to vulnerable communities when it serves their bottom line. This is a provocative claim, but one must merely look around us to find its truth. The San Francisco Chronicle has done plenty of reporting on Sutter’s persistent efforts to close St. Luke’s Hospital in San Francisco. In addition, Sutter attempted to close its hospital in Santa Rosa.
The County Boards of Supervisors in San Francisco and Santa Rosa forced Sutter back to the bargaining table in order to prevent an outcome which would have harmed their constituents. In the backlash to Alameda County’s secret negotiations with Sutter to take over San Leandro Hospital, the public is wishing to ensure that our Board of Supervisors and the Eden Township Healthcare District Board have all the information they need to do the right thing.
Public meetings at the County and District levels have revealed a number of disturbing details about the County’s offer and internal processes of the potential deal:
- Sutter reported to the County that over 80 percent of the 27,000-plus patients seen in SLH’s ER in 2008 had low level of illnesses appropriate for the proposed urgent care clinic. This was refuted by the director of San Leandro Hospital’s ER Dr. Gail Hubbell who publicly stated that over half of the patients were too ill to receive urgent care treatment, including over 1,300 patients in critical condition whose lives would be put at risk by delays in care.
- In order to justify their strained position that there is sufficient capacity in the system to absorb both SLH’s ER patients and 20,000 inpatient days, the county and Sutter would force ill people formerly treated in our Healthcare District to seek care at all hospitals from St. Rose and Kaiser in South Hayward to Alta Bates Summit in Berkeley and Oakland, along with the overloaded trauma-designated Eden and Highland Hospitals.
- SLH’s closure would reduce capacity at district hospitals from the current 300 beds and two ER’s to 130 beds and one ER by the year 2013. Sutter admits their goal for the new Castro Valley rebuild is for this new hospital to have an average 85 percent inpatient bed occupancy rate, unprecedented in our County and incompatible to safe health care. As a comparison, while its ER has extremely high use, the County’s Highland Hospital has had an average 60 percent inpatient occupancy rate in recent years.
- Sutter presented to the Agency in their negotiations that there were no other organizations interested in continuing current services at San Leandro Hospital, and that Sutter intended to end acute care services by Sept. 30. In reality, earlier this year Prime Healthcare entered into discussion with the Healthcare District about taking over current SLH services, and last week publicly reveal their offer to lease operations of the hospital.
- There is a perverse imbalance in the quality of the two proposals submitted to the District. The county’s proposal not only kills many vital hospital services, it also sees the District hand over the property to the county free of charge, and has Sutter paying the County $6.5 million. The Prime Healthcare proposal preserves current services, guarantees $20 million in prompt acute care improvements, and has Prime paying the Healthcare District throughout a 10-year lease with two 5-year options. This much-needed money for the District could be used to support their hospital and non-hospital health care activities. As mentioned on The Citizen, it would be neccesary to ask Prime hard questions about their practices before a well-crafted agreement addressing community concerns is completed; this would also be needed if any other provider came forward with a competing bid. All the same, with these facts only a corrupt Board would approve the County’s proposal.
- The President of the Healthcare District Board, Dr. Rajendra Ratnesar, was the subject of a story in the Daily Review this week. The story revealed Sutter Health paid Dr. Ratnesar up to $100,000 last year. The story further detailed that he will be allowed to vote on this issue, while the Healthcare District attorney has advised board member Carole Rogers she should not vote on the County proposal due to a specious conflict of interest (Rogers has publicly expressed opposition to the County deal; she has retained an attorney to defend her right to vote).
Monday’s action by the Healthcare District to vote on the inferior County proposal to the exclusion of Prime’s offer also disrespects a request of our County Supervisor Alice Lai-Bitker to the District Directors. In the Board of Supervisor President’s letter of May 11th, the President of the Supervisors said, “To date, neither Sutter nor the Health Care District has been forthcoming with data to reassure the community that health care needs have been considered and all option (sic) pursued in the decision to close San Leandro Hospital. This is simply an outrage!”
Frankly, the Healthcare District Board has let down the citizens of San Leandro, Castro Valley, San Lorenzo and Hayward often, particularly in its approval of a horrendous 2007 agreement which could put the hospital in jeopardy even if Monday’s vote goes as it should. One battle at a time, though, and we are hopeful that we will win Monday’s battle in the war Sutter Health is waging on our community.
Doug Jones is a resident of San Leandro and a former employee of Eden Medical Center. He is also a member of the San Leandro Community Action Network (SLCAN).