As the average age of county residents increases in tandem with continuing cuts in federal and state funding, Alameda County Health Care Service Agency Director Alex Briscoe is at the center of one of the region’s most fundamental and vexing questions: how to effectively care for the sick and poor. He spoke to The Citizen this week in Oakland where he addressed the county Board of Supervisors over the increasingly dire financial situation at St. Rose Hospital in Hayward.
 

Q: Is St. Rose Hospital trying to save itself by saving San Leandro Hospital?

 

A: It’s a good point because by joining the Eden Hospital District. St. Rose is being strategic in its thought to get a public revenue stream. By joining the district it is seeking taxing authority to pursue a parcel measure and such a parcel measure has a much greater likelihood of passing if it is to support both San Leandro [Hospital] and St. Rose.

Q: The idea is by uniting there is strength in numbers helping both facilities, correct?
A: It is very difficult for hospitals of that size and payer mix to stand alone.

Q: How is St. Rose being a non-union shop play in this situation?
A: I think Michael Mahoney’s plan was well-received for many reasons, but I don’t think it hurt for him to allow CNA to organize there in the future.

Q: How do you think this is perceived by the public that staffing at St. Rose will be cut? A: The reduction in force to the degree it was discussed today is necessary for St. Rose to survive. It doesn’t make sense to sugar-coat it. Just for them to survive long enough just to find other options is going to require a reduction in force. There’s no way around it.

Q: When Mahoney goes to the Eden Township board and asks for a $3 million loan, was the outlay needed for more than just an I.T. problem as it was stated in late July?
A: It was a problem, maybe even a major problem. If you’re just making rent, even a parking ticket is a big deal. If you’re just making it work because you’re serving a lot of poor people and you’re a safety institution, not getting revenue for 3-5 weeks is a killer.

Q: Isn’t it odd for people in San Leandro to now see St. Rose as also financially-strapped and think they they can help the situation at San Leandro Hospital?
A: It is certainly incongruous. If you detach yourself from the current crisis, seeking operating efficiencies, greater volumes and a new source of public funds—that’s good thinking. I don’t think St. Rose long-term can survive in its current form and its going to need a strategic alliance with somebody and whether it’s the Eden Township District or one of the many potential partners they are going to have to going to have to consider how to more effectively collaborate and reduce costs and improve competitive position.

Q: Regardless of the leadership on the ground, this is just the reality of business in health care, isn’t it?
A: It is the reality of a for-profit health care system that shamelessly profits on human illness and suffering. It leaves the rest of the responsible entities out there to deal with the uninsured, the under insured, Medicaid and Medicare. We have some of the most talented hospital administrators in the nation in our safety net system. [Alameda County Medical Center CEO] Wright Lassiter is one of the strongest health administrators in the state. We have great folks doing important entrepreneurial and aggressive work and it is still dicey.