He aims to create a working group made up of labor leaders, county staff, supervisors and Alameda Health System administrators and trustees to develop a more long-term plan.

Miley suggested that revenue from Measures W and A — sales taxes approved by voters to raise money for medical and essential services, among other things — could help offset some of the cuts.

He also floated the idea of the county easing up, at least temporarily, on repayment of what’s known as the “net negative balance,” essentially a county line of credit that Alameda Health System uses to cover expenses when bills come due before large state or federal reimbursements arrive.

“There are avenues we can pursue,” he said, noting that cuts to non-safety-net services might be left standing. “There might be some things that are good to have but are not necessary.”

Supervisor Nikki Fortunato Bas agreed that the county can likely stanch the bleeding in the near term, but she emphasized that the real solutions are systemic: “It’s about single payer. It’s about making sure that we close the loophole in Prop. 13 and really address how resources and wealth are distributed in our country, as well as our state and our communities.”

Nikki Fortunato Bas, a member of the Alameda County Board of Supervisors, speaks during a resident physician “unity break” outside Highland Hospital in Oakland on Feb. 24, 2026. Physicians cited layoffs, staffing shortages and contract negotiations with Alameda Health System. (Gustavo Hernandez/KQED)

In the meantime, she said she would seek to hold AHS accountable for doing everything possible to raise revenue and ensure officials there are “very clear and thoughtful about what they’re looking at, and that they’re actually talking in good faith with our labor partners to make sure that we’re addressing all the potential impacts.”

Some AHS employees and their unions have criticized system executives for acting rashly.

“These layoffs are anticipatory,” said Dr. Elijah Lustig, a resident physician at Highland Hospital and union leader with the Committee of Interns and Residents, part of Service Employees International Union.

“They’re not talking to our department heads before instituting cuts or proposing layoffs,” he said of the process. “The people who are deciding who gets fired, frankly, do not have a good grasp on how this hospital runs, on what services are crucial, on what services are impacted.”

The Wilma Chan Highland Hospital Campus is seen through flowering branches in Oakland on Feb. 24, 2026. The hospital is part of Alameda Health System. (Gustavo Hernandez/KQED)

In a statement, AHS said it “must take a proactive approach” to reducing costs. “We do not approach this painful decision lightly,” it said. “However, AHS reasonably predicts that it will run out of funds within six months, by August of 2026, if it does not act now.”

Wednesday’s hearing is required by law to give the public an opportunity to comment on the proposed cuts to health care services. Supervisors won’t take any action there, but Miley said he hopes the board will reach a decision on allocating funding to prevent layoffs as soon as March 3.

The hearing takes place at 3 p.m. at the Alameda County Administration Building, Board of Supervisors’ Chambers, Fifth Floor, Room 512, 1221 Oak St.