Beilenson hearing<\/a> \u2014 a legally required but largely procedural step before health systems like AHS can undertake these sorts of cuts. The meeting took nearly six hours; about 100 people packed into the supervisors\u2019 chamber on the fifth floor of the Alameda County Administration Building on Oak Street in Oakland. Many more filled an overflow room, and more than 300 tuned in via livestream. And more than 100 people signed up to give public comments.<\/p>\nDuring the hearing, Supervisor Nate Miley asked the county administration to try to find at least $10 million to offset some of the job cuts, and proposed a working group of supervisors, AHS executives and labor leaders representing AHS workers to tackle the long-term effects of H.R.1.<\/p>\n
\u201cI do think there seems to be a disconnect between what the AHS executive team has decided to do and what we\u2019re hearing from folks who are on the front lines,\u201d Miley said.<\/p>\n
The supervisors will meet on Tuesday again, just six days before the scheduled last day of work for those who have received layoff notices. The supervisors floated several approved ballot measures as possible funding sources:<\/p>\n
Measure A from 2004, renewed as Measure AA in 2014, a sales tax originally conceived to directly fund AHS, already struggling at the time<\/p>\n
Measure C, a 20-year sales tax from 2020 aimed at funding children\u2019s healthcare<\/p>\n
Measure W, another 2020 sales tax billed as targeting housing, homeless services and other uses<\/p>\n
Seventy-four employees have already taken buyouts, 31 opting for voluntary resignation with severance and 43 for retirement with incentives, according to Jet Chapman, AHS\u2019s human resources chief.<\/p>\n
Nevertheless, the system\u2019s finances are currently bleak. Expenses were $13.2 million higher than expected as of December (with only $4.6 million in higher-than-expected revenue), the system is projected to max out its credit line before the end of summer, and there are no cash reserves it can tap into, according to a presentation from Chief Financial Officer Kimberly Miranda.<\/p>\n
\u201cJust as a reminder to everyone, 92% of our payer mix is MediCal or other government-funded patients, so we are disproportionately affected as a hospital system and as a safety net system,\u201d Miranda said. On top of that, she said, recent higher-than-normal inflation nationwide meant spikes in the salaries and benefits AHS has paid, while fee schedules for MediCare and MediCal \u2014 effectively, what AHS can bill \u2014 did not keep pace.<\/p>\n
According to AHS, the programs hit hardest would be:<\/p>\n
Highland Hospital Outpatient Behavioral Health Wellness Program<\/p>\n
Fairmont Outpatient Behavioral Health Program<\/p>\n
Highland Hospital\u2019s Health Advocates program, which helps patients and their families navigate AHS and better access care<\/p>\n
Highland Hospital\u2019s Tele-sitter program, which helps AHS staff remotely monitor patients\u2019 well-being while they\u2019re hospitalized<\/p>\n
Fairmont Hospital\u2019s Kitchen Retail program, which provides meals to staff and visitors<\/p>\n
AHS\u2019s ambulatory plastic surgery program<\/p>\n
Highland Hospital\u2019s Complex Care Program, teams of staff who help people with multiple, chronic health issues who frequently need medical services<\/p>\n
If the cuts go through, AHS said, each of those programs will be shut down.<\/p>\n
Peter Masiak, an organizer for SEIU 1021, which represents several classifications of AHS workers, said executives had several times shifted their rationale for layoffs and failed to provide labor leaders pertinent information.\u00a0<\/p>\n
\u201cOur team heard more details and analysis about the cuts today than we\u2019ve ever heard in months of bargaining,\u201d Masiak said, adding that AHS was using federal spending cuts as a pretense to get rid of workers.<\/p>\n
\u201cThe Trump administration is an existential threat to public health everywhere. There may not be a way out of this, but that there ought to be, and should be, is collaboration,\u201d Masiak said.<\/p>\n
Besides layoffs, doctors and other AHS workers are worried about what they said is the hospital system\u2019s apparent unwillingness to fill vacancies that already exist. Several doctors pointed to staffing shortages, especially in vascular surgery and anesthesia, and said they are already threatening patient care and Highland Hospital\u2019s level-one trauma center certification.<\/p>\n
\u201cOne of our anesthesia colleagues just worked 48 hours in a row to ensure we did not go on trauma diversion,\u201d said Dr. Caitlin Bailey, medical director at Highland\u2019s emergency department. \u201cIf we don\u2019t staff our hospital, we cannot function.\u201d<\/p>\n
More than 300 doctors signed onto a letter to AHS leadership criticizing the proposed cuts; three of them read it aloud on Wednesday. They wrote the job cuts reflected \u201ca longstanding pattern of poor judgment, lack of understanding of clinical care for the underserved and systemic mismanagement that directly threatens patient safety.\u201d<\/p>\n
The doctors asked the supervisors \u201cto intervene decisively\u201d in the trustees\u2019 \u201cmismanagement.\u201d<\/p>\n
Dr. Daniel Allen, chief of plastic surgery at Highland, said the cuts to his department meant the hospital would keep up with the roughly three-dozen \u201ccomplex\u201d cases it typically sees in a year, but drop the roughly 174 other ones it would take on. But those abandoned cases, he said, \u201cinclude most of the skin cancers that we do, all of the complex wounds and exposed bone referrals \u2026 hidradenitis suppurativa, which is an absolutely horrible skin infection.\u201d<\/p>\n
The supervisors said they would take the matter up again at 2 p.m. on Tuesday, March 3.<\/p>\n
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