The Board of Trustees of the Alameda County Medical Center approved a $460 million budget on Tuesday, rejecting requests by union members for a no layoff pledge and to set aside $5 million from increased debt payments to Alameda County to fund staff development and training to help staff transition into new positions.
Following the meeting, SEIU Local 1021 researcher Brad Cleveland, who had made an emotional appeal to trustees prior to the vote, said he was “disappointed” in the board’s decision to reject the set-aside and no layoff pledge. “SEIU would have worked with the board to help secure three votes on the County Board of Supervisors to approve reduction in the debt payment,” Cleveland said. “We just needed the trustees to step up, but they didn’t.”
The ACMC budget, covering Highland Hospital and several clinics across the county, projects cutting 21 staff positions throughout the system, the bulk of them—twelve—at the sometimes-troubled John George Psychiatric Pavilion in San Leandro.
In late 2003, a doctor was killed by a patient at John George only months after Cal/OSHA had urged the facility to beef up security following earlier patient assaults on staff.
The budget projects a $1.4 million net operating income for the center, coming halfway to ACMC CEO Wright Lassiter’s three year goal of budgeting one percent operating income. Last year, trustees approved a break-even budget but actually achieved a .2 percent income; this year, operating income is budgeted at 0.5 percent.
The loan payments from which SEIU wanted to siphon off the job training money comes from some $191 million in money that the county had “loaned” to the medical center over a period of months to meet its operating expenses. County supervisors had not asked for repayment of that money until the summer of 2004, shortly after the Measure A tax money began supplementing the medical center’s income.
Last year, the medical center paid $10 million in principal payments and $7 million in interest payments to the county on the loan, but this year, county supervisors have called for a $5 million increase in payments. SEIU had asked the trustees vote to request supervisors to rescind the requested $5 million increase so that money could go for staff training.
The loan payments themselves have been something of a controversy, with some county health care advocates charging that the county’s demand for the payments—coming immediately following the passage of Measure A—violated the provision in Measure A that the money be used to supplement existing health care dollars.
Shortly before the board rejected the $5 million set-aside, trustee Ted Rose said that the issue of the loan repayment has been “simmering in the background” for several years, and called on the board to adopt a policy on the schedule of repayments. “We never have before,” Rose said. “We’ve always operated under the schedule of the Board of Supervisors.”
He suggested that the trustees work on a new loan payment schedule “in collaboration with our partners on the board of supervisors. I’m not trying to be confrontational, unless its necessary. But it’s high time we addressed this.”
Trustees did not act on Rose’s specific suggestion, which was not offered as a motion, but on a 2-6 vote (trustees Floyd Huen and Rose voting yes), they later rejected Huen’s motion to temporarily set aside the $5 million for staff development “while we explore whether or not the supervisors would agree to allow such a reduction.” Huen said he made the motion in part because “we have only had five months of positive fiscal activity. Holding off the loan increase for another year would make me more comfortable.”
But trustee Valerie Lewis said “we need to pass the budget based upon the situation that is before us, not what we project it to be,” and Finance Committee Chair Stanley Schiffman said that cutting $5 million in payments on the loan principal would cost the medical center money by increasing the amount of the overall payment that would have to go to interest on the loan.
Before the vote, Crystal Cox, a registered nurse with the county, told trustees that “I worked real hard on Measure A” (the 2004 half-cent transaction tax measure enacted to supplement health care in the county) “so we could maintain services, and I’ve lobbied in Washington for more health care funds. I didn’t do that so we could have layoffs and decreases in services. How can John George maintain quality care with a decrease in staff?”
And SEIU field representative Wayne Templeton said that without the set-aside money for staff development, “the budget threatens the improvements that have been made under CEO Lassiter. My members have been embattled over the last five years. We are simply asking for equity, now.”