A long time ago, when I delivered an ultimatum something like “you can pick up your Legos now, or you can go to your room all by yourself” to my, now teenage, son he responded tearfully “how come you and Poppa always get to decide what the choices are?” Without batting an eye, I responded, “when you are a grown up, you will get to decide what the choices are.” It was one of those moments in parenting where you want to grab the word balloon out of the air, and send it back where it came from.
I wish it were true, but the simple fact is that even when you’re a grown up, you rarely get to decide what the choices are.
As a community leader on the Alameda Hospital Board of Directors, I’m often called upon to make decisions where I wish there were more, and different, options to choose from. At Alameda Hospital, we have talented, hardworking and loyal employees, skilled and caring physicians and nurses, excellent clinical programs and recognition for the quality and safety of the care provided. A tireless and creative management and administrative team have worked hard and effectively to develop and launch innovative cost saving measures and revenue generating programs and services. We also have a community that wants the hospital to stay open, and wants the Emergency Room to be available, right here at home. (That community support was recently reconfirmed in the results of a third-party poll of Alameda voters; in which less than 12 percent said they would prefer to see the hospital close than to continue to pay the parcel tax.)
Unfortunately, what we don’t have is enough patients and healthcare service volume to cover the minimum overhead that keeps the hospital open. We’ve lost money from operations for several years. Our employees haven’t had a raise in three years, and some of them haven’t had one in five years. Our business partners and vendors wait a long time to be paid, and we struggle to meet financial performance requirements for our lenders. The outlook is even worse when we consider the cost of meeting the State of California’s seismic remediation requirements. And, we can’t get enough new volume on our own, even with the contribution of the parcel tax, even with the new programs like the Wound Care Center and Water’s Edge Skilled Nursing management agreement.
Which brings us to the choices that the Alameda Hospital Board is considering; do we affiliate with a larger health system to bring new patient and service volume to Alameda Hospital, or, must we begin the process of closing the hospital?
We’re moving down the path to affiliate with a larger system. In June, the Alameda Hospital Board accepted a proposal to develop a definitive agreement and become an affiliate of the Alameda Health System (AHS) – the newly named public health system in Alameda County that includes Highland Hospital, Fairmont and several community clinics and wellness centers. If the proposed affiliation takes place, it guarantees that Alameda Hospital, including the Emergency Room, will remain open, that the parcel tax will remain under the control of the locally elected Alameda Hospital Board, Alameda Hospital will have a voting seat on the AHS Board of Directors, and Alameda Hospital will meet California’s 2020 seismic remediation standards. The AHS affiliation will also bring patients and healthcare service volume to Alameda Hospital, filling hospital beds that are currently empty, and making full use of the 3 Operating Rooms that are currently vacant. After the affiliation, Alameda property owners will continue to pay the parcel tax, but the tax will be spent only in Alameda, only on Alameda Hospital – and will be used for capital improvements.
Right now we’re in the “due diligence” phase, where AHS and Alameda Hospital are working to develop the detailed agreement to make the affiliation a reality. Lots of questions are being raised, lots of answers are being developed – and many new challenges are being uncovered. Entering into a definitive agreement for a formal affiliation will answer some of the questions and address some of the challenges – but there will continue to be hard work to do to make this work.
Being a grown up, and a responsible community leader is a messy business. Things are rarely clear cut. You’re faced with choices you don’t like. You find the answer to a question, and it raises more questions. You find a solution to a problem – and it reveals a whole new set of decisions that need to be made. That’s how it is with the choices that are before the Alameda Hospital Board. What we’re keeping in laser-like focus is the choice we have right now; can we affiliate with a larger system, or, do we have to begin the process of closing Alameda Hospital?
Jordan Battani is the hardest working member of the Alameda Hospital Board. When she is not pondering weighty Alameda Hospital type issues, she enjoys gardening and has a thematically appropriate haiku for every occasion.