More detailed preview of 4/4 Meeting

The material is here.  I have to agree with Denise Lai that the District should be posting this material as soon as possible, and if possible, much more than 72 hours prior to the start of the meeting.  I’m pleased that the Wisconsin Republicans may have been tripped up by an open meeting law, but the current situation wrt the status of the union busting bill there makes it clear that there is always the risk if proper procedure is not followed.  Since the Board meeting does not begin until 6:00 pm on Monday, the 72 hours notice was certainly met, but posting earlier would minimize that risk of problems and better meet the needs of the public.  (I know that this was an irritation for me when I was a member of the public before I was elected to the Board.)

The consent agenda is relatively full.  I could not make the Finance Committee meeting so I need to have that pulled.  My questions will mainly be concerning the large loss for February (337k) just to get some clarification as to any urgent remedial steps that could be taken.  Also on the consent agenda is a Textile Service Agreement, I will be interested in understanding the terms of this contract especially any fixed costs.  Since consent items are always voted on without discussion by the Board (although the public can comment), this will also need to be pulled.  The most trivial questions pulls an item from the consent agenda is my understanding.

On the agenda is the President’s report which includes an update on discussions with City Officials.  I’m not sure what that means.  The City Council almost certainly endorses the majority view of the Board that Alameda Hospital is critical to the community.  This, as any reader of this blog knows, is not my view.  It is in conceivable that Lena Tam or Rob Bonta have changed their minds about the Hospital and given how closely allied Mayor Gilmore is with these two, I am sure that “city officials” view the Hospital in a favorable light.

The CEO’s report may include a date for the stroke certification accreditation visit.  My understanding as of last Board meeting is that the preliminaries necessary to schedule a visit were almost complete so with an additional month, that should be ready.  My views on the stroke program are also well known to most (I am against it.)

The meat of the meeting will be the Finance Committee report.  The 2011 YE projections are interesting and seem overly pessimistic to  me even given the expected lower census during the upcoming months.  Of course, there is going to be a non-operational (extraordinary) income item recognized in April adding 1473k to the bottom line.  Even with that boost, management is projecting only 200k of net income for the full year or, in other words, an operational loss of about 8 million dollars on just over 60 million in operating revenue or more than 10% operating loss.  In short, that’s not good. 

The budget calendar is also presented this month.  I hope that my fellow Board members seriously consider the fact that the acute care portion of the Hospital cannot survive much longer.  The forces of operational losses, seismic requirements, and healthcare reform are too large to be beaten back by optimistic projections or anecdotal assertions of the absolute life-saving necessity of continued operation.  Hopefully, the Board will think carefully about proactively addressing change instead of reacting.

Two last things, because I missed the committee meeting I did not get to question the 1206(b) clinic financials.  Some time in the next month, I will get the original projections and compare them to the actuals. Management did do that somewhat, but I would like to delve somewhat deeper into the numbers.  Also, if the projections regarding the final three months are correct then only if the DSCR includes the non-operating, non-cash net income of the 3rd party liability being reversed will the District meet the covenant ratios that I discussed in my notes of the last meeting.

About egorelick

Gadfly. Former City of Alameda Healthcare District Board member.
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