Board Meeting 8/8/11

1.  The open part of the Board meeting began with the Annual Auxillary Report.  When I walked in and saw a full room, I thought that there was going to be a succession of people criticizing me and saying how wonderful the Hospital was.  When I realized that the Auxilliary was there to report, I thought maybe it was just volunteers there to show the flag.  My first instinct was correct.  Anyway, the auxilliary has about 75 members who do everything from staff the gift shop to making well-check phone calls to seniors (telecare – pending approval).

2.  After pulling most of the consent calendar, it consisted of the regular meeting notes and a change to the medical staff rules.

3.  The June, 2011 financial statements are unaudited, but the year-to-date results are for the full fiscal year.  The projected FY2011 end of year income as of April 4, 2011 was 196k profit.  The unaudited actual presented at the Finance Committee on July 27 (and again at this Board meeting) shows a loss of 1658k.  Now that is almost a 2 million dollar swing in under four months.  No reasonable person can tell me that management or the Board is exercising competent oversight with a swing like that.  It cannot be all David Neapolitan’s fault.  If this was a public company then there would be resignations beyond just the CFO.  Audited result will be available in October.  CMS may cut the IGT number even more which just increases the misery.  No reasonable person would believe a budget number from an organization that had such a dismal track record in predicting future results.

4.  Board policy on confidential information –  This resolution, in my opinion, was built on a platform of misrepresentation by certain individuals.  I questioned its usefulness and got no useful answer.  I inquired as to whether I could avail myself of District counsel’s advice with respect to the the Brown Act and this blog and got no useful answer.  I think Mark Twain in Pudd’nhead Wilson expresses best my opinion regarding this resolution.

5.  The signature authority moves check signing authority to the Treasurer from the Secretary.  It makes sense to me.

6.  The Electronic Devices resolution could not find a second.  I will reiterate that I find it interesting that Mr. Driscoll had the time and that Director Battani felt it a useful expenditure of District funds to draft this resolution.   Of course, like I said above, Twain covered this ground over 100 years ago.

7.  The Medical Staff President report was preceeded by a parade of bitter MD’s and staff exhibiting admirable passion, but more than a little off the mark.  If they would have considered the question as a medical question for a patient, “Which location provides the best result?” in the same way they evaluate the question of which procedure or drug is best then their former preceptors would not be thrilled with the quality of their argumentation.  I certainly was happy that they care so much, but disappointed that they lacked the ability to articulate a coherent argument.  (The best I could do was smile weakly and awkwardly somewhat embarrassed on their behalf.)

8.  Approval of modification of the wound care Line of Credit.  I voted yes because the Board and management has committed the District to a 10 year lease that represents a commitment of over 2 million dollars.  Mr Driscoll has written a letter to confirm the fact that Alameda taxpayers will have to make good on that lease whether any value is received or not.  This is not a long-term liability for balance sheet purposes, but it certainly was a decision that obligated the District for a huge amount of money on an unproven strategy executed by management that has failed, in general, to meet its financial projections over the entire course that it has been at the helm.

9.  Approval of modification of the emergency line of credit.  I voted no.  Just another finger in the dike of the [Update 8/15 just to be clear “financial disaster”] disaster which is Alameda Hospital.

10. Presidents Report.  a.  Nothing particularly interesting.  Dan Dickenson gave a meaningful use update that seemed to cover the pertinent issues.
b.  Deborah Stebbins is somewhat optimistic about July results.   Most/all of the layoffs were effective 6/27 so, hopefully, the District has staunched the bleeding.
c.  Management will be meeting with Alex Briscoe (Alameda County public health) this week to get routing of stroke victims back to the Alameda Hospital’s ER.   I hope myself or my loved ones can convince the EMS personnel to take the few extra minutes to go somewhere else if I am ever so unfortunate as to suffer the signs and symptoms of a stroke.

11. I apologize, but I recall little of note of the remainder of the meeting.  Video is up at the Alameda website.

12. Near the end of the meeting, I responded as best I could to the earlier comments by medical staff.  Jim Yeh also responded.  I thought it was a decent beginning of a dialogue at that point.  The District takes 5.7 million dollars from Alamedans every year.  Apparently,  I am a minority of one on the Board in thinking that there is a moral and fiduciary obligation to justify spending those dollars.  It’s not good enough, in my mind, to be no worse than the alternative because the alternative does not cost 5.7 million dollars.  The alternative is free AND [if you are willing to believe the well-documented, enormous body of volume-outcome evidence published in the medical literature] will more likely than not lead to better healthcare outcomes.

About egorelick

Gadfly. Former City of Alameda Healthcare District Board member.
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