Notes for Board Meeting 9/12

[Sorry, I’m not going to respond to Lauren Do; I assume she knows the definition of statistical significance, but chose to ignore it.   I want to get these meeting notes out there and I will leave Lauren to her “fair and balanced” approach to Alameda news.  Obviously, she is a talented and prolific writer who has created a vibrant online community, but her self-appointed role as enforcer for a political clique she denies even exists is tiresome.]

1.  Not much to say about closed session.  The process of CEO performance evaluation has begun.

2.  Consent agenda was approved with the items below being pulled for individual discussion.
a. The regular meeting notes were amended by me slightly.  In the previous month’s discussion on the use of electronic devices (still wondering how that resolution got on the agenda and whether Mr. Driscoll drafted it for free), Director Battani had made an assertion that materials that I wanted to read into the record were unavailable to the Board.  This was reflected in the meeting notes.  I just wanted to have the record corrected to  point out that I had not distributed that material but that it had been part of the materials delivered to each Board member.   Director Battani should have known since she puts the Board agenda together as President (more on that below).  Too many words to explain a trivial correction.
b.  ALPHA Fund Resolution is a self-insurance pool for workman’s compensation.  This was the lowest price way to obtain workman’s comp insurance although it requires membership in the Association of California Health Care District at a cost of $28,000.  This amount was not included in the analysis that management included with the packet.  It still was the lowest cost alternative and it means I will continue to get junk mail from the ACHD as one of the perks of being a District Trusteee.
c.  July, 2011 unaudited financial statements.  I tried to find out whether there was any additional measures management hoped to take to avoid continuing losses.  The short answer was “no”.  The longer answer was that there might be some additional places staffing could tighten up.  Also, there is the unending hope for additional revenues.
d.  Approval of physician recruitment.  I abstained and thinking about it further wish I would have voted no.  This is a grant of up to 125,000 dollars to Alameda Family Physicians to pay for a new doctor in their office.  It is unclear to me how giving a large amount of money to fairly wealthy people to improve access for people who already have insurance is a good idea.  There is an access problem in Alameda, but it is not that dire for the insured.  An urgent care center would be much more beneficial than this use of funds, but Stebbins has denied that possibility because she fears it would cannibalize ER customers patients.  In other words she would rather route urgent care complaints through the ER where they are more remunerative to the Hospital even though that is more inefficient (and likely less profitable in the long run).

3.   The Board meeting for 10/3 was cancelled.  It is likely to be rescheduled for 10/10.  This Board meeting is intended to be the presentation of an expansion of SNF since the date listed for disclosure is 10/1.  I hope that Director Battani and Management give people sufficient time to evaluate the information that will be presented in support of the proposal.  Three days (or even five days) over a weekend is not going to cut it especially for the people, like me, who will assume, based on previous representations on other projects, that the numbers are less than completely trustworthy.

4.    District referrals policy was approved with one change which was denial of placement on the agenda would need to be at least four days in advance of the meeting so that the “2 person rule” could be invoked if necessary.  That is the rule that allows any 2 Board members to place an item on the agenda even if the Board President disapproves.  The discussion was confusing to me since it is the Board President and Management who, in my opinion, have been most likely to spring surprises on fellow Board members (such as the Physician Recruitment Agreement, this self-same resolution itself, or more annoyingly the electronic device resolution Battani unilaterally placed on the agenda last month).  Also, Battani claims that she has never denied a request which I believer is literally true, but she has certainly deflected and discouraged me from making requests.  Since I believe since my election, I am the only one who has made any type of request, I have to assume that this resolution only impacts me. 

5.  Do not recall if there was any President’s Report.

6.  CEO Report.
a.  Stroke survey is this Friday, September 23.  Routing of stroke victims already resumed to Alameda Hospital.
b.  Possibility of receiving funding from Alameda County Uncompensated Care Program.  Director Chen asked what changed between now and previous times when the County has told the Hospital to pound sand when seeking these funds.  The answer for me, is that now big Hospital booster, Wilma Chan is on the Board of Supervisors.  My guess, although I haven’t confirmed it, is that Chan sits on the Health Subcommittee that will approve any request from Alameda Hospital.  (She also sat on the State Subcommittee that approved the IGT funds in 2009/2010 – the surprise funds or “bluebird” that made the District cash flow positive that year.)  Not really a mystery why things changed; somebody please correct me if I am wrong.
c. IGT Update.  Stebbins claims that the pot will be bigger this year representing an opportunity for 700k more than budgeted from IGT funds.  Sounds like “happy talk” to me.  I’ll believe it when I see it.
d.  Every month Stebbins will be highlighting a quality metric.  Hardly expect any actual discussion about these.  See previous posts regarding this type of information where the Board and Management choose to be willfully ignorant or just go on over to Lauren Do’s blog for distorted analysis (or what passes for analysis).
e.  August volumes were up.  Case mix index was down.  Stebbins emphasized one and glossed over the other.  Dishonest or not?  You decide.  My prediction is that the District failed to meet budget in August unless the additional (unbudgeted?) parcel tax revenues (I think I heard about 200k) are booked as revenue for this month rather than last year.
f.  Alameda Hospital is offering tickets to the gala on October 1 for $175 per person.  I cannot afford that; have better places to make my charitable contributions, and would hardly be welcome.

7.  The Marina Village Wound Care Program is going to take longer than previously projected to get started and cost more than originally estimated.  This is the kind of thing that makes me doubt Management.  That kind of shading/spin/mirepresentation/consistent misforecasting usually flows straight from the top – in other words, Stebbins.

8.  Audit will be complete in October, I believe.  The results will not vary much it is assumed from the unaudited results with the possible exception of the 200k additional in parcel taxes.  I’m not entirely clear on that point.

About egorelick

Gadfly. Former City of Alameda Healthcare District Board member.
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1 Response to Notes for Board Meeting 9/12

  1. notoz says:

    Alameda Family Physicians are part of the dysfunctional organization that is Alameda Hospital. When I had my ED event/trauma in May 2010, I went to an Alameda Family Physician for the follow up. When I reported the problems at the ED, rather than report them to the hospital (his obligation and responsibility [he never did]), he told me “you're making me feel bad about my hospital”. His personal emotional ties to the hospital were more important to him than any failed medical care and deviations from medical standards and practices that I'd been subjected to!

    I suspect that the grant for another physician is for no other purpose than to ensure and strengthen the pro Alameda Hospital power alliances in this city. The hospital cannot give campaign contributions to AFP, but they can do this….and influence local politics and positions. Something like this has to be true, otherwise why would a nearly bankrupt hospital spend money on this? It' must be about survival, pure and simple.

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