Monday, May 31, 2004

“Hey, No One’s Watching the Dogs!”

After the Alameda County Hospital Authority Board signed away the first $3,000,000 dollars to consultants, the public got a little concerned. When they then agreed to pay another $700,000 dollars for telecommuting consultant/executives to manage the Medical Center, shock set in. The Hospital Authority Board has been on a non-stop consultant-spending spree for months now.

The Authority Board contends that the only way to stop the financial crisis is to spend even more on consultants. “You have to spend money to make money.” It’s the consultant mantra. “Healthcare for all” the slogan used to get Measure A passed is just more California claptrap to our imported experts. They will focus on cost reduction first, and then they will explore “revenue opportunities.” Two thirds of the voters in Alameda County figured out that a critical lack of “revenue opportunities” necessitates subsidies for the public hospital. If insurance companies could suck a profit out of the very sick, the very poor and the uninsured, we wouldn’t need the Medical Center!

In addition to lavish spending on consultants the Board now needs five or more Sheriffs at public meetings. Are they afraid the Grey Panthers will storm the stage? Do they think the Medical Staff will attack them in a fevered frenzy? Who’s paying for all this firepower and do they have live ammunition or rubber bullets? Is this just another situation where we have to spend money to make money?

Well, the Dirt went back to Measure A and looked at the language. Nowhere within the text does it say, “You have to spend money to make money.” It does say something about a Citizen’s Oversight Committee. They’re supposed to look at the spending once a year and report back to the Board of Supervisors. The voters are paying for this mess, not the politicians. Besides, the consultants will likely have flown back to Tennessee, first class, long before this report gets written.

Sunday, May 23, 2004

Consult This!

For years the county hospital has been a treated like a stepchild by Alameda County’s top bureaucrats, Sheriff Plummer and the Health Czar, Dave Kears. They’ve complained, huffed, diverted funds and mostly just plain neglected the Medical Center. Highland Hospital, Fairmont, and the County clinics have stayed alive mostly because of the work and dedication of care providers, patients, real leaders like Supervisor Carson and community groups. Measure A put it to the voters. The people of Alameda County were asked if they would pay a little more to keep the public hospital open and they answered,” yes” by more than a two thirds majority.

And that’s where the trouble began, 70 million dollars worth of trouble. Supervisor Steele appointed her best “buddy” to the Authority Board and even tried to put the Sheriff on it. All of a sudden everyone wanted to help the Medical Center, consultants came crawling out of the woodwork. An Authority Board runs the Medical Center. This is a device designed to keep a comfortable distance between the politicians and public.

All of a sudden the Authority Board had money in its pocket. County Supervisors calling them daily and top bureaucrats lobbying them. They became important people. Money and power, they had to do something. Actually they had to do exactly what the County Supervisors who appointed them wanted. That’s why they needed every politician’s best friend, consultants. They’re solicitous, they’re loyal; they’re not burdened by strong connections to the community or institutions they serve; and if it doesn’t work out the consultants can be blamed. The Board got really extravagant when they hired Cambio, who brought in their turnaround team, a bunch of guys from Tennessee in dark suites and tight shoes. The turnaround team turned around and hired more consultants, they then fired the entire executive staff of the Medical Center and replaced them with, that’s right, you got it, more consultants. The Board also hired $100,000 dollars worth of public relations consultants to explain the activities of the other consultants to the confused taxpayers, who just wanted a public hospital.

Why consultants? Have they been successful in the past? No. Do they understand the Byzantine complexities of the County of Alameda’s Health Care Services Agency? No. Do they have strong ties to the community, or the trust of the labor and community groups who advocate for the hospital? Of course not.

So why does the Board of Supervisors have such a never-ending romance with consultants? Politicians bring in consultants to solve their political problems. They don’t strengthen public institutions; they cut costs and take the heat, so politicians don’t have to get involved. Fixing the Medical Center would require political involvement, investment in infrastructure, committed permanent administrators, and real leadership from the Board of Supervisors. This clearly isn’t happening, so what do we get, consultants, cuts in services, and public relations, to tell us it’s a good thing. McMedicine, brought to you for the bargain price of 3.2 million dollars per year, and if you don’t like it, don’t call your County Supervisor; it’s not their problem, it’s yours.

The Dirt gets around: circulation 118 and growing!

News Call: the Daily Needs the Dirt

Well, the dirt’s piling up at the public hospital, Memo Mike, the Permanent Interim CEO has begun carrying the “communication ball,” he’s glad-handing and we’ll soon be having “chats.” Our newly acquired $100,000 dollar PR firm pumps out updates faster then employees can say, “recycle”, and the Hospital Authority may be planning another round of musical board members. Who’ll be the next president? The Dirt heard that the turnaround team is back peddling on the lay-offs. What have you heard? The dirt wants to know.

Send any tips, tid-bits or advice to the comments or to

Saturday, May 15, 2004

Highland’s CEO Shuffle

Gee, when those Cambio Consultants say, “turnaround team” they really mean it. It’s costing taxpayers three million two hundred thousand dollars to get this consultant team into the Medical Center to turn things around. Once in the door they turned around and hired more consultants, consultants to consultants, to fix John George, the psychiatric hospital. Next, they turned around and fired the entire executive staff. They then noted that there was a vacuum of leadership at the Medical Center. In an attempt to be helpful, they offered to hire their own staff as executives for a meager $720,000 a year. So Cambio’s Susan Crutchfield replaced Efton Hall as Interim Chief Executive Officer. Ms. Crutchfield’s only visible act as Interim Chief Executive Officer was to put out a memo. The memo confirmed that consultants had run over a Highland employee in the parking lot and pointed out that police had not cited anyone. For the record the consultants were backing up; not turning around when the accident occurred. Then exactly one week after CEO Hall’s surprise dismissal, Cambio announced the new Permanent Interim Chief Executive Officer, Michael Burroughs. Three CEOs in one week, I don’t know about everyone else, but I don’t feel like I’m getting my 3 or 4 millions dollars worth.

Alameda County Healthcare History

1992: The State (of California) provides approximately 40 million in Disproportionate Share Hospital (DSH) funding earmarked for Highland and Fairmont. Instead of using this money to improve the hospital, Supervisors Steele and King choose to divert half of it to the County Sheriff. Kears “borrows” the other half for projects which, it is said, will save the County money in future years. It is unknown if these “savings” were ever returned to assist ACMC.

Excerpted from the “Alameda County Health Care Timeline” Produced by Vote Health, PUSH, and the Bella Vista Neighbors, 1998.

Thursday, May 13, 2004

Highland Consultants Cut Waste and Fat

Cambio did it; they found the fat and waste. They announced their long awaited lay-off list. Cambio’s cut list spared the bloated middle management structure. They concentrated their efforts mostly on laying-off clerks, housekeepers, and patient care providers.

The emergency room will lose all its nursing assistants. I guess we’d rather pay an RN or MD to push a gurney to a broken elevator and wait there to take the patient to their room. It can take up to an hour to get a patient from the emergency department to a room and we’ve just doubled or tripled the salary of the staff that will perform this task. Then I suppose the doctor will come back and clean the equipment for the next patient. But hey, there is an upside with Highland’s highly unreliable elevators it’s probably is safer to have a registered nurse or doctor riding them at all times.

They also hit housekeeping hard-that makes sense, patients often complain that Highland’s just too clean. Maybe it’s that excessive cleanliness that results in so many patients with multi-drug resistant infections. I’m sure the cost of excessive cleaning has driven many businesses into financial ruin. Isn’t that what happened with Enron?

Medical clerks, there’s another huge waste. Why do you need someone on a nursing floor who can decipher physician’s orders or coordinate admissions and discharges. It just takes all the fun out of medicine. Nurses should just guess what the doctor wrote, and since they can’t read the signatures either, just guess who wrote it. As for discharges, well if they go slow enough patients will learn to get themselves home. Admissions, well that should be less of a problem because now that doctors will be doing transport and equipment cleaning we’ll be expecting far fewer admissions.

You just have to give it to those consultants and many of the staff would like to, but you just can’t find them. One was spotted last week scurrying up the backstairs.