Wednesday, October 27, 2004

Another One Bites the Dust!

The medical center has no real communication system, sure we get the memos but people try not to read them. So when inquiring minds want to know, where do the go, the grapevine. The hospital has a pulse, it has moods and it has one of the most sophisticated systems of informal verbal communication on the planet. It’s sort of an oral history; it’s fast, funny and usually highly accurate.

So here’s what’s on the vine. The Permanent Interim CEO, Mike Burroughs, quit and that’s right, we get another Interim CEO. Let’s get real here, these aren’t “Interim CEOs” these are “Interval CEOs.” This makes four CEOs and counting since Cambio Healthcare Solutions took over in May. If it gets any worse, Cambio will be calling the executive registry and sending CEOs over to work shifts.

Rebecca's latest

Well, the medical center made the news again. The medical center has a huge budget for spin doctors, so why can't they buy us some good news? To read Rebecca Vesely's latest piece click here:,1413,82%257E1726%257E2494700,00.html

Monday, October 25, 2004

A Rally Really?

Yes, folks we have to do it again. Tuesday, October 26 at noon. Hospital employees will once again go out in front of the medical center facilities and rally. This time to remind our leaders that you have to give workers a contract and fair pay or there will be no one left to take care of patients.

See you there.

I Want A Refund

Well, the Cambio Healthcare Solutions consultants had an epiphany; they realized they have run off many of the caregivers they need to run the hospital. Half of the image technicians (people who work in x-ray, ultra sound and MRI) quit or threatened to quit in one week. Pharmacy, respiratory therapy and nursing have the same problem.

You can’t run a hospital with all of the critical service providers running out the door and what exactly have our leaders done to keep them here. Well, lets review, they told these highly trained employees they were overstaffed and threatened to lay them off. They also threatened to lay off all the support staff (nursing assistants, medical clerks, housekeepers, food services workers) all the people you need to make things run. What about wages, well these groups get paid 5% -20% less than people doing the same job in other hospitals.

Then there’s the public relations war, fought internally with piles of meaningless annoying memos and externally with “Bring it on Braley” saying the medical center just needs to cut the fat. They’ve got the medical center crawling with state inspectors and they started a war with the union represented workforce, apparently Cambio Healthcare Solutions had never heard of organized labor before they came to Alameda County.

So now that they realize they will have to pay workers or they will continue to quit, what now? Well guess what, now they say they don’t have any money. As Charlie Ridgell pointed out, “the medical center had money when they signed over millions to Cambio for consultants, they had money for PR and PG &E, they even had an extra million for more Sheriffs at John George, they had enough money for a walkout and a lockout (over a million dollars), but now that they have to pay the people who actually do the work they’re flat broke. This is entirely unacceptable.”

I’ve got a bright idea, consultant costs and expenses would pretty much cover the cost of a fair raise for hospital workers, how about if the board of supervisors just goes to Cambio and asks for a refund? I don’t know about Cambio, but most of us little people doing the work don’t think this relationship is working out, maybe its time to say, “Adios Cambio! “

Sunday, October 17, 2004

Charlie’s Place

Why does the Alameda county board of supervisors dislike the medical center so much? Excellent question. Well, county supervisors have a huge budget (1,944,765,581 dollars) a bigger bureaucracy (8,658 budgeted positions) and hopelessly frustrated personal political careers. The supervisors don’t run the county the bureaucrats do: Chief Administrator Susan Muranishi, Director of Health Care Services Dave Kears and Sheriff Charlie Plummer. Every year Dave, Susan and Charlie divide up the tax dollars and throw a few crumbs to politician’s pet projects. So Gail Steele, Alice Lai-Bitker, Keith Carson, Nate Miley, and Scott Haggerty get to cut a few ribbons, do a few opening ceremonies, and fund a few non-profits. The county government has a responsibility to take care of the underserved, this means healthcare (for the uninsured and underinsured), behavioral health (the mentally ill), public assistance (welfare), public protection (courts and prisons) and general government in the unincorporated areas (this means municipal programs: schools libraries, sheriff’s and such.) They also do transportation, buses ect.

Here’s the rub, the poor, the sick, the incarcerated and the needy don’t vote much and they are not big donors to political campaigns either. So county supervisors spend most of their time sucking up to corporations, developers and non-profits that provide the services. Telecare, the biggest for profit mental health contractor in the county is a generous donator. Non-profits, lawyers, and consultants, now all of these people understand how county government works. They know how to support a campaign. Special interest groups and voter rich unincorporated areas also have lots of suction with the sups.

Every year Sheriff Charlie and Dave Kears duke it out over money and every year Charlie wins. Susan Muranishi’s primary contribution to the county is to create a budget and budget process so boring, complicated and convoluted that it would take a team of forensic accountants ten years to find an extra fifty cents. Meanwhile Dave or Susan can always find a little cash in the other shoe, should the need arise. So when political insiders need to get something done, they don’t go to a county supervisor, they go to Dave, Susan or Charlie.

Ok, enough of the civics lesson why don’t Dave and the Sups like the medical center. Well, Dave feels the county should be “purchaser not a provider” of healthcare services. It’s the greed is good philosophy. Besides bureaucrats prefer tidy little contracts with non-union organizations, keep the healthcare providers without a voice and employment protection.

Still what’s wrong with taking care of sick people? Well, here’s the real problem, you know those tidy contacts and neat little focused lean county programs: they don’t work. When someone doesn’t get enough general assistance to buy their medications and has a stroke, where do they go? The medical center. When Adult Protective Services fails to get a senior out of an unsafe home and they get hurt, where do they go? The medical center. When the Sheriff decides to compassionately release a felon who has cancer and can no longer walk, talk or take care of themselves, where do they go? The medical center. When a mental health case managed client has a psychotic episode and then withdraws, where do they go? The medical center. As Dave and Susan improve efficiency (cut services and ration care) more and more people fall through the cracks, the medical center catches them. The county supervisors and bureaucrats hate the medical center because it reminds them how miserably they have failed the people they are supposed to serve. They also hate the medical center’s staff who refuse to dump these clients back out on the streets without first addressing their needs, this costs.

So when the supervisors close the medical center where will people go? Well, for years the county prison system has enjoyed fat funding, infra-structural upgrades and political support. If the sick and needy become a nuisance or a political liability the police can just pick them up and take them to Charlie’s place, Santa Rita Prison.

Monday, October 11, 2004

Imagine if there weren't a county Medical Center

Well, today's Oakland Tribune opinion piece said it all.

To read "Imagine if there weren't a county Medical Center":

Click here

Thursday, October 07, 2004

Managing Up

Well, Cambio Health Solutions changed their mind. They decided they had better not layoff 180 staff and maybe they should have a word with some of the employees or at least check in with the Service Employees International Union before completely reorganizing the medical center. Gee, it took them nine months and two work actions to arrive at the obvious. I hope these guys know how to do something besides layoffs.

Thank goodness for healthcare unions. Apparently they’re all that is left between patients and bad business decisions. Medical center employees have used their unions to manage up; they helped the Board of Supervisors to see the dangers of caregiver cuts. They have also pointed out that hospital workers feel demoralized and fatigued, and that getting a contract signed and removing the threat of layoffs is a necessary first step toward making the medical center work.

In spite of the rhetoric, the Cambio executives still have an aversion to speaking to working people. You need a suit or an MD to be heard at the hospital. Joyce Mc Glory, the Head of Human Resources, is the notable exception; she likes Highland and actually listens to employees. The Board of Trustees is still escorted by sheriffs, as are some Cambio executives. Come on guys, we’re overworked healthcare providers, no one’s going to hurt you. Shoot, if you got assaulted we’d just have to take you over to the emergency department and fix you up, and in case you haven’t noticed we have plenty of business already.

Look here’s the deal, this isn’t a good staff; this is a great staff. These are the people you want to take care of you, if something happens. We have an antique computer system, broken wheelchairs, no infrastructure and we make it work. The Cambio team spent a couple million on scab labor during work actions and probably fifty grand on a payroll goof, how about spending five hundred on donuts and coffee and trying to cheer up your worn out employees before more good people quit.

In and Out of My Mind

I’m born and raised in Berkeley so reality for me is negotiable, but I lost myself a little. I found myself crying in the behavioral health clinic. I couldn’t focus; I sat there just leafing through the magazines not even looking at the pictures. Did you know they have Guns and Ammo magazines in the psychiatry waiting room? I’m no shrink, but I think it might be a better idea to put the gun magazines in the dermatology or podiatry departments. I never heard of the acne or hammertoe defense.

I must have been pretty messed up because Kaiser told me take a week off, I thought you had to be bleeding from a major artery to get a week off from Kaiser. They gave me one of those little information sheets. It said I had post-traumatic stress disorder. I read the sheets, I think this stuff might be contagious and I definitely think it’s going around the medical center. It’s not like a different reality, just all the worst parts of your usual reality over and over again. You get stuck bouncing if the walls of your own mind. It comes from too many bad things happening in rapid succession. Since the upcoming presidential election could be ugly, we should all fortify ourselves with good news, multivitamins and extra sleep.