Vote Health Letter to Hospital Authority

The Medical Center needs a permanent, experienced public hospital management team to establish a strategic vision for ACMC and to lead its restructuring effort. Cambio's part-time management team has not and cannot fulfill this role because they have no long term commitment to the success of the institution or to county residents who depend on ACMC for its life-saving services.

We are concerned that the Board of Trustees did not begin its search for a permanent CEO last year. Now that you contracted with Russell Reynolds Associates, we ask your board to:

· Expedite its efforts to hire a permanent CEO, and
· Allow the new CEO to hire the executive team of COO, CFO and HR Director.

We also ask that the Board of Trustees conduct a performance evaluation of Cambio and its management team, and make this review public. One year into Cambio's tenure at the Medical Center, the Trustees have yet to hold Cambio accountable for delivering on its promises. Some of these failures are reflected in the most recent financial report:

1. Registry use "hit new highs" of $1.7 million in December, and runs $2 million
over budget in just six months, a 30% variance;

2. Discharged Not Final Billed has risen for the past three months;

3. Medi-Cal is under-budget by over $12.5 million, while CMSP is over-budget by
$3 million;

4. Despite an investment of $300,000 into a "marketing campaign,"
obstetrical deliveries continue to decline.

We believe the quality of care at ACMC has suffered under Cambio’s leadership. The most egregious example of Cambio’s failures involves ACMC’s growing reliance on temporary nurses. The situation is particularly dangerous at John George, and in Highland's ER, ICU and TCU. Cambio's team of consultants and managers has only exacerbated a difficult situation. According to the HR Department, there were 117 RN vacancies in November, but ACMC conducted only five interviews that month. The Medical Center hired five RNs, but eight quit. In a letter to the Trustee's HR Committee, SEIU Local 616 wrote that Cambio has failed to act on its own recommendations regarding nurse recruitment and retention, contained in its May, 2004 Nursing Assessment.

The Medical Center's staff and patients, and county residents who fund this institution deserve better. Vote Health has confidence that you will act expeditiously to hire a permanent CEO and to hold Cambio accountable for its performance.

Sincerely yours,
Kay Eisenhower
Kay Eisenhower, Chair
Vote Health http://www.votehealth.net