County supervisors are poised to assume governance of Alameda Health System
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COUNTY NEWS
HEALTH CARE
—BITTER PILL—Governance of Alameda Health System (AHS), the county health care provider that operates Highland Hospital, San Leandro Hospital, and Alameda Hospital, among other facilities, has been a looming question for several years.
—In the midst of a venomous labor fight in 2020 between AHS management and SEIU Local 1021 that pulled the Alameda County Board of Supervisors into the fray, late Supervisors Wilma Chan and Richard Valle sought a new governance model for the beleaguered, debt-ridden health care provider.
—In a telling interaction between Valle and the AHS Board of Trustees back in October 2020, he told them, “Thank you for service. We appreciate what you have done to this point, but clearly you are no longer effective.”
—AHS is somewhat unique in county government. It receives county, state, and federal funding, but the Board of Supervisors do not have full oversight, as they do with most areas of county government. Instead, AHS’ is separate legal entity from the county. A nine-member Board of Trustees hold oversight powers over AHS.
—Over the years, as AHS has struggled and its debt to the county has been stubbornly static. Some county supervisors, to their consternation, have borne the brunt of public criticism about AHS.
—Supervisor Nate Miley expressed this sentiment last week, saying the public perception with AHS is “all roads lead to the Board of Supervisors.” The board is not privy to any of AHS’ negotiations, including labor and legal issues, Miley said.
—Meanwhile, there now appears support building for the Board of Supervisors to take over governance of AHS going forward.
—A proposal, labeled Option 1, is backed by SEIU Local 1021, and James Jackson, AHS’ chief executive officer, and would give the Board of Supervisors ultimate authority and responsibility over AHS, while allowing the health care provider to continue as a public hospital authority.
—As an aside, Jackson reported labor relations between AHS management and SEIU Local 1021 have greatly improved since their battles in recent years.
—In addition, under the proposal, the Board of Supervisors would have power to hire and fire AHS’ chief executive officer, and have full budget authority.
—Under Option 1, which was one of three offered to the board last week, the AHS Board of Trustees would be refashioned as an oversight board.
—There could be some issues associated with AHS remaining as the public hospital authority and the Board of Supervisors assuming governance powers, county staff believes, such as dual loyalties that could arise if county supervisors and AHS trustees are on opposite sides of a negotiation.
—For Alameda residents and Alameda Hospital, the change in governance could affect a Joint Powers Agreement between AHS and the City of Alameda to operate the hospital facility. The county is not part of the Alameda Hospital JPA.
—For Hayward and South County residents, discussion of AHS’ governance model also raises concerns about St. Rose Hospital, the long-struggling indigent care facility in South Hayward.
—In a signal the county may be edging toward absorbing St. Rose Hospital into AHS at some point, Supervisor Lena Tam said any new affiliation between the county and AHS needs to be structured, if such an opportunity arises.
—However, bringing St. Rose Hospital under the umbrella of AHS has discussed several times over the past decade.
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