Trustees who oversee public health hospitals fired
Board of Supervisors out to revamp system with ‘severe problems’
OAKLAND >> In a dramatic move following a five-hour public hearing riddled with complaints from disgruntled employees and union representatives Tuesday, Alameda County supervisors fired all the trustees who govern the county’s public health care system.
The shake-up also includes reviewing how Alameda Health System is governed and coming up with proposals for changing it.
The board’s decision follows 3,000 nurses and other health care workers walking off the job for five days over what they allege has been the administration’s bad faith during contract talks and its failure to protect them and patients amid the COVID-19 pandemic.
“We have never seen the kind of chaos as we have seen at AHS with people who are on the front lines,” Supervisor Richard Valle said. “Clearly, there’s severe problems.”
The strike cost the hospital system $10 million, according to supervisors.
Each trustee has the option of submitting a letter by Nov. 6 saying why he should keep his position. Supervisors will review the applications. The dismissals will take effect Nov. 30.
And anyone wishing to serve as a new trustee must submit a résumé before Nov. 6.
Supervisors aim to have a new nine-member board in place by Dec. 1, a quick timeline aimed at avoiding additional instability amid the pandemic.
The Alameda Health System operates Oakland’s Highland Hospital, San Leandro and Alameda hospitals, as well as John
George Psychiatric Hospital and nine other health care facilities.
County supervisors have authority over the system, which serves as a safety net for homeless people and low-income residents. The health care system’s trustees, appointed by supervisors, oversee its operation.
Supervisors want to revamp how the network is run, including finding ways for more direct accountability between its chief executive officer and trustees over operations and finances, more collaboration between management and employees and full transparency by the administration about problems within the system.
“We are facing some huge questions and difficulties in the Alameda Health System,” Supervisor Wilma Chan said during the meeting. “There really is a problem right now regarding trust, accountability, and it’s not an easy thing to resolve.”
A subcommittee of supervisors plans to meet with the system’s administrators, union leaders and representatives from other public health agencies early in December or January to craft recommendations on what changes should take place going forward.
The full board will consider the proposals before March.
“There’s not a trustee that does not agree that we have to look at the governing structure,” trustee Dr. Noha Aboelata told supervisors. But current trustees should remain until changes in how the network operates take effect, she said.
“In my opinion, (otherwise) you will be taking two steps backward rather than one step forward,” Aboelata said.
About 50 people spoke over more than five hours as supervisors considered the network’s fate.
Among them were hospital administrators and vendors who work with Alameda Health System. They praised its services and especially the leadership of Delvecchio Finley, its chief executive officer.
But Chan noted that last November, Finley sent a letter — without consulting trustees or supervisors — announcing that women’s health services would end at Highland Hospital and inpatient beds no longer would be available at John George Psychiatric Hospital because of budget constraints.
A decision about such sweeping changes should not be made unilaterally, she said. It apparently left staffers at the facilities confused about what services they would be providing.
“It also turned out that none of those came to pass,” Chan said, citing it as one of the reasons why supervisors decided a shake-up was needed.
Finley did not respond to requests for comment.
Alameda Health System also has not had a chief financial officer for more than a year, Chan said. “For a billion- dollar operation, that’s risky,” she said during an interview Wednesday.
The strike earlier this month was “the tipping point,” Chan said.
Supervisor Nate Miley said the county shares responsibility for the problems at Alameda Health System because the health care provider is under its authority.
“I think we are also culpable,” Miley said during Tuesday’s meeting. “It’s the model that has caused the problem.”
On Tuesday, nurses complained about working conditions, saying the network does not respect those on the front line with patients.
“Those of us who take care of patients each day need this change to happen,” said John Pearson, an emergency room nurse at Highland Hospital.
But Dr. Neha Gupta, a primary physician with Alameda Health System, urged supervisors to hold off on firing trustees.
“My patients are the sickest they have ever been,” Gupta said. “But thankfully, our system is capable of taking care of them. Now more than ever we need our leadership structure to be stable.”
Dr. David Tian, a doctor at Highland, said he was worried the system’s leadership would come to a “standstill” if trustees are dismissed.
“It sounds like a labor discussion (is taking place),” Tian told supervisors. “I have to call that out. How will it help patients?”
Supervisor Keith Carson abstained on both the vote for firing trustees and reviewing how the system is governed, saying he wanted more information. All other supervisors voted yes for both actions.
The strike involved the California Nurses Association, which represents nurses in Alameda and San Leandro, and Service Employees International Union Local 1021, which represents nurses and workers at Highland Hospital.
The nurses association has been in contract talks for two years. SEIU has been negotiating since January.
“We have been fighting for a long time to bring a structural change to the way AHS is funded and governed,” SEIU 1021’s Veronica Palacios, an eligibility specialist at Highland, said in a statement Wednesday. “The current board of trustees mismanaged the system, and it hurt our patients, and it hurt our workers. This is an exciting and proud moment for AHS workers; it’s a huge milestone. We are feeling hopeful that the Board of Supervisors is returning AHS workers and patients to safe hands.”