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PUBLIC NOTICECITY OF ALAMEDA HEALTH CARE DISTRICT
BOARD OF DIRECTORSAGENDA
Monday, July 12, 2010 – 6:00 p.m.Location: Alameda Hospital (Dal Cielo Conference Room)
2070 Clinton Avenue, Alameda, CA 94501
Office of the Clerk: (510) 814-4001
Regular Meeting
Members of the public who wish to comment on agenda items will be given an opportunity before or during the considerationof each agenda item. Those wishing to comment must complete a speaker card indicating the agenda item that they wish toaddress and present to the District Clerk. This will ensure your opportunity to speak. Please make your comments clear andconcise, limiting your remarks to no more than three (3) minutes.
I. Call to Order (6:00 p.m. – 2 East Board Room) Jordan Battani
II. Roll Call Kristen Thorson
III. Adjourn into Executive Closed Session
IV. Closed Session Agenda
A. Approval of Closed Session Minutes
B. Medical Executive Committee Report and Approval ofCredentialing Recommendations
H & S Code Sec. 32155
C. Board Quality Committee Report (BQC) H & S Code Sec. 32155
D. Consultation with Legal Counsel Regarding Pending Litigation Gov’t Code Sec. 54956.9(a)
E. Discussion of Pooled Insurance Claims Gov’t Code Sec. 54956.95
F. Instructions to Bargaining Representatives Regarding Salaries,Fringe Benefits and Working Conditions
Gov’t Code Sec. 54957.6
G. Discussion of Report Involving Trade Secrets
1. Discussion of Hospital Trade Secrets applicable to development ofnew hospital services, programs and facilities. No action will be taken.
2. Discussion of Hospital Trade Secrets applicable to development ofnew hospital services, programs and facilities. No action will be taken.
3. Discussion of Hospital Trade Secrets applicable to development ofnew hospital services, programs and facilities. No action will be taken.
4. Discussion of Hospital Trade Secrets applicable to development ofnew hospital services, programs and facilities. No action will be taken.
H & S Code Sec. 32106
1
City of Alameda Health Care DistrictAgenda – July 12, 2010
2 of 3
H. Public Employee Performance Evaluation Title: Chief ExecutiveOfficer
Gov’t Code Sec 54957
V. Reconvene to Public Session (Expected to start at 7:30 p.m. – Dal Cielo Conference Room)
A. Announcements from Closed Session Jordan Battani
VI. Consent Agenda
A. Approval of June 7, 2010 Minutes ACTION ITEM [enclosure] (PAGES 4-14)
B. Approval of June 23, 2010 Minutes ACTION ITEM [enclosure] (PAGES 15-17)
C. Acceptance of May 2010 Financial Statements ACTION ITEM [enclosure] (PAGES 18-38)
D. Approval of Resolution 2010-2H Levying the City of Alameda Health Care District ParcelTax for the Fiscal Year 2010-2011 ACTION ITEM [enclosure] (PAGES 39-40)
E. Approval of Certification of Taxes, Assessments and Fees ACTION ITEM [enclosure] (PAGES 41-42)
VII. Regular Agenda
A. President’s Report
1) Approval to Cancel August Board Meeting ACTION ITEM
2) Consideration of Special Board Meeting to DiscussStrategic Planning
Jordan Battani
B. Chief Executive Officer’s Report
1) Recommendation to Approve OPEIU, Local #29Memorandum of Understanding (Agreement) ACTION ITEM[enclosure] (PAGES 43-57)
2) Information and Timeline Regarding November 2010General Election [enclosure] (PAGES 58-62)
3) City Council Presentation “Update on the Hospital” –September 7, 2010
4) Monthly Statistics
5) Facilities Update
a. Seismic
b. Program Development
Deborah E. Stebbins
Deborah E. Stebbins
Deborah E. Stebbins
Deborah E. Stebbins
Kerry Easthope
C. Community Relations and Outreach Report
1) Committee Report – June 8, 2010 Rob Bonta
2
City of Alameda Health Care DistrictAgenda – July 12, 2010
3 of 3
D. Finance and Management Committee Report
1) Committee Report – June 30, 2010
2) Approval of FYE 2011 Operating Budget ACTION ITEM[enclosure] (PAGES 63-71)
Jordan Battani
David A. Neapolitan
E. Medical Staff President Report Alka Sharma, MD
VIII. General Public Comments
IX. Board Comments
X. Adjournment
3
Min
ute
s o
f th
e B
oa
rd
of
Dir
ect
ors
Ju
ne 7
, 201
0 D
irec
tors
Pre
sent
: Jo
rdan
Bat
tani
R
ober
t Bon
ta
Rob
ert D
euts
ch, M
D
J. M
icha
el M
cCor
mic
k
Man
agem
ent P
rese
nt:
Deb
orah
E. S
tebb
ins
Ker
ry J.
Eas
thop
e D
avid
A. N
eapo
litan
Med
ical
Sta
ff Pr
esen
t:
Alk
a Sh
arm
a, M
.D.
Leg
al C
ouns
el P
rese
nt:
Thom
as D
risco
ll, E
sq.
E
xcus
ed:
Subm
itted
by:
Le
ah W
illia
ms
Ja
clyn
Yus
on
A
ctio
n
1.
Cal
l to
Ord
er
Jord
an B
atta
ni c
alle
d th
e O
pen
Sess
ion
of th
e B
oard
of D
irect
ors o
f the
City
of
Ala
med
a H
ealth
Car
e D
istric
t to
orde
r at 6
:13
p.m
.
2.
Rol
l Cal
l K
riste
n Th
orso
n ca
lled
roll,
not
ing
that
a q
uoru
m o
f Dire
ctor
s wer
e pr
esen
t.
3.
Adj
ourn
into
Exe
cutiv
e C
lose
d Se
ssio
n
At 6
:14
p.m
. the
mee
ting
adjo
urne
d to
Exe
cutiv
e C
lose
d Se
ssio
n.
4
4.
Rec
onve
ne to
Pub
lic
Sess
ion
A.
Ann
ounc
emen
ts fr
om C
lose
d Se
ssio
n
Dire
ctor
Bat
tani
reco
nven
ed th
e m
eetin
g in
to p
ublic
ses
sion
at 7
:59
p.m
. The
fo
llow
ing
clos
ed se
ssio
n an
noun
cem
ents
wer
e m
ade.
[1
] Clo
sed
Sess
ion
min
utes
–M
ay 3
, 201
0 an
d M
ay 1
8, 2
010
[2] M
edic
al E
xecu
tive
Com
mitt
ee R
epor
t and
App
rova
l of C
rede
ntia
ling
Rec
omm
enda
tions
[3
] Th
e B
oard
Qua
lity
Com
mitt
ee (B
QC
) Rep
ort –
Mar
ch 2
010
[1
] The
Clo
sed
Sess
ion
Min
utes
fo
r May
3, 2
010,
and
May
18,
20
10 w
ere
appr
oved
. [2
] The
Med
ical
Exe
cutiv
e C
omm
ittee
Rep
ort a
nd
Cre
dent
ialin
g R
ecom
men
datio
ns
wer
e ap
prov
ed a
s pre
sent
ed
belo
w.
[3] T
he M
arch
201
0 BQ
C re
port
was
acc
epte
d as
pre
sent
ed.
R
eapp
oint
men
ts –
Med
ical
Sta
ff
Nam
e Sp
ecia
lty
Stat
us
App
oint
men
t Per
iod
○
Dav
id B
elk,
MD
In
tern
al M
edic
ine
Act
ive
07/0
1/10
– 0
6/30
/12
○
Oliv
ia B
utt,
MD
G
ynec
olog
y A
ctiv
e 07
/01/
10 –
06/
30/1
2
○ Ja
cque
line
DeC
ayet
te, M
D
Ane
sthe
siol
ogy
Cou
rtesy
07
/01/
10 –
06/
30/1
2
○ Ja
gmoh
an K
haira
, MD
In
tern
al M
edic
ine
Act
ive
07/0
1/10
– 0
6/30
/12
○
Will
iam
Lew
is, M
D
Oto
lary
ngol
ogy
Cou
rtesy
07
/01/
10 –
06/
30/1
2
○ Er
ic O
tani
, MD
Em
erge
ncy
Med
icin
e A
ctiv
e 07
/01/
10 –
06/
30/1
2
Res
igna
tions
Nam
e Sp
ecia
lty
○
Julie
Bro
wn,
CR
NA
N
urse
Ane
sthe
tist
○
Barr
y C
hant
relle
, MD
N
ephr
olog
y
○
Ric
ardo
Cha
rles,
CR
NA
N
urse
Ane
sthe
tist
○
Nik
hil D
esai
, MD
O
ral/M
ax S
urge
ry
5
○
Jam
es F
agan
, DPM
Po
diat
ry
○
John
Hat
ch, C
RN
A
Nur
se A
nest
hetis
t
○
Ther
esa
Hic
key,
MD
A
nest
hesi
olog
y
○
Dia
ne N
ishik
awa,
CR
NA
N
urse
Ane
sthe
tist
○
Ken
neth
Raa
p, D
PM
Podi
atry
○
Nan
cy S
aund
ers,
CRN
A
Nur
se A
nest
hetis
t
○
Cha
rlotte
Shu
m, M
D
Orth
oped
ics
○
Rob
ert W
agne
r, M
D
Ora
l/Max
Sur
gery
5.
C
onse
nt A
gend
a
[A] A
ppro
val o
f May
3, 2
010
Min
utes
[B] A
ppro
val o
f May
18,
201
0 M
inut
es
The
May
3, 2
010
min
utes
had
add
ition
al in
form
atio
n ad
ded
afte
r the
June
bo
ard
pack
ets h
ad b
een
dist
ribut
ed. T
he re
vise
d m
inut
es w
ere
dist
ribut
ed to
the
Boar
d m
embe
rs a
t the
mee
ting
for r
evie
w.
Cha
nges
to th
e m
inut
es w
ill b
e re
flect
ed o
nlin
e as
wel
l as i
n th
e or
igin
al fi
le lo
cate
d in
the
Dist
rict C
lerk
’s
offic
e.
D
irect
or M
cCor
mic
k w
as p
rese
nt d
urin
g th
e Ex
ecut
ive
Clo
sed
Sess
ion
and
step
ped
out d
urin
g th
e be
ginn
ing
porti
on o
f the
Ope
n Se
ssio
n m
eetin
g to
atte
nd
to a
per
sona
l mat
ter.
Dire
ctor
Deu
tsch
mov
ed to
ap
prov
e th
e C
onse
nt A
gend
a as
pr
esen
ted.
Dire
ctor
Bon
ta
seco
nded
the
mot
ion.
The
mot
ion
carr
ied
unan
imou
sly.
6.
Reg
ular
Age
nda
A.
Aux
iliar
y A
nnua
l Rep
ort t
o th
e B
oard
Ms.
Joan
ne S
erge
nt, P
resi
dent
of t
he A
uxili
ary
Dep
artm
ent,
prov
ided
an
annu
al re
port
to th
e B
oard
. Ms.
Serg
eant
ann
ounc
ed th
at th
ere
will
be
a ne
w
Aux
iliar
y Pr
esid
ent a
nd V
ice
Pres
iden
t for
201
1, L
inda
Lin
gles
er a
nd T
omm
ie
And
erso
n, re
spec
tivel
y.
As p
rese
nted
in th
e an
nual
repo
rt, th
e A
uxili
ary
Dep
artm
ent h
as a
ppro
xim
atel
y $3
8,48
4.57
in th
e A
uxili
ary
acco
unt a
nd $
28,0
86.0
5 in
the
Gift
Sho
p ac
coun
t.
Oth
er so
urce
s of
reve
nue
for t
he A
uxili
ary
Dep
artm
ent a
re: D
omin
o an
d Br
idge
Mar
atho
ns, M
emor
ial d
onat
ions
, and
ven
ding
mac
hine
s.
This
year
, the
Aux
iliar
y pr
ovid
ed a
gift
to th
e H
ospi
tal i
n th
e am
ount
of
6
$40,
000
to p
urch
ase
two
surg
ical
bed
s.
On
beha
lf of
the
Med
ical
Sta
ff an
d B
oard
of D
irect
ors,
Dr.
Shar
ma,
Dire
ctor
Bo
nta,
and
Dr.
Deu
tsch
ext
end
thei
r sin
cere
gra
titud
e an
d ap
prec
iatio
n to
war
d th
e A
uxili
ary
team
for a
ll th
eir h
ard
wor
k an
d ef
forts
in p
atie
nt c
are
and
assis
tanc
e w
ith p
rovi
ding
anc
illar
y se
rvic
es to
pat
ient
s and
thei
r fam
ilies
.
At 8
:04
p.m
. Dire
ctor
McC
orm
ick
join
ed th
e O
pen
Sess
ion
mee
ting.
B.
Pres
iden
t’s R
epor
t 1.
R
eque
st to
Mov
e Ju
ly 2
010
Dist
rict B
oard
Mee
ting
Dire
ctor
Bat
tani
has
requ
este
d to
the
Boa
rd to
mov
e th
e Ju
ly B
oard
mee
ting
to
July
12,
201
0.
2.
A
dopt
ion
of F
Y 2
010
Exec
utiv
e Pe
rfor
man
ce M
etric
s A
revi
sed
FY 2
010
Exec
utiv
e Pe
rfor
man
ce M
etric
s doc
umen
t was
dist
ribut
ed
to th
e B
oard
Mem
bers
as a
dditi
onal
edi
ts /
corr
ectio
ns h
ad b
een
mad
e af
ter t
he
dist
ribut
ion
of th
e B
oard
Pac
kets
. C
hang
es to
the
docu
men
t will
be
refle
cted
on
line
as w
ell a
s in
the
orig
inal
file
loca
ted
in th
e D
istric
t Cle
rk’s
off
ice.
Dire
ctor
Bat
tani
disc
usse
d th
e FY
201
0 Ex
ecut
ive
Perf
orm
ance
Met
rics a
nd
ince
ntiv
e pr
ogra
m. D
irect
or B
atta
ni in
dica
ted
the
Chi
ef E
xecu
tive
Off
icer
re
ceiv
es a
bas
e sa
lary
and
an
addi
tiona
l pay
out
per
cent
age
whi
ch is
bas
ed o
n th
e ac
hiev
emen
t of t
he m
etric
s upo
n a
perf
orm
ance
eva
luat
ion.
Th
e do
llar a
mou
nts,
actio
ns, a
nd p
erfo
rman
ce it
ems r
efle
cted
in th
e Ex
ecut
ive
Perf
orm
ance
Met
rics d
ocum
ent a
re th
ose
that
wer
e ag
reed
on
by th
e B
oard
in
the
orig
inal
bud
get p
ropo
sal w
ith th
e ex
cept
ion
of a
new
per
form
ance
met
ric
that
had
bee
n ad
ded
unde
r “O
pera
tiona
l Suc
cess
” in
rega
rds t
o in
crea
sing
su
rgic
al v
olum
e fr
om A
lam
eda
surg
eons
bet
wee
n A
pril-
June
201
0 to
exc
eed
June
200
9 –
Mar
ch 2
010
mon
thly
ave
rage
s by
10%
. A
New
Bus
ines
s Dev
elop
men
t goa
l had
also
bee
n ad
ded
to th
e pl
an in
dica
ting
the
deve
lopm
ent o
f new
bus
ines
ses a
nd p
rogr
am d
evel
opm
ent p
roje
cts t
hat
will
ens
ure
long
-term
fina
ncia
l via
bilit
y w
hile
redu
cing
the
relia
nce
on u
se o
f th
e pa
rcel
tax
for o
pera
tiona
l pur
pose
s.
Dire
ctor
Bon
ta st
ated
that
the
re-a
lignm
ent o
f the
wei
ghtin
g is
appr
opria
te w
ith
Dire
ctor
Bon
ta m
ade
a m
otio
n to
ap
prov
e m
ovin
g th
e Ju
ly 2
010
Boar
d M
eetin
g to
a la
ter d
ate.
Mr.
McC
orm
ick
seco
nded
the
mot
ion.
Th
e m
otio
n ca
rrie
d un
anim
ousl
y.
Dire
ctor
Bon
ta m
ade
a m
otio
n to
ad
opt t
he F
Y 2
010
Exec
utiv
e Pe
rfor
man
ce M
etric
s. M
r. M
cCor
mic
k se
cond
ed th
e m
otio
n.
The
mot
ion
carr
ied
unan
imou
sly.
7
this
year
’s g
oals.
He
felt
that
the
Exec
utiv
e Pe
rfor
man
ce M
etric
s was
an
exce
llent
tool
for t
he B
oard
to u
se w
hen
eval
uatin
g pe
rfor
man
ce. D
irect
or
McC
orm
ick
and
Dr.
Deu
tsch
wer
e in
favo
r the
per
form
ance
met
rics a
s wel
l.
C
. C
hief
Exe
cutiv
e O
ffice
r’s R
epor
t
1.
Rec
omm
enda
tion
to A
ppro
ve I.
L.W
.U L
ocal
6 M
emor
andu
m
of U
nder
stan
ding
(Agr
eem
ent)
Ms.
Steb
bins
stat
ed th
at m
anag
emen
t is r
ecom
men
ding
that
the
Boa
rd ra
tify
a te
ntat
ive
agre
emen
t with
Loc
al 6
whi
ch re
pres
ents
Dia
gnos
tic Im
agin
g Te
chno
logi
sts,
Radi
olog
y A
ides
, and
Rec
eptio
nist
s.
Man
agem
ent h
as b
een
nego
tiatin
g w
ith L
ocal
6 si
nce
thei
r con
tract
end
ed o
n Ju
ne 3
0, 2
009.
Key
issu
es a
nd/o
r mod
ified
term
s of t
he L
ocal
6 a
gree
men
t are
as
follo
ws:
Fou
r (4)
yea
r ter
m (0
7/1/
09 –
6/3
0/10
), an
18-
mon
th w
age
free
ze
from
07/
01/0
9 –
12/3
0/10
, wag
e op
ener
on
12/3
1/10
, and
wag
e an
d gr
oup
heal
th p
lan
bene
fits o
pene
r on
6/30
/11
and
6/30
/12.
Loc
al 6
mem
bers
un
anim
ousl
y ag
reed
to th
e te
rms
of th
e ag
reem
ent.
Mr.
East
hope
pra
ised
Phyl
lis W
eiss
, Dire
ctor
of H
uman
Res
ourc
es, f
or h
er
hard
wor
k an
d ef
forts
in g
athe
ring
data
as w
ell a
s Loc
al 6
(the
uni
on
repr
esen
tativ
e, a
nd sh
op st
ewar
d) fo
r bei
ng a
mia
ble
durin
g th
e ne
gotia
tion
proc
ess.
D
irect
or B
atta
ni st
ated
the
outc
ome
of th
e ag
reem
ent r
efle
cts p
artn
ersh
ip
betw
een
the
Hos
pita
l and
Loc
al 6
mai
ntai
ning
a jo
int c
omm
itmen
t to
the
viab
ility
and
stab
ility
of t
he o
rgan
izat
ion.
M
s. St
ebbi
ns c
omm
ende
d bo
th M
r. Ea
stho
pe a
nd M
s. W
eiss
for b
eing
goo
d ne
gotia
ting
partn
ers.
2.
Med
i-Cal
Con
tract
Upd
ate
/ Ala
med
a A
llian
ce
Ms.
Steb
bins
ann
ounc
ed th
at in
May
the
Hos
pita
l rea
ched
agr
eem
ent w
ith
CM
AC
, the
con
tract
ing
nego
tiatin
g bo
dy fo
r Med
i-Cal
con
tract
s on
a sta
te
wid
e ba
sis. B
ack
in 2
007,
the
Hos
pita
l ter
min
ated
the
Med
i-Cal
con
tract
as t
he
leve
l of r
eim
burs
emen
t was
not
ade
quat
e to
cov
erin
g th
e co
st to
car
e fo
r Med
i-C
al p
atie
nts a
t Ala
med
a H
ospi
tal.
Dire
ctor
Deu
tsch
mad
e a
mot
ion
to a
ppro
ve th
e I.L
.W.U
Loc
al 6
M
emor
andu
m o
f Und
erst
andi
ng
(Agr
eem
ent).
Mr.
McC
orm
ick
seco
nded
the
mot
ion.
The
mot
ion
carr
ied
unan
imou
sly.
8
Hos
pita
l man
agem
ent m
ade
this
deci
sion
in re
cogn
ition
of t
he d
iffic
ulty
Med
i-C
al p
atie
nts h
ave
in a
cces
sing
hea
lth c
are
both
on
the
hosp
ital a
nd p
hysi
cian
le
vel.
In a
dditi
on, a
n op
portu
nity
aro
se fo
r Dist
rict h
ospi
tals
that
hav
e M
edi-
Cal
con
tract
s to
rece
ive
som
e fe
dera
l mat
chin
g fu
nds t
hrou
gh a
n in
terg
over
nmen
tal t
rans
fer (
IGT)
as a
dditi
onal
com
pens
atio
n fo
r the
pro
visi
on
of c
are
to M
edi-C
al p
atie
nts.
The
new
con
tract
with
the
Stat
e ca
lls fo
r the
Hos
pita
l rec
eivi
ng a
subs
tant
ial
decl
ine
in re
imbu
rsem
ent c
ompa
red
to w
hat w
as re
ceiv
ed w
ith n
o co
ntra
ct in
pl
ace.
How
ever
, the
mat
chin
g fu
nds r
ecei
ved
thro
ugh
the
IGT
will
hel
p of
f-set
th
e re
venu
e lo
ss fr
om re
duce
d ra
tes.
The
Hos
pita
l has
sinc
e re
ceiv
ed th
e m
atch
ing
fund
s.
Ms.
Steb
bins
men
tione
d th
at A
lam
eda
Alli
ance
, a H
MO
mod
el, s
erve
s Med
i-C
al p
atie
nts i
n th
e co
unty
and
has
impr
oved
thei
r rei
mbu
rsem
ent r
ates
allo
win
g ph
ysic
ians
to tr
eat m
ore
Med
i-Cal
pat
ient
s.
Man
agem
ent i
s pla
nnin
g to
mak
e a
publ
ic p
ress
rele
ase
statin
g th
e ch
ange
in
dica
ting
the
Hos
pita
l now
acc
epts
Med
i-Cal
pat
ient
s.
3.
Fa
cilit
ies
Upd
ate
a.
Seis
mic
M
r. Ea
stho
pe p
rovi
ded
a se
ism
ic u
pdat
e to
the
Boa
rd. R
atcl
iff A
rchi
tect
s is i
n ch
arge
of b
oth
stru
ctur
al a
nd k
itche
n re
loca
tion
proj
ects
. Man
agem
ent h
ad
give
n R
atcl
iff a
“N
otic
e to
Pro
ceed
” de
taili
ng th
e de
sign
pla
n re
gard
ing
the
kitc
hen
relo
catio
n pr
ojec
t for
OSH
PD. S
truct
ural
and
kitc
hen
plan
s will
be
subm
itted
to O
SPH
D u
nder
one
per
mit
as it
is b
eing
man
aged
und
er o
ne
proj
ect.
Jtec
h H
CM
, the
Con
stru
ctio
n M
anag
emen
t firm
, has
bee
n ch
osen
to o
vers
ee
cons
truct
ion
man
agem
ent s
eism
ic w
ork
and
SB 1
953
com
plia
nce.
M
anag
emen
t and
Jtec
ent
ered
into
a $
135,
000
agre
emen
t. So
me
of J
tec’
s pr
iorit
ies t
hey
are
curr
ently
wor
king
on
are:
par
ticip
atin
g in
wee
kly
mee
tings
th
at m
anag
emen
t has
with
the
arch
itect
and
eng
inee
ring
firm
s reg
ardi
ng d
esig
n an
d O
SHPD
subm
ittal
, pro
ject
mas
ter p
lan
and
sche
dule
, pro
ject
mas
ter
budg
et, a
nd th
e de
velo
pmen
t of b
id d
ocum
ents
. A
noth
er se
ism
ic re
quire
men
t is N
PC3 (N
on-S
truct
ural
Pla
ns) w
ork
invo
lvin
g br
acin
g an
d an
chor
ing
whi
ch h
ave
been
app
rove
d by
OSP
HD
.
9
Ther
e is
a po
ssib
ility
the
Hos
pita
l can
get
app
rove
d fo
r an
exte
nsio
n un
der S
B 4
99 to
def
er th
is pr
ojec
t for
a fe
w y
ears
. M
anag
emen
t is
mee
ting
with
a fi
nanc
ial c
onsu
ltant
Gar
y H
icks
to
disc
uss s
trate
gy a
nd ti
min
g fo
r sei
smic
pro
ject
fina
ncin
g at
the
end
of
June
.
b.
Prog
ram
Dev
elop
men
t M
r. Ea
stho
pe p
rovi
ded
an u
pdat
e on
the
expa
nsio
n of
the
suba
cute
uni
t. M
anag
emen
t has
eng
aged
and
arc
hite
ctur
al fi
rm, A
nshe
n A
llen,
to
perfo
rm fe
asib
ility
and
con
stru
ctab
ility
ana
lysi
s fo
r exp
andi
ng th
e su
b ac
ute
prog
ram
by
addi
ng m
ore
beds
in th
e 3-
Wes
t nur
sing
uni
t. M
anag
emen
t rec
eive
d an
d re
view
ed a
n in
itial
dra
ft fe
asib
ility
pla
n w
hich
pro
vide
d fo
r a n
et in
crea
se o
f 8 su
b ac
ute
beds
at a
n es
timat
ed
cost
of $
2.4
to $
2.8
mill
ion.
Ski
lled
nurs
ing
has
mor
e ac
cess
ibili
ty
requ
irem
ents
. Roo
ms a
nd sp
aces
aro
und
the
beds
nee
d to
be
mor
e sp
acio
us, d
oors
nee
d to
be
wid
er, r
oom
s ne
ed to
be
bigg
er, v
entil
atio
n sy
stem
nee
ds to
be
re-d
one,
etc
. M
anag
emen
t req
uest
ed a
seco
ndar
y pl
an re
view
that
wou
ld a
llow
for a
ne
t inc
reas
e of
10
beds
, and
wra
p th
e pr
ogra
m a
roun
d to
the
first
room
on
3-S
outh
. D
irect
or M
cCor
mic
k as
ked
for c
larif
icat
ion
on th
e es
timat
ed
cont
ribut
ion
mar
gin
per s
ub a
cute
bed
. Mr.
East
hope
said
the
estim
ated
co
ntrib
utio
n m
argi
n is
abou
t $10
0,00
0.00
per
bed
.
M
anag
emen
t is a
lso lo
okin
g in
to p
oten
tial h
ealth
car
e pa
rtner
s and
/or
foun
datio
n gr
ants
to fu
nd th
is ca
pita
l pro
ject
. A
noth
er p
lan
unde
rway
is th
e po
tent
ial d
evel
opm
ent o
f an
Acu
te R
ehab
Pr
ogra
m. A
dmin
istra
tion
has
had
seve
ral d
iscu
ssio
ns w
ith A
cute
Reh
ab
Car
e re
gard
ing
a po
tent
ial p
artn
ersh
ip to
impl
emen
t and
ope
rate
an
Acu
te R
ehab
Pro
gram
. The
2-S
outh
nur
sing
uni
t wou
ld b
e a
pote
ntia
l lo
catio
n fo
r thi
s pro
gram
. The
mar
ket p
ro fo
rma
and
phys
ical
spac
e in
dica
tes t
hat t
he u
nit c
ould
supp
ort a
12
bed
prog
ram
.
10
New
Acu
te R
ehab
pro
gram
s m
ust b
egin
ope
ratio
n on
July
1, p
er C
MS
certi
ficat
ion/
reim
burs
emen
t req
uire
men
ts. I
f man
agem
ent d
ecid
es to
pr
ocee
d w
ith th
is pr
ogra
m, J
uly
1, 2
011
wou
ld b
e th
e tim
e to
beg
in th
e A
cute
Reh
ab P
rogr
am.
Man
agem
ent i
s wai
ting
for a
dditi
onal
dat
a to
bet
ter u
nder
stan
d th
e m
arke
t dem
and
and
enha
ncem
ent s
ervi
ce th
at w
ould
supp
ort t
his
prog
ram
.
Dire
ctor
Bat
tani
ask
ed if
the
reno
vatio
ns fo
r thi
s pro
ject
wou
ld re
quire
O
SHPD
app
rova
l. M
r. Ea
stho
pe st
ated
this
prog
ram
wou
ld n
eed
OSH
PD re
view
and
app
rova
l.
4.
Bo
ard
Educ
atio
nal O
ppor
tuni
ty
Ms.
Steb
bins
stat
ed th
at th
e D
irect
ors R
ound
tabl
e is
invi
ting
Boa
rd o
f D
irect
ors t
o at
tend
a p
rogr
am p
erta
inin
g to
“K
ey Is
sues
Fac
ing
Boa
rds o
f D
irect
ors:
Pros
perin
g in
a P
ost H
ealth
Ref
orm
Wor
ld th
e R
evol
utio
n in
Hea
lth
Car
e an
d O
ther
Ben
efits
.” T
he c
onfe
renc
e w
ill b
e he
ld o
n W
edne
sday
, Jun
e 16
, 20
10 a
t 9:0
0 a.
m. –
11:
00 a
.m. i
n Sa
n Fr
anci
sco.
D
irect
or B
atta
ni m
entio
ned
she
will
not
be
able
to a
ttend
the
mee
ting.
H
owev
er, s
he e
ncou
rage
s oth
er B
oard
mem
bers
to a
ttend
as s
he h
as a
lway
s le
arne
d a
lot o
f inf
orm
atio
n fr
om p
ast c
onfe
renc
es fr
om P
rice
Wat
er H
ouse
C
oope
rs sp
eake
rs.
5.
M
onth
ly S
tatis
tics
Ms.
Steb
bins
repo
rted
the
key
stat
istic
s for
May
201
0. A
vera
ge D
aily
Cen
sus
was
und
er b
udge
t at 8
4.2
vers
us a
bud
get o
f 89.
1. A
cute
cen
sus
was
bel
ow
budg
et, 2
7.6
vers
us a
bud
get o
f 34.
3. S
ubac
ute
and
Sout
h Sh
ore
wer
e ab
ove
budg
et a
t 33.
5 an
d 23
.2, r
espe
ctiv
ely.
Tot
al P
atie
nt D
ays w
ere
5% b
elow
bu
dget
, 2,6
10 v
ersu
s a b
udge
t of 2
,763
. ER
Vis
its w
ere
unde
r bud
get b
y 2%
, 1,
436
com
pare
d to
a b
udge
t of 1
,465
. Tot
al O
utpa
tient
Reg
istra
tions
wer
e be
low
bud
get,
1,97
2 ve
rsus
a b
udge
t of 2
,964
.
Stat
istic
s M
ay
(Pre
lim)
May
Bu
dget
A
pril
Act
ual
Ave
rage
Dai
ly C
ensu
s 84
.2
89.1
88
.5
Acu
te
27.6
34
.3
27.9
11
Sub
acut
e 33
.5
33.3
33
.9
Sou
th S
hore
23
.2
21.5
23
.0
Patie
nt D
ays
2,61
0 2,
763
2,54
4 ER
Visi
ts
1,43
6 1,
465
1,40
2 O
P R
egist
ratio
n 1,
972
2,96
4 1,
945
Tota
l Sur
gerie
s 15
5 14
6 19
2
D
. Q
ualit
y U
pdat
es &
Edu
catio
n
1.
Spec
ial P
rese
ntat
ion
– A
sses
smen
t, Pr
even
tion
and
Trea
tmen
t of
Ski
n Im
pairm
ents
Ir
ene
Pake
l, C
linic
al N
urse
Spe
cial
ist, p
rese
nted
to th
e Bo
ard
a pr
ogra
m th
at
has b
een
in p
lace
at t
he H
ospi
tal f
or th
e pa
st 1
0 m
onth
s. T
he H
ospi
tal f
orm
ed a
H
ealth
care
-Acq
uire
d Pr
essu
re U
lcer
s (H
APU
) Com
mitt
ee. P
ress
ure
ulce
rs a
re
com
mon
ly k
now
n as
bed
sor
es o
r pre
ssur
e w
ound
s. M
s. Pa
kel s
tate
d th
at th
ere
is a
finan
cial
impa
ct o
f HA
PU to
the
Hos
pita
l. A
n ex
tend
ed le
ngth
of s
tay
to
treat
a p
ress
ure
ulce
r can
cos
t up
to $
500,
000
for o
ne p
atie
nt. C
ente
rs fo
r M
edic
are
and
Med
icai
d Se
rvic
es (C
MS)
will
no
long
er re
imbu
rse
for
heal
thca
re o
r hos
pita
l acq
uire
d pr
essu
re u
lcer
s.
Man
y A
lam
eda
Hos
pita
l pat
ient
s hav
e pr
essu
re u
lcer
s on
adm
issio
n to
the
Hos
pita
l and
are
at h
igh
risk
for d
evel
opin
g ne
w p
ress
ure
ulce
rs.
The
com
mitt
ee m
akes
ong
oing
cha
nges
to th
e H
APU
pro
gram
bas
ed o
n th
e N
atio
nal P
ress
ure
Ulc
er A
dvis
ory
Pane
l (N
PUA
P) w
ho p
ublis
hes n
atio
nal
guid
elin
es re
cogn
ized
as t
he st
anda
rds o
f car
e fo
r pre
ssur
e ul
cer p
reve
ntio
n an
d tre
atm
ent.
Th
e H
APU
Com
mitt
ee h
as se
en a
dec
reas
e in
HA
PU c
ases
dur
ing
Q4
2009
–
Q1
2010
. Sta
ff ha
s bee
n ed
ucat
ed w
ith p
ress
ure
ulce
r pre
vent
ion
whi
ch is
a b
ig
cont
ribut
ion
to th
e lo
w re
sults
. Th
e co
mm
ittee
’s g
oals
and
obje
ctiv
es a
re to
redu
ce th
e nu
mbe
r of H
APU
&
impr
ove
patie
nt c
are
by:
•
Incr
easi
ng th
e fr
eque
ncy
of sk
in a
sses
smen
ts
• Id
entif
ying
pat
ient
s at r
isk fo
r ski
n br
eakd
own
• C
onsi
sten
t Wou
nd C
are
Spec
ialis
t Cov
erag
e •
Impr
ovin
g co
mm
unic
atio
n &
doc
umen
tatio
n
12
• In
itiat
ing
appr
opria
te in
terv
entio
ns
• Im
prov
ing
data
col
lect
ion
and
anal
ysis
•
Rev
ising
the
prot
ocol
/pol
icy
& p
roce
dure
to c
larif
y pr
oces
s •
Educ
atin
g st
aff,
patie
nt a
nd fa
mily
mem
bers
E.
Stra
tegi
c Pl
anni
ng a
nd C
omm
unity
Rel
atio
ns R
epor
t
1.
Com
mitt
ee R
epor
t M
r. Bo
nta
repo
rted
that
the
May
Com
mun
ity R
elat
ions
mee
ting
had
been
po
stpo
ned
to th
e se
cond
Tue
sday
in Ju
ne. N
o ad
ditio
nal r
epor
t was
giv
en a
t th
is tim
e.
F.
Fi
nanc
e an
d M
anag
emen
t Com
mitt
ee R
epor
t
1.
Com
mitt
ee R
epor
t – M
ay 2
6, 2
010
Dire
ctor
Bat
tani
repo
rted
to th
e B
oard
that
the
Apr
il fin
anci
als
wer
e no
t up
to
par f
allin
g sh
ort o
n bu
dget
exp
ecta
tions
and
inpa
tient
vol
umes
wer
e no
t at
expe
cted
bud
get l
evel
s.
2.
A
ccep
tanc
e of
Apr
il 20
10 F
inan
cial
Sta
tem
ents
M
r. N
eapo
litan
pre
sent
ed th
e A
pril
finan
cial
s sta
ting
the
cens
us h
ad b
een
one
of th
e dr
ivin
g fa
ctor
s for
the
poor
fina
ncia
l per
form
ance
of t
he m
onth
. To
tal
patie
nt d
ays
wer
e 6.
0% le
ss th
an b
udge
t exp
ecta
tions
for M
arch
(2,5
44 v
s. 2,
705)
and
wer
e 6.
3% le
ss th
an th
e pr
ior y
ear,
Apr
il 20
09 a
t 2,7
15.
Surg
ery
case
s w
ere
62.0
% le
ss th
an b
udge
t at 1
92 c
ases
ver
sus a
bud
get o
f 505
as
a re
sult
of th
e fir
st m
onth
with
out K
aise
r act
ivity
. Th
e in
crea
se in
Ala
med
a ca
ses (
192
vs. 1
56) w
ere
driv
en b
y in
crea
sed
volu
me
in o
utpa
tient
cas
es o
f 44
and
wer
e pr
imar
ily d
riven
by
eye
rela
ted
case
s whi
ch w
ere
33 g
reat
er th
an th
e pr
ior m
onth
.
Emer
genc
y ca
re v
isits
wer
e 46
.7 v
ersu
s 47.
3 vi
sits
per
day
in th
e pr
ior m
onth
. H
owev
er, t
he g
ross
num
ber o
f vis
its w
ere
grea
ter t
han
budg
eted
by
3.1%
. In
Apr
il, 1
5.6%
of t
hese
vis
its w
ere
conv
erte
d to
inpa
tient
stay
s ver
sus 1
6.9%
in
Mar
ch a
nd th
e Y
TD a
vera
ge o
f 16.
4%.
Ave
rage
dai
ly c
ensu
s for
Apr
il w
as 8
4.8
vers
us a
bud
get o
f 90.
1. T
otal
gro
ss
patie
nt re
venu
e w
as le
ss th
an b
udge
t by
$6.2
M. N
et P
atie
nt R
even
ue $
617,
000
or 1
0% le
ss th
an b
udge
t. O
pera
ting
expe
nses
wer
e $3
68,0
00 0
6 6%
less
than
bu
dget
.
Dire
ctor
Bon
ta m
ade
a m
otio
n to
ap
prov
e th
e A
pril
2010
Fin
anci
al
Stat
emen
ts. M
r. M
cCor
mic
k se
cond
ed th
e m
otio
n. T
he m
otio
n ca
rrie
d un
anim
ousl
y.
13
Dire
ctor
Deu
tsch
ask
ed w
hat t
he a
vera
ge c
ensu
s was
for p
atie
nts g
ettin
g re
ferr
ed to
the
Hos
pita
l fro
m th
e cl
inic
. Mr.
Nea
polit
an d
id n
ot h
ave
a sp
ecifi
c nu
mbe
r of p
atie
nts t
hat c
ame
from
the
clin
ic. H
owev
er, M
r. N
eapo
litan
stat
ed
that
he
wou
ld re
fer t
o hi
s file
s to
track
the
num
ber o
f pat
ient
s tha
t wer
e re
ferr
ed to
the
Hos
pita
l by
phys
icia
n an
d re
port
back
the
boar
d in
July
.
3.
App
rova
l of R
esol
utio
n 20
10 –
1H
Ext
ensi
on o
f Spe
ndin
g D
irect
or B
atta
ni st
ated
the
purp
ose
of th
e re
solu
tion
is to
allo
w m
anag
emen
t to
cont
inue
to u
tiliz
e sp
endi
ng a
utho
rity
until
an
appr
oved
bud
get f
or F
Y 2
010-
2011
can
be
adop
ted
by th
e B
oard
whi
ch is
due
to b
e fin
aliz
ed n
o la
ter t
han
July
31,
201
0.
G
. M
edic
al S
taff
Pres
iden
t’s R
epor
t D
r. Sh
arm
a an
noun
ced
that
a g
uest
spea
ker w
ill b
e pr
esen
ting
to th
e m
edic
al
staf
f abo
ut V
itam
in D
def
icie
ncy
and
ever
yone
is w
elco
me
to a
ttend
.
Dire
ctor
Bon
ta m
ade
a m
otio
n to
ap
prov
e R
esol
utio
n 20
10 –
1H
Ex
tens
ion
of S
pend
ing.
Mr.
McC
orm
ick
seco
nded
the
mot
ion.
Th
e m
otio
n ca
rrie
d un
anim
ousl
y.
7. G
ener
al P
ublic
C
omm
ents
Non
e at
this
time.
8.
Boa
rd C
omm
ents
9.
A
djou
rnm
ent
A m
otio
n w
as m
ade
to a
djou
rn
the
mee
ting
and
bein
g no
furth
er
busin
ess,
the
mee
ting
was
ad
jour
ned
at 9
:10
p.m
.
Atte
st:
Jord
an B
atta
ni
R
ober
t Bon
ta
Pr
esid
ent
Secr
etar
y
DIS
TRIC
T BO
AR
D/M
INU
TES/
REG
.06.
07.1
0
14
Min
ute
s o
f th
e B
oa
rd o
f D
irec
tors
Sp
ecia
l Mee
ting
June
23,
201
0 D
irec
tors
Pre
sent
: R
ober
t Bon
ta
Rob
ert D
euts
ch, M
D
J. M
icha
el M
cCor
mic
k Le
ah D
. Will
iam
s
Man
agem
ent P
rese
nt:
Deb
orah
E. S
tebb
ins
Ker
ry J.
Eas
thop
e D
avid
A. N
eapo
litan
Med
ical
Sta
ff Pr
esen
t:
L
egal
Cou
nsel
Pre
sent
: Th
omas
Dris
coll,
Esq
. (vi
a te
leco
nfer
ence
)
Exc
used
: Su
bmitt
ed b
y:
Jord
an B
atta
ni
Alk
a Sh
arm
a, M
D
Kris
ten
Thor
son
Top
ic
Dis
cuss
ion
Act
ion
/ Fol
low
-Up
I. C
all t
o O
rder
R
ober
Deu
tsch
, MD
cal
led
the
Ope
n Se
ssio
n of
the
Boa
rd o
f Dire
ctor
s of t
he C
ity o
f Ala
med
a H
ealth
Car
e D
istric
t to
orde
r at 7
:36
a.m
.
II.
Rol
l Cal
l K
riste
n Th
orso
n ca
lled
roll,
not
ing
that
a q
uoru
m o
f Dire
ctor
s wer
e pr
esen
t.
III.
Reg
ular
Age
nda
A.
Chi
ef E
xecu
tive
Off
icer
’s R
epor
t
1)
Rec
omm
enda
tion
to a
ppro
ve C
.N.A
. (C
alifo
rnia
Nur
ses A
ssoc
iatio
n) –
M
emor
andu
m o
f Und
erst
andi
ng (A
gree
men
t) M
s. St
ebbi
ns re
com
men
ded
that
the
Boa
rd o
f Dire
ctor
s app
rove
the
rene
wal
of t
he D
istric
t’s
Mem
oran
dum
of U
nder
stan
ding
(MO
U) w
ith th
e C
alifo
rnia
Nur
ses A
ssoc
iatio
n (C
.N.A
.). M
s. St
ebbi
ns re
view
ed th
e m
ore
sign
ifica
nt is
sues
/ cha
nges
to th
e M
OU
and
are
out
lined
bel
ow.
T
erm
: Th
ree
year
s: Ju
ly 1
, 200
9 th
roug
h Ju
ne 3
0, 2
012
Wag
es:
No
wag
e in
crea
ses d
urin
g th
e te
rm o
f the
agr
eem
ent
D
irect
or M
cCor
mic
k m
ade
a m
otio
n to
app
rove
the
term
s of t
he C
.N.A
. M
emor
andu
m o
f U
nder
stan
ding
(A
gree
men
t) as
pre
sent
ed.
Dire
ctor
Will
iam
s se
cond
ed th
e m
otio
n. T
he
mot
ion
carr
ied
unan
imou
sly.
15
Cre
atio
n of
a jo
int l
abor
-man
agem
ent R
ecru
itmen
t and
Ret
entio
n C
omm
ittee
in th
e ev
ent w
ages
bec
ome
an is
sue
for e
ither
recr
uitm
ent o
r ret
entio
n (C
EO h
as
final
app
rova
l and
it’s
exe
mpt
from
grie
vanc
e/ar
bitra
tion
proc
ess)
Rem
oved
the
cap
on w
ages
for h
iring
exp
erie
nced
RN
s C
larif
ied
the
diff
eren
tial t
o be
pai
d w
hen
a sh
ift c
ross
es o
ver f
rom
day
s/pm
’s a
nd p
m/n
ight
s
Esta
blish
ed a
Cha
rge
Nur
se ro
le a
t the
sam
e w
age
rate
as t
he e
xist
ing
SN II
Is w
ith a
del
ayed
im
plem
enta
tion
Agr
eed
to u
se “
best
eff
orts
” no
t to
sche
dule
lunc
h du
ring
the
first
or l
ast t
wo
hour
s of t
he
shift
.
A
gree
d to
equ
itabl
y di
strib
ute
over
time
to fu
ll an
d pa
rt tim
e R
Ns
Agr
eed
to e
quita
bly
dist
ribut
e vo
lunt
ary
EA d
ays
C
larif
ied
exist
ing
lang
uage
to p
rovi
de p
rote
ctio
n fr
om d
iscip
linar
y ac
tion
on a
bsen
ces
prot
ecte
d un
der F
MLA
, etc
.
Prov
ided
mos
tly p
reve
ntat
ive
heal
th u
pgra
des t
o th
e pl
an in
exc
hang
e fo
r an
incr
ease
to th
e ou
t-of-p
ocke
t max
imum
s. T
his g
ives
RN
s acc
ess t
o th
e FS
A; h
owev
er, t
hey
chos
e no
t to
acce
pt th
e O
pt-O
ut o
ptio
n.
Edu
catio
n L
eave
:
Add
ed H
ome
Stud
y
Cha
nge
in O
ps:
Cla
rifie
d th
e H
ospi
tal’s
resp
onsib
ility
to th
e M
OU
in th
e ev
ent o
f a sa
le,
mer
ger o
r cha
nge
of o
wne
rshi
p.
SN (S
taff
Nur
se) I
II:
Mov
ed th
is to
pic
to a
join
t sub
com
mitt
ee to
refr
esh
the
thre
shol
d re
quire
men
ts to
bec
ome
a SN
III.
D
irect
or B
onta
ask
ed h
ow th
e nu
rses
(C.N
.A.)
wer
e tre
ndin
g on
wag
es b
efor
e th
ey a
gree
d to
no
wag
e in
crea
ses.
Ms S
tebb
ins s
tate
d th
at th
ey w
ere
at 2
.5%
eve
ry 6
mon
ths.
Ther
e w
as a
lso
disc
ussi
on d
urin
g ne
gotia
tions
that
kee
ping
wag
es fl
at o
ver t
he 3
yea
r ter
m c
ould
impa
ir re
crui
tmen
t and
rete
ntio
n of
nur
ses w
hich
in tu
rn p
rom
pted
the
crea
tion
of a
join
t lab
or-
man
agem
ent R
ecru
itmen
t and
Ret
entio
n C
omm
ittee
. M
r. M
cCor
mic
k as
ked
abou
t oth
er te
rms
that
had
a fi
nanc
ial i
mpa
ct c
ompa
red
to th
e pr
evio
us M
OU
. M
r. Ea
sthop
e in
dica
ted
that
C.N
.A.
agre
ed to
hig
her o
ut o
f poc
ket h
ealth
car
e pr
emiu
ms.
M
s. St
ebbi
ns st
ated
that
Pre
side
nt, J
orda
n Ba
ttani
had
writ
ten
a sta
tem
ent r
egar
ding
the
unio
n
16
nego
tiatio
ns th
at sh
e re
ques
ted
be re
ad a
t the
mee
ting
in h
er a
bsen
ce.
“I
hav
e ju
st fin
ishe
d re
adin
g th
e m
ater
ials
abou
t the
CN
A m
emo
of u
nder
stand
ing
(MO
U)
that
will
be
revi
ewed
and
vot
ed o
n at
the
Alam
eda
Hea
lth C
are
Dis
trict
Boa
rd m
eetin
g on
Ju
ne 2
3rd.
Unf
ortu
nate
ly, I
am
una
ble
to a
ttend
the
mee
ting,
and
as a
resu
lt I a
m u
nabl
e to
pa
rtic
ipat
e in
the
vote
on
this
impo
rtan
t iss
ue.
Nev
erth
eles
s, I w
ante
d to
be
cert
ain
to
expr
ess h
ow im
pres
sed
I am
with
the
work
that
was
don
e by
all
parti
es –
our
man
agem
ent
team
, the
repr
esen
tativ
es fr
om C
NA
and
our o
wn n
ursin
g st
aff,
who
I und
erst
and
have
ra
tifie
d an
d en
dors
ed th
e do
cum
ents
I ha
ve b
een
revi
ewin
g.
I am
wel
l awa
re o
f the
leve
l of
effo
rt it
has
requ
ired
for a
ll th
e pa
rtici
pant
s to
care
fully
wor
k th
roug
h th
e di
fficu
lt an
d co
mpl
ex is
sues
that
had
to b
e re
solv
ed to
reac
h th
is ag
reem
ent.
It’s
a si
gnifi
cant
and
im
pres
sive
ach
ieve
men
t – p
artic
ular
ly in
ligh
t of t
he v
ery
diffi
cult
year
we
have
all
just
com
plet
ed.
The
fact
that
our
org
aniz
atio
ns h
ave
been
abl
e to
wor
k to
geth
er so
effe
ctiv
ely
to
reac
h th
is ba
lanc
ed a
gree
men
t cle
arly
repr
esen
ts o
ur c
omm
on c
omm
itmen
t to
the
heal
th a
nd
safe
ty o
f our
com
mun
ity a
nd o
ur o
rgan
izatio
ns.
Plea
se a
ccep
t my
cong
ratu
latio
ns o
n yo
ur
achi
evem
ent,
and
my
than
ks fo
r you
r com
mitm
ent t
o th
e H
ospi
tal a
nd th
e H
ealth
Car
e D
istr
ict.”
– J
orda
n Ba
ttani
, Boa
rd P
resi
dent
M
s. St
ebbi
ns a
lso a
ckno
wle
dged
the
nurs
es c
omm
itmen
t to
the
dist
rict /
hos
pita
l and
than
ked
Ker
ry E
asth
ope,
Ass
ocia
te A
dmin
istra
tor a
nd P
hylli
s Wei
ss. D
irect
or o
f Hum
an R
esou
rces
for
thei
r har
d w
ork
and
a su
cces
sful
neg
otia
tion
of th
e C
.N.A
con
tract
.
IV.
Gen
eral
Pub
lic
Com
men
ts
Non
e.
V.
Boar
d C
omm
ents
Bo
th D
irect
or B
onta
and
Deu
tsch
com
men
ded
man
agem
ent,
the
lead
ersh
ip o
f C.N
.A. a
nd a
ll of
th
e nu
rses
for a
succ
essf
ul e
nd to
neg
otia
tions
.
VI.
Adj
ourn
men
t
A m
otio
n w
as m
ade
to
adjo
urn
the
mee
ting
and
bein
g no
furth
er b
usin
ess,
the
mee
ting
was
adj
ourn
ed
at 8
:03
a.m
. A
ttest
:
Jo
rdan
Bat
tani
Rob
ert B
onta
Pres
iden
t
Se
cret
ary
D
ISTR
ICT
BOA
RD
/MIN
UTE
S/R
EG.0
6.23
.10
17
THE CITY OF ALAMEDA HEALTH CARE DISTRICT
ALAMEDA HOSPITAL UNAUDITED FINANCIAL STATEMENTS
FOR THE PERIOD ENDING MAY 31, 2010
18
CITY OF ALAMEDA HEALTH CARE DISTRICT ALAMEDA HOSPITAL
MAY 31, 2010 Table of Contents Page
Financial Management Discussion 1 – 15
Balance Sheet 16
Statement of Revenue and Expenses 17
Statement of Revenue and Expenses – Per Adjusted Patient Day 18
Key Statistics for Current Month and Year-to-Date 19
19
Alameda Hospital May 2010 Management Discussion and Analysis
Page 1
ALAMEDA HOSPITAL
MANAGEMENT DISCUSSION AND ANALYSIS MAY, 2010
The management of the Alameda Hospital (the “Hospital”) has prepared this discussion and analysis in order to provide an overview of the Hospital’s performance for the period ending May 31, 2010 in accordance with the Governmental Accounting Standards Board Statement No. 34, Basic Financials Statements; Management’s Discussion and Analysis for State and Local Governments. The intent of this document is to provide additional information on the Hospital’s financial performance as a whole. Financial Overview as of May 31, 2010 Gross patient revenue was less than budget by $7,418,000 or 27.6%. Inpatient revenue was less than budgeted by
17.7% and outpatient revenue was 40.9% less than budgeted. On an adjusted patient day basis gross patient revenue was 12.8% less than budgeted at $4,867 compared to a budgeted amount of $5,583.
Total patient days were 2,620 compared to the prior month’s total patient days of 2,544 and the prior year’s 2,717
total patient days. The average daily acute care census was 27.6 compared to a budget of 34.3 and an actual average daily census of 27.9 in the prior month; the average daily Sub-Acute census was 33.5 versus a budget of 33.3 and 33.9 in the prior month and the Skilled Nursing program had an average daily census of 23.2 versus a budget of 21.5 and prior month census of 23.0, respectively.
Emergency Care Center visits were 1,436 but were 2.0% less than the budgeted 1,465 visits and were less than the
prior year’s visits of 1,599. Total Alameda Physician surgery cases were 6.2% greater than budget at 155 versus the budgeted 146 cases but
were 19.3% less than April’s surgical cases of 192.
Outpatient registrations were 33.5% below budgeted targets at 1,972 but were slightly greater than the prior month’s 1,954 registrations and were 20.8% lower than the prior year’s 2,491 registrations.
Combined excess expenses over revenue (loss) for May was $107,000 versus a budgeted excess of revenues over
expenses (profit) of $21,000. Total assets decreased by $622,000 from the prior month as a result of a decrease in current assets of $572,000, a
decrease in net fixed assets of $62,000 and an increase in restricted contributions of $11,000. The following items make up the increase in current assets:
Total unrestricted cash and cash equivalents for May decreased by $2,361,000. This decrease was the result
of the transfer of $2 million to the Department of Health Care Services in order to participate in the intergovernmental transfer program. These funds plus the Federal government’s match of $2.2 million was returned to the hospital on June 3, 2010. As a result of these items day’s cash on hand decreased to 3.9 at May 31, 2010 from April’s 15.9 days. If the transfer had been received prior to month-end the organization’s day’s cash on hand would have been 25.3.
Net patient accounts receivable decreased in May by $5,000 compared to an increase of $78,000 in April.
Day’s in outstanding receivables increased to 60.3 in May from 53.7 at April 30, 2010. This increase in day’s outstanding was the result of a decline in cash collections in May ($4.5 million) coupled with the decline in average daily revenues which declined to $715,000 from $776,000. However, cash collections per day have increased by 11.5% over the prior year’s average daily collections.
20
Alameda Hospital May 2010 Management Discussion and Analysis
Page 2
Estimated third-party settlement receivable decreased by $189,000 as a result of the receipt of Distinct Part
Skilled Nursing Supplemental receivables for the four quarters ended July 31, 2009.
Other assets increased by $1,973,000 as a result of the transfer of $2 million to the Department of Health Care Services for the IGT program which will be returned in June offset by the monthly amortization of prepaid expenses and deposits of $102,000.
Total liabilities decreased by $526,000 compared to a decrease of $805,000 in the prior month. This decrease was
the result of the following: Accounts payable and accrued expenses decreased by $26,000. As a result of this decrease and the increase in
accrued payroll and benefits liabilities of $455,000 coupled with a slight decrease in the year to date average daily expenses, the average payment period increased in May to 62.5 from 59.8 as of April 30, 2010.
Payroll and benefit related accruals increased by $455,000 from the prior month. This increase was the result
of an increase in payroll and related payroll tax accruals of $456,000, increased accruals for employee health insurance benefits coverage of $121,000 offset by the reversal of accruals for potential bargaining unit wage adjustments of $134,000 that had been accrued during the course of the fiscal year.
Estimated third-party payer settlement payable decreased by $440,000 as a result of the release of prior year
audited Medi-Cal cost report settlements. Other liabilities decreased by $477,000 as a result of the amortization of one month’s deferred revenue related
to the 2009/2010 parcel tax revenues.
21
Alameda Hospital May 2010 Management Discussion and Analysis
Page 3
Volumes The combined actual daily census was 84.2 versus a budget of 89.1. May’s lower than budgeted census was primarily a result of lower than budgeted census in the acute care program which was 19.7% lower than budgeted with an average daily census of 27.6 versus the budgeted 34.3. The Sub-Acute program was slightly greater than budgeted with an average daily census of 33.5 versus a budgeted census of 33.3 while the Skilled Nursing program was 7.6% better than budgeted with an average daily census of 23.2 versus a budgeted census of 21.5.
Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May YTDActual SNF 21.7 19.7 18.8 20.6 19.4 21.3 21.0 21.7 24.1 23.0 23.2 21.3Actual Sub-Acute 31.3 33.6 34.3 33.9 33.2 31.9 33.7 34.0 34.0 33.9 33.5 33.4Actual Acute 33.1 28.7 29.6 32.3 22.6 32.1 27.0 31.2 30.4 27.9 27.5 29.3
33.1
28.7
29.6
32.3
22.6 32
.1
27.0 31
.2
30.4
27.9
27.5
29.3
31.3
33.6
34.3 33
.9
33.2
31.9
33.7 34
.0
34.0
33.9
33.5 33.4
21.7
19.7
18.8 20
.6
19.4
21.3
21.0 21
.7
24.1
23.0
23.2
21.3
0
10
20
30
40
50
60
70
80
90
100
110
Total patient days in May were 5.5% less than budgeted and were 3.9% less than prior year volumes. The graph below shows the total patient days by month for fiscal year 2010.
Total Patient Days
1,900
2,100
2,300
2,500
2,700
2,900
3,100
Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun
Pati
ent D
ays
Actual - 2009-2010 Budget - 2009-2010 Prior Year - 2008-2009
22
Alameda Hospital May 2010 Management Discussion and Analysis
Page 4
The various inpatient components of our volumes for the month of May are discussed in the following sections.
The acute care patient days were 19.7% (209 days) less than budgeted and were 17.1% less than the prior year’s average daily census of 33.2. The acute care program was comprised of Critical Care Unit (2.4 ADC, 22.3% unfavorable to budget), Definitive Observation Unit (8.5 ADC, 38.3% unfavorable to budget) and Med/Surg Units (16.7 ADC, 4.1% unfavorable to budget).
Acute Care
Inpatient Acute Care Average Daily Census
20.0
25.0
30.0
35.0
40.0
45.0
50.0
Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun
Ave
rage
Dai
ly C
ensu
s
Actual Acute Budget Acute Prior Year Acute The average length of stay (ALOS) increased from that of the prior month to 4.34 days for the month of May. This brings the year-to-date ALOS to 3.80 which remains lower than our projected year to date ALOS of 4.10, and is shown in the graph below.
Average Length of Stay
3.61
4.04 4.07
3.51
3.773.64 3.64
4.07
3.56
3.85
4.34
3.80
3.00
3.25
3.50
3.75
4.00
4.25
4.50
4.75
5.00
Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun YTD
Actual Acute Budget Acute
23
Alameda Hospital May 2010 Management Discussion and Analysis
Page 5
The Sub-Acute program patient days were slightly greater than budget by 0.5% or 5 patient days for the month of May. The graph below shows the Sub-Acute programs average daily census for the current fiscal year as compared to budget and the prior year.
Sub-Acute Care
Sub-Acute Care Average Daily Census
30.0
30.5
31.0
31.5
32.0
32.5
33.0
33.5
34.0
34.5
35.0
Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun
Ave
rage
Dai
ly C
ensu
s
Actual Sub-Acute Budget Sub-Acute Prior Year Sub-Acute
The Skilled Nursing Unit (South Shore) patient days were 7.6% or 51 patient days greater than budgeted for the month of May. Comparing performance to the prior year this program was better than May 2009 with an average daily census of 23.2 versus 22.2. The following graph show the Skilled Nursing Unit average daily census as compared to budget by month.
Skilled Nursing Care
Skilled Nursing Unit Average Daily Census
0.0
5.0
10.0
15.0
20.0
25.0
30.0
Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun
Ave
rage
Dai
ly C
ensu
s
Actual SNF Budget SNF Prior Year SNF
24
Alameda Hospital May 2010 Management Discussion and Analysis
Page 6
Emergency Care Center visits at 1,436 were 2.0% less than budgeted for the month of May and 14.3% of these visits resulted in inpatient admissions versus 15.6% in April. In May there were 223 ambulance arrivals versus 202 in the month of April, an increase of 10.4% from the prior month. Of the 223 ambulance arrivals 185 or 83.0% were from Alameda Fire Department ambulances. The graph below shows the Emergency Care Centers average visits per day for fiscal year 2010 as compared to budget and the prior year performance.
Emergency Care Center
Emergency Care Center Visits per Day
40.0
42.0
44.0
46.0
48.0
50.0
52.0
54.0
Actual 2009-2010 Budget 2009-2010 Prior Year 2008-2009
Surgery cases were 155 versus the 507 budgeted and 501 in the prior year. The primary reason for the decline in surgical cases is related to the March 31, 2010 ending of the Kaiser contract. In May, Alameda physician cases decreased to 155 cases or 19.3% less than the prior month. The decrease of 37 cases over the prior month was the result of a decrease of 36 outpatient cases. Inpatient and outpatient cases totaled 43 and 112 versus 44 and 148 in April, respectively. The decrease was driven by decreases in Ophthalmology (18), Gastroenterology (10), General (5) and Orthopedic (4).
Surgery
The graph on the following page shows the number of surgical cases by month for fiscal year 2010.
25
Alameda Hospital May 2010 Management Discussion and Analysis
Page 7
Surgical Cases
0
100
200
300
400
500
600
Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun
Surg
ical
Cas
es
Kaiser Outpatient Surgical Kaiser Inpatient Surgical Alameda Outpatient Surgical Alameda Inpatient Surgical
Income Statement Gross Patient Charges Gross patient charges in May were less than budgeted by $7,418,000. This unfavorable variance was comprised of unfavorable variances of $2,724,000 and $4,694,000 in inpatient and outpatient revenues respectively. On an adjusted patient day basis total patient revenue was $4,867 versus the budgeted $5,583 or a 12.8% unfavorable variance from budget for the month of May.
Gross Charges per Adjusted Patient Day
$5,5
48
$5,6
66
$5,4
64
$5,4
96
$5,1
38
$5,6
10
$5,4
34
$5,3
95
$5,4
38
$5,3
11
$4,8
67
$5,4
06
$5,2
31
$5,1
06
$5,1
71
$5,2
18
$5,2
62
$5,2
28 $5
,528
$5,6
53
$5,5
22
$5,4
30
$5,5
83
$5,3
61
$3,000
$3,500
$4,000
$4,500
$5,000
$5,500
$6,000
Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun YTD
Dol
lars
Actual Revenue Per Adjusted Patient Day Budget Revenue Per Adjusted Patient Day
26
Alameda Hospital May 2010 Management Discussion and Analysis
Page 8
Payor Mix Medicare total gross revenue in May made up 39.3% of our total gross patient revenue. Medicare was followed by HMO/PPO utilization at 19.3%, Medi-Cal utilization at 18.8% and self pay at 6.4%. The graph below shows the percentage of revenues generated by each of the major payors for the current month and fiscal year to date as well as the current months estimated reimbursement for each payor.
Combined Payor Mix
-5.0%0.0%5.0%
10.0%15.0%20.0%25.0%30.0%35.0%40.0%
Current Month YTD
Current month gross Medicare charges made up 50.2% of our total inpatient acute care gross revenues followed by HMO/PPO at 17.0% and Medi-Cal at 9.1%. The hospitals overall Case Mix Index (CMI) increased to 1.4927 from 1.4711 in the prior month while the Medicare CMI decreased over the prior month from 1.5759 in April to 1.4927 in May. In May there were no outlier cases in the month. The overall Medicare reimbursement remained at 27.0% in May. The graph below shows the CMI for the hospital during the current fiscal year.
1.3812
1.4355
1.5052
1.3620
1.4981
1.2832
1.3752
1.4047
1.3679
1.5759
1.4927
1.2000
1.2500
1.3000
1.3500
1.4000
1.4500
1.5000
1.5500
1.6000
Jul-09 Aug-09 Sep-09 Oct-09 Nov-09 Dec-09 Jan-10 Feb-10 Mar-10 Apr-10 May-10
Cas
e M
ix In
dex
Medicare Total
The overall net patient revenue percentage increased from the prior month as a result of the change in payor mix
27
Alameda Hospital May 2010 Management Discussion and Analysis
Page 9
(increased HMO/PPO volumes), higher acuity level of inpatients treated during the month, the inclusion of $440,000 of audited Medi-Cal cost report settlements for FY 2009, these factors resulted in the overall estimated reimbursement for May to be 25.7% (23.4% without 3rd Party Settlement) versus 25.2% in April (23.9% without the additional AB915 accrual). The graph below shows the current month and year to date payor mix and current month estimated net revenue percentage for fiscal year 2010.
Inpatient Acute Care Payor Mix
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
Current Month YTD
In May the Sub-Acute care program again was dominated by Medi-Cal utilization of 72.8% versus 71.5% in April. The graph on the following page shows the payor mix for the current month and fiscal year to date and the current months estimated reimbursement rate for each payor.
28
Alameda Hospital May 2010 Management Discussion and Analysis
Page 10
Inpatient Sub-Acute Care Payor Mix
0.0%10.0%20.0%30.0%40.0%50.0%60.0%70.0%80.0%
Current Month YTD
In May the Skilled Nursing program was again comprised primarily of Medicare at 49.0% and Medi-Cal at 40.8%. The graph below shows the current month and fiscal year to date skilled nursing payor mix and the current months estimated level of reimbursement for each payor.
Inpatient Skilled Nursing Payor Mix
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
Current Month YTD
29
Alameda Hospital May 2010 Management Discussion and Analysis
Page 11
The outpatient gross revenue payor mix for May was comprised of 33.4% Medicare, 19.5% PPO, 12.9% HMO and 10.6% self pay. The graph below shows the current month and fiscal year to date outpatient payor mix and the current months estimated level of reimbursement for each payor.
Outpatient Services Payor Mix
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
40.0%
Current Month YTD
Deductions from Revenue Contractual allowances are computed as deductions from gross patient revenues based on the difference between gross patient charges and the contractually agreed upon rates of reimbursement with third party government-based programs such as Medicare, Medi-Cal and other third party payors such as Blue Cross. In the month of May contractual allowances, bad debt and charity adjustments (as a percentage of gross patient charges) were 74.3% versus the budgeted 78.4%. Net Patient Service Revenue Net patient service revenues are the resulting difference between gross patient charges and the deductions from revenue. This difference reflects what the anticipated cash payments the Hospital is expecting to receive for the services provided. The graph on the following page shows the level of reimbursement that the Hospital has estimated for fiscal year 2010 by major payor category.
30
Alameda Hospital May 2010 Management Discussion and Analysis
Page 12
32.4%
27.1%
20.5%
27.6%
20.7%
11.9%
22.6%
24.1%
19.2%
16.8%
29.3%
30.6%
23.1%
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
Average Reimbursement % by PayorMay
2010 Year-to-Date
Total Operating Expenses Total operating expenses were less than the fixed budget by $726,000 or 11.4%. On an adjusted patient day basis, our cost per adjusted patient day was $1,409 which was $88 per adjusted patient day unfavorable to budget. This variance in expenses per adjusted patient day was the result of unfavorable variances in virtually all expense categories. The graph on the following page shows the hospital operating expenses on an adjusted patient day basis for the 2010 fiscal year by month and is followed by explanations of the significant areas of variance that were experienced in the current month.
31
Alameda Hospital May 2010 Management Discussion and Analysis
Page 13
Expenses per Adjusted Patient Day
$1,3
87
$1,4
07
$1,3
86
$1,3
65
$1,4
35
$1,3
95
$1,4
56
$1,3
76
$1,2
75
$1,5
40
$1,4
09
$1,3
99
$1,3
37
$1,3
07
$1,3
45
$1,3
21
$1,3
72
$1,3
76
$1,3
20
$1,3
03
$1,3
06
$1,2
75
$1,3
21
$1,3
25
$800
$900
$1,000
$1,100
$1,200
$1,300
$1,400
$1,500
$1,600
Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun YTD
Dol
lars
Actual Expenses Per Adjusted Patient Day Budgeted Expense Per Adjusted Patient Day
Salary and Registry Expenses Salary and registry costs combined were favorable to the fixed budget by $289,000 but were unfavorable to budgeted levels on a per adjusted patient day basis in May by $66. The majority to the variance from the fixed budget related to surgical services departments which contributed $208,000 toward this favorable variance followed by the combined inpatient nursing units which were $63,000 favorable to the fixed budget. On an adjusted occupied bed basis, productive FTE’s were 2.8 in May versus the budgeted 2.6. The graph below shows the productive and paid FTE’s per adjusted occupied bed for FY 2010 by month and year to date.
FTE’s per Adjusted Occupied Bed
2.69
2.60
2.72
2.75
2.83
2.77
2.56
2.60
2.60
2.96
2.83
2.81
3.11
2.93
3.07
3.04
3.21
3.18
3.12
2.98
2.90
3.41
3.22
3.25
1.00
1.25
1.50
1.75
2.00
2.25
2.50
2.75
3.00
3.25
3.50
3.75
4.00
Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun YTD
FTE
's
Productive FTE/Adjusted Occupied Bed Paid FTE/Adjusted Occupied Bed
32
Alameda Hospital May 2010 Management Discussion and Analysis
Page 14
Benefits Benefit costs were $71,000 favorable to the fixed budget and were $21 unfavorable to budget on an adjusted patient day basis in May. Benefit costs were favorable to the fixed budget as a result of lower than budgeted payroll taxes ($32,000), pension and group health costs ($20,000) and other benefit accrual adjustments ($71,000) offset by additional estimated accruals for time off benefits ($70,000) and workers compensation insurance ($14,000) for the current month. The following graph shows the combined salary, registry and benefit costs on an adjusted patient basis for FY 2010 by month.
Salary, Registry and Benefit Cost per APD
$950
$971
$922
$942
$998
$944
$1,0
44
$986
$888
$1,0
67
$992
$970
$915
$888
$919
$894
$943
$907
$873
$900
$894
$870
$907
$900
$400
$500
$600
$700
$800
$900
$1,000
$1,100
$1,200
Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun YTD
Dol
lars
Actual Total Salary, Registry & Beneift Expense Per Adjusted Patient Day Budget Total Salary, Registry & Beneift Expense Per Adjusted Patient Day
Professional Fees Professional fees were favorable to budget by $70,000 and $3 per adjusted patient day favorable to budget. This favorable variance was the result of $26,000 less in medical professional fees and $44,000 less in non-medical professional fees. The majority of the favorable variance in medical professional fees was related to budgeted amounts for physician services in the Community Clinic that are actually reflected in the salary and wage classification. In the non-medical grouping which includes consulting and management, audit and legal fees, lower than budgeted consulting and management and legal fees were responsible for the favorable variance in this category. Supplies Supply expense was favorable to budget by $122,000 and only $4 per adjusted patient day unfavorable to budget. This favorable variance from the fixed budget was the result of favorable variances in both medical and non-medical supplies of $86,000 and $36,000, respectively. On the medical side we experienced favorable variances in surgical supplies ($100,000), pharmacy supplies ($67,000) and other medical supplies ($30,000) offset by greater than budgeted prosthesis supplies of ($113,000). The higher prosthesis costs were driven by the use of $58,000 in nerve stimulators, $47,000 in pacemakers and $40,000 in hip and knee devices. Purchased Services Purchased services was favorable to the fixed budget by $54,000 but were $4 per adjusted patient day unfavorable to budget as a result of variable variances of $40,000 and $35,000 in purchased services medical and repairs and maintenance, respectively. These favorable variances were offset by an unfavorable variance in non-medical purchased services. The unfavorable variance in non-medical purchased services was caused by additional fees
33
Alameda Hospital May 2010 Management Discussion and Analysis
Page 15
paid to the consultant who assisted with the Intergovernmental Transfer (IGT) program while the favorable variances in medical purchased services was the result of lower than budgeted renal dialysis care services in the current month ($7,000) and the true up of previously accrued amounts ($15,000). The favorable variance in repairs and maintenance was the result of lower than budgeted expenses across the organization. Rents and Leases Rents and lease expense was unfavorable to budget by $9,000 or $5 per adjusted patient day unfavorable as a result of the accrual of prior period invoices for the rental of respirators ($5,000 from August and $10,000 from April). Utilities and Telephone Utilities and telephone was favorable to budget by $26,000 or $3 per adjusted patient day favorable to budget as a result of lower actual natural gas utilization in April which was adjusted in May and used to then estimate the accrual for May. Depreciation Expense Depreciation expense was $54,000 or $8 per adjusted patient day favorable to budget as a result of additional pieces of equipment becoming fully depreciated in addition to the equipment that became fully depreciated in June 2009. The majority of the equipment that became fully depreciated in March was our CT scanner. The following pages include the detailed financial statements for the eleven months ended May 31, 2010.
34
May 31,2010 April 30,2010
AuditedJune 30,
2009Assets
Current assets:Cash and cash equivalents 760,873$ 3,122,199$ 1,866,540$ Net Accounts Receivable 9,725,093 9,730,369 10,069,536
Net Accounts Receivable % 22.19% 22.75% 22.15%
Inventories 1,303,789 1,292,593 1,291,072Est.Third-party payer settlement receivable 391,395 580,774 351,648Other assets 3,526,451 1,553,392 6,920,987
Total Current Assets 15,707,601 16,279,327 20,499,783
Restricted by contributors and grantors for capital acquisitions and research-Jaber Estate 468,534 457,464 468,209
Total Non-Current Assets 468,534 457,464 468,209
Fixed Assets:Land 877,945 877,945 877,945Depreciable capital assets, net of accumulated depreciation 5,853,966 5,915,528 6,029,967
Total fixed assets, net of accumulated depreciation 6,731,911 6,793,473 6,907,912
Total Assets 22,908,046$ 23,530,264$ 27,875,904$
Liabilities and Net AssetsCurrent Liabilities:
Current portion of long term debt 419,214$ 421,262$ 436,733$ Accounts payable and accrued expenses 6,260,012 6,286,106 6,244,967 Payroll and benefit related accruals 5,306,426 4,851,579 3,765,683 Est.Third-party payer settlement payable 445,550 885,550 306,588 Other liabilities 1,252,891 1,729,516 7,274,242
Total Current Liabilities 13,684,093 14,174,013 18,028,213
Long-Term Liabilities:Debt borrowings net of current maturities 1,307,162 1,343,064 1,733,631
Total Long-Term Liabilities 1,307,162 1,343,064 1,733,631
Total Liabilities 14,991,255 15,517,077 19,761,844
Net Assets
Unrestricted Funds 7,378,257 7,485,723 7,615,851 Restricted Funds 538,534 527,464 498,209 Net Assets 7,916,791 8,013,187 8,114,060
Total Liabilities and Net Assets 22,908,046$ 23,530,264$ 27,875,904$
ALAMEDA HOSPITALBalance SheetMay 31, 2010
Page 16 35
Act
ual
Bud
get
$ V
aria
nce
% V
aria
nce
Prio
r Yea
rA
ctua
lB
udge
t$
Var
ianc
e%
Var
ianc
ePr
ior Y
ear
Rev
enue
sG
ross
Inpa
tient
Rev
enue
s12
,702
$
15
,426
$
(2
,724
)$
-17.
7%13
,807
$
15
2,02
5$
15
7,33
9$
(5
,314
)$
-3.4
%14
6,21
7$
G
ross
Out
patie
nt R
even
ues
6,78
0
11
,474
(4
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)
-40.
9%11
,830
10
7,38
3
11
5,97
1
(8
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)
-7.4
%11
0,76
3
To
tal G
ross
Rev
enue
s19
,482
26
,900
(7
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)
-27.
6%25
,637
25
9,40
8
27
3,31
0
(1
3,90
1)
-5.1
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6,98
1
C
ontra
ctua
l Ded
uctio
ns13
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20
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6,
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34.0
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19
1,79
9
20
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6.
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1,47
1
B
ad D
ebts
586
51
3
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-1
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866
5,
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5,14
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(6
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Cha
rity
and
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er A
djus
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99
(275
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76.8
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7)
-1.7
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5
Net
Pat
ient
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9
(7
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-13.
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60,7
54
61,5
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(750
)
-1
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57,6
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Net
Pat
ient
Rev
enue
%25
.7%
21.6
%21
.3%
23.4
%22
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22.4
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et C
linic
Rev
enue
44
64
(20)
-3
1.5%
-
155
64
2
(487
)
-7
5.9%
-
Oth
er O
pera
ting
Rev
enue
(7)
15
(22)
-1
43.8
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41
0
166
24
4
147.
0%16
2
Tot
al R
even
ues
5,03
8
5,
879
(840
)
-1
4.3%
5,46
6
61
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62
,312
(9
92)
-1.6
%57
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Expe
nses
Sa
larie
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3,26
0
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9
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3,06
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34
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34
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74
0.
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R
egis
try14
4
182
39
21
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240
1,
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1,89
9
37
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Ben
efits
855
92
6
71
7.6%
869
10
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9,
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(405
)
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9,22
4
Pr
ofes
sion
al F
ees
278
34
9
70
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4
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554
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Su
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12
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14.8
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9
9,16
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(494
)
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Pu
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ices
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54
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733
Ren
ts a
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ease
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(9
)
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60
794
77
2
(22)
-2
.9%
651
U
tiliti
es a
nd T
elep
hone
53
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In
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nce
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ortiz
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3
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385
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ther
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rtain
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pens
es81
88
7
7.6%
82
890
94
8
59
6.2%
827
T
otal
Exp
ense
s 5,
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6,36
5
72
6
11.4
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869
67,1
25
67,5
48
423
0.
6%62
,833
Ope
ratin
g ga
in (l
oss)
(601
)
(4
86)
(114
)
-2
3.5%
(403
)
(5
,805
)
(5,2
36)
(5
69)
10.9
%(5
,069
)
Non
-Ope
ratin
g In
com
e / (
Exp
ense
) N
et N
on-O
pera
ting
Inco
me
/ (E
xpen
se)
493
50
7
(14)
-2
.7%
483
5,
452
5,57
6
(1
24)
-2.2
%5,
400
Exc
ess o
f Rev
enue
s Ove
r E
xpen
ses
(107
)$
21
$
(1
28)
$
-624
.2%
80$
(353
)$
34
0$
(692
)$
-2
03.9
%33
1$
Cur
rent
Mon
thY
ear-
to-D
ate
City
of A
lam
eda
Hea
lth C
are
Dis
tric
tSt
atem
ents
of O
pera
tions
May
31,
201
0$'
s in
thou
sand
s
Page
17
36
Act
ual
Bud
get
$ V
aria
nce
% V
aria
nce
Prio
r Yea
rA
ctua
lB
udge
t$
Var
ianc
e%
Var
ianc
ePr
ior Y
ear
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enue
sG
ross
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tient
Rev
enue
s3,
173
$
3,20
2$
(2
8)$
-0.9
%2,
738
$
3,16
5$
3,
087
$
79$
2.6%
3,00
0$
G
ross
Out
patie
nt R
even
ues
1,69
4
2,
381
(688
)
-2
8.9%
2,34
6
2,
236
2,27
5
(3
9)
-1.7
%2,
272
Tota
l Gro
ss R
even
ues
4,86
7
5,
583
(716
)
-1
2.8%
5,08
4
5,
401
5,36
2
40
0.
7%5,
272
Con
tract
ual D
educ
tions
3,37
8
4,
252
875
20
.6%
3,81
2
3,
994
4,03
5
41
1.
0%3,
928
Bad
Deb
ts14
6
106
(4
0)
-37.
5%17
2
122
10
1
(21)
-2
0.5%
142
C
harit
y an
d O
ther
Adj
ustm
ents
93
21
(73)
-3
53.5
%19
21
20
(2
)
-8
.0%
20
Net
Pat
ient
Rev
enue
s1,
249
1,20
4
46
3.
8%1,
081
1,26
5
1,
207
58
4.8%
1,18
2
N
et P
atie
nt R
even
ue %
25.7
%21
.6%
21.3
%23
.4%
22.5
%22
.4%
Net
Clin
ic R
even
ue11
13
(2
)
-1
7.6%
-
3
13
(9
)
-7
4.4%
-
Oth
er O
pera
ting
Rev
enue
(2)
3
(5
)
-1
52.7
%3
9
3
5
16
2.2%
3
T
otal
Rev
enue
s1,
259
1,22
0
38
3.
2%1,
084
1,27
7
1,
223
54
4.4%
1,18
5
Ex
pens
es
Sala
ries
742
67
7
(66)
-9
.7%
607
71
6
676
(4
0)
-5.9
%65
3
Reg
istry
36
38
2
5.
1%48
39
37
(2
)
-4
.1%
50
Ben
efits
214
19
2
(21)
-1
1.2%
172
21
5
194
(2
0)
-10.
5%18
9
Prof
essi
onal
Fee
s70
72
3
3.9%
48
67
74
7
9.
5%67
Su
pplie
s 17
6
172
(4
)
-2
.6%
146
19
1
170
(2
1)
-12.
2%17
0
Purc
hase
d Se
rvic
es87
84
(4
)
-4
.3%
72
88
85
(3)
-3.0
%77
R
ents
and
Lea
ses
20
15
(5)
-35.
1%12
17
15
(1
)
-9
.2%
13
Util
ities
and
Tel
epho
ne13
16
3
19.1
%13
16
17
1
5.5%
16
Insu
ranc
e11
10
(1
)
-1
1.0%
7
10
10
(0
)
-3
.5%
10
Dep
reci
atio
n an
d A
mor
tizat
ion
20
28
8
28
.2%
22
22
28
6
22
.3%
27
Oth
er O
pera
ting
Expe
nses
20
18
(2)
-11.
3%16
19
19
0
0.4%
17
Tot
al E
xpen
ses
1,40
9
1,
321
(88)
-6
.6%
1,16
4
1,
398
1,32
5
(7
3)
-5.5
%1,
289
Ope
ratin
g G
ain
/ (L
oss)
(150
)
(1
01)
(49)
-4
8.6%
(80)
(1
21)
(102
)
(1
8)
17.7
%(1
04)
Net
Non
-Ope
ratin
g In
com
e / (
Exp
ense
)12
3
105
18
17
.1%
96
114
10
9
4
3.
8%11
1
Exc
ess o
f Rev
enue
s Ove
r E
xpen
ses
(27)
$
4
$
(31)
$
-7
30.9
%16
$
(7
)$
7
$
(14)
$
-2
03.3
%7
$
Cur
rent
Mon
thY
ear-
to-D
ate
City
of A
lam
eda
Hea
lth C
are
Dis
tric
tSt
atem
ents
of O
pera
tions
- Pe
r A
djus
ted
Patie
nt D
ayM
ay 3
1, 2
010
Page
18
37
ACTU
ALC
UR
REN
TYT
DYT
DYT
DM
AYFI
XED
VAR
IAN
CE
MAY
MAY
FIXE
DM
AY20
10B
UD
GET
(UN
DER
) OVE
R%
2009
2010
BU
DG
ETVA
RIA
NC
E%
2009
Dis
char
ges:
Tota
l Acu
te19
7
259
(6
2)
-23.
9%23
6
2,
583
2,67
2
(89)
-3
.3%
2,56
1
Tota
l Sub
-Acu
te1
4
(3
)
-75.
0%2
13
41
(2
8)
-68.
3%34
Tota
l Ski
lled
Nur
sing
14
13
1
7.7%
6
116
142
(2
6)
-1
8.3%
104
21
2
276
(6
4)
-23.
2%24
4
2,
712
2,85
5
(143
)
-5
.0%
2,69
9
Patie
nt D
ays:
Tota
l Acu
te85
4
1,06
3
(2
09)
-19.
7%1,
030
9,
817
10,9
52
(1
,135
)
-10.
4%10
,744
Tota
l Sub
-Acu
te1,
038
1,03
3
5
0.5%
1,00
0
11,1
83
11,1
87
(4
)
0.0%
11,0
20
To
tal S
kille
d N
ursi
ng71
8
667
51
7.6%
687
7,14
6
7,20
6
(6
0)
-0
.8%
5,97
2
2,
610
2,76
3
(1
53)
-5.5
%2,
717
28
,146
29
,345
(1,1
99)
-4
.1%
27,7
36
Ave
rage
Len
gth
of S
tay
Tota
l Acu
te4.
34
4.
10
0.23
5.6%
4.36
3.80
4.10
(0
.30)
-7.3
%4.
20
Ave
rage
Dai
ly C
ensu
s
To
tal A
cute
27.5
5
34
.29
(6.7
4)
-1
9.7%
33.2
3
29.3
0
32
.69
(3
.39)
-10.
4%32
.07
To
tal S
ub-A
cute
33.4
8
33
.32
0.16
0.5%
32.2
6
33.3
8
33
.39
(0
.01)
0.0%
32.9
0
Tota
l Ski
lled
Nur
sing
23.1
6
21
.52
1.65
7.
6%22
.16
21
.33
21
.51
(0.1
8)
-0.8
%20
.59
84.1
9
89
.13
(4.9
4)
-5
.5%
87.6
5
84.0
2
87
.60
(3
.40)
-3.9
%85
.56
Emer
genc
y R
oom
Vis
its1,
436
1,46
5
(2
9)
-2.0
%1,
599
16
,228
15
,440
788
5.1%
15,8
10
ALAM
EDA
HO
SPIT
ALK
EY S
TATI
STIC
SM
AY 2
010
Out
patie
nt R
egis
trat
ions
1,97
2
2,
964
(992
)
-3
3.5%
2,49
1
27,0
04
27,9
96
(9
92)
-3.5
%27
,395
Surg
ery
Cas
es:
Inpa
tient
43
57
(1
4)
-24.
6%56
62
8
609
19
3.1%
620
Out
patie
nt11
2
450
(3
38)
-75.
1%44
5
4,
098
4,48
6
(388
)
-8
.6%
4,70
5
155
50
7
(352
)
-6
9.4%
501
4,72
6
5,
095
(3
69)
-7.2
%5,
325
Kai
ser I
npat
ient
Cas
es-
7
(7)
-
7
91
96
(5
)
-
93
Kai
ser E
ye C
ases
-
180
(1
80)
16
4
1,
461
1,
711
(250
)
-14.
6%1,
789
Kai
ser O
utpa
tient
Cas
es-
17
4
(174
)
172
1,41
7
1,69
5
(2
78)
-1
6.4%
1,75
2
To
tal K
aise
r Cas
es-
36
1
(361
)
343
2,96
9
3,50
2
(5
33)
-1
5.2%
3,63
4
%
Kai
ser C
ases
0.0%
71.2
%68
.5%
62.8
%68
.7%
68.2
%
Adj
uste
d O
ccup
ied
Bed
128.
46
152.
1023
.64
15
.5%
162.
68
143.
36
151.
84(8
.48)
-5.6
%14
5.19
Prod
uctiv
e FT
E36
5.63
390.
9025
.27
6.5%
400.
63
388.
9838
8.25
(0.7
3)
-0
.2%
377.
14
Tota
l FTE
415.
9845
0.07
34.0
97.
6%44
3.36
44
3.80
445.
832.
03
0.
5%42
7.87
Prod
uctiv
e FT
E/A
dj. O
cc. B
ed2.
85
2.
57
(0.2
8)
-1
0.7%
2.46
2.71
2.56
(0
.16)
-6.1
%2.
60
Tota
l FTE
/ Adj
. Occ
. Bed
3.24
2.96
(0
.28)
-9.4
%2.
73
3.
10
2.
94
(0.1
6)
-5
.4%
2.95
Page
19
38
RESOLUTION NO. 2010-2H
BOARD OF DIRECTORS, CITY OF ALAMEDA HEALTH CARE DISTRICT
STATE OF CALIFORNIA
* * * LEVYING THE CITY OF ALAMEDA HEALTH CARE DISTRICT
PARCEL TAX FOR THE FISCAL YEAR 2010-2011
WHEREAS, the Alameda County Local Agency Formation Commission (“LAFCo”) resolved on January 10, 2002 to present a ballot measure to the registered voters of the City of Alameda which, if approved, would authorize the formation of the new health care district within the boundaries of the City of Alameda and authorize the District to levy a parcel tax of up to $298.00 on each parcel and possessory interest within the proposed district; and
WHEREAS, on April 9, 2002, over two-thirds of the registered voters of the City of Alameda, who voted that day, voted in favor of creating a health care district authorized to tax each parcel and possessory interest within the district’s boundaries in an amount up to $298.00 per year in order to defray ongoing hospital general operating expenses and capital improvement expenses; and
WHEREAS, the City of Alameda Health Care District (the “District”) was formally organized and began its existence on July 1, 2002; and
WHEREAS, without tax revenue Alameda Hospital can not fulfill its mission to serve the health needs of the Alameda City Community due to a lack of sustained revenue sufficient to finance continued operation of all necessary hospital services; and
WHEREAS, the District operates Alameda Hospital; and
WHEREAS, without the levy of a parcel and possessory interest tax in the amount of $298.00, the District’s revenue stream will be insufficient to allow the provision of continued local access to emergency room care, acute hospital care, and other necessary medical services; and
WHEREAS, the District is authorized under Section 53730.01 of the California Government Code to impose special taxes on all real property within its boundaries.
39
2
NOW, THEREFORE, BE IT RESOLVED by the Board of Directors of the District that the District hereby levies an annual tax on every parcel and possessory interest within the District’s boundaries in the amount of Two Hundred Ninety-Eight Dollars ($298.00) per year (the “Parcel Tax”) in order to defray ongoing hospital general operating expenses and capital improvement expenses; provided, however, that parcels or possessory interests that have an assessed value (real property and improvements combined) of less than $30,000 shall be automatically exempt from the Parcel Tax.
PASSED AND ADOPTED on July 12, 2010 by the following vote:
AYES: NOES: ABSENT:
__________________________________ Jordan Battani President
ATTEST:
__________________________________ Robert Bonta Secretary DISTRICT BOARD/RESOLUTIONS/TAX LEVY.2010-2H
40
4141
4242
DATE: July 12, 2010 TO: City of Alameda Health Care District, Board of Directors FROM: Kerry Easthope, Associate Administrator Phyllis Weiss, Director of Human Resources SUBJECT: Recommendation to Approve OPEIU, Local #29 Memorandum of Understanding
(Agreement) Recommendation: Hospital Administration is hereby recommending that the City of Alameda Health Care District Board of Directors approve the renewal of the District’s Memorandum of Understanding (MOU) with OPEIU, Local #29. This Union represents the Clinical Laboratory Scientists and Phlebotomists who work in the Clinical Laboratory of the Hospital. The term of the MOU is retroactive to February 1, 2010 to January 31, 2013. The Tentative Agreements, which reflect the modifications to the existing MOU, were ratified by the Local #29 members on July 9, 2010. A summary of the more significant issues/changes to the MOU are itemized in the “discussion” section below and a complete copy of the Tentative Agreements and expired MOU are available for your review upon request. Background: Hospital Management has been in contract negotiations with the bargaining team from Local #29 since the contract ended in February of 2010. Members have been working under a mutually agreed to extension of the contract since that time, while the terms and conditions of a new contract were finalized. Negotiation sessions were amicable and conducted in a professional manner. There were a number of difficult issues to work through as proposed during these negotiations, including the need to deal with the challenge presented by the expiration of the Kaiser contract. Management feels that Local #29 representatives understood and took the District’s concerns on this issue very seriously as reflected in the terms of this three (3) year agreement. Discussion: A summary of the key issues and/or modified terms of this new MOU are as follows:
• Three (3) years term (2/1/10 – 1/31/13)
• A 12-month wage freeze from 2/1/10 to 1/31/11
• Wage openers on 2/1/11 and 2/1/12
43
• Clarified the internal posting process for open positions
• Clarified the language in the “Change of Operations” section
• Added new Lead Phlebotomist classification
• Provided for some enhanced health plan coverage with a modest increase to the out-of-pocket maximums and deductibles, to mirror the benefits offered to the members of the California Nurses Association.
A copy of the Tentative Agreement reached with Local #29 is attached for your reference.
44
45
46
47
48
49
50
51
52
53
54
55
56
57
Date: July 12, 1010 To: City of Alameda Health Care District From: Kristen Thorson, District Clerk Subject: November 2, 2010 General Election Information The attached Notice of General Election was submitted to the Registrar of Voters, as done in prior elections. Below is a summary of key information for incumbents/candidates regarding the November 2, 2010 election.
a. The elective offices of the District to be filled at the next General District Election and names of the incumbents involved. Each office will be elected to a four (4) year term ending December, 2014. Robert Bonta Robert Deutsch Leah Williams
b. Issuing and Filing of Candidate Nomination Packets:
All Nomination documents will be issued and filed only through
the Registrar of Voters office at: 1225 Fallon St. G-1 Oakland, CA 94612
(510) 272-6933
c. Candidate Statement of Qualification Candidate will pay total estimated costs upon submitting
statement.
d. Nomination period is from July 12 to August 6, 2010. See attached timeline for additional information and key dates.
58
59
60
61
1
Day
s B
efor
e El
ectio
nAc
tion
Take
n B
yO
bjec
tive
Cod
e Se
ctio
nsJu
ly 1
2, to
Aug
ust 6
, 201
0R
egis
trar o
f Vot
erR
egis
tar o
f Vot
ers
will
issu
e al
l nom
inat
ion
docu
men
ts.
Dec
lara
tion
of C
andi
dacy
and
oth
er fi
lings
can
be
obta
ined
EC
105
10(E
- 113
to E
-88)
betw
een
Mon
day
thro
ugh
Frid
ay, 8
:30
to 5
:00p
m
Augu
st 7
to A
ugus
t 11,
201
0R
egis
trar o
f Vot
erEx
tens
ion
perio
d- i
f Inc
umbe
nt d
oes
not f
ile a
Dec
lara
iton
of C
andi
dacy
, the
nom
inat
ion
perio
d is
ext
ende
d 5
days
.EC
105
16
(E-8
7 to
E-8
3)Ev
eryo
ne o
ther
than
the
incu
mbe
nts
can
pull
pape
r dur
ing
this
per
iod.
Augu
st 1
2, 2
010
Reg
istra
r of V
oter
Ran
dom
Dra
win
g- A
lpha
bet D
raw
ing
by S
ecre
tary
of S
tate
. Res
ults
will
be s
ent t
o R
egis
trar o
f Vot
ers'
offi
ce.
EC 1
3112
(E-8
2)Th
e re
gist
rar o
ffice
will
also
do
the
loca
l dra
win
g at
this
tim
e.
Sept
. 6 to
Oct
ober
19,
201
0R
egis
trar o
f Vot
erD
ecla
ratio
n of
Writ
e-in
per
iod.
All
nom
inat
ion
pape
r will
be is
sued
from
the
Reg
istra
r of V
oter
s of
fice.
EC 8
600-
8605
(E-5
7 to
E-1
4)
Aug.
21
to A
ug. 3
1, 2
010
Reg
istra
r of V
oter
The
publ
ic h
as 1
0 da
ys to
insp
ect m
ater
ials
to b
e su
bmitt
ed fo
r prin
ting.
EC 9
295
(E-7
3 to
E-6
3)O
ct. 4
, 201
0R
egis
trar o
f Vot
erFi
rst d
ay o
f mai
ling
the
Vote
by
Mai
l Bal
lots
.EC
300
1
(E-2
9)
Oct
. 18,
201
0R
egis
trar o
f Vot
erLa
st d
ay to
regi
ster
to v
ote
for t
he N
ovem
ber 2
, 201
0 El
ectio
nEC
210
7(E
-15)
Oct
ober
26,
201
0R
egis
trar o
f Vot
erD
eadl
ine
to a
pply
for a
Vot
e by
Mai
l Bal
lots
EC 3
001
(E-1
5)
Oct
ober
28,
201
0R
egis
trar o
f Vot
ers
Dea
dlin
e to
app
ly fo
r a V
ote
by M
ail B
allo
t. A
pplic
atio
ns m
ust
be re
ceiv
ed b
y ou
r offi
ce n
o la
ter t
han
5:00
P:M
.EC
300
1(E
-7)
Nov
embe
r 2, 2
010
Reg
istra
r of V
oter
sEl
ectio
n D
ay -
Polls
ope
n at
7:0
0 A.
M to
8:0
0 P.
M.
Nov
embe
r 2, 2
010
Gen
eral
Ele
ctio
nEL
ECTI
ON
TIM
ETAB
LE F
OR
SPE
CIA
L D
ISTR
ICT
ELEC
TIO
N
62
63
64
65
66
67
68
69
70
71