Health Care District Board candidate J. Michael McCormick
Health Care District Board candidate J. Michael McCormick
J. Michael McCormick
Adjunct History Instructor, retired technology businessman.
Incumbent with 4 years on Alameda Hospital Board
What is your vision for the health care district and what are the key steps you would take to implement it during your four-year term, if elected?
Like other independent hospitals, Alameda faces continual challenges in a period of high costs and the concentrated regional market dominated by Sutter Health and Kaiser Permanente. If I am re-elected my top three priorities will be:
a. To keep the hospital open by managing costs, looking for niche opportunities (such as the wound care center, expanded SNF and Orthopedic services we are now offering) and seeking partnerships that maintain our mission.
b. To work with the administration on a plan and revenue stream to meet the state’s seismic requirements.
c. To maintain fair working conditions and wages for nurses and other staff before increasing salaries and benefits to managers.
This is an important healthcare election, as there are some in the community who are actively working for the hospital’s closure including a member of the District Board. Among their ideas is one that has a fleet of Medi-Vac helicopters flying from airports to emergency rooms to rooftops and back. This is a serious election and it takes a serious minded vision to protect our fellow citizens.
What are the most significant challenges facing Alameda Hospital at this moment?
The Board will need to keep a steady eye on the next year in preparation for the mandates of 2014. 160,000 new enrollees to the Affordable Healthcare initiative will sign on to either MediCal or the new California Exchange in Alameda County. This challenge can be met and new opportunities can be presented by working with county and state healthcare officials in charge of the initiative to ward off challenges and seize opportunities.
Should Alameda Hospital remain open? Why or why not?
Yes, it should remain open. My understanding is that if an emergency room closes, the County conducts a hearing and issues findings to the state. However, the state has not used this information to keep hospitals open even when the data is most dire. I would support legislation to put more teeth into the County’s findings or force the state to consider the option of alternatives to closure. I would support a local ordinance regarding declarations of “essential public services” for ER, trauma and ICU. This is truly the case in Alameda where the nearest emergency room outside of the island is at least a 15-20 minute ride.
If the hospital closed, what would you do with the parcel tax money the district collects and what if any services should the health care district continue to provide?
If the Health Care District closed the Hospital and, offered no services then the parcel tax revenue, which makes up 10% of present net revenues, should be ended. It should be noted that the Hospital carries extremely low long term debt responsibilities.
How would you fund seismic upgrades that are required under state law?
The opportunities to find funding partners in the private or public or a combination of both sectors should increase in the years ahead as new revenue hits the books. The projections for our new initiatives (see answers below) should spike yearly net revenue by $11M in the years ahead, from $60M or so today to $71M in the near future. Presently, management is working toward a retrofit extension from the State until the year 2020. This is one of my top priorities in 2013-14.
What kind of medical services do you believe Alamedans need on-Island?
I think you mean the most basic of services. And that would include emergency and acute care. Alameda Hospital provides all the services that the State requires for a general acute care hospital. Emergency care must remain open. Assertions by others that the ER is not “up to 21st century standards” is haphazard and dangerously lacking in facts. The most recent County analysis made by the Kaufman Hall firm found that the Hospital offers excellent service at a very low cost compared to most all other hospitals in the region.
What do you think is the role of the board in overseeing the hospital? What would you improve about how the board carries out its work and/or works together with hospital leaders?
We most recently voted to approve a policy directive that defines the role and responsibilities of the District’s Board of Directors. The policy outlines what the State Joint Commission will soon require as part of its tri-annual accreditation survey. Anticipating the Commission, management will, in addition to this policy, review all administrative policies and procedures. The policy is a logical set of steps to regularly undertake; from strategy to legality, from audits to ethics, from reporting to quality controls, it outlines the District Board’s role and responsibilities.
I believe a working good Board neither totally agrees nor totally disagrees with the efforts and outcomes of management. A volunteer citizen based leadership Board has no business micro-managing the healthcare professionals that the Board itself hired to do the everyday work of running a Healthcare District. Each Board Member has a direct fiduciary responsibility to the citizens of Alameda. And the overall strategy we implement must be representative of what the citizens of Alameda will expect in any given role or policy issue. That is simply being responsible to our constituency.
How would you advise the hospital’s leadership to improve operations, financial stability, and patient satisfaction at the hospital?
You present three big, big questions. The County of Alameda recently contracted with the firm of Kaufman Hall to analyze how hospitals compare to each other in quality of care and cost of care. The City of Alameda Healthcare District today continues to give excellent quality at the lowest cost of any of the 20 or so hospitals from Sutter to SF General to Santa Clara to ACMC.
Committee responsibilities (Management and Finance, Quality Control, and Community Relations) are to regularly see and hear high level administrator’s monthly reports. I have served on all three Committees during my 4 years and am presently Chairman of the Management and Finance Committee. Today, finances are most difficult and challenging.
We can’t simply increase revenues by increasing sick people, the amount of people needing healthcare services determine that revenue. However, we can expand our services, and we have done so. We have put together 3 new healthcare services to add to our existing ones. They all are opening: Water’s Edge Nursing Home, the Kate Creedon Wound Care Center, and the new Orthopedic Department are now in place. If they are successful, and we have all the reason to believe that they will be, then the financial pressure on existing services will be lessened and a return to a controlled cost position will be reachable.
The District’s goal should not be to produce high profit at all cost but rather to produce high quality at all cost. According to the Kaufman report we are producing high quality healthcare. We acted to acquire Stroke Certification this past year and the EMS District again sends emergency stroke victims to the hospital. But, the Board should have been told of the stroke care status before we were informed by the County and had to acquire the Certification. I have pushed for more transparency from healthcare managers to allow the Board to see into their professions with more understanding of what is being observed and reported upon.
What are the near- and long-term implications of the Affordable Health Care for America Act (“Obamacare”) for reimbursements and revenues at Alameda Hospital?
Time will tell and the first solid indicators will be apparent in 2014. We must be in position to act and act quickly as some of the newly insured will looking to the Hospital for care. One of the strategic advantages of being small is the ability to succeed in times of rapid change. County and local officials along with the state will be our bellwether for change and our partners in securing a positive healthcare experience for all.
On the long term, I do not think healthcare should be a for profit business, so I do not support takeovers of community hospitals by “profit first” corporations. I would support legislation to tighten the definition of “charity care” and hold tax exempt hospitals to a higher standard. I want to keep Alameda Hospital open, which serves a growing number of poor and elderly patients.
Thanks for your questions.