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HomeMy WebLinkAboutMINUTES - 07191994 - MR.2 MR. 2 THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA DATE: July 19, 1994 MATTER OF RECORD ------------------------------------------------------------------ ------------------------------------------------------------------ On this date the Board of Supervisors heard comments from Mr. Paul Katz, Local I, on the County Hospital issue . THIS IS A MATTER FOR RECORD PURPOSES ONLY NO BOARD ACTION TAKEN ci- mail � t"LE �L on CID N C O CD rl b w G11, 17 ro z � a m 1 ►aa G -s G -1s tv d �o w °� ° o w'°. G QGa cam-+• o mQti Ct. � G �N �@ G �+cn -,w�ma�n ro N. ,Co.� �' re p, co`� woG �� Q y 0a � �'"C C V�'�G CD t7 b cC 7 CC �Q•p: owM{D �Gf�� � "` 'a w wa•° � a a ° Ow • � '� w r* G w� eta o 7 ro aMw � �•R O w �'a C • o ,., � � aoyywn OR �.1 c�R va w aCL Q °M � F ^ � ro r« a •cs:a"�c It N C. vn. a o v1 m n w ro s�� Oro c.wcn`� eaa `9w� C � f9 '-• a.�maim fA�,� �4+ c�4u m Y d° - w 1 Sr o UD ? w I? R oac a►9G t REFERENDUMPLEDGE ' M Motion by the Contra Costa.,C00111ty.,,.. o�r� �f �uperv�sors A� S�ospend �Q�ts��ri�ctlo� of #he��1��'Coun:t_.,,... flosp*taI and X. . .. ............... . ............ ... .... o��B�l�t�#........ for Uo#erg Approval .. ...... . ... ....... ....... A: ................ .......... ............... ... .... .. .........%._........ .... . ..................... k , .............. ... .. x", .... . ..... .......... .... ............ . -X. i"XX ..... . _X. .............. ............... Pursuant fio my d�ti�s:a�d.............. respons.............. ......... ibilities as..X.. .. .............. .....-.h.. .t....... eci F, public oial to represent Che fest interests of the citizens ................. ..................... ... .......... ............. and taxpayer s �f my Superv[sorial district, I t1�.hereDy pledge to suspend �bristruction plans fnr the epl�c�rrient of wr iihevu Hos�iia! u�itil such plans, haue beers lhor� , oughly°debated_ and approved �y tkie "voters of �a�iira Costa County in ori official ballot me�s�ire. .TOM POWERS , District I . Date' Chairman of the 136ard �. SAN F..RANGISCO BUSINESSTIMES t ' dWEEKa -OP Q:N b M r County hospital proponents 1* 1 • t3'. P P P argue that the,system is needed?as a"safety ? net"for the poor.But health-care PI'ognos lS■ ,f trends suggest"thatin the'future,the x u , , ., only`ones landing in-the net will be Whitt t t `�� Whitt 'h f ' The issues facmg county hospitals 4 .�-w, q• r, are the same as those facing private q health care providers during:a period SICk nth '19 mbition of massive changes'in the'health�are Medical-industry experts have" industry:And while'private hospitals' ` i''" have'had,toFcut costs and`con`"solidate studied thenymptoms,and made,a .} `.'• � _ diagnosis:-Four:bay�Area counties:_ many California counties have a're a fllicted'witha'spending ; abandoned the hospital business . disorder: ' I` - altogether. . Alameda;Contra'Costa,San Mateo,., Michael Gallagher,president of the •and Saiita�Clara counties are Hospital.Coiiricil.ofNorthern`arid- . re arui to disperse$550.milhon m Central Califorma,'said counties ' p P, g P - state'and federal funds to'renovate' 4 y must face a'critical`question "Is there. S3 14: '}, &G i;� i*jt 1 1-�K :.66 ($< n ! ..:.. and rebuildcounty:hospitals y; •the necessary capacity.for•us to have:., .p � s-�' � ' our own hos ital?" ' despite a slinnkirig patient volume � P and agrowing abundance of empty �F.orhospitals with a`spending , hospital•beds ' ' t ;disorder;inthe answer lie`s tlie: tThe�construction is funded through dire.■ .... ,16 's'state- enate Bill'1732;which• k says�hospitals''t at serve''an, unusually large'percentage of Medi-..' Cal p6tiefitsi can get up to 50 percent of their,coristruction costs covered: Thus tempted ,the:quartet of counties., has chosen to put,aside common :sense and pickup a jackhammer. ,This-`should come as no surprise. All the"classic symptoms pointed to t. sudden bout-of.binge:'spending. __Symptom.No. 1:Loss of touch,with reality:The new construction comes:. as'competition"iis rising for the county' hospitals'traditional role as;l i providers of care•to tiie'poor.',The state-is,encouraging Medi-Cal patients=;the'poor Californians who make up mu&of the county;; t ::.• facilitiespatient loads=to move into`Medi=CaIHMO'programs. "' t Managed=care;progr'ams encourage out-patient'care;•meaning fdwer.'. hospitdFS_tays; a t,s YSyinptom�No 2:'Disregard fora, fiscal'health Altlidugh tfie state will" pay a large.portion of construction` 'costs°thetconnties�must still fill their "lieds�If they`can't,"they�will,suffer big , ,':oper'atuig'losses'and'may struggle`to'"'' niget<bond payments for their�share.. I of the tab- , , x t Y fi3... t � -.. x.d 'T't4� f_§a e .�. 1. -` �d,nE-Y t,h ..us.^K. t :. `" WEEK�OF'JUNE 123 1994° i ti x ttrSAN FRANGiSCO BUSINESS;TIMES 7 r . �� -_.7*�g.,.r,,,,.�.°....a�,.n^-.rs:::��....'::�:z_.....�..,� ..�..=:�,.L:•:�'� �....:r rtu...�"•L"hh.+:�-�..�""t��:.e:�,P�''`^ ' • _ .��� 71Gg h7°Li 3 kaw ...r e 'y-u�..,����•}ta. 1,.r,,, .�'y t.�-����2:'•Y.._yti a.-.sx,r -t '.� — ----.:> k o�~ ebloo eattin armed m5 aay r 2ryt1 x1 h't V r" •°tZk',akur +3�ia" 'w7"` � t-. t ...• k -ar . ems= u '�- ����at� al��4#Pacif4�c��M�edyw�Ceniter��s� �.j 4' �1-.-$ .qr'�p' �.o-'Yt�°':.'34��5� 2i'�'R'.`31-'�`�ic§_ p�'�£Ip.rl ii��,�.i.,�.,Y.3T'`A .vim' y •"`.;*Y"L `C� ' < S � �� Y Coti ntLnUed, Oye 11IT1 K recommen a ions - ,.? .�1 .wna..+ •- er�rrPS.- - _._ g°i i. t k v-k' -`,.°?.; • - uc a � r k s nlike r 5 „ya xi>:�a ,pital,not�ucross townrivalsSt s ut e` so orm a ospitalsaf a .... y,.',d ar zit--Wil' e.'R`"'. Y &--L ,_ r," ,� Mary s�Medlcal Centerrand,Saint F an�`�gip`medical"staffxand�employeesklid his op; cis MemonalHospitalSenfhng told doc motions arelimited r tors and em to ees last monthIf�1t'dces P Y "The realities of�health care finance�r r"51i. x-•51 snot its creditors are likely to ado rtheJob; wherepnvate andagovernmentmsurers� a�"r afia "'e'Fw" �o�°'' r"'.atm..+ ;'ke�'.aa-4�xSr-z`3�,f' `ra. a t"v` 'l' `s'E *".as' 'YA SerIlmg rreportedly�warneclk� �; � are wieldmg ncredible power,over ally'- Despite500 layoffs since January1993r�,provider8�,d wands 'that we place an icon muous cos cu Ing, ed a exythmg on th�etalile`�`forexammatiion r. 7 dti .s=f- e ,>>" .'° rhe' fir+, x� e-. . California Pacific has been aunabl' toy and`analysis SerIling+said in a��May;311 v ' r eM sto fits Pfinanc,iYahemorh4 ge:v tkto&t memoAd the hospital s medical staff Keyr wily lost�$6 millloni on'�hospital opera , insurers MV ade t�cleai�thatatliey� ' (tions through March 31 Mand is�on trackparen't vlhngto�support the`'hospit`al's ;1696Maniestunatedi 18$million'to 20r`� `" 'F¢ $ $ education research and commumty ser milhon'uy+1994pF ces�progra�m;Iie said g,x Pre dff)A1163memo Serfliiigialso questionied ust�the be hospltal;coris iltanit_Wanda Jones l"You kwhether_Cahforiia Pacific could"contin= » "�- 7e dry l._ _]y Y - have not yet seen the bloodbaths 1 ue to operate 1n a university model with ^.s'a• ]r }y ss, w�ri` •"x�i m, bg 'f i e`ens ! x.= i Other observers agreedlthat 1i adds ',ZNUthe�kmd�of$endowmentenJoyed by - tional cutbacks,bemg proposed at Cali Stanford�or the'taxpayer support;ofUC,"' 1 �forria Pacific are the inevitable result'of ref rnng toSt fgrd Universty�Hospital � massive(changes in a wayAO health:care and UC San Francisco s medical center "The hos`1talmust`consider is a ivere s an_ o eraman ed�F ;U a p p care o ganiz -ions are}s ric yam„r tmgf tions�`4�if'we aretto have aYviable(future;" � nsive s.eci 'L x•a <: � P � an.�are�=1he�saiil�-`Tve'declicated�myself�to�this in. y_g Or_IlOn a entaex f " $ z Y r a s.j �v , > _ _ stitutlon for 20 years and+I can t n ecall a peeie aupoessionals , naroon tHan' ug- erF ospitalbills x- Jim w. ,r r, Gc ✓'.¢. .4 e new prop"a s come just five ;W. Any significant reconfiguration of Cah IS` Z41y'rr M6 5. 'i! S's' A fi 11 monthsYafter CaliformaWPacificsSboard of t x, ""� f pi�_point could also call onn1P- i'i. Ft31 - directors approved a f v yea&Atrategie 4 mto question the"health of the California plan deslgnied to overhaul the facility I--HealtlicarerSystem the;fdff hospital .� Y S "RT"i*.. r, ,. .r aY;k �u fas,1 '1 T = t 4y k. r The boardrls expected;to consider Ser San Francisco;basedinetwork iii which fling's latest recommendations earl 'z .-i . California Pacific has=been�the�crown month and opposition is already fo ma + jy �i � Fb`x xis ' g ,�� ,� 3 4b ,Jewel Becauseits strategy has,always'fo-� y r x,r ctised on providing�high-end'car'e some FInsteadtoffSerflmg's�restructurnng� s � •� x� ''� ' -'�-r� -__�'� �r�;:�: .•. F _ -:�_ _.,; �souxres•say CHS s raison d etre�could;be _ ,some factions within the�two campusi', ��" '=�= .. under mmed if California Pacific resur Hospital rare clamoring fo the closure of , v� �= t �...� middle;,of the-road community its so called California-Campus(formerly e r rs a r llOspltal #mssas ��, ; r " children s HospntaI of San Francisco), ��S6fn has faced mtense me � t which 1A bemg:converted into a pnmanly cisme from some doctors and­,_11`, mployees outpatient center Meanwhile,the hospl rwF_ r �. m , , over�the,proposed changes However, tai also aces, possiblerevolt;by'its�Lso1 se`�to th s tuation uisist that OB/GYN doctors, who are talking about Serfiln still,has the confidence„of lis 1 t takmg their business to St SMary's, 1n } and 1 e elements of the medical ,s... >t8` ¢ s�..was-7vrh$�"'d}" t' p' .� t1 § d t^, formed sources sa t n �' ' — �" �- � Y staff and the employee popM. ulation I In alwntten stagy went Serflini con ­46y �, , i� ,r cog- Nonetheless, h1s hospltal has hemor firmed the boardtwill�vote on'changes�m �rh�a ed k`sm a 1t was cr'ea`ted b 9 a' y .'s .rF-u - �'p a-?7•...�3'� '%'.g y, �2'Since .`�st r'+*it• y°fey i strategy and services withm two months, Ltie 1991 merger of Pacific{Presbyter an r and that those changes will- irbeyond �M n VAn n's�HosPital� the clinical reconfiguration that will be In ani,ranclsco�iIl= as ap rp oxi�-: completed by,July 30 _�, ma y9 on mreaerves but Serer .a- Y•�L— _� •s .3T ._t—:"t. b G..�4"v. 3 .0 1..c4 :..�.�yi"''=c 5 e flng oul�d not be reachedtforrir� flingtoldemployees lasmonththat, #t tM comment about the hospitals plans, thescurrent rate;that money-would u= or about`h1s own�future�wlil h�some�""appea withm four to�fi a yearsK , sources say.couldsbe 1n Jeop'ard�yY&Iri a� ��"Wat�1s the pmt 1�n,,that? he�said,�,�-, May 25:employee foruin,'Serf]"�iig repol'��. a:ccording to�Fan�lnte�nal�h�ospital�, edl�told employees that s cri 1cs will� memo.!- ` e Dove"nsize or die, hospitals told. Cutbacks .can avert closings, Downsize.to sumve,. hospitals told report says N HOSPITALS they did not plan any major re- manager of communications for front Page 1B structuring beyond converting O'Connor hospital. "Fewer hospi BY DONNA ALVARADO some of their hospital beds to tals will be in the county. Th, Mercury News Staff Writer ry Healthcare Institute in San skilled nursing care, an interme- hospitals aligning themselves Santa Clara County's 13 hospi- Francisco. "If it were not for diate step between hospital care with network systems, includini talc face.astark future,according their (financial) reserves, you and nursing home care. physicians (as O'Connor is), at-( to a new report, that could force would find hospitals closing mo- "We don't really think the pie- going to make it. It's like a retool them to downsize drastically o►• nwntarily — h► l.11e next 16 111111- lure is that, bleak," said Graham, Ing effort.." see nine of them go out of busi- u� ness. "Within the next five years, In the changing health care cli- : you will probably have involun- mate, there won't.be-n•.need for.;' tary.,closures, .she added, "Your all the hospital beds avallable.In= ' choices are whether:they are ran creasing efforts to controi health';: doM..or',planned.'1,y. care costs will.•lead: to patients.., '' Iiut',isome hospital representa- t getting more care outside the ho,tl tives.`said Tuesday they thought pital, ,decreasing demand for:. ttie report.might:<be too bleak. i. beds. Hospitals Ghat don't down- coij"Fewer hospitals will-be in the c l.(�✓G 1 �� will bsize e left In alfinancially Precir�` spokeswoman ort0 Conhor hleen Ill s� 1 �nous position.;;.. '. " �`1' ital.'In San Jose.:"But we'reo There ort released, ing';to' have an older and.sicker p yi`'`' population, We're going to need 0 was commissioned'by Good'Sa-;! : to take care of that population." maritan Health Systems ,. . the tt.. •. New-rOentury did similar pro-.: network of four;local;;hos rtals,z;+ pro­ ,.,,,network jection9 his year' for:all`of:the formerly known as Health Dimen�� �� ; . „ 8011' Y Bay.Areas;,73.,hospitals; It`pre Bions Inc.A spokeswoniati foi'the :, •dieted up to half would close in network said, the .report:was:;'.i the next:10 to 12 years.-The new made public in an effort to collab=` rep was.deIive0d,at,a.break- . orate with other hospitals and':;: Rist a'ttended. by,�i ospital and.. y community leaders in planning commuhity leaders & in$an Jose r ; for,the,future. :They Good�Sainaritan.,network P '.'They're the ones tliat are go already•has announced 1 plans to r; ing to shape the future of health C110ts budget by $26 million and 'care in the valley,"'said Christi''' consolidate some of its:medical 'i Welter, spokesrNornati fol'Good j services.•Within the network,the Samaritan hospital, most likely to feel the lit the report s mosf'.'dai ntliig ftfst cutbacks is 629-bed San Jose, scenario, in whldli".liospita�s:`Ye Medical Center; which serves`a i fuse to downsize at all;_.excesii heavily ethnic:populution in East-, capacity would lead .to a dowH=�; and,dow toWit'�San'-Jose. Two: Ward financial spirat.!that could`, prOgramslikely to get thp,ax are close nine of the 13 hospitals by•!; cardio44cular surgery,,and an-, the year 2006.In another draniat=`1' gioplast ',.Which also::a a provid- k scenario, all 13 would remain', ' ed"9f Good Samititdn 0 Iptal., open but only by shutting down:;; .rThereIts pain in al 6 Alds,".:. ,.two-thirds of their bed capacity'' shid:;:MlAael Guthrie,�president and operating on a weak financial and{chief-•exceutibe ofhcec• of. base, Good Samaritah;I;lealtit Systems. A more likely, Intermediate so- 'i Akthougli),Guthrie denied•',in Feb-. lution would.be for:five.of the 13 `'-I ftikey.that theng-was any�chance s hospitals to close, with`the eight"; Sah: efJose Medical Center._Wotild be survivors cutting their,size At- closed, 'he;`r' u'sed 11.iesday to most in half.`' '' ":'" "' ' M6e out thb.possibility of closing. "This county hasa fairly seri-`�'� any;of the network,'s hospitals:, t' ous surplus," said Wanda Jones,:. within the next yearn ..;,president of the group'that'pre:,;:) But he added that he had made, ,.pared the.report,the New Centu.- . 6i7.`commitment:to staying.in the " Sa1t;3ose Medical.Center location &eHOSPIT.",Back Pagd lq,some form,:though;"what goes ; t ^>- 0 iii that location,Wlh•bd aramat- Icahy different inthe next,six to elght:years.'' 1^'Anne Moses, associate director off the county's public•hospital, Siirtta.Clara,;Vahe.y Medical Cen- ter;;reacted cautiously to there-, , it ;';'It's provocative,:and that's: .; od;.':'• she.said.,'tut it's superfi- tial.=:and that's misleading." !,;i The report did not analyze how. geography and patient population could influence whether financial pressures,force some hospitals to close, she said. i,,. t, .Moses said the::report would not influence,Valley.Medical Cen- ters pians to build a,$200 million re"placem6rittor,'its-aging main. h4ildingi:Some county.officials• have questioned whether the pro-; Ject;is too,expensiv6;.and,too,big.,, . ._ jut Moses;held,firm Tuesday. aVMC is not.interchangeable with ftiiy,;otlter hospital in the county, slie said, it would be unwise for the public:hospital..to_:downsize because it serves'a population of,. titil'dAured:and ,loW•1ne0m0,,pa-; �lerlts Who are not usually Wei- , came at other hospitals, elle said. :'Other hospital executives said ve ra=.rte v dt' v f ���County hosp�tals�-�rr� Y �plan� 50M ne�u�constru�tion i �WCHRIS RA_UBER• Z-"' 1,�'"";"`Rosi,Hess Tirrres staff vmte� �`" " ,�•s.a,�� Four Bay Area counties areYpreparing y to spend close to WO on torenovate and rebuild existing � � 1 county hospitals, ieyen though¢tfie gion's hospital in ustry is suffering,,-....:,,.�? vfrom shi7nking_pd tient volume ocean of empty beds r The counties �5mr Alameda, Contra rt Costa, San Mateo Robert en `and Santa"Clara :x :say there val advantage of a vanish ing opportunity for so=called "dispropor Turn'to page 17 N _ rC! `�" er rA1ACCF' .'� O ��".""` �0 Y• ,(l8ii`'3s!zi_y` ._-���gg8 'F'°'�pA�rr O; IlO "; y�R A ::(� GQ'' 'fD�'R j ee•r�R�'A � A �n fi ��p .d` 5lw-� �£vTi i � i �R f Y.� F.,� ;ry m .."''.i'._,_- �"�t,....- s0 � :� O Ca�#�b.�rwt~D���,�{'�a �t�oA�r� ;O Pza�tt t-� ya�y ��p r�-• �� ��7,�p�3QC fD ���flr:g���y � ,$� 7Ct -.•,� ,r• � C. ,.,yap_� od ��co�xtT,�ky�C;��p� ���,�e,�+.�"a�' s '�-a ff•+� "'*y-M.'�a0 '�X,; _:r,pj �p.- 3 e} y ��2:' "_' -�.- w A :J':.. tp.•-;. � a�eyy� ' St�i'Lf�n ,e�•G -"' � 4,"d . 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I ..cam „L :,µ.ms j R s+�:r - ry t y fi � i•- -.e>� a ,� -�'��' ti � . w.. � '* .� �,� { s s. ._.1, ti r a-. -r � :7 x w'�-'` � .i1-. �ty-�•'" z - ..r ,-w .. .fir_ -•- -a ;,," l� RM,74 NO w , =ca PAGE�1$a Me K i, a'�' '''i"i'u `''G�Fi4' mm, ir. ...yF-H^�,«, 'it' 1 'fs�t�'51m 5v.eii �x�� t� ` t RK .xs .y T, 'Will SS �4Ti.., FWSX t+rtt�-fix'' n " t + t •n s = 7 S� $` T#r7��".r: -:1 r +.� r� ':.nYw".e Y 2y` rte * il { 'MCtiC'ortanuedfrom a-•�! �tik-y 5* r��fi u7 _+ . aN t zf�, ��� �formerstate�director ofthealth services��-� 'r r sMally Coye, saysWUYalley Medical Lente s;ff s1 „ dreamsgmaycomecrashing toearth€as cediY ..,, r sr _�,q, k= } �healthxcare�reform and Medi Cal man e d- �,�`�`�ragel�'care�`eat�into�its patient,valume���� `C .ry y+ £y:,'.-,. 9Lk"4*w'.l F 1h F c z � SFurther;a 1994MSanta ded Clara�County,f X ,- 1 vgrand�ury report'recammen �thattthe � icy 3 d ao �wliagli,*�countyxreview itsigptlonsbefore proceed. " G t- a`�x "i7=c i .r. zQ r . Axa ' �'` 1Tlg,with the ;me o. edly the+Coon wsF h s�=� � ty'simost expensive'capital;prqJect ever , N M- ~ * ��'1. D ContraCosta'officialsare embroiled n �-�' r'3 Xltl.3'' >,A' t -•t� a e- is Illfita8lmilar�COntroYerSy OVerkplan8 tore= R 'M, f:Q*1tuajH '�� t Merrithew 4Memorial Hosprtal7liwj t ti A . Martiuez�w�th�anew 144 bedfacility, �! iwl�cliwillYcos $1256�millionsupfiront t Lr A?NA k h �t9 Gt�?5r I w p� i' ��r *S y�T' •t S`s.'§-kcm F'�ra y.ncludmgprepaidinterest; t�,�.�, M � '�:;- ``x' t X 4'''S 3' -i e *iGr s.„• r +✓. atxev�M e " ' � t'*�Furancxally pressed�&i r I iablo.Medicals I r �a s tr. r a r{ rp Vie. ' sem }: f4 Ceriter � Concord and+•San P2ablos, -91to,ase •v sx s 3 C fisfi r^" 1 tp Braoks�deHospital haveoffered to��oui ?, -Wfor s rvr thm, county i treatisomerof Ul ���� the poor�and mciigent patents nowacared�� atMeirithewButfcounty supervisorsi� t _;_� °voted lViay 24 to rlet�construction of�the ,;�, 1 J k x r s ro ? a ,,new #} , j Ctrt 4 x �► .Sai1�l�lateO W111 Spend=an'estmlatetl x fiY �n �t$130nullonta fireplace its antiquatede t MateotCounty Genaral'Hospital with � s ati8 news110Spltal,rehak?ihtatlonrCenteraIld' � ' a° rEmanageil=carecomplexConstruction of L��l t , PRI .� ����� ��� the naw faczl�ty, which�wdl pro�ceed:ini,�+�� t13tage$y beg--MO n7May r SanJMateo sXplans to build its new coin= Alex rcon blidate_e _t ne fac .< ilities:.and empha6iz6lmanaged care have received 4aurelatively fit Ie crit�ciam. However;l=a ,� `�F✓rt:AFata 1993`countygrgnd fury report questloned $ whether"axcbmplex of this'magrutude"Ls a" +T h v3tr<xr r� ttf�: r r c fp r ; 41 cessary,46ndpSuppivisor Tom,Huenmgr' $V Yr ri t i rSv a a:J^. has obiectecl"strenuously to the plan 0gpi>"Alameda County,, l'a pnsto, spend a �$105nulhonfona new&story critical career I1 wk r •e a { � bwlding,� quipment and Ffix t new equi�ment'­andlli� ures, ' fk N}n �i1d SAY �5 C pat kiii iBtrii iie ion the k 1 a:. s"i'3 Srb.I_ 4 &•8= ;" ca F�}',�,int Y # a 'siaf itsxrrent Highland General Hos {a , rx K ami r #rsr , :$ f petal campus swell as improvements toe 5 5 Ss * } existing faphtleS r a: vs F ,1 isf3,r5` r t ^�,' ,+xy„�41 "Atfa �'�` Although the controversie Pini a ta' �- M C =4 r e Lara�arid Contra Costa coiintae8 have at 1 2 5 5 tft+< tb iu �'• i y '� `'m �,�.� yrpnr^e,,p j 1 < � � �tracted signifcent inediaattention' the x :� F � public anusmess=commumties int the Sk;tla ey, Yt �' g 3 C �` lw` AI rs�" y Area a largely ignored the broad t Q•. e i' Yrs * y f i u x'1eFeT iSSlles fSi Couiity�haspitals au?mg a peeriod o intens&'change in5'the local , & llealt�l-A n11YStry u }vSl�w?x�{ S `frY1 *:-t?i z, a`3 v..y., Primaril because of the SB'17,32 ; $ a a K r 3a orb rt�i i }rr, js� ti fundsthe fourcountiesaare able to con t s atemplate rJe C StTUCti021 ppa r0 eCt$8t x �w vF�i,fit? z R {t> Fa rtuTevlhe22m�nyrp�llvate h03p 1tals amore`} 3 �� having trouble keeping their bizdge`t I + x^ tS { 0"u� .t"�,,a 'lag arcceen giant Kaiser-PermanenteE f "s`Tis jettisonmgcess j bs arid`costsk' k; t' 1,i rest t4•' .tS'+ K But.man �iiestions remain about the v "very +� x,„,� � futui.6 of c ui i y hospita s and their'vilder- !� � `• "ori`+ f3,�'i��rOle^ � � �S�es,,#� -c.`g�' �a � ,.rx-,e a s�,�•� s,4 mthg HaArea s health-care acture v��-�ga �. �',.�� �`:' �.•�asr,.,v R�-` r x's se,1p�, r7� = >k d a� ;Ma11jT4C0uI 1@$1Tl,afi&I1fOI13I$hayeaban,q 21 dared he ht3spnt—la tFusiness" toe er,, t y ' �au^co gats' a ornia� sociation'of> � PubhcHosptals And°those=whoremam y iiy. s v� •Fa i j.?'$ .�•s o r'» y -�",(' N i S�faceeo,air mst3tutaonal�dilemma, accord to;lVliichaeFGallagher,president of the Hospital3Cqua C of<Northern and'`Central °'l r r S L..�.tn, `at -s •-x' b s «* `fir a y,�:r . 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V w ao oD pt ,,. w �n n y ,^tntn n ; , V :.Na (o " a n n o m P CJ 2 a-.0o -0 -.00 -o o c ' o.I WEEK OF JUNE 17-23,1994 • $1 eWrrhatm gra 0M.Fm hospitLal U a, r BY CHRIS RAUBER Business Times stat(writer California Pacific Medical Center, facing losses of up to $20 million this year, is considering downgrad- ing the high-end private institution to a community hospital, eliminating specialties, scrapping research and curtailing educa- ion and training. Calling the upmarket ti hospital's current focus � on cost-cutting"a strate- gy for failure," CEO M Aubrey Serfling has asked the board to ap- prove radical changes. Under the proposal,Cal- ifornia Pacific would re- IT portedly discontinue high-tech surgi�caTs e- _ o s ciar le­ss uas Iver, hea _ eart and kidney trans- plants and pediatric. specialties, cut deeply ma into educational and training programs, and eliminate the hospital's university-style re- search efforts. Up to 700 new layoffs apparently will also be on the table. California Pacific,the region's largest private hospital, must reformulate itself as a"first-class"community hos- Turn to page 25