Poor management and a lack of oversight by public officials have left beleaguered Alameda County Medical Center, Oakland, Calif., in disarray, a civil grand jury report found. The grand jury blamed "lax executive management and insufficient attention" from the board of supervisors and its appointed board of trustees, which oversees the three-hospital system, for allowing a culture of wasteful spending to develop and concluded that the trustees made poor choices in selecting top executives. The system laid off 176 employees and closed two clinics in 2003 after losing a total of $109 million during the prior four years. Cambio Health Solutions, the turnaround consultant hired in February to help repair the system, has recommended cutting another 350 positions this year to make up a $62 million deficit in fiscal 2004, ended June 30. The grand jury advised the trustees to closely monitor all of Cambio's recommendations, but implement only those that "improve financial efficiency without sacrificing medical care." It further advised the board to examine any fee increases to Cambio, calling the firm's current $3.2 million contract "extremely expensive." In March, Alameda County residents approved a half-cent increase in sales tax to prop up the county's cash-strapped public healthcare system. The tax increase, which took effect July 1, will generate up to $100 million annually for 15 years, of which 75% will go to the medical center. The remaining 25% would be divided between the county's other healthcare facilities that serve the poor. -- by Laura B. Benko
Management blamed for system's finances
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