October 28, 1998
By Yolanda Reynolds
Healthy Families program available to low income county residents
The dedication of the new wing of the Valley Medical Center last week, Oct. 16, will stand as one of the proudest and most timely events to take place in this valley. It is timely because, in this decade, the nation’s residents have seen a serious decline of access to health services. Millions, including children and working people, no longer have medical coverage. This is taking place at the same time that major medical advances have occurred.
For various reasons, most often the lack of political leadership, the problem of access to health care is ignored. In September of 1994, four members of the Santa Clara County Board of Supervisors, Mike Honda, Rod Diridon, Zoe Lofgren and Dianne McKenna voted to build this new wing and to continue the County’s commitment to directly provide health services to all of the community, including the indigent.
VMC has had a large building which served as a hospital, clinic and for doctor’ s offices. According to Matt Schenone, of the VMC Public Information Office, state officials determined that the hospital building no longer met earthquake (major disaster) standards of safety and could no longer be used as a hospital. One Supervisor, Ron Gonzalez, along with a number of private hospital officials argued for fanning out VMC hospitals patients to their respective hospital. The argument was that there were increasing numbers of empty beds and that constructing a new wing for patients, would just add to the existing glut of empty hospital beds.
What is often not well understood, or is simply ignored, is that no longer simply a hospital but is more importantly, a health can system whose emphasis is on health education, out-patient clinical care and prevention. Robert Sillen who is the Executive Director of the Santa Clara Valle Health and Hospital System of which VMC is a part, explains that the new facility and hospital, “is the ﬂagship of our health-care system, and this new facility is no only a technology marvel, but was designed to optimize patient recovery.”
A tour of the new facility showed that the very best and latest technology is available then for handling some of the most difficult medical problems. Shenone pointed out that VMC is known and recognized as providing the best care and facilities in Northern California for bum victims VMC was ranked 20th nationwide by US News and World Reports in the care and services provided to victims of brain trauma and spinal cord injuries. The new VMC wing will now house the latest state of the art equipment for neonatal care, as well as cardiac surgery, including the invaluable diagnostic imaging department. The Diagnostic Imaging Department will now include two mammography rooms, 8 general radiology rooms, a CT scanner, one angiography suite, one MRI machine and 5 ultrasound rooms.
Sillen and his staff have designed a program that not only serves those without health insurance, but also those who either have lots of money or health insurance. VMC is a nonproﬁt hospital and uses the revenues it earns by serving paying customers, along with a combination of other funds both public and private, to assure that every resident of the county who needs medical attention can get it.
In 1990, then County Supervisor Zoe Lofgren and Suzy Wilson convened a group of County Commissioners and County staff to assess the future of Santa Clara County from a variety of indicators and perspectives. The result of those months of review is available in a document entitled, “Alternative Futures-Trends and Choices.” With regard to children’s health, it was concluded that there was a decline. The conclusion then made was that, “Increasing poverty, lack of prenatal care, substance abuse by pregnant women, malnutrition, and teen pregnancy will continue to be serious threats to the health of Santa Clara County’s children.”
The new VMC facility is a response to these threats.
During the tour of the of the neonatal unit, Shenone demonstrated a bed called “Nature’s Cradle,” which simulates, for a premature baby, the sensation a baby feels in the womb of its mother. That cradle was developed with the participation of VMC. The particular cradle in the new neonatal ward was donated by the Kiwanis Club of San Jose and the Santa Clara Metro Kiwanis Club. Shenone explained that the Santa Clara Valley Health and Hospital System as well enjoys the support of many volunteers, including school youth (primarily senior high and college students) along with a large and active volunteer contingent from the general community.
Another important part of Santa Clara Valley Hospital and Health System are the eight satellite health centers that are scattered about the Valley from Alviso to South County and other sites in between.
The County coordinates with many County based non-profit organizations whose mission is to provide important community educational and health services. For example, a recently formed “Healthy Families Program” is, meant to help bring affordable health coverage to families who, until now, could not afford dental, health and vision coverage. Like the county, state legislators realized that the best health care is early intervention and preventive care. This new program is directed to families whose incomes range from $16,450 to $32,000 per year for a family of four, too often the most needy in terms if access to health care. The actual cost per family varies depending upon the number of children and the type of health plan the family chooses. The premium rates can be as low as $4-$6 per month per child. There is a $5 copayment for prescriptions and non-preventive care. Preventive care is free. Healthy Families covers children from 1-18 who live in California and are either U.S citizens or legal immigrants. According to Healthy Families, for a child to qualify for health coverage, the child must not have been covered by an employer sponsored health insurance plan during the three months prior to applying.
Access to adequate health care is a growing concern. The number of people without health insurance has steadily grown in recent years. In the Alternative Future Report, the number of uninsured rose to 230,360 in 1990 from 180,000 uninsured persons in 1985. In that same period the cost of health care rose 100%. It has continued to rise in subsequent years.
The number of uninsured in Santa Clara County is today estimated to total 116,222. And still health care costs continue to rise. In the state of California 24.7 of the Hispanic community lacks health insurance.
In the local daily, critics have stated that VMC is a “monument to the poor” and proceed to point out that the sum spent on the new building is $197 million and that there is an anticipated operational cost deﬁcit.
These same authors have never written a similar story regarding the huge sum of the money that has been spent by the RDA (Redevelopment Agency of San Jose) most of whose projects are of dubious merit. That total exceeds $2.2 billion with very little, if any, spent to save lives and truly improve the fundamental necessities of life that can be had with good health and a healthy life style, which is the mission of the Santa Clara County Health Care System and Hospital.
Rising costs are the stated reasons underlying the recent spate of sales of not-for-profit hospitals across the county. Santa Clara County hospitals operated and owned by the Alexian Brothers, has served the East Side community for over 33 years. The hospital became a reality in 1960 when a wealthy and generous landowner, Mrs. Overfelt, deeded a portion of her land to the Brothers for the hospital. In subsequent years, the brothers bought several more parcels, thus expanding the Alexian Brothers Hospital campus to its current size.
An exchange of this hospital with the for-proﬁt Columbia/HCA was sought by the Alexian Brothers, who say that their order is too small and that this hospital in San Jose is “too far away from their headquarters in the Midwest” and “there are too few Brothers to manage all of the hospitals and other organizations (they) sponsor…”
PACT (People Acting Together in Community), a faith based organization that in San Jose counts over 35,000 low and middle income families as members of its organization, has expressed concern over the effect of this proposed exchange. Columbia/HCA is well known across the country.
This for-profit health care company has been characterized as an organization that is almost exclusively dedicated to making a proﬁt for its investors.
Al Bartel, a Kaiser nurse and a spokesperson for the local chapter of the California Nurses Association questioned Columbia’s compatibility with the commitment with which Alexian Brothers has operated its hospital in San Jose. Alexian Brothers has had a philosophy of providing holistic health care for its patients, he says, and, furthermore, it has a Foundation whose purpose is to raise money to provide health care to indigent patients.
The state and federal government has enacted legislation requiring that a not-for-profit hospital must, upon the sale of its programs, return donations, even those collected over time, to the community. There are numerous other regulations that must be observed. One major problem could be the creation of a health care monopoly. According to reports made at the hearing last week, Columbia/HCA seems to have a strategy of “buying up a number of hospitals in an area and then, after paring down or eliminating its competition closing down facilities in order to maximize profitably.”
In the San Jose area, that scenario seems to be planned for Santa Clara County as well. Columbia/HCA now owns Good Samaritan Hospital, located between Los Gatos and Saratoga, San Jose Medical Clinic in downtown San Jose, South Valley Hospital in Gilroy, and Mission Oaks Hospital in the Los Gatos Almaden area. Alexian Brothers Hospital is the only hospital in the East Side of San Jose and serves a large portion of San Jose’s population, many of whom are low income in this multi ethnic neighborhood.
For example, the largest (16,000 students) of the seven elementary school districts that serve the east side of San Jose have a student body whose population, in 1998, was 67% Hispanic, 12.6% Asian, 7.7% Filipino, 7.1% White, 3% African American, 1.3% Pacific Islander and .05% Native American. Of that population, in 68% of the homes English is not the dominant language spoken. Approximately 72% of the total student body qualify for reduced fee or free lunches.
It is the continuation of the commitment to service that includes service to the poor which concerns the PACT community, County government leaders and health care providers. When Columbia/HCA says that it promises to continue charitable services for “three more years” and refuses to say what will happen after that, alarms began to ring. Columbia HCA spokespersons also refuse to state their charitable commitments in writing.
The anxiety level regarding the access to health care in the East Side was heightened further upon hearing a Columbia/HCA spokesperson admit that upon acquiring Alexian Brothers, the company is considering closing down either San Jose Medical Hospital or Alexian Bros. Hospital.
Such a closure raises the specter that, true to the past performance of Columbia/HCA, the hospital will be acquired and then closed. In a ﬂyer prepared by the California Nurse Association, the director of a hospital system in Arlington, Va., John Robinson, is quoted as saying “(they) buy up hospitals in a area, perhaps focusing on minority communities where there is less political inﬂuence, stifle remaining concerns with talk about community service, wait a year or so and then shutdown the hospital, in the name of efficiency. Then it can move the beds closer to the money.”
The San Jose Medical Hospital is outﬁtted with a helicopter pad to accept critical emergency patients. A hospital cannot operate an emergency care program without being physically attached to a hospital.
It could be that Columbia HCA would close Alexian Brothers in a few short years. If they choose to close San Jose Medical hospital, emergency services would be closed down. As the population grows, the need for all sorts of services obviously increases. Kaiser Permanente recently announced the possibility that it will not rebuild its hospital in the city of Santa Clara. That facility alone serves over 250,000 patents. It has an emergency room which would crease to exist if the hospital is not rebuilt. Such closures raise serious questions regarding accessibility of health care and the creation of a monopoly in the provision of select services. When that occurs and there is great demand, the cost usually goes up to what the market can bear. Santa Clara City political leaders fought unsuccessfully to delay the awarding of building permits to Kaiser Permanente if the plan did not include a hospital.
The quality and extent of health care available to the broader community is of vital importance. Neglecting basic health services has already shown that contagious diseases, once thought to be under control, are once again resurfacing. These include Hepatitis ‘B,’ tuberculosis, etc. New diseases are often not well understood such as AIDS. Diabetes, heart disease and such illnesses are common. These illnesses, in fact, can often be avoided or controlled by life style changes.
At the meeting, a number of interesting and troubling revelations were made. It was just two weeks ago that the community became aware that the Alexian Brothers were in negotiations with Columbia/HCA. An Alexian spokesman, Brother Lawrence Krueger, said that they hoped to conclude their negotiations with Columbia/HCA by the end of October and, rather curtly, responded to queries regarding community concerns that, “We will consider them.” Among the question was a request that the discussion be held in public. Another request was that Columbia/HCA be required to make a commitment, in writing, to provide services to the poor in perpetuity.
Among those in attendance at the hearing were numerous public ofﬁcials including Supervisor and Board Chairwomen Blanca Alvarado, San Jose City Councilman Manny Diaz, Alum Rock Board members Felix Alvarez and Bill Horn, Deputy State Attorney General, Mr. Horn, Santa Clara County Assessor Larry Stone, Mavis Toscano Chief Aide to Congresswoman Zoe Lofgren, SantaClara Valley Health and Hospital System Director Robert Sillen and numerous local Catholic Church clergy, among others, along with several hundred San Joseans, mostly residents of central and east San Jose.
For more information regarding Healthy Families, contact Felix Alvarez at 260-4482. To volunteer at Santa Clara Valley Health & Hospital System, contact their public information office at 885-4161. For more information on the Alexian Brothers Hospital swap, PACT can be reached at 926-2820. © La Oferta Newspaper.