By Khalida Sarwari
The Santa Clara County Board of Supervisors today held a special study session to address concerns about a consultant group hired to remodel the county’s hospital system after receiving criticism last month from some who claimed that the county was not being transparent.
A number of members from the local chapter of the Service Employees International Union appeared at a meeting on March 29 to voice their concerns about the county’s $6 million contract with Alvarez and Marsal, a consultant group county Executive Jeff Smith hired last year to prepare the county’s hospitals for health care reform.
They claimed the contract had been rushed through without adequate evaluation, setting of benchmarks or a competitive bidding process.
At that meeting, the board approved the appropriation of $500,000 to the firm, but decided to defer payment on the rest of the original proposal of $1 million to a later date following a public study session to review the contract.
That session was held today, with a presentation by representatives from Alvarez and Marsal on how the firm is evaluating the Santa Clara Valley Medical Center’s core information technology system to find cost-saving measures and to prepare for health care reform.
As part of their work, they found that the hospital had an “unusually” high number of one-day stays and helped decrease the number by rearranging the priority of patients in the emergency department, sending those with maladies that do not require immediate attention to see a primary care or urgent care doctor the following day.
Representatives said among the firm’s accomplishments were reopening and sustaining access to adult medicine primary care physicians so that patients who needed care could get it on an ongoing basis.
Prior to the presentation, Smith gave an overview of the financial history of the county’s health care system, focusing especially on factors that have impacted the county’s general fund, the most significant being property tax revenues, which he said will not likely return to a “reasonable
level” for another four to five years.
Smith said his aim is to reduce the cost of services by controlling the hospital’s operations and to empower mid-level management, citing that they would know what needs to change and how to make those changes.
“We need to change the operations to be ready for a new world,” Smith said.
Wren Bradley, a county social worker, was one of five people who addressed the board, saying the public study session was a step in the right direction.
“I’m pleased that they had this forum,” she said.
Bradley said the presentation made her come to a number of realizations, among them that the county is not prepared for health care reform, that the contract should have undergone a competitive bidding process, and that county workers and community organizations should be a part of the process.
“We are the people that hold up the hospital,” she said. “We have to be a part of the solution.”
SEIU Vice President Ellen Rollins said while she appreciated the detailed presentation, she is still unhappy with the hiring of Alvarez and Marsal, saying that for the money they are being paid, they should have built upon the work of Deloitte and Touche, a consulting firm the county hired for $20 million prior to Alvarez and Marsal.
“They just re-did an analysis that was done two times before,” Rollins said.
Smith has said the work that Deloitte had done was different from that of Alvarez and Marsal and Supervisor Liz Kniss has said Deloitte was replaced because they did not have a strategic plan even after two years.