Defying the Downturn: Sales Tax Helps Maintain and Expand County Health Services

By Joe Sadusky, Alameda County Health Care Services Agency/Measure A Oversight Committee

While the debate about health care reform and potential cuts carries on at the federal and state level, Alameda County residents continue to benefit from a voter-approved tax designed to ensure the provision a basic level of health care services across all segments of the population.

The latest report about “Measure A” health care spending in Alameda County, covering fiscal years 08/09 and 09/10, describes how over 100 County health care service providers used Measure A sales tax funds to enhance services, expand outreach, and upgrade facilities.

Measure A, the Essential Health Care Services Initiative approved by voters in March 2004, raised the County sales tax by one-half cent to support emergency medical, hospital inpatient, outpatient, public health, mental health, and substance abuse services for indigent, low-income, and uninsured County residents. This “half-cent on the dollar” has made a big difference: Measure A generated $101,261,219 in FY 08/09 and $94,117,187 in FY 09/10.

Measure A also created a Citizen Oversight Committee that monitors Measure A spending for each fiscal year. In March 2011, the committee published its fourth report, covering Measure A spending for FY 08/09 and FY 09/10. Highlights from the report include the following:

• Alameda County Medical Center. Measure A funding helped the Medical Center reduce clinic waiting times and expand service offerings through renovation of the Newark Health Center and establishment of the Fall Prevention Center at its Highland Campus. The Medical Center improved its ranking both among hospitals serving the uninsured and among all Bay Area hospitals, and realized savings of over $3 million in FY 09/10. In FY 08/09, the Medical Center Measure A allocation was $75,951,290; in FY 09/10, the allocation was $70,587,890.

• School Health Services Coalition. The School Health Services Coalition used Measure A funds to provide access to on-campus, low- and no-cost services to more than 21,300 middle and high school students in Alameda County. The Coalition opened two new school-based health centers to serve students attending continuation high schools. Students in the youth development and empowerment programs reported improvement in their communication skills, self-esteem, interpersonal skills, presentation and public speaking skills, grades, and school attendance. In both FY 08/09 and FY 09/10, the Coalition’s Measure A allocation was $1,060,900.

• St. Rose Hospital. St. Rose is a designated Disproportionate Share Hospital (DSH): a hospital that serves a disproportionate number of Medi-Cal, uninsured, and indigent patients, thus providing a safety net for these patients in South County. With help from Measure A, St. Rose began construction of 30 medically monitored beds, to be completed in 2011. The hospital completed both a required hospital seismic retrofit and installation of a modern Radiology Picture Archiving and Communications System. St. Rose partnered with Delphi Healthcare Partners to develop a new OB/GYN hospital program and created a state-of-the-art imaging center in partnership with local physicians to offer comprehensive diagnostic services to the community. In both FY 08/09 and FY 09/10, the St. Rose Measure A allocation was $2,387,025.

• Detox/Sobering Station. The Cherry Hill detoxification program and the Safe House-Sobering Center are 100% funded by Measure A. Over the two years covered in the Measure A report, Cherry Hill Detox saw a significant decrease in the waitlist due to the use of the Sobering Center as a service entry point. Of those admitted to the Sobering Center, 33% moved on to Cherry Hill, and reduced medication abuse occurred among those admitted. Almost 100% of individuals in the program received referrals to outside agencies. In both FY 08/09 and FY 09/10, the Measure A allocation was $2,121,800.

• Alameda County Board of Supervisors. Measure A gives the County flexibility to address unmet needs and unanticipated costs by allocating funding to individual Supervisors to respond to unanticipated needs in their districts. In both FY 08/09 and 09/10, the budgeted allocation per district was $209,090. During this time, the Supervisors awarded 42 service contracts for youth, children, seniors, and the general population, with a focus on healthy living, wellness, and prevention.

• Matching funds. Several recipients, such as the non-county hospitals, school-based health centers, and the Juvenile Justice Center Victims of Crime unit, used Measure A funds as leverage to draw down matching funds, both federal and foundation grants. Over the two-year period, Children’s Hospital doubled its $2.3 million yearly Measure A allocation to $4.6 million through matching funds received from the State of California each year.

• Inter-agency collaboration. The two-year period covered by this report saw a growing collaboration among Alameda County, the Alameda County Medical Center, the Public Health Department, and community-based clinics. Measure A helped fund some of these collaborative efforts. For example, Preventive Care Pathways collaborated with Healthy Oakland, Alameda County Medical Center, Sutter Health, LifeLong Medical Center, and other organizations to provide disease prevention, intervention, and treatment to at-risk members of the community.

• Geographic spread. From Axis Community Health sites in Livermore and Pleasanton, to the Fremont-based Tri-City Health Center and the Newark Health Center, to multiple agencies in Berkeley, Measure A funding touched all areas of the County, thus delivering on its promise to help ensure basic health care for all County residents.

Louis Chicoine, chair of the Oversight Committee, offered this thought: "In the face of this extremely serious economic downturn, Measure A continues to enable a large number of health care providers serving low-income and uninsured patients to maintain and even expand the service levels they offer. Alameda County voters should take pride in their contribution toward making sure health care is available to all members of our community.”

The full report contains comprehensive information, such as a complete list of all providers receiving Measure A funds in FY 08/09 and FY 09/10; the amounts received by each provider; descriptions of the services offered by Measure A recipients; maps showing the geographic distribution of Measure A fund recipients, indicating the spread of services throughout all parts of Alameda County; and more.

To request a free copy of the report, or for information on becoming a member of the Measure A Subcommittee, please call (510) 618-2016 or email Jennifer.Chan@acgov.org. You can also download a free copy of the report at www.acgov.org/health/.