1 Subcommittee of the City Council
and
Alameda Health Care District Board
Meeting Notes
Monday, November 13, 2023, at 1:00 PM
City Hall Room 360
Attendees: Mayor Marilyn Ezzy Ashcraft, City Manager Jennifer Ott, Fire Chief Nicholas Luby, Executive Director Deborah E. Stebbins, Assistant City Manager Amy Wooldridge, AHCD President Dr. Bobby Deutsch, AHS COO Mark Fratzke, AHCD Board Member Jeff Cambra, AHS Chief Administrative Officer Mario Harding
1 Call to Order/General Introduction
Mayor Ashcraft called the Subcommittee of the City Council and Alameda Health Care District Board meeting to order at 1:02 PM on November 13, 2023.
Members of the Subcommittee introduced themselves. All attendees appeared in person.
2 Oral Communication Non-Agenda (Public Comment)
Speakers may address the Subcommittee in regard to any matter over which the Subcommittee has jurisdiction or of which it may take cognizance that is not on the agenda.
Mayor Ashcraft asked for any individuals with oral communications regarding non agenda items to advise the attendees of their presence for inclusion.
No additional attendees, either in person or remote via Zoom, were noted.
3 City/District Issues
3-A 2023-3534 Minutes of the Subcommittee of the City Council and Alameda Health Care District Board held on February 14, 2023.
Attachments: Minutes
Mayor Ashcraft asked for feedback from the Subcommittee regarding their review of the Minutes from the most recent meeting, which occurred on February 14, 2023. Mayor Ashcraft specifically asked the Members for their recollection regarding Page 2, Item 3C, and whether the acronym “AHS” Leadership referred to Alameda High School, as detailed in the draft of the Minutes, or if “AHS” referred to Alameda Hospital leadership, or the Alameda Health System or the
2 Alameda Health Care District. It was agreed that “AHS” referred to Alameda Health System, and it was noted that EMS was not present at the meeting, although referred to in the minutes.
Dr. Deutsch moved to accept the corrected minutes for the meeting that occurred on February 14, 2023, and Mark Fratzke seconded. Motion passed.
3-B Alameda Health Care District/Alameda Health System Update on Seismic Retrofit Plans (Stebbins/Harding)
Ms. Stebbins reported the seismic retrofit progress is good thus far. The process of converting from thirty (30) acute care beds to fifteen (15) skilled nursing facility beds for long term care is underway. This conversion involves increased costs and enhanced licensing. Conversion of the west wing of the Stevens Facility has begun with estimates received and under review. The District has approved redirection of retrofitting funds and is approaching the AHS Board. The estimated cost is $60-75 Million for certificates of participation, which Ms. Stebbins is working on. A public vote is not required, which streamlines the process. This will be secured by the parcel tax, to be used to secure the bond. This proposal must next go to the Board within the next couple of months to approve redirection of funds to secure financing. Ultimately this process will likely result in alignment with 2030 seismic requirements. Dr. Deutsch asked Ms. Stebbins to expound on the number of beds. Currently there are 56 licensed acute care beds, which will reduce to 31, along with 8 AICU beds, as well as a total number of 45 skilled nursing facility beds. The OB/GYN unit is not currently included in the redesign plan and utilization is under consideration for a new program depending on AHS and their decision of how to develop the space. Dr. Deutsch suggested the OB/GYN unit could be dedicated to behavioral programs.
Mayor Ashcraft asked about the change in use of the parcel tax, and whether or not this option has been considered by the City Clerk to ensure feasibility? Dr.
Deutsch responded that a 24-hour emergency facility, as well as skilled nursing facility beds, would result from this redirection. Mayor Ashcraft asked for a copy of the ballot language for her review. (Measure A ballot attached for review.)
Mayor Ashcraft advised that on the November 2024 ballot there will be the Taxpayer Protection and Government Accountability Act, which is sponsored by the California Business Roundtable (CBRT). This act will restrict cities’ ability to raise taxes and fees, and works retroactively to January 1, 2022, on any fees passed since that time. Sunset dates for the current parcel tax may be required, as well as potentially re-approaching voters for consideration of a second use of funds. If this measure passes it will be detrimental overall, and we should be aware of its impending voter response next year, as well as the likely impact to school districts, etc. The State Chamber of Commerce may be marshaled to support opposition to this measure.
3 Mr. Harding mentioned the enhanced reporting requirements commencing next year, and that facilities will be required to more closely report their NSB (Non- Structural Building) and SPC (Structural Performance Category) numbers. On a scale of 5 to 1, with 5 as the best, Alameda Hospital currently ranks 1 in the SPC performance category – which is a large gap to bridge. To reach a rank of 5, the requirements are for full preparation for a seismic event to ensure a significant earthquake causes little to no physical disruption to the facility, nor operations.
Reporting is required each year to show progress toward the goal of 5. Any facility’s current rank may be viewed online. Working with an architect, a plan is in place to show the hospital moved from a rank of NBC 1 to NBC 2 and will be available to view at entrances to the hospital.
City Manager Ott inquired how the utilization of the AHCD tax fund will be backfilled, and Mr. Fratzke mentioned anticipated revenue from operational changes will contribute to backfilling the fund. It will take some time to remodel, up to a year. Staff should be hired and equipment should be ready to go as work is completed. Inpatient floor(s) will be more challenging. Mayor Ashcraft asked about financing, vendors, etc., and Mr. Fratzke stated 12-15 months are required to put plans in place, then work will need to phased in as it fits into the overall plan – with the understanding that seismic security is the priority, then remodeling. Ms. Stebbins stated 15 months out is the minimum due to lack of funding. Mr. Fratzke mentioned the $60-70 million budget mentioned previously does include remodeling of the second floor. Fire Chief Luby asked Mr. Harding about SPC and where it stands. Ms. Stebbins stated the West and Stevens wings are at SBC 2 and must be at 4 by 2030. All equipment must be bolted down to achieve compliance. Ms. Stebbins stated the 2020 standard ensures the building is safe from collapse, and the 2030 standard ensures little to no disruption of service at all.
Mayor Ashcraft asked if Stevens – second floor south wing – will be converted.
Dr. Deutsch mentioned the progress already is really incredible. Currently there is a specific plan and a design for patients, funding is secured, and a bond specialist said the JPA may be changed – hopefully within the next couple of months. The HVAC project will commence next year, with the benefit of a $2M donation -- which is also contributing to the quick timeline. Mr. Fratzke stated the completed 2030 facility will be very nice.
Mayor Ashcraft asked about the financing, and Ms. Stebbins said it is in process.
AHS Board approval is required before moving forward too quickly.
3-C Hospital/City Opportunities for Behavioral Health Services Partnership (Ott/Wooldridge)
City Manager Jennifer Ott and Assistant City Manager Amy Wooldridge presented options for behavioral health partnerships, with Assistant City Manager Wooldridge outlining that Housing and Human Services is already working with
4 Fire on acute mental care possibilities. Space on the second floor is available, and the hope is that funds may be utilized to increase access to mental health care for more patients. Various entities around the Bay Area were consulted to outline opportunities and models for service provision to unhoused individuals, and to determine needs for these types of facilities. City leadership and Housing and Human Services visited Amber House in Oakland, which includes rest and service bridges. There is a 12-bed area for stabilization, then opportunities are in place to move patients forward to additional supportive services.
Alameda Hospital has potential space for crisis residential treatment, but it is not well suited for this type of treatment model with no alternative entrance(s) other than through the hospital proper. The former cafeteria was also deemed unsuitable.
Amber House is a good model for unhoused individuals in need of mental health treatment, and we can move patients there as needed, and space is available.
Ensuring funding is in place for future growth of these types of programs is important. Medical detox and outpatient care are both still needed, and Highland Hospital has an excellent outpatient program.
Ms. Stebbins mentioned the old cafeteria is not suitable for any interior use, and there is no plan to bring it up to code. The District needs to decide if the building should be demolished for safety.
Mayor Ashcraft asked what the plan is for inpatient services. Mr. Mark Fratzke mentioned inpatient substance abuse treatment, as well as a medical psych unit, with primary diagnosis of physical problem with mental issue, are in the discussion phase, as well as care program(s) for elderly individuals with mental health issues. More research is necessary to decide the best option.
Fire Chief Luby inquired about using the second floor for adolescent eating disorders treatment. No adolescent eating disorder clinics are currently in the planning stages, but that treatment model has been discussed during teen health conversations with Assistant City Manager Wooldridge. Mr. Harding mentioned that San Leandro has a good program, and he experienced several quite successful for-profit eating disorder treatment facilities during his tenure in Denver. Mr. Fratzke mentioned an overall program must be in place for children and teens that encompasses eating disorders.
The Amber House crisis stabilization unit is fairly available, but it gets busier on weekends. Outreach to advise of availability of Amber House is ongoing. They opened during December of 2019, so they are now up to full steam post Covid.
Located near the bottom of pill hill, it is a very nice facility. It is a challenge for them to maintain staffing for low capacity, so they would like to get the numbers up for continuity.
5 4 Adjournment
Mayor Ashcraft thanked everyone for their diligence and participation.
It was suggested that future meetings should be scheduled quarterly, with the option to move as needed. Mr. Fratzke suggested every six months, and more frequently as needed, which was accepted. The next meeting is scheduled for May 6, 2024, from 4:00 to 5:00 PM.
Allison Rigau will coordinate with Jodi Owens to transition the agenda, minutes, and scheduling to Fire Chief Luby’s office.
There being no further business, the meeting was adjourned by Mayor Ashcraft at 1:54 PM.
Respectfully submitted:
Allison Rigau
Alameda Fire Department
City of Alameda