Title
Minutes of the December 17, 2020 Meeting
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MINUTES OF THE SUBCOMMITTEE OF THE CITY COUNCIL AND ALAMEDA HEALTH CARE DISTRICT BOARD MEETING
Thursday, December 17, 2020
Attendees: Mayor Marilyn Ezzy Ashcraft, Acting Fire Chief Rick Zombeck, AHS COO Luis Fonseca, City Manager Eric Levitt, Assistant City Manager Gerry Beaudin, District Executive Director Deborah E. Stebbins, and Human Resources Director Nancy Bronstein, President of Alameda Health Care District/Division Chief Michael Williams,
Dr. Robert Deutsch
1. Call to Order/ General Introduction
Mayor Ezzy Ashcraft convened the meeting at 4:04. She asked for everyone to introduce themselves.
2. Oral Communication Non-Agenda (Public Comment)
There were no public comments.
3. City /District Issue
3-A Minutes of the October 13, 2020 Meeting
The minutes of October 13, 2020 were accepted. Chief Zombeck motioned to approve and seconded by Michael Williams. A roll call vote was taken and they were unanimously approved.
3-B- Update on COVID-19 Impacts on Alameda Hospital
Mayor Ezzy Ashcraft - The City and the County are experiencing a disconcerting increase in the increasing pace of the COVID case numbers and our intensive care unit bed capacity has fallen below the 15% threshold that the Governor set for the current stay at home order. Alameda County proactively decided to join that order when we were still at about 25% County-wide capacity as I understand, on December 7th, but we are not there anymore.
Questions I would like answered from this committee, of our ICU beds how may do we have? How many are available? Number of current ICU/Covid-19 patients? The schedule for vaccinations for medical staff in phase 1A of vaccination roll out?
Dr. Deutsch - ICU is not overloaded, there are two ventilator patients from COVID-19, we haven’t had a high number of ICU beds and are doing pretty well at Alameda Hospital and doing well on PPE at this junction as well. There are eight beds in ICU, two patients are on ventilators/COVID-19 and there are six other type of patients.
There are a couple of other patients not in ICU and there are patients under investigation waiting on test results. We have onsite PCR testing at Alameda Hospital for quick turn-around almost on a daily basis.
The hospital has already looked at plans, there are several other locations to include four beds called a tele-unit, and we can use our recovery room and double capacity. The other issue is staffing. We need qualified ICU staff and respiratory therapists that are trained with ventilators, and we are prepared to do it but always scrambling for staff.
The usual ratio in an ICU is 2:1 ratio which are state wide guidelines, per Governor Newsom, when hospital under surge with Pubic Health Emergency we can have a 3:1 ratio, but it’s hard to care for COVID patients….i.e. PPE, stressful for staff but allowed.
Mayor Ezzy Ashcraft - Luis, what is the readiness of Alameda Hospital for a surge?
Luis Fonseca - Dr. Deutch is there on front line, the only thing I would like to clarify is the modification to the staffing ratio. The California Department of Public Health issued an AFLA that allows more flexibility and a waiver for patient care. We are able to increase ratios and we can apply for waivers at the state level. It is extremely challenging providing care for the patient, but as a last resort, the hospital is well positioned to complete and submit waivers. We have plenty of capacity, the biggest challenge system or even region wide is staffing. There aren’t enough nurses and staff; there just aren’t enough travelers available. We tried to bring in ICU, critical care staff at $200 hr. but have been unsuccessful. We are managing well with current staff and managing the population.
The hospital has invested and expanded testing capabilities. Brought in necessary equipment to conduct test in our facilities for our patients. Very active and had great success with Kaiser Oakland testing site. We ran some numbers and evaluated data, braking out by zip code, there are large numbers coming from the city of Alameda. Original contract with County was set to expire December 30th. On Tuesday the Board of Supervisors approved additional funding to continue testing sites through the end of March.
We received vaccines today at Highland Hospital. Will receive a total of 3,000 vaccines coming into Alameda Health Systems. We will distribute to other sites to include Alameda Hospital. We have a plan to vaccinate staff and have developed a group to identify top priorities. Group 1A, Group 1B & Group 2. Then continue with the rest of staff. With initial shipment we can address all phase 1A & 1B critical care staff across the entire system. Tomorrow at 10:00 am we are vaccinating first group of workers. Media team will be there to capture milestone. We need to ensure social distancing during process and we are required to monitor for 15-30 minutes. Our goal is to vaccinate 200 staff members per day across the entire system. Very exciting that we’re there, we have it and are well positioned to add another tool to our arsenal to combat this pandemic.
Mayor Ezzy Ashcraft - So you received 3,000 doses, so the two dose regimen for 1,500 medical staff or second batch on its way?
Luis Fonseca - The later so to do total of 3,000. FDA approved the Moderna vaccine we have received word that we may receive that next week. Then the second batch of the Pfizer which will be for the second dose. We have freezers and equipment, some on order and should receive new order of freezers on Monday. We are using staff to administer vaccines and some public health nurses are available to assist.
Mayor Ezzy Ashcraft - We hear there are side effects, i.e. may need to stay home for a day, are you factoring that into your scheduling of vaccinations?
Luis Fonseca - There are minor side effects, with first dose of Pfizer only 11% have experienced symptoms. Minor pain at site of injection, we can evaluate side effects and have added this as another level of the complexity. We can stagger our staff to bring them in.
Mayor Ezzy Ashcraft - So exciting to hear this is happening. We heard and it surprised me that in another state 2/3 of doctors are willing to get vaccinated but only ½ of the nurses, but I don’t think you can mandate them to get the vaccine.
Luis Fonseca - We put out a survey and there were over 1,000 respondents, 80% are open to receiving the vaccination.
Eric Levitt - Question on step down or telemetry units, are those convertible to ICU if you exceeded ICU capacity?
Luis Fonseca - We have identified several locations with the capability to provide higher level of care and capable to go from eight beds to 16 beds with ventilators and staff at the facility.
Deborah E. Stebbins - In terms of people in 1A group are people in long care facilities, will that 3,000 be able to cover about 170 residents in long term care?
Mayor Ezzy Ashcraft - County protocol we are in 1A criteria by County high risk health workers first responders/high risk, followed by those in phase 1B with underlying conditions.
Luis Fonseca - We are following the same criteria, looking at additional vaccines from Walgreens to distribute to those in skilled nursing facilities.
Deborah E. Stebbins - We’ve been remarkably successful with limited cases in Long Term care facilities.
Luis Fonseca - Yes over the last 10 months we’ve had only four positive cases in skilled nursing facilities with over 300 beds.
Michael Williams - First Responders are starting to get vaccinated tomorrow.
Mayor Ezzy Ashcraft - What are you hearing about willingness to get vaccinated? It’s 18-30 old that are the cases but think that they are invincible. What is case with your first responders?
Michael Williams - First are the paramedics that work in the field out of 41 paramedics, 41 have agreed. Phase two of EMTs to sign up tonight, vaccinations will take place at St. Rose hospital in Hayward.
Rick Zombeck - Has any consideration been given to transfer of patients from one facility to another if you get overloaded?
Luis Fonseca - We do transfer regular from Highland to Alameda and vice versa, we have capability and agreements in place for inter facility transports, in position and monitors it daily. Part of our daily operational check in.
Mayor Ezzy Ashcraft - Very hopeful that our capacities don’t get down to zero, we have gotten ahead of things. I am concerned about medical staff. I said it before but time and science are on our side, if people can stay home and not gather for the holidays.
3-C Status of Planning for 2030 Seismic Compliance
Deborah E. Stebbins - There was a bill pending before the state legislature that sort of died on the floor, it was not acted on. The amendments that were proposed for that, the extension went from seven years to two years, not worth the effort to delay it for two years. It’s estimated 100 hospitals in state will close if the current seismic standard are imposed by 2030.
The resistance was imposed by organized labors is the resistance, tradeoff is with COVID, it’s not likely 100 hospitals can find money to bring up to 2030 seismic standards. It’s no likely during the wake of a pandemic. One idea, might be worth getting together SCIU and CNA, there are members on the new AHA board, get a foot in the door to reason with them or alternatively thinking of Nancy Skinner or Bonta. There’s no way when we get to 2030 that hospitals will be closed by licensing agency. Looking ahead to advocate for this.
Typically, legislature will postpone at last minute and then get many hospitals to comply. Little chance to come up with capitalization it’s a 150-200 million dollar project.
At the district level we are re-innervating community advisory board, to give feedback to District from community on important services, what are priorities pre pandemic?
Mayor Ezzy Ashcraft - Great idea to reach out to elected representatives. Is there any hope coming from Washington with federal assistance coming to our hospitals?
Deborah E. Stebbins - It’s getting hard to get money to trickle down to the local jurisdictions. It would be great if there was some capitalization from the state.
Mayor Ezzy Ashcraft - stay in touch with City Manager Eric Levitt & Assistant City Manager Gerry Beaudin. The City has lobbyist in Washington.
3-D 2030 Leadership Changes at Alameda Health Systems
Luis Fonseca - The County Board of Supervisors made a decision to transition the entire board of trustees for Alameda Health Systems and appointed a whole new set of trustees of which 3 are existing or were from the prior board.
Their names are:
• Taft Bhuket MD, President,
• Tracy Jensen, Vice President
There were five others that were appointed:
• Luisa Blue - A retired executive vice president for SCIU international
• Jennifer Esteen- A psychiatric registered nurse in SF and vice president of organizing at SCIU
• Jeanette Dong - Worked with City of San Leandro
• Splend Splenddorio - Corporate Law Attorney in Pleasanton,
• Allen Fox - Retired Chief Financial Officer with decades of experience in health care
The ninth position is to be filled.
The trustees were sworn in beginning of December and provided general orientation, they had their first special meeting last night.
They identified members of key committees.
The important committee in the seismic compliance for Alameda Hospital. All committee assignments have been completed.
The administration CEO transitioning from organization with last day January 22, 2021. There is an urgency to identify that transition plan. Board to establish an Ad Hoc committee to define that path and strategy for new support of health system. I continue to provide support to providers in our health system.
Mayor Ezzy Ashcraft - There was a hospital election. Des Paplavo did not rerun, Stuart Chen and Williams ran for board election. Stuart Chen was appointed to the hospital board. Williams back for four more years. Stuart is to do community outreach.
Mayor Ezzy Ashcraft - Thank you Dr. Deutsch and Luis Fonseca we’re glad to have you in our community.
Adjournment
There being no further business, the meeting was adjourned at 5:02 pm City and District staff will confer to set a date for the next Subcommittee meeting.
Respectfully submitted:
Monique Raqueno
Alameda Fire Department
City of Alameda