Residents of the El Camino Hospital District could be forgiven if they find it difficult to make sense of how the five elected members of the hospital district's board manage the nearly 3,000 employees who work here or in Los Gatos. The governing structure of the hospital is complicated, so much so that the county commission that oversees special districts raised serious questions about transparency over a concern that residents could not track the taxes they pay to the district.
It was an embarrassing episode for the district directors, who quickly enacted a number of measures designed to improve the public's ability to understand their operation. With these changes in place — including adding two members to the operating board and appointing 24 new members to a number of advisory boards, the hospital has demonstrated a serious commitment to opening many more details of its operations to the public, although there is more work to do.
On Nov. 6, district voters will select three of five candidates for the district board who will oversee this giant enterprise, which had revenues of $600 million-plus last year, along with more than $40 million in profit. We believe that the two experienced incumbents, Wes Alles and John Zoglin, deserve to be returned to the board. Both have assured us that in addition to measures already implemented, that they will support making transparency a major goal of the board. Bill James, who last ran for a board seat in 2002, is our choice for the third seat, although we must acknowledge that candidate Dennis Chiu also demonstrated a deep knowledge of hospital policy and finances.
In his more than 10 years on the hospital district board, Wes Alles has served as chairman and head of government compliance and has a deep knowledge of the health care industry through his academic job as director of Stanford's health improvement program. It would be difficult to lose a member with his experience. He is committed to moving past the board's run-in with the Local Agency Formation Commission, the county agency that found the district's policies made it difficult for residents to understand where their tax monies are spent. He and the current board have already taken significant steps to make the hospital's operations more transparent.
Alles stands by the board's decision to purchase the Los Gatos hospital, which is profitable now, saying that the El Camino district was created as an enterprise district, which enables it to do business outside district boundaries. Los Gatos gives El Camino extra clout when negotiating contracts with insurance carriers, he says, and is now home to specialty care that is not offered at El Camino's Mountain View campus.
Alles said he believes passage of Measure M, to limit the salaries of El Camino's top employees to twice the governor's salary, is misguided, and could result in having to hire managers that lack the skills to oversee a facility the size of El Camino. He said the hospital strives to pay salaries that are comparable with similar jobs in the local area or around the nation.
If given another four-year term, Alles' priorities will be financial stewardship, continuation of clinical care beyond what most community hospitals offer and alignment with the hospital's partners, which will be more important as the changes in national healthcare police take hold.
We urge voters to reelect Wes Alles to the El Camino Hospital District Board.
With inspiration from his father, who was chief of the medical staff at El Camino, and his mother, who was a longtime member of the Mountain View City Council, John Zoglin brings a family tradition of public service to his run for for reelection to the hospital board. He has served more than five years and deserves another term to continue the work of building more transparency into board operations.
Like his fellow incumbent Wesley Alles, Zoglin said he believes that the board is moving forward by appointing of 24 new advisory committee members plus two new members of the hospital (operating) board. Two-thirds of the advisory board members live in the district, which will be helpful in getting the hospital's message out, he said.
And although Zoglin admits that the LAFCO audit made some good points, he defends the roles of a district and operating board, which have been composed of the same people, although all power is vested in the hospital board, which now includes two new members. The two-tier board structure provides the hospital a $7 million tax advantage as a 501(c)(3) corporation and helps El Camino compete with Stanford and Good Samaritan Hospital, Zoglin said.
Zoglin believes that Measure M could be a "massive negative" for El Camino if passed by the voters. He said consultants told the board if the measure passed, "we might get someone who managed a hospital with $100 million in annual revenue, not the $650 million at El Camino." The AFL-CIO union guidelines are that a CEO should not make more than 50 times what is paid to rank and file workers. At El Camino, CEO Tomi Ryba's pay amounts to 17 times the average hospital worker, Zoglin said.
Zoglin admits that the board's relationship with its employee unions has been rocky in recent times, but he said the decision to require workers to pay for 10 percent of their health care costs was a good one at the time. The board has retreated from that position, recently signing contracts with its nurses and other union employees that include a healthcare package paid for entirely by the hospital.
The purchase of the Los Gatos Hospital was justified by El Camino's charter, Zoglin says, which allows it to see patients outside the district. He added that Los Gatos has already contributed more than 25 percent of El Camino's profit and has strengthened the quality of care at both hospitals.
We urge voters to reelect John Zoglin to the El Camino Hospital District Board.
Despite viewing its ups and downs from the sidelines, Bill James has a deep understanding of El Camino Hospital operations, an avocation of his since his last run for the board in 2002 when he lost by a narrow margin. James, an attorney, would push the board to reduce the number of executive sessions and take other steps to makes its operations more transparent to the public. He worked with the League of Women Voters in 2005 to successfully convince the board to file Form 990, which discloses the earnings of the CEO and 10 other top executives of the corporation. And he is supportive of the LAFCO audit that requires the district to be more transparent and careful when reporting actions of its district board and hospital or operating board. James contends the hospital still has requirements to meet as a result of the audit. He also recommends that hospital spokespersons step up their public outreach to local business clubs and other groups to explain how the hospital operates.
A more open policy would have been helpful, James says, during the unexplained dismissal of former CEO Ken Graham. "The board didn't say anything. It makes me wonder whether it (Graham's dismissal) was lined up ahead of time," he said.
James traces Measure M, which would reduce hospital CEO Tomi Ryba's salary to twice that paid the California governor, to the hostility from unions, who were irate about the imposition of a contract last year. Members of the Service Employees International were primarily responsible for putting the measure on the ballot. He would advocate more straight talk with unions and sharing some of the hospital's profits during good years. "It is awkward for a hospital to say they can't provide health care when the hospital is financially strong," he said.
James would have opposed the purchase of the Los Gatos hospital, but now that it is profitable would not advocate selling it. But he disagrees with board members who say that Los Gatos was not purchased using taxpayer funds, contending that district taxpayers did provide the seed money to build up the district that generated the profits used to purchase Los Gatos.
James' top priorities are to keep the hospital financially strong and continue to make sure there is good executive oversight that assures patients have a positive experience. He also would focus on providing the public "character level detail" as required in the LAFCO and study how to adjust the working relationship between the district and hospital boards, also called for in the audit.
We urge voters to support William James for a seat on the El Camino Hospital District Board.