The chilling cost of budget cuts - life hanging in the balance

When the leadership of Santa Clara County and The Santa Clara Valley Health & Hospital System decided to spend 20 million dollars on
So what does this mean? VMC just expanded its cancer care. With our new Sobrato Cancer Center, we’re serving more people than ever before...we're still hurting, but we're still here.

What if our county leadership hadn’t done this? The results could have been devastating, as it is today in Las Vegas. If you saw 60 Minutes last week, you know what I’m talking about. University Medical Center just closed their cancer clinic due to budget cuts.

It's worth ten minutes to watch this, seriously:
Watch CBS Videos Online

Their patients see it as a death sentence, though many are trying to get area hospitals to take them…and they are searching further and further from Las Vegas. Soon, we expect, some may knock on Valley Medical Center’s door.

And VMC will answer. Thanks, county leadership. Thanks, Deloitte.

The State of Silicon Valley (hint: not ALL bad!)

Silicon Valley is mostly Santa Clara County, and the “State of the County” address was presented yesterday by the President of the Board of Supervisors, the Honorable Liz Kniss.

Economically speaking, things are not super. Oh. You already knew that.

What impressed me though was President Kniss’s ability to muster a positive outlook and instill some hope among the hundreds who had gathered to hear her address. Since almost half the county’s budget involves Valley Medical Center and the Health & Hospital System, I was excited to hear her positive messages about what we’ve been up to.

Of course, she reminded everyone about Measure A, and what that means for the future of VMC. But VMC has also been working with Deloitte to increase efficiencies. After eight straight years of budget cuts—and rising patient population—it’s likely that we are the most efficient health care system in the nation. I’m not exaggerating.

But part of why VMC is so good is that we work hard to stay modern and state-of-the-art. That’s why I’m inviting you to a Grand Opening Ceremony to see the brand new crown jewel of VMC’s campus, Valley Specialty Center. This gigantic new beautiful outpatient building is not just the most prominent feature of our campus (right on the corner of Bascom and Moorpark in San Jose), it also allows us to serve more patients, much more efficiently, with more dignity to all who come to us for care.

So come on out on Friday, March 6, at 9:30am. You can meet Supervisor Kniss and ask her what this building means for the residents of Silicon Valley…I promise you that her answer will leave you feeling optimistic about the future – that would be a nice change wouldn’t it?

Oh – and there will be live music too! Yes, the Idol Hands Band with Yours Truly on bass guitar will be rocking the party. Let us know you want to come: 408-885-5299.

Protecting our Public Health Department (that protects US)

When I was six, my father bought my brother and me two little turtles. They lived in a bowl, ate leafy greens, and gave my father a case of Salmonella.

some species of turtles carry the disease, which we didn't know at the time. The other thing I didn't know until Friday is that my father got lucky. He got better in a couple weeks...but he could have died.

That's why we're ALL lucky that Santa Clara County has a great Department of Public Health, which does lots of important things including monitoring outbreaks of diseases like Salmonella. It's part of the system that includes Valley Medical Center, of course.

You've probably heard about Salmonella recently, and our Public Health Officers wrote a great piece in the Mercury News the other day...you can read it below.

I think there are two valuable lessons to learn here: One is that we need to keep our Public Health Department strong, because Salmonella is just one of many serious risks they mitigate.

The other is not to buy your kids everything they ask for.

Opinion: Salmonella outbreak illustrates importance of public health programs
By Dr. Marty Fenstersheib and Dr. Sara Cody
Special to the Mercury News

Lately, there's been a lot of alarming news about the national outbreak of Salmonella Typhimurium and people getting sick because of eating certain peanut butter and peanut-butter products. The recent recall of cookie dough products affected 13 schools in Santa Clara County. This outbreak is a reminder of the critical role our Public Health Department plays in protecting the health and safety of Santa Clara County's 1.8 million residents.

Nationally, there have been nearly 500 salmonella cases reported in 43 states. In California there have been more than 60 reported cases, including one confirmed case in Santa Clara County. Although most people who get salmonella will get better on their own, others are not so fortunate. Of those infected in this recent outbreak, more than 100 have been hospitalized and seven have died. While these illnesses and others like it are serious, they can be prevented and contained — if local public health departments and other agencies responsible for response are robust enough to act.

In this outbreak, initial reports of illness come to local health departments from community health care providers. The ability of the federal Centers for Disease Control and Prevention (CDC) and state health departments to understand the scope of the problem and respond is only as good as the information that the local health departments can collect and report. If our capacity to rapidly identify, investigate and prevent infection is diminished, so is the national response against the spread of infectious diseases. Local public health departments are the front lines of defense when disease breaks out.

Salmonella is just one of 89 different diseases that are tracked by your Public Health Department. We receive more than 900 reports of confirmed food-borne illnesses each year. Almost once a week we are investigating a disease outbreak. T

he staff of your Public Health Department is on call 24 hours a day, working to keep our community safe from these potentially dangerous outbreaks. Right now the news is about food-borne illnesses, but over the next year and at any given time, we will be dealing with many more public health concerns including meningitis, tuberculosis, measles, sexually transmitted diseases and whooping cough.

Much of what we do is invisible to the general public. So, why does the work of public health matter? Because when it comes to disease outbreaks, immediate actions are taken to protect the health and well-being of every one of us. Those actions include surveillance of diseases, investigation of cases and following up with people who may have been exposed. When it comes to contagious diseases, our local public health department will provide medications and, if needed, will restrict people from going to school or work until they are no longer contagious.

This work is about protecting the health of our community and preventing disease, illness and injury. Everyone in our county wants and expects to be safe from a communicable disease, and we believe they deserve this protection.

Maintaining a strong and stable public health infrastructure is critical to keeping Santa Clara County a safe, healthy place to live. It is an essential part of the front line of defense for the well-being and safety of this community. And yet, even with a new president and heartening promises of commitment and investment in infrastructure and health care, public health departments are facing very serious fiscal challenges and budget shortfalls.

The work of public health is too important to overlook. The work of public health is just too important to each and every one of us.

Dr. Marty Fenstersheib is Santa Clara County"s health officer. Dr. Sara Cody is a deputy health officer and the communicable disease controller for Santa Clara County. They wrote this article for the Mercury News.

Health news you may have missed...

Now and then I like to use this space to ensure you saw a bit of news that could effect you...today I have two:

First, things are going from bad to worse at Los Gatos Community Hospital, which is now set to close in early April - and may not re-open again until fall despite El Camino Hosptial's best efforts. When/if it does re-open, it seems unclear (to me, at least) exactly what services it will or won't offer.

Subscribers (free) to the on-line Mercury News can read more here. This will surely have an effect on Valley Medical Center and other hospitals in Silicon Valley...not a good effect.

Second, our own Michael Skehan, Executive Director of VMC, wrote a great piece for the Editorial Page of the Merc this week...here it is:

Opinion: While we are saving the banks, we should save our safety net
By Michael Skehan
Special to the Mercury News
Posted: 01/19/2009

It is heartening to see President-elect Barack Obama and our congressional leaders already at work tackling the huge challenges our nation faces. After the divisive political environment of the last eight years, we especially need to come together now to address the nation's economic crisis and the economic, social and health challenges facing our society's most vulnerable.

Just as was done during the economic crisis of the 1930s, today we must ensure that in the midst of devastating losses — of jobs, homes or, in some cases, both — that our programs for caring for our vulnerable citizens are stable, if not strengthened.

One of those vital programs is our system of providing health care to those who are uninsured and underinsured. The numbers of our fellow Americans who fit these categories increase each day as our unemployment numbers rise and employer-sponsored health insurance decreases.
As executive director of Santa Clara Valley Medical Center, I see firsthand the care provided by the safety net, the system of hospitals, clinics and long-term care facilities that are committed to caring for patients regardless of their health condition or their ability to pay.

But it's not just the uninsured who benefit from VMC's presence in our community. VMC houses our area's only Level 1 trauma center, its only burn unit and an outstanding neonatal department. Our mental health services are excellent, as are our preventive health programs that keep members of our community healthier for longer and in their own homes.

These are among the key reasons why Santa Clara County voters overwhelmingly supported the passage of Measure A, the seismic safety bond on the November 2008 ballot.

Safety net hospitals like VMC are adept at working within tight budgets, but we can only do so much. In the last seven years, VMC has saved taxpayers more than $159 million through budget reductions and restructuring. Thanks to the "Transformation 2010" Initiative, we are now in the process of making aggressive new changes that will improve the quality of care while further reducing the use of tax dollars.

VMC is not alone in this difficult budget environment. Forty-three states are facing budgetary shortfalls for fiscal year 2009 because of declines in revenue and increased enrollment in state programs, like Medicaid (Medi-Cal in California). As Gov. Schwarzenegger and other state leaders across the nation are seeking ways to close budget deficits by proposing massive cuts in Medicaid, doing so would be devastating to the health of local communities, and the long-term viability of many safety net hospitals.

Instead, Congress and the Obama administration should immediately provide operating and capital relief to safety net hospital systems to help ensure that the newly uninsured can access needed health care services, and that safety net hospitals remain stable and vital through this economic crisis. If we can afford to bail out banks, surely we can afford to assist our nation's safety net hospitals.

Hospitals are facing huge cuts from state and local governments grappling with the recession and facing very tough choices about possible layoffs of employees and service closures to people in need. Now is not the time to tie the hands of the hospitals that care for the most vulnerable among us. Public hospitals have always been there during hard times, but they need help from the federal government to keep them viable during this economic crisis.

VMC's surgeons help a man breathe on his own

The following story appeared Friday on NBC 11 News, and reminds us why spinal cord injury care at Valley Medical Center is above and beyond...and why we must protect Silicon Valley's largest hospital. Read on!

San Jose Surgeons Help Paralyzed Man Breathe on His Own
Procedure could allow thousands of people to regain critical functions
By Jane Ann Furer

Doctors at Santa Clara Valley Medical Center performed a first of its kind surgery to help a paralyzed man breathe on his own.

Four months ago, 59-year-old Kevin Brady fell at his home in Tucson, Arizona. He broke his neck, fractured his skull and until last week, relied on a ventilator to help him breathe.
Oct. 15, a team of surgeons at Santa Clara Valley Medical Center (SCVMC) in San Jose implanted electrodes in the muscles of his diaphragm.

They stimulate the diaphragm's muscles to expand and contract, which pulls air in and out of the lungs.

Those electrodes are connected to a pacemaker that's worn outside the body.

The procedure is significant because it's the first time it's been performed on a recently injured patient.

Doctors say it works because the muscles can still regain function as opposed to someone with an old injury.

"When Kevin's diaphragm muscles recover their strength, he will be able to breathe without a ventilator for longer and longer periods of time," said Dr. Akshat Shah, a physical medicine and rehabilitation specialist at SCVMC. "Even though he came to us with severe pulmonary problems, his progress so far has been remarkable."

SCVMC is one of the first hospitals in the nation to perform such a procedure.

Doctors say it could open the door for hundreds or even thousands of paralyzed Californians to breathe, taste, smell and talk normally for the first time since their injuries.

"Access Denied?" ...a groundbreaking new report.

A new study was released today by The Health Trust that shines a light on some major problems in Silicon Valley...problems we can and must solve.

Among the crucial issues contained in their report, Access Denied?, are the alarming lack of hospital beds per capita in our community, and the worstening plight of the uninsured and "under-insured." The stories of VMC's patients in the study are astounding examples of the human spirit...worth your time to read.

This ground-breaking report also points to the seismic mandate facing hospitals in California, which of course Measure A will address if approved by voters on November 4. More on Measure A in today's Mercury News.

Please do find time to read Access Denied? and as always, let me know your thoughts.

Trauma Team saves a life under extraordiary circumstances...

The best place to perform emergency trauma surgery is in an O.R.

But when that's impossible, VMC's trauma team will go the extra mile(s) to save a life. That's what happened this week, as the following incredible story graphically describes:

San Martin winery employee loses leg after accident; doctors perform amputation on site

By Lisa Fernandez
Mercury News 10-8-08

A 20-year-old man working at a San Martin winery lost his right leg after he got caught in a piece of equipment used to drill holes in wine barrels.

Mike Van Loben Sels, battalion chief for the South Santa Clara County Fire Protection District, said the accident was reported at 9:47 p.m. Monday at ASV Wines, 12805 Llagas Road.

The employee's leg was caught in an auger — a large spiral screw used in different parts of the wine production process, such as removing grape skins.

Valley Medical Center doctors flew by helicopter to the winery and helped extract the man from the machine.

Dr. John Sherk, chief trauma surgeon, and anesthesiologist Dr. Barry Waddell amputated the man's right leg at mid-thigh, before he was taken to Valley Medical in San Jose.

"It's amazing,'' said hospital spokeswoman Amy Carta. "The community should know that doctors go out to the site when necessary.''

Seen any good movies lately?

When we redesigned the VMC Foundation website last year, we thought it would be fun to post videos on YouTube to show off parts of Silicon Valley's biggest, busiest hospital.

By "we", I mean me and a couple of our staff members, including Michael Elliott, Director of Program Development. Our goal was to share some of what goes on at VMC, our work in the community - especially for folks who haven't been on a tour of our campus (I recommend them).

They were not designed to be high-budget, big-production jobs starring Ben Stiller (at least not yet) or Paris Hilton (not ever), but rather a new way to share information. You can see our past episodes of "VMC Foundation TV" at the bottom of our home page at http://www.vmcfoundation.org/ (If your employer blocks access to YouTube, just send this link to your personal account.)

But today, a NEW video has been completed, and I'm really excited about it. This one was specifically requested by the Gordon and Betty Moore Foundation to exemplify our work to enhance nursing practices at VMC on our journey to "Magnet Status" - that's the highest level of nursing designation a hospital can get, and VMC is the ONLY public hospital so far to apply for this top honor.

So that means big name actors, gourmet deli trays and gaffers, right? WRONG! It's all about the story that one nurse has to tell, and the audience will be the Gordon and Betty Moore Foundation's Board of Directors, not the Hollywood A-List. Michael Elliott may not win his first directing Oscar for this one, but he did succeed in helping share our story with one of the VMC Foundation's most important collaborators. We hope they enjoy it as much as you do, but please don't nominate Linda Fenn, R.N., for a Best Actress award...she's not acting.

Corporate citizenship is alive in Silicon Valley!

This morning I read Time Magazine's article on corporate social responsibility/history of capitalism, written by a man who knows (Bill Gates). It's a very well done piece, with a national and global perspective.

How the issue plays here in Silicon Valley is one of my favorite topics...and the timing of the article is amazing.

You see, when I finished reading the piece in Time, I drove to a meeting of the Silicon Valley Leadership Group, a very powerful organization made up of the biggest names in Silicon Valley. Founded by David Packard and led by Carl Guardino, SVLG looks out for the interests of Silicon Valley corporations.

But here's the cool part: They look out for the entire community's well-being too...and not as an aside, but as a MAJOR focus of their work. SVLG's members understand that corporate profits ring pretty hollow without good schools, transportation, housing and, yes, HEALTH CARE for everyone.

So it comes as no surprise that they enthusiastically endorsed Measure A today, the bond to safeguard Valley Medical Center. New to this blog? Read a couple posts below for more info on this important measure, which Santa Clara County voters can approve this November.

The SVLG's endorsement of Measure A adds them to a long list of supporters, and it's growing fast. I think that David Packard - and Bill Gates - would be proud.

Wanna learn more? Call Elizabeth at the campaign at 408-888-0397.

Hooked on Reality TV?

Real emergencies happen every day...maybe not to you, thankfully, but they have - and they will again. Are you prepared?

You may have missed this fantastic article in the Mercury News from earlier this spring, and since we have kind permission from the Newspaper of Silicon Valley to reprint it, I'm sharing it with you today. Kirstin Hofmann directs the County Office of Emergency Services, and Dr. Fenstersheib is the Public Health Officer for the county. Between them, they have the power to close all the schools and hockey games in the county with a single phone call. Woah.

They also have taken a critically important issue and made it fun to read, so enjoy:

Hooked on reality TV? Get ready for some reality of your own
By Kirstin Hofmann and Marty Fenstersheib

Article Launched: 05/12/2008 01:32:08 AM PDT

Americans seem to be sharing an obsession with the "real life" of others. While we are watching more and more reality TV shows, we are ignoring a critical reality of our own.

We all know that there will be an earthquake of a major magnitude, as well as other emergencies like fires and floods or pandemic flu. Yet we constantly avoid dealing with that reality. This denial makes us dangerously unprepared to effectively respond to these real emergencies.

Here's more reality. While Washington and Sacramento talk a lot about emergency preparedness, public dollars and resources for preparedness are limited and quickly disappearing. And one of the biggest realities we need to face is that government can't do it alone. We all share responsibility for being prepared.

In Santa Clara County, local governments have taken their responsibility seriously and have undertaken a number of preparedness activities. For example, Santa Clara County government has embarked on an intensive, comprehensive effort to educate, inform and train county personnel to respond effectively to emergencies that affect the health and welfare of our community.

But these activities point to another reality - preparedness will never be finished. Even if every public agency were able to do all it wanted to do, business, community organizations, the news media, schools, individuals and families have to get ready, too. That's real.

All of us - in government, the news media, businesses, schools and other community organizations - have a shared responsibility to prepare for basic emergencies. The reality is that we will be on our own for at least the initial period of any disaster. How well will we do? If all of us, including individuals and families, are not prepared at the most basic level, we will not do very well.

We all need to hold our own "reality" rehearsals and get ready for a major emergency event. Whether it's finally having your family emergency plan in place, knowing what steps your employer has taken to deal with the aftermath of an earthquake, or helping your kid's school prepare for pandemic flu, it is critically important that we all do our part.

It isn't all that difficult to get started. By doing just three things you will help yourself, your loved ones and your community.

• Have a basic family communication plan: who's calling whom, lists for everyone with the phone numbers to call (and loaded into cell phones) and an out-of-the-area number to call when local lines are overloaded.

• Shop for basic supplies like a battery-operated radio and extra batteries, flashlights that work and more batteries, food and water, and throw in some extra trash bags.

• Put a first aid kit together and include items that would be useful in a pandemic flu: supplies of face masks and plastic gloves, medicines that treat flu symptoms like ibuprofen, Tylenol, aspirin and cough medicine. Include disinfectants to clean surfaces where the virus may linger.

We know this is a community of people who are strong, resilient, independent and compassionate. In most cases, we are able to take care of ourselves. We understand the value and benefit in reaching out and helping others. It will take all of us being aware, prepared and ready to successfully deal with the real world we live in - a world where disasters do strike.

You can find out more about how to prepare for emergencies by visiting the Santa Clara County's Office of Emergency Web site at www.sccgov.org/portal/site/oes; the Santa Clara County Public Health Web site at www.sccphd.org, and other emergency preparedness Web sites, including www.ready.gov.

KIRSTIN HOFMANN is the Santa Clara County Director of Emergency Services. MARTY FENSTERSHEIB is the Santa Clara Valley Health & Hospital System Health Officer, Public Health Department.

Wow...you want a humbling experience?

Now, I know I'm not the first person to Google themselves...but really - how many people find out that they share a name with a famous serial killer?

Yep. Especially because I'm trying to educate folks about Measure A on the November ballot, I figured it would be important that they be able to find me on line. Oops! That's not me...that's, uh...some other guy! Who killed people. Bad luck? Yes. I'm not even REMOTELY related to that Chris Wilder. Honest.

So, then I Googled "Chris Wilder Health" and found a cool copy of Connections, the employee magazine for those who work for the Santa Clara Valley Health & Hospital System. It's over four years old, but it told me three things:

1. The mission of the VMC Foundation hasn't changed - we're still at it, with all enthusiasm!
2. The photo, taken a full 12 years ago, shows I could use some time on the stairmaster.
3. We've got to figure out a way to get "googlers" to get to http://www.vmcfoundation.org/ , right?

Right.

I'm no Internet expert, so I'll share this with my brillaint staff and they'll help me figure out how to get more traffic to our website, and to info about Measure A, and not to a serial killer. I mean, honestly...killing Captain Crunch? King Vitamin? Too horrible.

Silicon Valley losing another hospital?

A story appeared in the San Jose Mercury News this week that you may have missed...but to paraphrase Paul Harvey, it could be "the day's news of most lasting significance".



The story reports that Los Gatos Community Hospital's future is in doubt, as Tenet Healthcare Corporation - LGCH's operator - will not renew their lease next year. Scary, since we already have fewer hospital beds per capita in the South Bay than any other urban center in America.



True. I attended the National Association of Public Hospital's annual conference last week, and learned that the nation's average is 2.7 beds per 1,000 residents. In our community, it's about half that. If we lose Los Gatos Community Hospital next year--not three years after San Jose Medical Center closed--well, we'd have a problem.



But that problem will seem minor compared to what would happen if Santa Clara Valley Medical Center loses half its beds. That's what Santa Clara County is trying to avoid by placing Measure A on the November Ballot. If passed, the alert reader of this blog will recall, SCVMC would be able to meet state seismic safety law by rebuilding the oldest parts of our hospital.



If not, best estimates are that 11,000 people a year who need a hospital bed would be unable to find one available. Lives truly hang in the balance. Please watch this space as this story develops...and let me know what you think: echristopher.wilder@hhs.sccgov.org

Remembering Robert Kennedy

"Each time a man stands up for an ideal, or acts to improve the lot of others, or strikes out against injustice, he sends forth a tiny ripple of hope, and crossing each other from a million different centers of energy and daring those ripples build a current which can sweep down the mightiest walls of oppression and resistance."

- Robert Kennedy, Cape Town, 6/6/66

The Battle of the Hospital Bands is ON!!!

Sometimes hospitals can compete even when they cooperate.

Last night, we held a great event to highlight VMC’s excellent women and children’s services, including our NICU, OBGYN and other programs. We do this in coordination and cooperation with other great medical centers in Silicon Valley, one of which being O’Connor Hospital – our nearest neighbor dating back to the 1800’s (just like VMC.)

I was chatting with O’Connor’s CEO Robert Curry at our mixer over a glass of wine, when the topic of music came up. “We have a ‘house band’ at O’Connor, you know”, he told me.

“So do we”, was my reply, just three days before VMC Idol. 30 seconds of mutual chest-thumping later, and the VMC/O’Connor “Battle of the Bands” was born!

So VMC’s Idol Hands (I play bass) will take on O’Connor’s band (Mr. Curry plays keyboards) in a rock spectacle of epic proportions…we’re just not sure when yet. When it happens, you can count on an event to remember. Someone call Rolling Stone Magazine.

The Mercury News calls for the question

You may have noticed a large number of stories in the Newspaper of Silicon Valley lately about Valley Medical Center, and the lives saved there every day.

These stories are extremely compelling in their own right. Yet, the media savvy readers among us, on noting the increasing frequency of VMC-related articles (and photos...see the "lifestyle" section today for some great shots of the Rotaract Club and the heroic work they did for VMC's Neonatal Intensive Care Unit), may be asking themselves "Okay, so where are they going with all this?"

For starters, here.

From today's Editorial page, said better than I ever could:

EDITORIAL - Funding seismic upgrade for VMC urgently needed

(By the way, that part where it says "a capital campaign is already underway"? Boy, are we going to need YOUR help! I'll write more after Tuesday's proceedings...check back here soon!)

Does this concern you? YES. Is it serious? YES.

I know not everyone reads the San Jose Mercury News every day...but I do, and in case you missed today's lead editorial, it's crucial.

It concerns us all.

Please take a moment to learn about one of serveral threats to Valley Medical Center, and if you have friends in other states whose congressional rep's may not yet "get it", why not send them a link to this page? Thanks...read on:

Editorial: Public hospitals need protection from federal cuts
Mercury News Editorial
Article Launched: 05/30/2008 01:33:46 AM PDT

President Bush has spent the past seven years worsening the nation's health care crisis. The number of uninsured children has grown from 7.9 million to 8.7 million in the past four years, now nearly equal to the population of North Carolina.

But that may not be his worst health care legacy. That would be the harm he's caused to public hospitals, including Santa Clara County's Valley Medical Center and the Alameda County Medical Center. Aiming to privatize health care, Bush has been draining resources from the only recourse left to uninsured residents who are sick or injured.

He's taking one last whack at public hospital budgets this spring by trying to further limit federal payments for Medicare and Medicaid. Congress must not let this stand. It should extend a moratorium on new cost limits for a year.

California's public hospitals would lose $500 million under this proposal. That would mean a $40 million hit for Valley Medical Center on top of funding cuts by the county, which is facing a $174 million deficit.

The threat to Alameda County Medical Center is even greater, since a quirk of the administration's proposal would punish public hospitals that are not directly run by the county. The Oakland hospital could lose $100 million, about 20 percent of its budget.

Alameda County filed suit over the anticipated cuts, which would be unfair and excessive. The U.S. District Court in Washington, D.C., last week agreed. That at least could delay implementation.

Public hospitals represent only 6 percent of the hospitals in the state. But they provide 60 percent of the trauma care and 45 percent of the burn-unit care. If you're critically injured, chances are the ambulance will whisk you to a public hospital. If these services wither, the wealthy will suffer along with the poor.

Federal officials say they're trying to rein in costs, but they're not. They're simply passing them along to counties, which in many cases are barred from turning away emergency and trauma patients. The federal government instead should find ways to reduce the number of uninsured and support preventive programs to keep people from developing chronic diseases that cost so much to treat.

Another provision of the proposed rules is especially troubling. After 40 years of sharing costs, federal officials want to stop paying to help train future doctors. Valley Medical now trains one out of four doctors in the county. Pulling federal support will lead to greater shortages of doctors, already a national challenge as baby boomers age.

California's congressional delegation opposes the Bush payment limits. Members will need all the support they can muster from valley leaders - including business - when Congress reconvenes Tuesday and attempts to block these draconian rules.

Firefighters ROCK!

(that's the view out our back deck...you better believe we love fire fighters!)

As of this morning, the Summit Fire in the Santa Cruz Mountains is now 100% contained!

Thursday that was hardly the case, as fierce winds pushed the blaze down into a populated area...and frighteningly near my home. My wife Kate was out of town, so I had to figure out what of our valued possessions might fit in the car, with the dogs and cats taking up the bulk of the room.

Fortunately, we didn't lose our home and didn't need to evacuate. sadly, not everyone living near me was as lucky. Our community lost at least 30 homes, and several fire fighters were injured. It's a little exasperating when the media fails to mention WHERE a fire fighter with a burn injury will be treated; Yes, you guessed it: Valley Medical Center is one of two burn trauma centers in California north of Los Angeles...and folks should know that.

Santa Cruz County, where I live, has NO trauma centers at all - and neither does Monterey County. As the air begins to clear and those who lost homes begin to plan their futures, we need to thank VMC for being there for a huge number of us in northern California. And for me, I'll keep thanking our fire fighters - heroes all - when I see them. Cal Fire and our local volunteers saved my home this week. My gratitude is beyond measure.

An unwelcome bridge to 1988

Twenty years ago, I was a junior at San Jose State University. I bet I’m not alone in remembering the multitudes of homeless mentally ill people that roamed the campus everyday, after massive budget cuts left them nowhere to go in downtown San Jose.

Fast-forward twenty years, and reading today’s Mercury News article, and I fear we’re heading the same direction – a disgrace and a tragedy. Folks, the money is just NOT THERE to provide for the severely mentally ill, most of whom also have substance abuse issues. As the article describes, if we cut services for treatment today, we’ll pay much more tomorrow when they wind up in our jails.

If you’re as upset about this as I am, you can at least be assured that our elected officials on the Board of Supervisors are as well…their task to balance the budget is a horrific one. If you’re in a position to donate to the VMC Foundation for VMC’s mental health or alcohol/drug treatment services, we’ll ensure your gift is put to good use…and soon.

Call me at 408-885-5299 if you want to help...or just to vent your frustrations!

The budget crisis hits VMC hard, and we are truly at risk

This week was a rough one, friends…the county budget crisis is very real, and very bad: The Santa Clara Valley Health & Hospital System stands to lose nearly forty million dollars - just to start. Since 2002, cuts exceed $250,000,000. The Mercury News has been reporting on this daily, and the bad news doesn’t stop there: The Governor’s proposed budget (among other bad things) will drop a million Californians from Medi-Cal, according to Assemblyman Jim Beall with whom I had lunch today. He’s pretty upset, as am I, as should we all be.

We should also remember what’s at risk: It’s not just the “safety net”, but also amazing programs that contribute to the quality of life in Silicon Valley for everyone, rich or poor. Please read the following excerpt from an email that SCVHHS CEO Kim Roberts sent to all employees of SCVHHS just a few minutes ago:

While these fiscal issues may seem overwhelming, we continue – every day - to provide remarkable services and value to our community. HHS is currently nowhere near being able to do all that we want to do for our patients, clients, and community. There is the real possibility that we will be forced to do less in the future. Through it all, we make an important, personal and positive difference to nearly 250,000 people each year.

I had an opportunity to highlight some of our good work during the Budget Workshop. One point I made was about the positive external validation we get with all the awards we receive. The short list includes:
• The Traumatic Brain Injury program at SCVMC is one of 14 such programs in the United States to get a Model System of Care grant from the National Institute on Disability & Rehabilitation Research.
• Pediatric Healthy Lifestyle Center has received numerous awards, including the National and California Associations of Public Hospitals and the YMCA Activate America Award.
• Dr. Marty Fenstersheib, Health Officer, was the 2008 Early Intervention Program Special Honoree at the 20th Anniversary conference of the State Office of AIDS.
• Children’s Shelter & Custody Health Services received full accreditation from the Institute for Medical Quality.
• By fully integrating the community in their MHSA planning process and involving more that 10,000 people (speaking 5 different languages), the Mental Health Department was recognized by the California Mental Health Directors Association for having one of the broadest and most inclusive MHSA planning processes.
• The Neonatal Intensive Care Unit at SCVMC is the only on in Northern California to get the March of Dimes NICU Family Support Center designation.
• SCVMC was selected to participate in the State’s Coverage Initiative and, through the efforts of CHS, has one of the highest enrollments of any participant.
• The Children’s Health Initiative was recognized at the Santa Clara County Children’s Summit.
• Next week, the American Red Cross will honor the SCVMC Trauma Team as a local “Hero”.

Continue to do what you do best – provide high quality, compassionate, innovative healthcare to all who we serve – and together, we will get through these challenging times.