Gambling with Children 

Kaiser says its new hospital in Oakland offers first-rate services, but critics say the healthcare giant's decision to close pediatric care facilities in the East Bay has had grave consequences.

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In 2010, to the surprise of Kaiser's East Bay pediatric medical staff, officials from the healthcare giant announced that, in addition to the closure of the Hayward pediatrics unit, a pediatrics unit would not be included in the new Kaiser San Leandro Medical Center. Consequently, central and southern Alameda County — San Leandro, Hayward, Castro Valley, San Lorenzo, Union City, Newark, and Fremont — no longer has an inpatient hospital for children. San Leandro has a pediatric clinic, which nurses contend doesn't provide sufficient services for young patients suffering from serious illnesses.

"Clinics are not designed to take care of patients in need of hospitalization," said Richter, who now works in the clinic. She said clinics don't have the staff and resources for patients in need of immediate care, and do not have pediatric staff available at all times. The only other Kaiser hospitals besides Oakland that offer inpatient pediatric care in Northern California are in Santa Clara and Roseville.

Kaiser officials said that, before it closed, the Hayward pediatric unit was underused, and that, on average, it served fewer than four patients per day. Kaiser officials used this same reasoning for not including a pediatric care unit at the new San Leandro facility. Instead, the nonprofit decided that its new hospital in Oakland would be the central hub for pediatrics for the entire region.

Since the announcement in 2010, southern Alameda County community members and union nurses and officials have been locked in an on-going battle with Kaiser to keep a pediatrics unit open in central and southern Alameda County. They argue that consolidating pediatrics services in Oakland is about cutting costs. "[Kaiser's] decision to cut pediatric services is mainly motivated by money," argued Karen Chan, director of the Kaiser division at the California Nurses Association (CNA). She asserted that, in recent years, Kaiser has been consolidating "specialty" services — not necessarily to improve quality, but rather to reduce the costs of operating more facilities. "Kaiser is an insurance company that collects all of its premiums upfront and owns all of its hospitals and clinics," Chan continued. "So every time they have to deliver care it's considered an expense for them, and ultimately they're incentivized to provide less care."

But Kaiser officials contend that consolidating pediatrics services in Oakland is strictly about improving quality. "The level of care that was once available in the low-volume inpatient pediatric unit in Hayward did not and could not equal the level of care now available in the Oakland Medical Center's specialized pediatric inpatient unit," wrote Tom Hanenburg, a Kaiser Permanente senior vice president and area manager, in an email to me.  

But critics say the newer and larger facility in Oakland does not necessarily mean an overall improvement in quality. Leaving an entire community without immediate access to expert pediatric care can not only be inconvenient, but even hazardous for families, critics say, especially if a child needs immediate, specialized care for conditions such as asthma or, in the case of little Jenevieve Dagatan, bacterial meningitis.

"It's a big deal," said Kathy Donohue, a nurse who works in the Kaiser Oakland Medical Center's neonatal intensive care unit. "If you're in traffic — you have a baby with respiratory distress or a lethal condition — there are chances the baby can die before it reaches a facility that can help them."


Interstate 880, which connects southern Alameda County to Oakland, is one of the most congested freeways in the East Bay. "If you're trying to go from Hayward to Oakland on 880 — in rush hour traffic — it's going to take you an extra 45 minutes to an hour to get there, and that's assuming you have a car," said Hayward parent and former Castro Valley High School teacher John Green.

In 2008, the Kaiser Hayward pediatrics inpatient care unit was still available for Green and his family. That year, he and his wife took their daughter Chloe to Kaiser Hayward for a checkup, two days after she was born. Doctors noticed that Chloe had jaundice and told Green that the condition could result in permanent brain damage. The hospital admitted Chloe to the pediatrics unit overnight, during which time pediatricians treated her illness.

"The experience of her being sick was very stressful, but the care was amazing — and the fact that they were able to resolve her situation in short order and get her right in and right to the care was impressive," Green said. "The nurses were supportive, and the doctors were excellent."

Years later, however, Green was stunned when he learned that a pediatrics unit would no longer be available in central or southern Alameda County to Kaiser patients. He spoke with neighbors, parents of his daughter's friends, and with moms' groups. "It's scary and people feel powerless," Green said. "They feel like, 'What's the alternative?' Kaiser is the low-cost provider in the county. People aren't going to leave Kaiser and go to Blue Cross where the rates are double. Kaiser knows they have us in a corner."

He added that newer parents, like him and Olguin and Dagatan, might not be aware of the consequences of having no pediatric care in Hayward until their child gets seriously ill. "I think a lot of families aren't aware that there are services being taken away from their children — particularly if you're not using the services on a regular basis, you won't know until you're being asked to drive up to Oakland or down to Santa Clara during rush hour."

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