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 fact, Green said that he received little notice from Kaiser about the closure of the pediatric unit in Hayward and didn't know about the healthcare giant's decision not to include a pediatric unit its new San Leandro Medical Center until he saw a CNA protest on television. "All we received were messages saying, 'We're here to stay in the community and we care about kids,'" he said. "That's what I would want my healthcare provider to say and believe, but the fine print is that they're going to provide less services for children — and we're talking about sick children."

As someone who worked with youth on a daily basis, Green saw the "effects of healthcare on kids who have access and those who don't," he said. "It affects their entire lives ... their readiness for school ... [and] their ability to be successful. So thinking about the high-schoolers I would teach, it breaks my heart to imagine that people like them would be denied quality healthcare in their most formative stages.

"I'm not in the medical field," he continued. "I'm not saying that there needs to be five nurses on staff at all times. I'm just saying ... there should be a wing in the community for children — it doesn't need to be some big development."

In January, the Express reported that there had been a spike in cost-cutting measures at the Kaiser Oakland Medical Center, including nurse layoffs and early discharges of patients, resulting in substandard care for patients there. In addition, the Express reported last week in part one of this series that Kaiser has come under increasing criticism for failing to provide adequate care to patients with severe mental health problems, and for delays in treatment, in violation of the law.

CNA officials say Kaiser's unwillingness to include a pediatric inpatient care unit in San Leandro is yet another example of the healthcare giant cutting costs and shortchanging patients. "Over the last few years there's been a steady program of patients who used to be monitored for various symptoms but are now being sent home with medication and more in-home monitoring," Chan said. "Kaiser has been trying to say patients don't need to be admitted to the hospital, and that these patients should just be discharged."

This is exactly what happened with Jenevieve, Chan asserted. "She should have been hospitalized for observation, so that she could have been monitored to see if anything else would have happened — that way they could have caught the meningitis a lot sooner."

When asked about the nurses' assertion that consolidation of services is a cost-cutting measure, Kaiser's Tom Hanenburg wrote in an email to me, "This is not about money, as the nurses' union leadership would like everyone to believe — it is about quality. Specifically, how to offer the best, most highly specialized inpatient care to the children we care for."

Hanenburg also said that that the nurses' union's claims about Kaiser's quality, staffing, and cost-cutting measures "are not only unfounded, they are a deliberate and irresponsible strategy by the union to apply pressure before and during contract bargaining." (Kaiser officials made similar assertions about the National Union of Healthcare Workers concerning that union's criticisms of Kaiser's mental health services.)

The CNA isn't alone in denouncing Kaiser's decision to provide no pediatric inpatient services in central and southern Alameda County or in contending that it was part of a cost-cutting move. State Assemblymember Robert Wieckowski of Fremont has urged Kaiser multiple times to keep a pediatric inpatient unit open in south county. "There's someone in corporate saying we can cut costs by consolidating these efforts and make the patients drive ... saying you come to us instead of us being there for you," he said.

Wieckowski introduced legislation this year aimed at providing extra financial incentives to nonprofit hospitals that offer an adequate "community benefit." But Kaiser officials have been uninterested in his plan. "They had made a decision that this is how they're going to deliver healthcare — and I still disagree," he said. "Hell, open a pediatrics center in Fremont. You have 32,000 [patients] there. Put something in south county and at least you have coverage for everyone, instead of just one hospital."

Wieckowski's sentiments are shared by California state Senate Majority Leader Ellen Corbett, who, along with Wieckowski and other local politicians, has participated in nurses' union rallies about the pediatrics issue. "I have been very concerned ever since I first heard that Kaiser Permanente inpatient pediatric services were being consolidated in Oakland," Corbett wrote in an email to me. "Families that have to travel longer distances to receive care and visit a very sick child in the hospital face many challenges. In addition to having to travel farther distances to the hospital, they still have to commute to work, take children to school and have many other family responsibilities. I am confident that Kaiser Permanente will continue to provide high quality care to our local children and families and I sincerely hope that — in the near future — an arrangement can be made to reestablish pediatric inpatient care services closer to Hayward and San Leandro."

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