American Medical International would pay UC Irvine a minimum of $3 million a year to take over the university's debt-ridden medical center, according to a preliminary draft of the national hospital chain's management proposal. A copy of the draft proposal was obtained by The Times.
Officials with AMI and UCI refused to discuss specifics of the draft because the matter is still in negotiation. Further, they cautioned that the document is a "discussion draft" that has changed many times in recent months and is bound to be revised before a final proposal is presented.
However, the document--excerpts of which are being circulated for discussion by the medical school's faculty and some medical center officials--offers the first glimpse of what is being contemplated for the teaching hospital, which was about $10 million in debt last fiscal year.
According to the draft, the lease agreement would last for four years, with an option for AMI to renew. The company's lease payment to the university would be adjusted by the consumer price index yearly, and the university's proceeds from the lease would be restricted to providing support for education and research at the teaching hospital in Orange.
In other provisions of the company's draft proposal:
- All medical center employees would be transferred to AMI's payrolls for at least one year. The employees would retain their seniority acquired from the university and carry it over into AMI's retirement and benefits system, the document says. However, physicians would remain on the staff of the College of Medicine and their salaries would not be paid by AMI, officials said. Also, the university would still have to provide, supervise and control the training of doctors.
- UCI Medical Center would continue to provide medical care for the county's poor. The draft proposal states that AMI would "continue to support the care of indigents to the extent that resources are made available by local, state and federal governmental agencies." But if indigent patients require care beyond the services paid for by the government agencies, the indigents would "also be treated to the extent medically required," the document continues. It further states that an indigent requiring emergency admission would not be denied care due to the patient's inability to pay.
AMI's interest in the former county hospital in Orange is intertwined with its partnership in a venture to build a hospital complex in Irvine, which also will be affiliated with the university.
------------------------------------------------------------------Teaching hospitals increasingly affiliate with private chains.
Today, a growing number of teaching hospitals like UCI are affiliating with private hospital chains. These teaching hospitals are at a competitive disadvantage with community hospitals because they must grapple with debts caused by large indigent patient loads, inadequate government reimbursement and the higher costs associated with research, teaching and complicated medical cases, authorities have said.
About 70% of UCI Medical Center's patients are covered by federal, state or county health care programs which do not fully reimburse the hospital for the cost of care. UCI is attempting to enhance its image and attract more privately insured patients to boost its finances.
However, the proposed agreement between UCI and AMI has drawn flack from an employees' union representative.
Edward Edwards, council representative for the American Federation of State, County and Municipal Employees, charged that UCI employees would not be treated fairly under the agreement. He also questioned Thursday how the hospital chain could care for the poor and still produce a profit.
"There's 101 back doors to take on this. There's just no way they (AMI) are going to enter into an agreement that allows for their profit to be affected by it," said Edwards, whose union represents the hospital's clerks and patient care technicians.
Edwards explained that the union was surprised to find out only recently that, if AMI is successful in its negotiations with UCI, all the hospital workers will leave the university's employment and be transferred to AMI's payroll. Edwards said he had been under the impression that the negotiations involved turning over only management of the hospital to AMI.
He also criticized UCI for not giving his organization a copy of the draft proposal.
Edwards called the one-year employment guarantee for the medical center employees "garbage . . . . The university offers that as a bouquet of flowers. If I was contracting, I would keep everyone for one year, just for transitional purposes," he said. At a meeting with university medical center management this week, he asked about AMI's pay scales, benefits and retirement programs but got no answers, he said.
"We're being sold down the river," added one employee who asked not to be identified.