Faced with imminent shutdown, the Fairmont Hospital may be saved for now -- by tobacco money.

But the fate of two other county health programs remains uncertain. Alameda County officials are looking into spending $2 million of county tobacco settlement money to keep open the 109-bed nursing home the rest of this fiscal year, which ends in June. Dave Kears, director of the county Health Care Services Agency, is drafting a proposal to use $2 million, part of $500 million in tobacco money the county expects to get over 25 years. "There's no way we can close the SNF (skilled nursing facility)," said Alameda County Supervisor Alice Lai-Bitker. "We need to address this issue head-on." The Alameda County Medical Center, which operates Fairmont Hospital and other county health facilities, has been threatening to close the nursing home and the Alameda Health Wellness Center as well as cut off psychotropic drugs for people seen at outpatient clinics to make up a $4 million deficit. For two months, medical center officials have been asking county supervisors and the Alameda Alliance for Health, an insurance provider for low-income people, for the $4 million to stave off the cuts. For now, the medical center has withdrawn its request for money from the Alliance. The insurance provider earlier this fiscal year gave the medical center $7.7 million to close another deficit. Instead, medical center officials are relying on the Board of Supervisors to come up with the $4 million, and possibly another $2.2 million by the end of June. News of the $2.2 million additional deficit was reported by Ken Cohen, chief executive officer of the medical center, at a Wednesday meeting of the medical center and Board of Supervisors steering committee. The medical center only got word in the last week or two that it may receive $2.2 million less in Medi-Cal reimbursements from the state than anticipated, said Melinda Paras, president of the medical center board. Although Supervisors Lai-Bitker and Gail Steele on Monday said they were in favor of using $2 million in tobacco funds to keep the skilled nursing facility open, Supervisor Keith Carson said he won't commit to using such funds until he sees the full deficit picture for the medical center and county. There have been no promises yet on using the tobacco money from the full Board of Supervisors and the issue isn't scheduled to come before them on Tuesday. "We're facing a very bleak picture in terms of our budget," Lai-Bitker said at Wednesday's meeting of the steering committee. "We know that as a county we will try to avoid any disruption in services." County Administrator Susan Muranishi has declined so far to release an estimate of the county deficit, although her office plans to reveal that number on April 11. Supervisor Steele has put the deficit at $30 million to $50 million. As far as the other two possible medical center program cuts, it is not known whether they will go through. The medical center would save $500,000 a year by closing the Alameda wellness clinic and $1.4 million a year by opting not to pay for psychotropic medication for outpatients. Lai-Bitker, who lives in Alameda, said the "Alameda center is very important for my constituents." Lai-Bitker and her aide, Jean Fong, explained that the Department of Veterans Affairs is exploring moving its Oakland clinic to extra space at the Alameda wellness center, an outpatient clinic open two days a week. Fong said the rental agreement for the space then could be renegotiated. On the psychotropics issue, Cohen and Kears said Wednesday they planned to try to resolve it by the end of the month. Up to now, both agency heads have insisted it's the other's responsibility to pay for the medication.

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