Proposed constitutional amendment would put public health and safety at risk

By Dr. J. Douglas Kirk and Mel Levine, Special to CalMatters

One recent morning at the UC Davis Medical Center’s Emergency Department, 16 mental health patients were under involuntary observation to determine if they were a danger to themselves or others. 

Each needed a full-time mental health worker to ensure the safety of the patient and others.

This was more than the medical center’s staffing could handle, so supervisors reached out to contract employees to fill the gap. On any given day, at inland Northern California’s only Level 1 trauma center between Fresno and the Oregon border, UC Davis Medical Center administrators must move quickly to adjust staffing, and they need the flexibility to use contract workers to respond to often-changing patient numbers and medical needs.

The University of California has joined with the California Coalition for Public Higher Education to oppose Assembly Constitutional Amendment 14. This costly and crippling constitutional amendment would prohibit UC from entering into contracts for these contingency workers who provide a wide array of support and clinical services.

Public employee unions are championing ACA 14, and both of us have worked collaboratively with labor. But when a constitutional change is proposed that could put the public’s health and safety at risk, we need to speak out.

UC hospitals treat higher percentages of very sick patients than other California hospitals. With five nationally ranked academic medical centers and 18 health professional schools, UC Health trains nearly half of all of California’s medical students and medical residents. UC medical centers are public safety net hospitals that must keep their doors open to all patients.

But the restrictions established by ACA 14 by Assemblywoman Lorena Gonzalez, San Diego Democrat, would prevent UC hospitals from being able to obtain the trained staff they need on short notice to serve these patients–many of whom require highly complex care. 

This flexibility is critical to manage unforeseen changes in hospital census, patient acuity, employee absenteeism and unanticipated increases in patient volumes arriving to our emergency departments as a result of multi-casualty trauma incidents or other environmental factors.

A staffing shortage in any area of the hospital can quickly cascade into others. For instance, a housekeeping shortage means hospital rooms aren’t clean and ready for incoming patients. Those patients take up beds in the emergency department while they wait, and that can lead to further overcrowding, delays in treatment and poor patient outcomes.

ACA 14 would be disastrous not only for hospitals, but for the entire UC. It would prohibit UC from using contracted workers for a wide range of functions, from increased security for commencement and other special events to occasional landscapers who have specialized skills and equipment. 

ACA 14 would cost UC an estimated $172.6 million more per year, or the equivalent of about $500 per student in annual tuition, and for what?

ACA 14 won’t protect union jobs. They are already protected under bargaining agreements. Over the last five years, the number of represented UC workers has grown to 85,020 workers, but less than 4% of all UC workers are contract employees. They’re a small minority that make a major difference in health care costs and quality.

ACA 14 is scheduled for a Senate committee vote on Aug. 20, which could send it to the full Senate for a vote to place it on the statewide ballot. We urge legislators to say no to this costly and crippling measure. 

While labor may be our partner, its support of this misguided effort could threaten patient safety instead of helping save lives – and that should be the priority for all Californians.


Dr. J. Douglas Kirk is chief medical officer for UC Davis Health, [email protected] Mel Levine is a former member of Congress and assembly member who serves as co-chair of California Coalition for Public Higher Education, [email protected]. They wrote this commentary for CalMatters.

Latest in Commentary

California State House


State budget depends on the rich

Bernie Sanders, left, and Donald Trump


Voters beware of our populist threat. It comes from the right and left


An invitation to mentor. These California women do

California State House


The man who changed the Capitol


Gov. Newsom needs to stand up to the Trump administration on the Delta

California State House


An uber-complex presidential primary