The Alameda County half-cent sales tax for health care provides critical funds to help keep the region's public hospital system solvent and for community medical services for indigent, low-income and uninsured residents.
But voters should reject Measure AA, which would prematurely extend the tax until 2034, on the June 3 ballot. Serious problems with the current use of the money must first be addressed.
Voters approved the original tax in 2004. It won't expire until 2019. That gives county officials plenty of time to fix the problems and submit a new measure that addresses legitimate concerns.
Some problems were revealed in a critical report issued this month by the tax oversight committee, a collection of public officials and community representatives appointed by the county board of supervisors.
The committee was mandated in the 2004 measure to ensure responsible expenditure of what is now about $125 million a year. But, the committee complained, county counsel has interpreted the measure to limit its ability to review program efficacy and cost-effectiveness.
While 75 percent of the tax goes to the Alameda Health System, a public hospital consortium, the balance is distributed to other health providers. The distribution of the money should ensure it complies with the voter-approved measure and provide the best bang for the buck. But, as the oversight committee noted, that's hard to monitor because recipients often fail to provide data to justify that their programs make a difference.
Further, each county supervisor can direct $150,000 annually, with the blessing of the rest of the board, to individual programs. This sort of slush fund is unacceptable. All money should be allocated by the same standards and review process.
Finally, the state is indirectly raiding some of this money. Under the federal Affordable Care Act, more poor people have been enrolled in Medi-Cal, which insures at federal expense patients whose costs were previously covered by state funds.
Consequently, the state wants some of its money back for other purposes. But in calculating how much, the state has unfairly penalized Alameda County because it has the additional sales tax revenues. Under the complex formula, the state grab would be less if the county didn't have the sales tax.
The grab probably will last a few years and could amount to tens of millions of dollars. If voters reject Measure AA, county officials should determine the cost of the state raid and advise voters of it when they bring back the next renewal measure.
Like everything else about this tax, voters deserve full transparency.