Formerly operated by Alameda County, California, it now has an independent board of trustees appointed by the Alameda County Board of Supervisors. It operates five hospitals (Alameda Hospital, Fairmont Hospital, Highland Hospital, John George Psychiatric Hospital, and San Leandro Hospital), and four primary care medical clinics (called ambulatory Wellness Centers) within the county. In March 2013, ACMC officially changed its name to Alameda Health System.
The system began as the Alameda County Infirmary in 1864. In the 1920s, it became the Fairmont Hospital, the first public rehabilitation center in the western United States. In 1927, Highland Hospital was established. In the 1960s, Ambulatory Health Care Services, a network of neighborhood-based health clinics called Wellness Centers, was established. In the 1992, an acute psychiatric hospital, John George Psychiatric Pavilion, above Fairmont Hospital was opened.
In the 1990s, the three hospitals, along with the Wellness Centers, were consolidated to form the Alameda County Medical Center.
Throughout the 1990s, ACMC faced structural deficits resulting from changes in the American health care industry. On July 11, 1996, California State Assembly Bill 2374 (AB 2374) was passed to permit Alameda County to establish a public health authority to manage, administer and control the Alameda County Medical Center. On July 1, 1998, the Board of Supervisors formally handed control of ACMC to a newly formed Medical Center Hospital Authority.
AHS received a $200 million bailout from Alameda County in the 1990s, and as of 2013 still owes about $130 million. In addition, a half-cent sales tax from local Measure A has provided financial relief, including $105.5 million in fiscal year, 2010-11; Measure A is designed and implemented to provide additional financial support for many of the medical departments of the Alameda Health System (emergency medical, hospital inpatient, outpatient, public health, mental health and substance abuse services) and is meant to primarily serve indigent, low-income, and uninsured adults, children, families, seniors and other residents of Alameda County that are traditionally seen as very vulnerable populations and those that are usually at proportionately high rates coming to AHS facilities.
In 2013, Alameda Health System took ownership of San Leandro Hospital from Sutter Health and ensured its emergency room remained open. Sutter Health had previously announced its intention to close the hospital. At the time, San Leandro Hospital was the sole acute care facility in San Leandro. Its emergency room served 26,478 people annually. The San Leandro City Council endorsed a plan proposed by Alameda County Supervisor Wilma Chan and advanced by San Leandro Mayor Stephen H. Cassidy for San Leandro to donate $1 million per year for three years. With other funding, the city's donation was intended to keep the hospital open until it could achieve profitability as part of its transfer to the Alameda Health System.
As of 2018, San Leandro Hospital remains open and is undergoing a $26.8 million renovation to provide 28 acute rehabilitation beds and administrative offices, along with speech, occupational and physical therapy treatment areas.
The pie charts reflect the data compiled from the Alameda Health System and indicate the demographics of the patient population. The majority of patients are African American and Latino, respectively. Additionally, about 40% of the patient population is a recipient of either Medicare or Medicaid. Research conducted by the Joint Center for Political and Economic Studies indicates that life expectancy in Alameda County is positively correlated with degree of economic opportunity. In a study conducted in 2012, the highest economic opportunity quintile lived 7.7 years longer on average than those in the lowest economic opportunity quintile.