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HomeMy WebLinkAboutMINUTES - 07251989 - IO.2 I.O. 2 TQ.: Board of Supervisors .;=_ FROM: INTERNAL OPERATIONS COMMITTEE ~ DATE: July 17, 1989 co SUBJECT: PROPOSED RESPONSE TO THE REPORT OF THE 1988-89 GRAND JURY ENTITLED "COUNTY HOSPITAL REPLACEMENT" Specific Request(s) or Recommendations(s) & Background & Justification RECOMMENDATIONS: 1. Adopt the following report of our Committee as the Board of Supervisors'response to the Report of the 1988- 89 Grand Jury entitled "County Hospital Replacement". 2. Remove this item as a referral to our Committee. BACKGROUND: On May 26, 1989 the 1988-89 Grand Jury approved the attached report on "County Hospital Replacement". On July 17, 1989 our Committee met with the Health Services Director and members of the 1988-89 and 1989-90 Grand Juries. We reviewed the proposed response suggested by the Health Services Director and discussed the Grand Jury's recommendations with the members of the Grand Jury and the Health Services Director. At the conclusion of these discussions we formulated the following response,utilizing a format suggested by the Grand Jury in their final report, in which the Grand Jury requested that written responses to Grand Jury recommendations clearly specify: A. Whether the recommendation is accepted or adopted. B. If the recommendation is accepted, a statement as to who will be responsible for implementation and a definite target date. C. A delineation of constraints, if a recommendation is accepted but cannot be implemented within the calendar year. D. The reason for not adopting a recommendation. Continued on attachment: YES Signature: Recommendation of nt Administrator Recommendation of Board Committee A - Other- Signature(s): T M POW SUNNE WRIGHT MC PEAK Action of Board on: ' July 25, 1989 Approved as Recommended x Other Vote of Supervisors I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF AN ACTION TAKEN x Unanimous (Absent - ) AND ENTERED ON THE MINUTES OF THE Ayes: Noes: BOARD OF SUPERVISORS ON DATE SHOWN. Absent: Abstain: cc: County Administrator Attested 24 09x /"I Health Services Director Wil BAchelor, Clerk of the Board Foreman, 1988-89 Grand Jury of Supervisors and County Administrator Foreman, 1989-90 Grand Jury Superior Court Judge Wayne Westover By � Deputy Clerk CLVM:eh(io-2) This and all future responses to Grand Jury recommendations coming from our Committee will follow this format as closely as possible. RECOMMENDATION# 1: Continue the deliberations which are currently being undertaken to determine the optimum size of the replacement for Merrithew Memorial Hospital. RESPONSE: A. This recommendation is adopted. B. The Health Services Director will be responsible, along with the County Administrator,for implementing this recommendation. Current plans are for a 190-bed hospital, but these plans could be modified over the next several months, depending on discussions which are now going on with other hospitals and depending on the final recommendations from the County's architectural and design consultants. C. The current status of negotiations with other facilities and the timeframe for reports from the County's consultants indicate that it may not be possible to make an absolutely final decision on the precise size of a replacement hospital by the end of the calendar year. RECOMMENDATION#2: Simultaneously engage an independent third party to facilitate a new round of negotiations with district and private hospitals to contract for use of their vacant beds and ancillary services. It is essential to: a. negotiate long-term contracts; b. make reasonable financial offers; c. approach ALL of the County's district and private hospitals; d. address the insurance issues; e. explore a variety of contractual options including use of County-employed, board-certified doctors as attending physicians for County patients at other hospitals. RESPONSE: A. This recommendation is adopted. B. The Health Services Director will be responsible for implementing this recommendation. At the conclusion of the current 90-day negotiations with Brookside Hospital,we would urge the Grand Jury to conduct a debriefing with the County and/or Brookside staff. We would also urge the 1989-90 Grand Jury to closely monitor progress on this issue. The Health Services Director is to convene a meeting of representatives from all hospitals in the County which are interested in exploring contracting with the County. Together this group should select an individual or firm who is knowledgeable in the field of health care economics and who is acceptable to all parties. This individual or firm's role should be to mediate proposals among all parties with the goal of attempting to determine whether there are parameters acceptable to the County and one or more of the hospitals within which the County could contract for inpatient beds at other facilities,primarily for patients from East County and West County, given that such a contract must extend for the normal lifespan of a new facility and that the cost paid to another facility not exceed the cost of having the County provide the services itself. The precise timeframe within which this can be conducted is not possible to determine at this point. However, the Health Services Director should establish such a target date by September 1, 1989 and advise the 1989-90 Grand Jury of that target date. C. It may be possible to complete work on this recommendation within the calendar year, depending on the willingness of other facilities to sit down with the County. The precise timetable for completing work on this recommendation will be clearer once the Health Services Director has had an opportunity to discuss this issue with the other health facilities in the County. I - 2 - RECOMMENDATION# 3: Include plans for needed enhancements of all County clinics/health centers as an integral part of the replacement hospital planning. Special consideration should be given to: a. upgrading facilities and equipment; b. expanding clinic hours; c. making urgent care services available at all clinics/health centers. RESPONSE: A. The recommendation is accepted. B. The Health Services Director will be responsible for implementation of this recommendation. Because the amount and timing within which state or federal funding for such facilities may be available, it is impossible at this time to provide a precise target date. However, the Health Services Director is asked to keep the 1989- 90 Grand Jury briefed on developments in this area. C. It is unlikely that this recommendation can be implemented within the calendar year due to the uncertainly of state and federal funding,the possibility that a county hospital bond issue may be placed on the ballot in 1990 and the fact that development of specific plans for outpatient facility enhancements must be viewed in the overall context of the County's financial picture,which does not,at this date,appear to permit the expansion of anyhealth facilities in the coming fiscal year (1989-90).