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HomeMy WebLinkAboutMINUTES - 08141990 - H.B N. 6 9: 30 A.M. THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Adopted this Order on August 14, 1990 by the following vote: AYES: NOES: (See below for vote) ABSENT: ABSTAIN: ------------------------------------------------------------------- SUBJECT: Implementation of State Budget Reductions Phil Batchelor, County Administrator, presented to the Board his recommendations as contained in the report ( attached and included as a part of this document) for implementation of State Budget reduc- tions imposed upon the County as a result of the $3 . 6 billion State shortfall in this fiscal year. The County Administrator noted that the Phase I cuts taken on August 6 , 1990 applied to County operated programs. He advised that the Phase II cuts under consideration by the Board today will implement reductions in certain mandated programs and are a direct result of the State shortfall. Mr. Batchelor advised that the reductions being proposed today amount to $9. 3 million in State funds no longer available to Contra Costa County. He also noted that the recommendations in the attached report included in the Fund category were changed to Fund/Watch due to the continuing uncertainly of final State cuts. Persons listed below spoke on the proposed cuts. Speakers opposed reductions in public health and mental health programs; expressed the need for development of a strategic planning process to identify revenue sources to mitigate the impact of the proposed reductions on the poor and disadvantaged; proposed the reduction or elimination of service contracts for mental health programs with these services absorbed by county personnel; referred to proposed reductions in the Justice System and the need to discuss the cuts with the judges; expressed concern for the needs of the homeless and the retention of programs to address these needs; opposed closure of mental health clinics; urged the Board to maintain the libraries at the current funding level; requested retention of programs providing services to children and their families; requested retention of detox programs; and proposed reduction of managerial staff positions in lieu of line staff as a means of maximizing fiscal resources for mandated programs. Those speaking were: Jean Siri , 1015 Leneve Place, E1 Cerrito; Clay Foreman, P.O. Box S, Martinez; Stanley Hutter, Contra Costa Employees, Local I , 2025 Port Chicago Highway, Concord; Norman Spellberg, Judge of the Supervisor Court, Martinez; Sarella Sue Ogden, P. O. Box 601 , Concord; John W. Olsson, Phoenix Program, 1535 Flora St. , Crockett; Barbara Bysier, Family Stress Center, 2086 -Commerce St. , Concord; George Sisikin, 2964 Knoll Dr. , Concord; Raymond Loveday, 9380 Lemon St. , Apt. A, Martinez ; Bruce Oberlander, P. O. Box 601, Concord; Steve Gallion, 211 C St. , Martinez; Larry Mars, Phoenix Programs, 1401 4th St. , Antioch; James T. Young, 1121 Detroit Ave. , Concord; Elizabeth P. Hastings , Project Second Chance and the Contra Costa Library, 450 Dale Rd. , Martinez; Raymond Neuman, 232 Broadway, Richmond; Michael Cornwall, 105 Oakview, #C, Concord; Susan Prather, P. O. Box 236, Crockett; Shirley Young, Phoenix Programs, Maple Ave. , Concord; Susan Cinelli, Alcohol Programs, Concord; Jenifer Mendalski, Central County Multi-Service Center, 2270 Bacon St. , Concord; Joe Gross, Residential Alcohol Provider, 305 Chesley, Richmond; Wayne Wechsler, We Care Foundation, 2191 Kirker Pass Rd. , Concord. At the conclusion of the speakers ' presentations, the Board considered the recommendations of the County Administrator. Supervisor Torlakson referred to potential legal problems that might occur if monies were diverted from the library to fund human service programs. However, he proposed transferring certain health education and prevention programs and some outreach activities to the jurisdiction of the County Library in order to maximize funds for health service programs providing direct services to people. Mr. Batchelor called attention to the fact that the Library has sustained numerous cuts over the years, noting as an example the reduced hours of operation available to library patrons. In referring to reductions sustained by county departments and non-profit agencies, Supervisor Schroder spoke on the need to appeal to private organizations with whom the County contracts to assist in controlling costs for services provided. Supervisor Powers expressed concern with the closure of the Girls ' Center and the problems and expense associated with the place- ment of these young women in board and care institutions. Supervisor Powers recommended that staff monitor the costs associated with these placements and report to the Board in six months. On motion of Supervisor Powers, seconded by Supervisor Schroder, the Board APPROVED the recommendations of the County Administrator as set forth in the attached report. The vote on the motion was as follows: AYES: Supervisors Powers, Schroder, McPeak, Fanden NOES: Supervisor Torlakson ABSENT: None Supervisor Torlakson then moved that staff be directed to develop a list of educational type public health and mental health programs that could be transferred to the library to manage. The motion died for lack of a second. I hereby certify that this is a true and correct copy of an action taken and entered or, the minutes of the cc: County Administrator Board of Supervisors on the data shown. Auditor-Controller ATTESTED' �[� g L /.541 / '� 13 Health Services Director PHIL SAT OR,Clerk of tib Board Director, Social Services of SuperAsors and County AdffdnWUBW By �'��L:�L��—..CePuty TO: BOARD OF SUPERVISORS Contra t FROM: Phil Batchelor, County Administrator f / � Costa ^o �J County DATE: August 14, 1990 SUBJECT: IMPLEMENTATION OF STATE BUDGET REDUCTIONS SPECIFIC REQUEST(S)OR RECOMMENDATION(S)6 BACKGROUND AND JUSTIFICATION I . RECOMMENDATIONS: 1. It is recommended that the revenue that is derived from booking fees be allocated to offset a portion of the reductions in the Juvenile System Subvention Programs and the Trial Court Funding Functions. 2. It is recommended that the Board accept the Justice System Advisory Group' s recommendations to reduce several of the projects which are currently funded by AB 90 funds as outlined in this report. . 3. It is recommended that sufficient funding ( $71,906) be allocated from the booking fee revenues to mitigate the detrimental effect on the AB 90 programs that must be reduced due to state cutbacks. 4. It is recommended that the Girls' Center be closed effective October 1, 1990. 5. It is recommended that savings from the Girls' Center closure be used to replace the state reductions that threaten the closure of the Byron Boys' Ranch. 6. It is recommended that $129,000 be allocated from the booking fee revenues to add two Deputy Probation Officer positions, one clerical position and one Probation Aide position to increase the resources available in the Probation Placement Unit needed to find placement opportunities for female delinquents. CONTINUED ON ATTACHMENT: _YES SIGNATURE: .; _RECOMMENDATION OF COUNTY ADMINISTRATOR _RECOMMENDATION OF BOARD COMMITTEE APPROVE -OTHER IGNATURE S: ACTION OF BOARD ON APPROVED AS RECOMMENDED OTHE 'VOTE OF SUPERVISORS, 1 HEREBY CERTIFY THAT THIS IS A -UNANIMOUS(ABSENT AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: AIN: OF SUPERVISORS ON THE DATE SHOWN. CC: ATTESTED PHIL BATCHELOR,CLERK OF THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR M (10/88) BY ,DEPUTY -2- 7. It is recommended that an additional $106,870 be allocated from the booking fee revenues to provide three Group Counselor positions for the Boys' Ranch to increase its capacity to 74. 8. It is recommended that the County Administrator's office be directed to work with the Probation Officer and Juvenile Court to explore alternative uses of the building that currently houses the Girls' Center to determine if it should serve as an addition to Juvenile Hall or be used as a co-educational facility which might serve as a privately operated AFDC supported transition center. 9. It is recommended that the balance of the savings from closing the Girls' Center be used to offset the targeted reductions in the Home Supervision Program that serves as an alternative to incarceration of juveniles. 10. It is recommended that booking revenues totaling $804,148 be used to offset the reduction in Trial Court Funding revenues. 11. It is recommended that the Board direct the County Administrator to work with the Courts to determine the precise program impacts of these reductions and return to the Board on September 25, 1990 with a report. 12. It is recommended that the revenue that is derived from the Property Tax Administrative Fees be dedicated to minimize the level of reductions that would otherwise be required due to state cuts in the Social Service and Health Service Departments. 13 . It is also recommended that three program specialist positions that currently work in the Staff Development Unit of Social Service be eliminated which will result in a savings of $113,000. 14. It is recommended that $387,000 be allocated from the Property Tax Administrative Fee to the Social Service Department for Child Protective Services to reduce the amount of cutbacks that have to be made in this program as a result of the Governor's veto. 15. It is recommended that $5. 3 million be earmarked from the Property Tax Administrative Fees to fund the county health care clinics. 16. It is recommended that immediate minimum reductions of $1,400,000 be made in the Health Services Department as a result of the cuts made by the State Legislature and Governor in services to the needy. 17. Direct the County Administrator to prepare necessary position reduction resolution, post any necessary notices and meet with affected unions in order to accomplish the needed reductions. 18. It is recommended that the County Administrator be directed to prepare a third budget status report for September 25 so that the Board can consider what additional reductions will have to be made to balance the budget once fund allocation formulas are known. II. BACKGROUND The budget report which was presented at the August 6, 1990 budget hearings indicated that the State Legislature and the Governor reduced county programs by an incredible three-quarter billion dollars for the 1990-91 fiscal year. To add insult to injury, these reductions were not made on a timely basis, thus requiring -3- that additional cuts be made in order to offset the financial obligations that could have been avoided had the information been provided within the time frame provided by state law. To offset some of the drastic reductions made by the state in adopting their budget, new revenue raising authority was provided to counties to lessen the impact of the expenditure cuts. However, the new revenue sources will not offset the cuts made by the state, so additional reductions need to be made. In order to put the challenge that has been placed on county government into perspective, it is necessary to consider that the record setting cuts made by the state this year are in addition to the burdens that have been piled on counties in each of the last 13 years. During this period the cost of administering state and federal programs has continually gone up at the same time that the number of unfunded and underfunded mandates which have emanated from these legislative bodies has continued to flow unrelentingly. Because of this cumulative erosion, Contra Costa County was already facing severe budget problems even before the dawning of the latest round of tragic reductions. This budget catastrophe is magnified when one considers that the county has the legal obligation to open a new jail that is estimated to cost over $12 million in the 1991-92 fiscal year as well as the obligation to take steps to alleviate the continuing deterioration of the obsolete medical facilities that are being used to serve an ever-growing number of clients. These new operational and capital demands must compete for scarce resources with the service requirements placed on the county as more and more people enter the criminal justice system and the caseloads in Social Service and Health Services continue to grow. Unfortunately as the county tries to deal with the cumulative damage of the past, the tragic casualties of the present and the increasing demands for the future, it appears that it must do so in light of a decline in new building construction, a slowing in the real estate market and the promise of a recession on the horizon which will also restrict the generation of revenues at the local level. In summary, it makes the goal of providing effective, courteous, responsive service to the public a challenge such as has never before been faced by counties in California. III. PROGRAMS AFFECTED A. Law and Justice Programs THE PROBLEM Trial Court Funding and Justice System Subvention Programs were reduced by $93 .7 million with adoption of the state budget. Program Impacts As a Result of Justice System Subvention Program (AB 90) Cutbacks The local impact that results from the Governor's veto of $33 million of the $67 million statewide appropriation for Justice System Subvention programs (AB 90) totals $862,241, or 49%. In order to understand what steps should be taken to deal with these devastating cuts, the Justice System Advisory Group, which was established by the Board to recommend allocation of AB 90 funds, was asked to consider this matter. After a preliminary investigation they have recommended that each program that is currently funded by AB 90 funds be reduced proportionately by 49%, as is shown in the table below. -4- Justice System Advisory Group Recommendations Just Syst Advisory 1990-91 Group Department or Proposed Recommended Agency Project Title Allocation Reductions Criminal Justice Planning, Coordination, $ 39, 537 $ 19, 387 Agency (CAO) Evaluation & Admin District Attorney Performance of AB 3121 256,056 125,559 Public Defender Defense of Juveniles 76,771 37,645 Brentwood Youth & Family Services 83 ,238 40, 816 Health Services Detention Facility Mental 149,841 73 ,475 Health Services Friends Outside Friends Outside 35,966 17,636 (Sheriff) Battered Women's Battering Abatement 24, 564 12, 045 Alternatives District Attorney Adult Pre-Trial Diversion 182, 561 89, 520 Probation Byron Boys' Ranch 834,328 409, 118 Probation Home Supervision 76,817 37,668 TOTAL $1,759,679 $862,869 -5- The Justice System Advisory Committee also recommended that booking revenues be used to offset losses to criminal justice agencies and that the Board support legislation to restore AB 90 reductions and implement a booking fee for juvenile facilities. Program Impacts as a Result of Trial Court Funding Reductions Trial Court Funding reductions, if implemented in the same manner as funding was provided in 1989-90, would be as follows: Trial Court Funding Possible 1989-90 Budget Reduction Amount County Clerk $ 688,000 $ 94,610 District Attorney 496,079 68,201 Municipal Court . 11180,368 162 ,299 Probation 172,492 23,717 Public Defender 292,890 400254 Sheriff-Court Related 313,000 43,075 Sheriff Other 413720417 601,454 Superior Court 1,2001000 165, 042 SB 90 Revenue Losses 606,000 83 ,329 TOTAL $9,321,246 •$1,281,981 APPROACH The Realization of Booking Fee Revenues A state task force of County Administrators, Auditors and Sheriffs is working on developing a standardized booking fee process. The recommendations from this task force will be made in the near future. However, it should be noted that each county has -6- different costs for booking and therefore the charge by county will vary, although the process used to determine the cost will be standardized as a result of the new task force's work. A very preliminary estimate indicates that $1,096,000 may be derived by the county from this source if a cost of approximately $123 is charged for each eligible booking. However, a number of factors need to be considered in computing this fee. Nineteen separate steps are currently used to process each person arrested. This process costs over $2 million annually, but county arrests, remands from the court and CHP arrests reduce the total amount that may be eligible to charge other agencies. Another factor that must be taken into consideration in calculating the amount of revenue that can be realistically anticipated from booking fees is the fact that a significant number of people are currently released on their own recognizance within a short time after being booked. Therefore, police departments may decide to simply not book individuals who will be immediately released if it is costing the city for each person they bring to the county jail. After a preliminary analysis of these factors and several others it has been determined that a total of approximately $1,100,000 can be derived as a result of charging booking fees to the cities and other jurisdictions that book people into the county jail. This revenue estimate will be refined once the state committee completes the task of determining which items are appropriate for inclusion in booking fees. Measures to Mitigate a Portion of the AB 90 Reductions 1. It is recommended that the revenue that is derived from booking fees be allocated to offset a portion of the reductions in the Juvenile System Subvention Programs and the Trial Court Funding Functions. The recommendation of the Justice System Advisory Committee to reduce all projects proportionately by 49% is appreciated. However, the county is currently financing mandated programs and essential juvenile housing facilities with Justice System Subvention funds (AB 90) , which will require some adjustments. 2. It is recommended that the Board accept the Justice System Advisory Group' s recommendations to reduce most of the programs currently financed with AB 90 funds. It should be noted that even if the decision is made to immediately reduce these programs by 49% they will have been fully funded for the month of July and August before the 'reductions can be made. 3 . It is recommended that sufficient funding ( $71,906) be allocated from the booking fee revenues to finance the full cost of these programs for the months of July and August. -7- RECOMMENDED AB 90 REDUCTIONS Advisory Group' s Booking CAO Department Reduction Revenue Recomm. or Agency Project Title Recomm. Offset Reduct. Criminal Justice Planning, Coordination, Agency (CAO) Evaluation & Admin $ 19,387 $ 1,616 $ 17,771 District Attorney Performance of required AB 3121 funding for juvenile prosecution 125,559 10,463 115, 096 Public Defender Defense of Juveniles 37,645 31137 34,508 Probation Home Supervision of Juveniles 37,668 3,139 34, 529 Brentwood Youth & Family Services - counseling and diversion for law enforcement juvenile referrals 40,816 3,401 37 , 415 Probation Byron Boys ' Ranch support 409,118 34,093 375,025 Health Services Detention Facility Mental Health Services 73 ,475 6, 123 67 , 352 Friends Outside Friends Outside-volunteer (Sheriff) services to inmates 17,636 11470 16,166 Battered Women' s Battering Abatement- Alternatives counseling and treatment for violent males who abuse their spouses 12,045 1,004 11 ,041 District Attorney Adult Pre-Trial Diversion - diverts offenders from court system 89,520 7,460 82,060 --------- ------- -------- TOTALS $ 862,869 $71,906 $790,963 If the 49% AB 90 reductions were applied equally to all programs, the Byron Boys ' Ranch would receive a $408,821 reduction. However, as Gerald Buck, the County probation .Officer states: "It is not advisable to consider closure of the Boys ' Ranch to accommodate revenue short fall. The Ranch is a critical component of the Juvenile Justice System and serves over 400 delinquents per year. " There is an alternative that can keep the Boys' Ranch open. Mr. Buck suggests that, "The only major non-mandated program in the Probation Department is the Girls' Center. While it is the only residential program operated for girls by the Department it should be noted that this is the only Probation Department which operates a locked program for girls in Northern California. Girls ' committed to this program have multiple problems usually personal and family related, including drugs, sexual promiscuity, pregnancy and mental health. Their delinquent acts tend to be of a less serious nature, usually precluding a commitment to the California Youth Authority." The Girls ' Center has the capacity to house 19 girls, but an average of only 14 girls per month from the county have been -8- placed at the Center during the past 12 months. In order to offset the high costs of running this facility, contract commitments from out of the county have been sought to utilize a portion of the excess capacity. The 1990-91 appropriation for the Girls' Center is $664,470 and the revenue anticipated from contract commitments from out of the county total $50,000. Therefore, the net cost of the Girls ' Center for 1990-91 equals $614,470 ($664,470-$50,000) , or $43, 890 per bed annually. If the Girls' Center were to be closed effective October 1, 1990, cost savings for 1990-91 of $460,800 could be realized. This would provide sufficient savings to keep the Boys' Ranch open. Since the Board approved in the 1990-91 Final Budget the addition of nine group counselor positions and one Institution Supervisor I to open the Juvenile Hall Monticello Unit, the closure of the Girls' Center would not result in layoffs, but could result in three demotions. 4. It is recommended that the Girls' Center be closed effective October 1, 1990. 5. It is recommended that savings from the Girls' Center closure be used to replace the state reductions that threaten the closure of the Byron Boys' Ranch. Once the Girls' Treatment Center is closed, an additional burden will be placed on Juvenile Probation Services to provide appropriate placements for the most troubled females. This negative impact can be reduced, by adding resources to the Juvenile Placement Unit. 6. It is recommended that $129,000 be allocated from the booking fee revenues to add two Deputy Probation Officer positions, one clerical position and one Group Counselor position to increase the resources available in the Probation Placement Unit needed to find placement opportunities for female delinquents. The Girls' Center has also served as an alternative to Juvenile Hall for girls awaiting placement. Absent this alternative, there will be added population pressure on the Hall. Additional population burden at Juvenile Hall could be partially offset by provision of additional counselors at the Boys' Ranch to increase the population capacity to 74 on a full-time basis. 7. It is recommended that an additional $106,870 be allocated from the booking fee revenues to provide three Group Counselor positions for the Boys' Ranch to increase its capacity to 74. 18. It is recommended that the County Administrator's office be directed to work with the Probation Officer and Juvenile Court to explore alternative uses of the building that currently houses the Girls' Center to determine if it should serve as an addition to Juvenile Hall or be used as a co-educational facility which might serve as a privately operated AFDC supported transition center. Full utilization of Home Supervision, a state mandated program that provides an alternative to incarceration for juveniles, is critical to keeping the Juvenile Hall population at minimally acceptable levels. The 49% recommended reduction would cut $37,640 from this program. 9. It is recommended that the balance of the savings from closing the' Girls ' Center be used to offset the targeted reductions in the Home Supervision Program that serves as an alternative to incarceration of juveniles. -9- Measures to Mitigate a Portion of Trial Court Funding Reduction 10. It is recommended that booking revenues totaling $804,148 be used to offset the reduction in Trial Court Funding revenues. The following chart demonstrates the new reduction amounts that would result. Trial Court Funding Recommended Reductions Booking Reductions Revenue CAO Rec Proposed Offset Reduction County Clerk $ 94,610 $ 59,354 $ 35,256 District Attorney 68,201 42,796 25, 405 Municipal Court 162,299 101,829 60,470 Probation 23,717 14,884 8,833 Public Defender 40,254 25,274 14,980 Sheriff-Court Related 43 ,075 27,003 160072 Sheriff Other 601,454 377,213 224,241 Superior Court 165,042 103,526 61,516 SB 90 Revenue Losses 83,329 52,269 31,060 --------- --------- --------- TOTAL $1,281,981 $ 804,148 $ 477,833 11. It is recommended that the Board direct the County Administrator to work with the Courts to determine the precise program impacts of these reductions and return to the Board on September 25, 1990 with a report. B. Human Services Programs THE PROBLEM Health Services and Social Service are the county's largest departments and constitute a significant portion of its budget. They are funded primarily by state and federal resources and as such are the most vulnerable during times of cutbacks. Besides the sizable reductions that have already been made in these budget units to balance the 1990-91 budget, additional adjustments are required to take into account the impact of the newly adopted state budget. The exact extent of the reductions that the county must face as a result of state actions is not known at this time due to the fact that the formulas which will allocate reductions have not been prepared by the State in most cases. Estimates indicate that $6.7 to $8.9 million in additional health and mental health cuts may be necessary, as well as $500,000 to $900,000 in Social Service child welfare services. Although precise reduction amounts are not known, it is prudent to move forward at this time to make adjustments that would not exceed the minimum negative impact Contra Costa can expect to receive, due to the fact that the longer the decision to make reductions is put off, the more people, programs and projects will have to be reduced. -10- APPROACH The Realization of Revenue from Property Tax Administrative Fees In order to alleviate some portion of the cuts, the State Legislature did mandate that the Auditor shall withhold a Property Tax Administrative Fee from the cities and collect the same from special districts and school districts. The legislation that passed regarding this source of revenue is silent on how these charges should be calculated. Therefore, a . statewide committee of County Administrators and Auditors has been established to review an appropriate methodology to be followed in calculating the appropriate costs that are chargeable to the various agencies. This committee will work with state agencies and the League of Cities to produce a recommended approach. Once their work has been completed, the county will be able to produce accurate revenue figures for 1990-91. The revenue estimates that are being recommended to be included in the budget at this time are based on preliminary calculations that have been made by the County Administrator's Office in conjunction with the Auditor. Although the recommended amount of revenue of $5.7 million is realistic, it will need to be refined in the weeks ahead. Any revenue refinements that may be required could be considered by the Board in its September budget status report. The County Administrator' s Office has developed preliminary estimates based on actual costs for the 1989-90 fiscal year which indicate that the three departments ' total costs, excluding overhead, are $10. 3 million. Overhead estimates add another $800,000 to this total amount. Subtracted from the total is the current fee revenues now authorized by state law, which include fees for administration of the supplemental roll, 1915 Act and General Obligations Bonds, special levies charges, collection fee contracts, and new charges recently adopted by the Board, yielding net costs of $7. 9 million. When the County general fund share of the total property tax allocation (26.84% in 1989-90) is also factored out, it leaves a potential revenue recoverable, under the new state law of $5.7 million. This revenue projection will be refined once the specific cost determination methodology has been provided by the state committee. 12. It is recommended that the revenue that is derived from the Property Tax Administrative Fees be dedicated to minimize the level of reductions that would otherwise be required due to state cuts in the Social Service and Health Service Departments. Social Service In addition to the significant reductions that the Department of Social Service has already taken, it still faces an additional cut of $500,000 to $900,000 in Child Welfare Services as a result of the Governor's vetoes. The exact amount that the county will be reduced will depend on the method chosen by the state in allocating the Child Welfare Services appropriations. The final allocation amounts are not anticipated to be available for several weeks, which means that 100% of the program costs which are subject to be reduced are a general fund expense for a minimum of two months and more realistically three months. Due to the fact that the Board has made Child Protective Services one of its highest priorities in the past and the requirement to be in compliance with federal and state requirements, it seems desirable to look for a way to minimize reductions in the child welfare area. Since the final allocations are not known at this time, a best case scenario is suggested that assumes only a $500,000 reduction will be needed. If the final figures that come from the state -11- indicate a larger reduction will be needed, then additional adjustments can be considered as part of the September 25, 1990 budget report. 13. It is also recommended that three Program Specialist positions that currently work in Staff Development of the Social Service Department be eliminated which will result in a savings of $113,000. 14. It is recommended that $387,000 be allocated from the Property Tax Administrative Fee to the Social Service Department for Child Protective Services to reduce the amount of cutbacks that have to Be made in this program as a result of the Governor' s veto. Health Services The previous adoption of the 1990-91 Final Budget required a $1.9 million reduction in the Health Services which did not take into account the full impact of the massive state cuts. The total amount that must be reduced in the Health Services budgets will not be fully known until the state approves allocation formulas to distribute reductions to all counties. However, what is known at this time is that the County lost the $700,000 COLA for AB 8 and a sizeable reduction in both the Medically Indigent Services Program (MISP) and the mental health program. Although the final formulas are not available at this time, it is anticipated that MISP will be reduced by a minimum of $3. 5 million if reduction allocations are based on expenditure amounts, and up to $5. 2 million if they are abased solely on the January 1, 1990 population statistics. The mental health cuts ranged from a low of $2. 5 million to a high of $3 . 0 million. The total amount that the State cut the Health Services Department ranges from a low of $6.7 million to a high of $8. 9 million. The final reduction numbers are not known at this time, nor is the certainty of realizing the estimated revenue amounts. Nevertheless, it is imperative to make immediate reductions at the lowest anticipated reduction levels in order to avoid the necessity of having to cut deeper into the health care programs later in the fiscal year. 15. It is recommended that $5. 3 million be earmarked from the Property Tax Administrative Fees to fund the county health care clinics. 16. It is recommended that immediate minimum reductions of $1,400, 000 be made in the Health Services Department as a result of the cuts made by the State Legislature and Governor in services to the needy. The following table contains the recommendations of the County Administrator's Office and the Health Services Department on how the $1. 4 million reduction should be allocated to existing health programs in light of the Phase I cuts that have previously been made, taking into account the maintenance of care issue required by Prop 99 and considering the overall impact on services to the public. -12- Health Services Department Reduction Plan Appropriation Under State Description Consideration Reduction Action 1. Close Brentwood Hlth Ctr $ 278,000 -- Save/Note (a) 2. Eliminate Sery to Med Indig Adults at Following Locations - Pittsburg 410,000 -- Save/Note (a) - Concord 80,000 -- Save/Note (a) - Richmond 920,000 -- Save/Note (a) - Martinez Family Practice Under Study -- -- 3. Close Richmond 1,619,000 -- Save/Note (a) 4. Close Pittsburg 1, 535,000 -- Save/Note (a) 5. Close Concord 496,000 -- Save/Note (a) 6. Close West County Crisis Unit 361 ,000 -- Fund (b) 7. Eliminate Suicide Prevention 70,000 -- Fund (b) 8. Eliminate Alcohol Detox Beds - East County 176,454 -- Fund (b) - Sunrise House Recovery* 87,772 -- Fund (b) - Holloman 303 ,713 -- Fund (b) - Shennum and Jail Detox 459,438 -- Fund (b) 9. Eliminate Children's Day Treatment Program 483, 000 -- Fund (b) -13- Appropriation Under State Description Consideration Reduction Action 10. Eliminate Children's Mental Hlth Treat Specs 200,000 Fund (b) 11. Reduce Outpatient Adult MH Clerical Support 140,000 -- Fund (b) 12. Reduce Det Facility - 33% Medical Staffing 500,000 -- Fund/Watch (c) 13 . Eliminate Detention Facility Psychiatric Staffing 640,000 -- Fund/Watch (c) 14. Reduce Ctr for Hum Dev (M.H. ) - NEAT 100% 33,000 - Fund/Watch (c) - Prevention 100% 61,000 -- Fund/Watch (c) 15. Reduce Phoenix/Rubicon Contracts 15% 326,000 -- Fund/Watch (c) 16. Eliminate San Pablo Discovery Centers 35,000 -- Fund/Watch (c) 17. Eliminate Horizons Disc Ctrs 93 ,416 -- Fund/Watch (c) 18. Reduce Center for Hum Dev (NEAT Contract Drug) 45% 30,000 -- Fund/Watch (c) 19. Reduce Many Hands Contract 10% 28,000 -- Fund/Watch (c) 20. Reduce Desarrollo Contract 10% 21,500 -- Fund/Watch (c) 21. Y Team (YMCA) Contract Reduction 100% 100,000 -- Fund/Watch (c) 22. Eliminate Advisory Board Staff 200,000 50,000 Reduce/Watch (d) Keeps position vacant, bi layoffs_ 23. Eliminate A/DA/MH Contr COLA 350,000 87,500 Reduce/Watch (d) Represents 1% of total payment limit. Means COLA' s effective 10/1/90, like county employees 24. Eliminate Providers (MD/FNP) * Affects clinics. One 717,000 100,000 Reduce/Watch (d) position will be eliminated and two reassigned. 25. Reduce Conservatorship Program Eliminates 1 supervisor, 3 200,000 75,000 Reduce/Watch (d) remain. Total staff 21 FTEs. 26. Reduce Outpatient Adult MH Services - MH Trtmt Svcs (9 FTE' s) 490,000 390,000 Reduce/Watch (d) - Supervisors (2) 140,000 140,000 Reduce (e) 27. Reduce HS Admin Staff (2 FTE' s) 75,000 75,000 Reduce (e) 28. Reduce Sunrise House, Inc. * Alcohol Residential Contract - 10,775 10,775 Reduce (e) 5.6% reduction in contract. Does not impact detox beds. -14- 29. Reduce Bi-Bett Corp, Inc.* (no detox reductions) 42,447 42,447 Reduce (e) Represents 3.6% reduction in total contract. 30. Reduce AIRS Program* 30,561 30,561 Reduce (e) Eliminates one vacant position 31. Reduce Alcohol/Drug Abuse Council* - represents 3 ,765 3 ,765 Reduce (e) 4% reduction. 32. Reduce Center for Human - Development Contract* - 12,452 12,452 Reduce (e) represents 4% reduction. 33 . Merge Discovery I & II - 125,885 125,885 Reduce (e) Combines two facilities, resulting in staff and operational savings 34. La Cheim Residential Contract Reduction - 100,000 100, 000 Reduce (e) 20% reduction will mean a reduction in rates, no impact on service levels. 35. Reduce Selected Contract* Physicians Payment Limits 83 ,000 83,000 Reduce (e) Reduces specialty rates, no service level impacts. 36. Public Health Nursing Supervision/Admin 75,000 75,000 Reduce (e) Eliminates one vacant supervisor position. * Substitute items from 8/6/90 hearing TOTAL $12,616,288 $11401,385 (a) Dedicate Property Tax Administrative Fees to fund these items on a continuing basis (b) Continue to fund from the department's existing resources. (c) Continue to fund with the understanding that these items may be recommended for reduction when the final allocations are considered by the Board on September 25, 1990. (d) Reduce a portion of these items immediately and consider for additional reductions when the final allocations are considered by the Board on September 25, 1990. (e) Reduce these items immediately. -15- 17. Direct the County Administrator to prepare necessary position reduction resolution, post any necessary notices and meet with affected unions in order to accomplish the needed reductions. 18. It is recommended that the County Administrator be directed to prepare a third budget status report for September 25 so that the Board can consider what additional reductions will have to be made to balance the budget once fund allocation formulas are known.