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Home My WebLink AboutMINUTES - 12201983 - 2.6 TO: BOARD OF SUPERVISORS FROM: M. G. Wingett, County Administrator DATE: December 19, 1983 SUBJECT: AB 8 Match SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION RECOMMENDATION: Declare that it is the intent of the Board to' provide a 40% match for State AB 8 funds; that the Board recognizes that the required match of County funds is $15,856,231 ; that the Board recognizes that the currently adopted budget for the Health Services Department is undermatched by $1 ,253,981 and that it is the intent of the Board to provide this match in order to maintain an orderly flow of AB 8 and MIA revenue from the State. BACKGROUND: There was some confusion at the hearing held December 13 regarding the level of funding needed to meet the County's required 40% match for State AB 8 dollars. The Health Services Department budget currently provides only $14,602,250 in County funds as an AB 8 match. This understates the required minimum match by $1 ,253,981 . This was done intentionally in an effort to get the State Department of Health Services to approve "rolling over" the overmatch in County funds from 1982-1983 resulting from the deficit in the Enterprise Fund for that year. At a meeting with the Associate Director of the State Department of Health Services on December 16, it became clear that the State cannot and will not allow the County to "roll-over" the 1982-83 overmatch which resulted from the deficit and take credit for it in 1983-84. If the County fails to appropriate the full 40% match in the current budget, the State will have no choice but to recover the $1 .2 million undermatch by withholding that amount of MIA revenue from the County. If this MIA revenue is withheld, it cannot be recovered later by the County and will result in a corresponding shortfall in revenue at the end of the fiscal year. On the other hand, if the County goes ahead and makes the required match now, it will insure that the County's full AB 8 and MIA revenue will be received timely. Because of the size of the Health Services Department's current year deficit, it is likely that your Board will have to appropriate at least this $1 .2 million to the Health Services Depart- ment sometime before the end of the fiscal year anyway in order to avoid having the Enterprise Fund end the current year with a deficit. The appropriation cannot actually be made today because it has not been listed on your agenda. However, it will be listed on your agenda for your next regularly scheduled meeting. In the meantime, the State has requested this clarification that your Board recognizes that the current budget remains undermatched, but that you intend to provide the full match at the 40% level . CONTINUED ON ATTACHMENT: YES SIGNATURE: X RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE X APPROVE OTHER SIGNATURE(S) r ACTION OF BOARD ON Dpcpmhpr 2W 1983 APPROVED AS RECOMMENDED OTHER VOTE OF SUPERVISORS UNANIMOUS (ABSENT ) 1 HEREBY CERTIFY THAT THIS IS A TRUE AYES: NOES: AND CORRECT COPY OF AN ACTION TAKEN ABSENT: ABSTAIN: AND ENTERED ON THE MINUTES OF THE BOARD County Administrator OF SUPERVISORS ON THE DATE SHOWN. CC: County Counsel ATTESTED �°,/f�3 Auditor-Controller HJ.R. OLSSON, COUNTY CLERK Health Services Director AND EX OFFICIO CLERK OF THE BOARD State Dept. of Health (via CAO) M382/7-63 B �L�`e-� V- `�`� Z'�" DEPUTY 3 f . December 15, 1983 COMPARATIVE SUMMARY OF FY 1982-83 AND FY 1983-84 1 2 3 4 1982-83 1983-841 1983-842 Anticipated Initial Submitted Final Sub- Difference Budget Budget mitted Budget (1-3) Total Appropriations $51,796,348 $55,063,462 $55,063,462 ($3,267, 114) Total Revenues $33,307,610 $41,211,212 $39,207,231 $7,903,602 Net `County Costs $18,488,738 $14,602,250 $15,856,231 ($2,632,507) Per Capita $ 2,627,342 $ 2,714,095 $ 2,714,095 $ 86,753 State/county cost share amounts $15,861,396 $11,888,155 $13,142, 136 ($2,719,260) State share $ 7,880,404 $ 7,132,893 $ 7,885,282 $ 4,878 County Share $ 7,980,991 $ 4,755,262 $ 5,256,854 ($2,724, 137) Match level 50:50 60:40 60:40 60:40 County overmatch (undermatch) .$ 100,587 $ 1,253,982 -0- ($ 100,587) 1 This represents what was submitted in the AB8 Plan and Budget for FY 83/84 2 This represents the level Contra Costa County anticipates will be in the final submitted budget and is the level of net county costs the Board of Supervisors was agreeing to at the 60:40 hearing, THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Adopted this Order on December 20 , 1983 , by the following vote: AYES: Supervisors Powers , Fanden, McPeak, Torlakson, .Schroder NOES: None ABSENT: None ABSTAIN: None SUBJECT: Re: Welfare and Institutions ) Resolution No. 83/1245 Code Section 16705 ) hearing findings ) Pursuant to Welfare and Institutions Code Section 16705(b) , the Board of Supervisors conducted a public hearing on December 139 1983 in order to determine whether the reduction in County funds under the County's 1983-84 Health Services- Plan and Budget will be detrimental to the health needs of indigents in the case of outpatient and inpatient health services and whether or not the reduced county contribution will impair the County' s ability to carry out the service levels in the County's health services plan for fiscal year 1983-84. I .. The Board received written and oral evidence as follows: A. Written documents consisting of the following were received into the hearing record. 1 . The AB-8 Plan and Budget for 1983-84, as approved by the Board of Supervisors on November 15, 1983; 2. Resolution 83/1230, the December 6 , 1983 Health and Safety Code Section 1442.5 hearing findings , and all documents specified therein; 3. The AB-8 Public Hearing Report forwarded to the State Department of Health Services on December 6 , 1983; 4. Resolution 83/1229 adopted December 6, 1983 defining indigency for purposes of the Bielenson hearing; 5 . Resolutions 82/1486 and 83/191 , placing the former medically indigent adults into the Contra Costa Health Plan; 6. Board Order dated November 15, 1983 fixing this time and place for the hearing; 7 . Proof of Publication of notice of hearing from Contra Costa Times dated November 28, .1983; 8 . A packet of materials presented by Mr. Milton Kinbly. Orig: Dept.: cc: State Health Svcs Dept . County Administrator Health Services Director County Counsel RESOLUTION 83/1245 B. Oral Testimony Received is Summarized as follows: 1 . Claude L. Van Marter, Assistant County Administrator, orally apprised the Board of the purpose for the hearing. He indicated that the County' s 1983-84 Health Services Plan does not reduce Public Health Services ; he also indicated that there will be no impact on indigents because they are either members , or eligible to become members , of the Contra Costa Health Plan. He also indicated that the County Plan and budget, as submitted , contemplates an approximate 60% State and 40% County match, and that the County remains able to carry out the service levels described in the 1983-84 County Health Services Plan and Budget . 2. Milton Camhi , Associate Director of Western Consortium of Health Professionals and Member of the Contra Costa Health Plan Advisory Board, provided the Board with a packet of materials relative to hospital and Health Maintenance Organization management . As he began his oral comments it became clear they they were related not to the AB-8 Plan but to possible hospital management issues noticed for a January 17 , 1984 hearing under Health and Safety Code § 1442.5. Mr. Camhi agreed to return and address the Board on that date. 3. Walter Carr , M.D. , Assistant Health Services Director, confirmed that the County has provided by Resolution for the County's indigents to receive medical care through the Contra Costa Health Plan. He indicated that through this means appropriate medical care is provided at a level of quality appropriate in the community. II . On the basis of the foregoing evidence , the Board makes the following findings: A. Notice of the Public Hearing was adopted and publi- cized as required by law and interested persons were accorded a reasonable opportunity thereby to learn of the time and place of the hearing and the purpose and subject matter to be considered . B. The Hearing was properly conducted and all interested persons were allowed to speak. C . "Indigents" are those persons defined in Resolution 83/1229. D. All indigents in Contra Costa County are members of, or eligible to become members of, the Contra Costa Health Plan. E. The level of Medical Care to be provided to indigents is set forth in Resolution 83/191 , and includes both inpatient and outpatient services . F. Nothing in the 1983-84 County Health Services Plan and Budget affects the ability of the Contra Costa Health Plan to continue to provide the required level of health care to indigents . -2- RESOLUTION NO. 83 /I245 G. The reductions in county contribution specified in the 1983-84 County health services plan and budget will not be detrimental to the health needs of the indigent in the case of outpatient or inpatient health services and will not impair the County's ability to carry out the service levels pre- viously provided to indigents . H. The County's Health Services Plan and Budget for . 1983-84 does not reduce funding for public health services; Public Health Services will. not be detrimentally impacted. I . The County's ability to carry out the level of ser- vices described in the Plan will not be affected by the shift to a 60%/40% match in that the plan and budget as submitted is predicated on such a match. I hereby certify that this is a true and correctcopy0f an action taken and entered on the minutes of the Board of '3upervisors on the date shown. ATTESTED: .� J..R. CI.S;:0ftj, C,Ci,"VTY GLE"RK a17d ex ofrivio Gierk of the Board ly Deputy t -3- RESOLUTION 8-'1.245 33f��