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Home My WebLink AboutMINUTES - 07251995 - C75 i 7_5 TO: BOARD OF SUPERVISORS 10-4 Contra �! `r FROM: �\ Costa INTERNAL OPERATIONS COMMITTEE A; County DATE; July 25, 1995s;;..= cuud SUBJECT: PROPOSED RESPONSES TO THE REPORTS OF THE 1994-1995 GRAND JURY; NO. 9503, "LACK OF EMERGENCY SPENDING PROCEDURES" AND NO. 9504 "PAYMENT TO LOS MEDANOS COMMUNITY HOSPITAL" SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATIONS: 1 . Adopt this report of our Committee as the Board of Supervisors ' response to the Reports of the 1994-1995 Grand Jury Report No. 9503, "Lack of Emergency Spending Procedures" and No. 9504, "Payment to Los Medanos Community Hospital. " 2 . Remove this item as a referral to our Committee. BACKGROUND: On May 5, 1995, the 1994-1995 Grand Jury filed the above reports which were reviewed by the Board of Supervisors on May 23, 1995 and were subsequently referred to the Internal Operations Committee. On July 17, 1995 our Committee met to discuss the recommendations and review proposed responses . At the conclusion of those discussions, we prepared this report utilizing a format suggested by a former Grand Jury, which clearly specifies : A. Whether the recommendation is accepted or adopted; B. If the recommendation is accepted, a statement as to who will be responsible for implementation of a definite target date; C. A delineation of the constraints if a recommendation is accepted but cannot be implemented within the calendar year; and D. The reason for not adopting a recommendation. NTINUED ON ATTACHMENT: RYES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIGNATURE(S): i ACTION OF BOARD ONjUly 25 1995 APPROVED AS RECOMMENDED ✓ OTHER s VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS(ABSENT AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. ATTESTED r Contact: PHIL ATC ELOR,CLERK OF THE BOARD OF CC: County Administrator SUPERVISORS AND COUNTY ADMINISTRATOR Presiding Judge, Superior Court Grand Jury Foreman County Counsel BY DEPUTY Health Services Director "LACK OF EMERGENCY SPENDING PROCEDURES" REPORT NO. 9503 The 1994-95 Contra Costa Grand Jury recommends that: RECOMMENDATION: The Board of Supervisors direct the County Administrator to complete within 90 calendar days, a procedure to define an emergency and the steps to be taken to authorize commencement of the Work and the ultimate approval by the Board of Supervisors . RESPONSE: A. This recommendation is accepted. B. The Board has directed that Department Heads make specific requests of the County Administrator for all emergency expenditures in excess of $25,000 and that the County Administrator subsequently recommend appropriate emergency expenditures for approval by the Board at the earliest opportunity. TO: BOARD OF SUPERVISORS Contra FROM: Costa Phil Batchelor, County Administrator a ;x `.�;.` _...t o DATE: July 18, 1995 N' ,.- ` County SUBJECT: Policy For Emergency Expenditures Above $25,000 SPECIFIC REQUEST(S)OR RECOMMENDATION(S)8 BACKGROUND AND JUSTIFICATION RECOMMENDATION: DIRECT all Department Heads to make specific requests of the County Administrator for all emergency expenditures above $25,000; and DIRECT the County Administrator to recommend appropriate emergency expenditures for approval by the Board of Supervisors. BACKGROUND: The 1994-1995 Contra Costa Grand Jury, in its Report Number 9503, noted that the County lacks emergency spending procedures and recommended that the Board of Supervisors take corrective, action. County policy specifies that the Board of Supervisors authorize all service contracts over $25,000. It may be necessary, in an emergency, for a Department to obtain authority for such an expenditure prior to routine administrative review. When such an emergency exists, approval of the County Administrator for emergency submission to the Board of Supervisors will be required. Emergency expenditures recommended by the County Administrator will be presented to the Board of Supervisors at the earliest possible opportunity. CONTI N LED ON ATTACHMENT: _YES SIGNATURE: RECOMMENDATION,OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE _APPROVE -OTHER SIGNATURE(S): ACTION OF BOARD ON ' APPROVED AS RECOMMENDED OTHER i VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS(ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. ATTESTED Contact: A. Dean Lucas 646-4077 PHIL BATCHELOR.CLERK OF THE BOARD OF cc: County Administrator SUPERVISORS AND COUNTY ADMINISTRATOR County Counsel All Departments (Via CAO) • Contra Costa County The Board of Supervisors HEALTH SERVICES DEPARTMENT OFFICE OF THE DIRECTOR Jim Rogers, 1st District Mark Finucane, Director Jeff Smith,2nd District ��E_s E•_ o� Gayle Bishop,3rd District , 20 Allen Street Mark DeSaulnier,4th District _ - Martinez, California 94553-3191 Tom Torlakson,5th District (510) 370-5003 Count Administrator xh m FAX(510)370-5098 Y Phil Batchelor ��Sra couK- cA County Administrator June 14, 1995 CONTRA COSTA COUNTY i RECEtYEQ t TO: Phil Batchelor, C my € Adinistr for FROM: Mark Finucan , Director OFFICE OF Health Services Department COUNTY ADM INISTRAT r SUBJECT: Grand Jury Report # 9503 The following is in response to Grand Jury Report #9503 "Lack of Emergency Spending Procedures": Facts: o The Health Services Department (HSD) directed an architect to provide professional services for remodeling Los Medanos Hospital in the event that it would be acquired by the County. o In order to meet a time schedule requiring drawings to be provided to the State by June 1994, the Architect was verbally authorized by the Health Department to proceed with work on March 11, 1994. o On May 24, 1994, the Board authorized the County Administrator to "explore the need to for contracting with additional specialized expert legal counsel, accounting professionals, and health care consultants to assist the County in evaluating and acquiring the assets of Los Medanos Community Hospital and to make further recommendations to the Board of Supervisors on any proposed contracts". o On April 15, 1994, the fee structure with the Architect was finalized. o On May 25, 1994, the General Services Department received the signed contract from the Architect. Merrithew Memorial Hospital&Clinics Public Health • Mental Health • Substance Abuse Environmental Health Contra Costa Health Plan Emergency Medical Services • Home Health Agency Geriatrics A-345 (12194) -2- o On July 14, 1994, General Services Department submitted a Board Order for approval of the contract. o On July 26, 1994, the Board approved the architectural contract. GRAND JURY CONCLUSION: There should be a-carefully writtemarnd approved County procedure for contract authorization when time does not allow established County procedures to be followed. This procedure should clearly define an emergency and the steps to be followed up to and including approval by the Board of Supervisors. GRAND JURY RECOMMENDATION: The Board of Supervisors direct the County Administrator to complete within 90 calendar days, a procedure to define an emergency and the steps to be taken to authorize commencement of the Work and the ultimate approval by the Board of Supervisors. DEPARTMENT RESPONSE: The Department believes current purchasing procedures are adequate. Due to a series of events: 1) the May 24th Board action which was originally targeted for early April was delayed; and 2) the Board authorization requested and granted for contracted services was general in nature and did not specifically define the spending levels contemplated. Accordingly, to insure timing delays associated with agenda scheduling, etc. are mitigated, the Department will notify in writing, within seven working days, the County Administrator and each Board member, of any emergency expenditure situation. The Department and County Administrator will take the necessary steps to bring the matter before the Board in a timely manner. Please advise if additional information or clarification is required. "PAYMENT TO LOS MEDANOS COMMUNITY HOSPITAL" REPORT NO. 9504 The 1994-95 Contra Costa Grand Jury recommends that: RECOMMENDATION NO. 1 : Within 30 calendar days, the Board of Supervisors rescind Board Order 1 .30 of September 1, 1993, which delegates to the Health Services Director the independent authority to spend Tobacco Tax funds (AB75) . RESPONSE: A. This recommendation is not adopted. B. The Board of Supervisors concurs with the Grand Jury's concern that the Board exercise its normal spending controls . The California Health Care for Indigents Program contract, the subject of the Board Order in the recommendation, is submitted to the Board annually. The distribution of the funding in 1993 was consistent with the intent of the enabling legislation. However, to insure that there is no misunderstanding in the future, the Health Services Department is to identify the recipient facilities in the Order presented to the Board for adoption. Contra Costa County The Board of Supervisors HEALTH SERVICES DEPARTMENT OFFICE OF THE DIRECTOR Jim Rogers, 1st District Mark Finucane, Director Jeff Smith,2nd District Gayle Bishop,3rd District20 Allen Street Mark DeSaulnier,4th District Martinez,California 94553-3191 Tom Torlakson,5th Districtas (510)370-5003 FAX(510)370-5098 County Administrator Phil Batchelor S'q counr County Administrator _ CONTRA COSTA COUNTY � June 13, 1995 RECEIVED i i i TO: __ --Phil Batchelor, CountSPA TAdministr for ' —' OFFICE OF FROM: Mark Fi ucane, ISi'ctor s Health Services Department COUNTY ADMiiVISTRATOP SUBJECT: Grand Jury Report # 9504 The following is in response to Grand Jury Report #9504 "Payment to Los Medanos Community Hospital": Facts: • Contra Costa County received during the 1993/94 fiscal period $3,694,658 of Tobacco Funding through the California Health Care for Indigents Program (CHIP). • $532,006 of the CHIP funding is designated by State statute to be distributed by the County to "Non-County" hospitals. • $282,006 of the non-county hospital funding is restricted, by facility, at the State level. • The balance of the "Non-County" funding, $250,000, is "discretionary" in nature and may be distributed to any hospital to "maintain access to emergency care and to purchase other necessary hospital services". • On September 1 , 1993 the Board approved the State CHIP Standard Agreement. • The Standard Agreement, consistent with State statute, effectively delegated to the Health Department distribution of the discretionary non- county hospital funding. Merrithew Memorial Hospital&Clinics Public Health • Mental Health • Substance Abuse Environmental Health Contra Costa Health Plan Emergency Medical Services • Home Health Agency Geriatrics A-345 (12/94) _2_ • On January 3, 1994, 5100,000 of the discretionary Tobacco Tax funding was allocated by the Health Department to Los Medanos Community Hospital in an effort to maintain emergency room access. • On January 21, 1994 an additional $150,000 was advanced to Los Medanos Community Hospital to meet a payroll shortfall. • The $150,000 was characterized as a "loan" but was drawn on Tobacco Tax funding to: a. Utilize Tobacco funds for the purpose intended (e.g., maintain access to emergency care); b. Keep negotiating pressure on Los Medanos; and c. Safeguard County funds in the event Los Medanos failed. Grand Jury Conclusion: • The action by the Board of Supervisors of September 1, 1993 allows the Health Services Department autonomy in disbursing Tobacco Tax funds (AB75) without action by or knowledge of the Board of Supervisors. This Board action is not consistent with spending controls normally exercised by the Board of Supervisors. Grand Jury Recommendation: • Within 30 calendar days, the Board of Supervisors rescind Board Order 1 .30 of September 1, 1993, which delegates to the Health Services Director the independent authority to spend Tobacco Tax funds (AB75). Department Response: • The Department believes the distribution of the funding was consistent with the intent of the enabling legislation and did, for a period of time, maintain emergency room access in East County. • To insure no misunderstanding in the future, the Department will be specific in the identification of the recipient facilities within the state CHIP Standard Agreement which is adopted on an annual basis by the Board. Please advise if additional information or clarification is required.