HomeMy WebLinkAboutMINUTES - 11151983 - 2.3 ,2. —A'
TO: BOARD OF SUPERVISORS Contra
FROM: M. G. Wingett, County Administrator r
Costa
DATE: November 8, 1983 2, County
SUBJECT: AB-8 Health Services Plan and Budget for 1983-1984
SPECIFIC REQUEST(S) OR RECOMMENDATION(S) & BACKGROUND AND JUSTIFICATION
RE UEST:
Approve and authorize Health Services Director to submit to the State Department of
Health Services the County's AB-8 Health Services Plan and Budget for 1983-1984; in
connection therewith fix Tuesday, December 13,1983, at 2:30 P.M. in the Board Chambers
as the date and time for a public hearing pursuant to Welfare & Institutions Code
Section 16705., and direct Clerk of the Board to publish notice of the hearing in a
newspaper of general circulation not less than ten (10) days before the hearing.
BACKGROUND/JUSTIFICATION:
Welfare & Institutions Code Section 16700 requires the County as a condition for
receiving State AB-8 Health Services funds to submit a plan and budget. The plan
describes all programs being operated by the County which qualify for AB-8 funding.
The budget documents the net county cost for these services, which serves as the base
for determining the amount of State money for which the County is eligible.
Welfare & Institutions Code Section 16705 allows a county to receive its maximum
allocation of State funds even if it does not provide the normal 50% match. In order
to do so, the Board of Supervisors must hold a public hearing, receive testimony,
make specified findings, and forward the hearing record to the Director, State
Department of Health Services, who has the final authority to approve the reduced
county match. In no case may the county drop below a 40% county--60% State match.
The Proposed Budget for 1983-1984 was designed to provide for only a 40% county match.
The Finance Committee Report on the budget directed the County Administrator, County
Counsel , and Health Services Director to take the steps necessary to comply with
Section 16705. The first step in the process is to fix the date for the public
hearing which must be held within 30 days after approval of the AB-8 Plan and Budget.
Notice of the hearing must be published in a newspaper of general circulation not
less than ten (10) days before the hearing.
CONTINUED ON ATTACHMENT: YES SIGNATURE: L'��✓�' �- /`
X RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
X APPROVE OTHER
SIGNATURE(S)
ACTION OF BOARD ON November 15. c1983 APPROVED AS RECOMMENDED Xn OTHER
VOTE OF SUPERVISORS
UNANIMOUS (ABSENT ILL ) I 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
OF SUPERVISORS ON THE DATE SHOWN.
CC: County Administrator ATTESTED ZL � /`/
Health Services Director J.R. OLSSON, COUNTY CLERK
County Counsel AND EX OFFICIO CLERK OF THE BOARD
i , 8
M382/7-63 BY m �. DEPUTY
THE BOARD OF SUPERVISORS
CONTRA COSTA COUNTY, CALIFORNIA
November 15, 1983 b the following vote:
Adopted this Order on y g
AYES: Supervisors Powers , Fanden, Torlakson, Schroder
NOES: None
ABSENT: Supervisor McPeak
SUBJECT: AB 8 Match Requirement
The County Administrator having transmitted to the Board a
report dated November 14, 1983, from Arnold S . Leff, M.D. , Director
of the Health Services Department , providing information on the
AB 8 match requirement and recommending that the Board take the
following actions to deal with the undermatch problem in the AB 8
plan and budget :
1 . Decrease non-allowable expenditures in the plan
and budget by two million dollars ;
2. Shift a total of one million dollars of MIA money
into mental health;
3 . Increase County contribution to the Health Services
Department by $2 million. This would be accompanied
by a corresponding decrease in other revenue sources
which are not being realized at the budgeted level,
and therefore would be no change in the expenditure
budget for said Department ;
4 . Request the State to allow the County to apply the
1982-1983 fiscal year deficit , which resulted in a
two million dollar overmatch for the 1982-1983 fiscal
year, toward the 1983-1984 fiscal year;
IT IS BY THE BOARD ORDERED that the aforesaid recommendations
are APPROVED.
I hereby certify that this is a true and correct copy of
an action takei and entered on the minutes of the
Board a,Sip rvi:,.)rs on. "Jate shown.
Bye"" z�— , Deputy
Orig. Dept.:
cc: County Administrator
Health Services Director
Auditor-Controller
189
CCONTRA COSTA COUNTY /
APPROPRIATION ADJUSTMENT
..T/r, 27
I. DEPARTMENT OR ORGANIZATION UNIT:
ACCOUNT CODING Health Services
)RGANIZATION SUB-OBJECT 2. FIXED ASSET /DECREASE INCREASE
OBJECT OF EXPENSE OR FIXED ASSET ITEM NO. QUANTITY \\
0465 3570 Contrib to Enterprise Fund 2,000,000
0990 6301 Reserve for Contingencies 2,0009000
APPROVED 3. EXPLANATION OF REQUEST
AUDITOR-CONTROLLER
1f Cg To increase county subsidy to the Health Services
By: Dote / / Department to offset a decrease in estimated
Medi-Cal revenue.
COUNTY ADMINISTRATOR
ORIGINAL SIGNED BY NOV i15 1
By: F. FERNANDEZ Date-
BOARD
BOARD OF SUPERVISORS
YES: s rehv[ Adey�
NO:
On
J.R. OLSSON, CLERK 4. Ile
// SIGN ATU E TITLE DATE
By: V APPROPRIATION A Poo 5062
ADJ. JOURNAL 10.
(N 129 Rev. 7/77) SEE INSTRUCTIONS ON REVERSE SIDE
190
- CONTRA COSTA COUNTY
ESTIMATED REVENUE ADJUSTMENT
T/C 24
1.DEPARTMENT OR ORGANIZATION UNIT:
ACCOUNT CODING Health Services
ORGANIZATION ACCOUNT Z' REVENUE DESCRIPTION INCREASE <DECREASE
0540 9817 M Cal RH - Patient Svcs 21000,000
0540 9865 County Subsidy - Med Svcs 250009000
APPROVED 3. EXPLANATION OF REQUEST
AUDITOR-CONTROLLER TO reduce Medi-Cal estimated revenues based on
By:
C--p 9���� — Dote /J/ 1 ower than expected utilization in the first
quarter. To increase county subsidy in an
COUNTY ADMINISTRATORequal amount. This will not increase total
NOV 1 5 19 3 available appropriations to the Health Services
By: ORIGINAL SIGNED BY Dote / / Department.
f. FERNANBEZ
BOARD OF
SUPERVISORS
Su GV Ors POw2yS l�h de
YES: T`/ailynn f�tireller �
NO: 7 °7"`J Date i///s713
/4h5e �t: Sup 1 7�thea
J.R. OLSSON, CLERK /
/y S16NA T11LE DAT!
B y:
10,
REVENUE AD). R A00 5062
JOURNAL NO.
(N 8134 Raw. 11/81)
191
THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTYr CALIFORNIA
Adopted this Order on November 15,, 1983_; ,by, the following vote:
AYES: Supervisors Powers, Fanden, Torlakson, Schroder
NOES: None
ABSENT: Supervisor McPeak
ABSTAIN: None
SUBJECT: Recovery of Medicare and Medi-Cal Revenue
In discussing the budget deficit in the Health Services
Department, Supervisor T. Powers referred to the need to resolve the
current fiscal crisis and explore options available to the County.
He expressed concern that the deficit could be carried into the next
fiscal year if cost saving procedures are not implemented in the
immediate future.
Supervisor Torlakson commented on the serious decisions
the Board must make and the need to have complete data. He referred
to the decline in the patient population at the hospital from 150 to
105 patients per day and inquired as to the period of time this
trend has been occurring. Supervisor Torlakson also referred to the
claims (totalling approximately $18 million) the County has sub-
mitted to the State for reimbursement for services to Medi-Cal
patients for which no money has been received, and inquired as to
the type of negotiations in progress with the State on this issue.
Supervisor Powers suggested that the County' s legislators
should be apprised of the County' s fiscal crisis and that an expla-
nation should be forthcoming as to the delay in compensating the
County pursuant to the County' s contract with the State for Medi-Cal
patients effective 7/1/83. He suggested that all hospitals with
similar Medi-Cal reimbursement problems join together in a united
effort to seek resolution of said claims.
Supervisor Torlakson then recommended that the County
Administrator and Director of the Health Services Department provide
the Board with an analysis of the Medicare and Medi-Cal problem,
said analysis to include data on eligibility requirements of the
State, procedures for filing clims for reimbursement, failure of the
State to respond to the County' s claim of approximately $18 million,
possible reasons for the delay, and options available to the County
to require the State to fulfill its mandates.
Board members being in agreement, IT IS ORDERED that the
recommendation of Supervisor Torlakson is APPROVED.
!hereby. ce-tify the"thls!c a tree errd correct copy of
Cr'. 2•f�.iG.. .....,-, ....',C`. ........-: ^7i minusea of the
A.Z"'t :rn v
/67 /rlXS
and e.:
Deputy
Orig Dept: Clerk of the Board
cc: County Administrator
Director of Health Services
County Counsel
192
THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Adopted this Order on November 15, 1983 , by the following vote:
AYES: Supervisors Powers, Fanden, Torlakson, Schroder
NOES: None
ABSENT: Supervisor McPeak
ABSTAIN: None
SUBJECT: Health Services Department Budget for
the 1983-1984 Fiscal Year
The Board having received from M. G. Wingett, County
Administrator, a letter dated November 14, 1983, providing current
information with respect to the deficit in the budget of the Health
Services Department, how it occurred, what the present spending pat-
terns are, and how the Department will end the 1983-1984 fiscal
year; and
Mr. Wingett having projected that the Health Services
Department will end the 1983-1984 fiscal year with a deficit of
approximately $10, 279, 351, and therefore having recommended that the
Board take the following actions:
1. Direct the County Administrator to recapitulate the
Enterprise Fund Budgets (similar in presentation as
set forth in the November 14, 1983, letter) and pre-
sent it the Board monthly so as to allow the Board to
monitor progress in reducing expenditures and
increasing revenues;
2. Direct the Health Services Director to determine what
actions will be necessary to stay within the expen-
diture assumptions as noted in the November 14, 1983,
letter and recommend to the Board what actions are
necessary to achieve those targets;
3. Direct the Health Services Director to report revised
revenue projections to the County Administrator and
Auditor-Controller on a monthly basis not more than 45
days following the close of each month;
4. Direct the County Administrator to request the firm of
Peat, Marwick, and Mitchell to update their audit of
the County budget through October 31, 1983 for the two
Health Enterprise Funds;
IT IS BY THE BOARD ORDERED that the recommendations of the
County Administrator are APPROVED.
I hereby certify that this Is a true and correct copy of
an action taker;Fnd onterod on the minutes of the
Boar,'of Su;;ervisora or, the date shown.
1-s,: CLPRK
cc: County Administrator srJ os c1i'(.i: C!u :; L-f tiic Doard
Health Services Director !
Auditor-Controller
ey &-.roc- 0 , Deputy
ref: 1115. 2. 3
193