Loading...
HomeMy WebLinkAboutMINUTES - 10091990 - H.2 H. 2 THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Adopted this Order on October 9 , 1990 by the following vote: AYES: Supervisors Schroder, McPeak, Torlakson, Fanden NOES: None ABSENT: Supervisor Powers ABSTAIN: None -------------------------------------------------------------------- -------------------------------------------------------------------- SUBJECT: Hearing on Proposed Reductions in the Health Services Department The Chair convened the hearing on proposed reductions in the Health Services Department. Arthur Walenta, Assistant County Counsel, advised that this hearing is being held pursuant to Health and Safety Code Section 1442. 5 and AB 3573 on health services reductions. He noted that these reductions were noticed by a September. 7 , 1990 notice of the Health Services Department; that they were previously considered by the Board on September 11 , 1990 and set for this date for formal hearing. Mr. Walenta requested the Board to receive into its record today the September 7 , 1990 hearing notice, the proceedings that took place on September 11 , 1990 on this subject, and the October 8 , 1990 report to the Board from the Health Services Director. Mr. Walenta advised that at the conclusion of the hearing the Board will be asked to make certain findings that the notice as referenced was posted, that indigents for the purpose of this hearing are those that are entitled to General Assistance under the Board' s resolutions, and that this hearing proceeded regularly. The Chair declared the hearing open and the persons as noted below spoke. Sherri Granados, 426 West 11th Street, Pittsburg, advised that she is an LVN, a diabetic, and a county health patient. She did not believe the care she has been receiving at the Pittsburg Clinic has been good, citing as an example that she believes she was given the wrong kind of insulin, and the wrong diet because she has experienced a sudden loss of weight. She noted that last week she was taken to the County Hospital with an adverse insulin reaction, that her medication was 'not changed, and that she was sent home by taxicab. Maggie Dee, P. O. Box 783 , Pittsburg, expressed concern with the reductions in health care and how they will impact on Ms. Granados who is her attendant. She commented on the need to make the State aware of the health care needs in Contra Costa County and the need to provide an adequate funding level to provide health care services to the poor.. She recommended that the Board take a serious look at developing an 800 telephone number where people can call in acts of fraud reflecting how monies are overspent by people who work for the County or who are using county services and labor from the County on their own private properties . She commented on her own health care needs and the economies she is required to practise. Supervisor McPeak requested the County Administrator to review the possibility of installing a telephone as the previous speaker proposed that may provide more information to reduce further waste. Mr. Batchelor responded that he would look into it. Philip Bertental, Contra Costa Legal Services Foundation, P. O. Box 2289 , Richmond, advised that he was at. the hearing today on behalf of his client, Mr. Harris, who is challenging a number of the health cuts approved by the Board in the course of the last several months. He addressed his concerns to the waiting time for appointments at clinics and requested that the County not implement - 1 - those cuts which will require the County to have waiting times for appointments in excess of what is set forth in State and Federal law, the County' s contracts with the State, and the regulations promul- gated by both the State and Federal Health Services Departments. He advised that it was his understanding that the operation of the Health Plan is in jeopardy because of those increased waiting times. Mark Finucane, Director of the Health Services Department, referred to two documents submitted to the Board, the first representing the Department' s original plan for reductions in the ambulatory care system, and the second which the Department is actually recommending. Mr. Finucane advised that over the past few weeks his staff has been able to effectuate some changes in service configurations to reduce $325,000 out of a $15 million budget. He noted that this will result in the loss of five employees out of 350 employees in the ambulatory care clinic system, and the loss of 20 or 22 out of more than 500 clinics provided weekly in the County; the reductions would impact on approximately 400 patients at clinics. Mr. Finucane stated that he did not believe these reductions violate Proposition 99 ' s maintenance of efforts provisions, nor that the Health Plan license is in jeopardy as a result of any waiting time problems. He advised that if at any point he believes the license is in jeopardy, he will immediately bring it to the attention of the County Administrator and the Board of Supervisors. Marueen E. Scherzberg, Family Nurse Practitioner of Contra Costa County, read a statement signed by 12 nurse practitioners expressing concern about potential cutbacks in county health care. All persons desiring to speak having "been heard, IT IS ORDERED ORDERED BY THE BOARD that the hearing is CLOSED. IT IS FURTHER ORDERED that County Counsel is REQUESTED to prepare appropriate findings for consideration by the Board on October 23 , 1990. 1 hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the cc: County Counsel Board of Supervisors on the date shown. County Administrator ATTESTED: (9lax&�?_, 23" Health Services Director PHIL BATCHELOR,Clark of the Board of Supervisors and County Administrator By -�'�`� ,Deputy i 2 - Contra The Board of supervisors Costa Health Services Department Tom Powers,1st District County Nancy C.Fanden,2nd District OFFICE OF THE DIRECTOR Robert I.Schroder,3rd District a r Sunne Wright McPeak,4th District Mark Finucane,Director Tom Torlakson,5th District : Administrative Offices County Administrator 20 Allen Street Martinez,California 94553 Phil Batchelor ry:., `rte (415)646-4416 �STa court' County Administrator DATE: October8 199 TO: Board of uperviso s FROM: Mark Finucane, Health Services Director SUBJECT: October 9 , 1990 Hearing Regarding Ambulatory Care Service Reductions ----------------------------------------------------------------- ----------------------------------------------------------------- The Health Services Department submits this report to the Board of Supervisors for the October 9 , 1990 hearing. The hearing, pursuant to AB-3573 and Health and Safety Code, Section 1442 . ,5, which was noticed on September 7 , 1990, concerns reductions in ambulatory care services . The Health Services Department had proposed reductions as delineated in the September 7 , 1990 notice (Attachment 1 ) . We have revised those reductions (Attachment 2) to lessen the impact on services to the indigents; however total dollar savings remain the same. MG:LB:dc Attachments A-345 (11/87) Attachment >t September 7, 1990 NOTICE . OF PUBLIC HEARING The Board of Supervisors of the County of Contra Costa will conduct a PUBLIC HEARING pursuant to AB 3573 and Health and Safety Code Section 1442 . 5, on the elimination of and/or reductions in the level of health services provided by the County, and/or the closing of County health facilities . The hearing will be held at the following place and time: Board of Supervisors Chambers Room 107 , Administration Building 651 Pine Street Martinez, California 94553 October 9 , 1990 - 11 :00 a.m. At the hearing, the Contra Costa County Board of Supervisors will consider the impact on the health care needs of the County's indigents of the implementation of the changes set forth in the attached summary. The Board does not consider all of the program changes in the attached summary to be within the required coverage of Health and Safety Code Section 1442 . 5 or AB 3573 . Its scheduling of this Hearing, giving this Notice of Public Hearing, the holding of a Hearing, and the making of any findings, shall not be construed as an admission by the County of Contra Costa, or the Board of Supervisors, that any of the actions included in the attached summary are subject to the hearing provisions of Health and Safety Code Section 1442.5 or AB 3573 . Attachment l (cont. ) September 7, 1990 CONTRA COSTA COUNTY HEALTH SERVICES DEPARTMENT REDUCTIONS FISCAL YEAR 1990--91 Ambulatory Care Services This program provides primary care and specialty services to the clients of the Health Services Department. Clinic services are generally between the hours of 8 :00 a.m. and 4 :00 p.m. , Monday through Friday. Sites : Clinic sites: Martinez, 2500 Alhambra Richmond, 38th & Bissell Pittsburg, 550 School Street Concord, 3052 Willow Pass Road Brentwood, 118 Oak Street This program is administered through the Division of Hospital and Clinics of the Health Services Department. Nature of the Reduction or Chancre: Approximately 120 physician hours would be reduced throughout the family practice clinics system at the three major health center sites : Richmond, Pittsburg, and Martinez . In addition, 80 family nurse practitioner (FNP) hours would be reduced ... •throughout the family nurse practitioner clinic system at the same sites . These reductions would impact the number of registered nurses (RN's) who provide support to the physicians and FNP's in the above-noted clinics . Staff Reductions : 3 Full Time Equivalent Physicians 2 Full Time Equivalent Family Nurse Practitioners 2 Full Time Equivalent Registered Nurses Resulting Planned Clinic Reductions Pittsburg Health Center: 1 Full Time Equivalent Physician 1 Full Time Equivalent Nurse Eliminate Following Clinics: Monday Urgent Care 8:00 a.m. - 12:00 Noon Monday Allergy 1 : 00 p.m. - 5 : 00 p.m. Tuesday Family Practice 8 : 00 a.m. - 5 : 00 p.m. Wednesday Family Practice 8 : 00 a.m. - 5 :00 p.m. Thursday Urgent Care 8:00 a.m. - 12:00 Noon Thursday Family Practice 1 :00 p.m. - 5 : 00 p.m. Friday Family Practice 8 : 00 a.m. - 5:00 p.m. Richmond Health Center: . 50 Full Time Equivalent Physician . 50 Full Time Equivalent Physician . 50 Full Time Equivalent Nurse Attachment .I ( cont. ) September 7, 1990 Eliminate Following Clinics : Monday Family Practice 8 :00 a.m. - 5 :00 p.m. Tuesday Family Practice 8:00 a.m. - 5 :00 p.m. Tuesday Urgent Care 1 :00 p.m. - 5 : 00 p.m. Wednesday Laotian Clinic 1 :00 p.m. - 5 :00 p.m. Thursday Family Practice 8: 00 a.m. - 5 : 00 p.m. Friday Family Practice 8 : 00 a.m. - 5 : 00 p.m. Martinez Health Center.: 2 Full Time Equivalent Family Nurse Practitioners Eliminate Following Two Clinics: Monday-Friday Family Practice 8:00 a.m. -5:00 p.m. Monday-Friday Family Practice 8:00 a.m. -5:00 p.m. Specialty Services : . 50 Full Time Equivalent Physician . 50 Full Time Equivalent Physician . 50 Full Time Equivalent Nurse Eliminate Following Clinics at Sites Noted: Martinez Tuesday Orthopedic 8:00 a.m. - 12:00 Noon Tuesday Rehab 8:00 a.m. - 12:00 Noon Wednesday EMG 8:00 a.m. - 12:00 Noon Thursday Orthopedic 8:00 a.m. - 12:00 Noon Thursday Rehab 8:00 a.m. - 12:00 Noon Friday Low Back 8:00 a.m. - 12:00 Noon Richmond Monday Low Back 8:00 a.m. - 12:00 Noon Friday Orthopedic 8:00 a.m. - 12:00 Noon Pittsburg Monday Orthopedic 8:00 a.m. - 12:00 Noon Patients Affected: Approximately 800 patients currently seen at the reduced clinics will be assigned to other physicians and FNP's throughout the system. Patients will continue to be seen at the primary care site of services, e.g. , Brentwood, Concord, Martinez, Pittsburg, and Richmond. This reduction may result in an increase in appointment waiting times up to approximately two weeks . Expected savings : $325, 000 2 Attachment 2 October 9, 1990 CONTRA COSTA COUNTY HEALTH SERVICES DEPARTMENT REDUCTIONS FISCAL YEAR 1990-91 Ambulatory Care services This program provides primary care and specialty services to the clients of the health Services Department. Clinic services are generally between the hours of 8:00 a.m. and 4:00 p.m. , Monday through Friday. Sites: Clinic sites: Martinez, 2500 Alhambra Richmond, 38th & Bissell Pittsburg, 550 School Street Concord, 3052 Willow Pass Road Brentwood, 118 Oak Street This program is administered through the Division of Hospital and Clinics of the Health Services Department. Nature of the Reductions or Changes: Approximately 52 physician hours would be reduced at Pittsburg, Martinez and Richmond Health Centers. In addition, 80 family nurse practitioner (FNP) hours would be reduced throughout the family nurse practitioner clinic program at the same sites. The reductions would impact the number of nursing personnel who provide support to the physicians in the above-noted clinics. Staff Reductions: 1.30 Full Time Equivalent Physicians 2 .0 Full Time Equivalent Family Nurse Practitioners 1.6 Full Time Equivalent Nurses Resulting Planned Clinic Reductions Pittsburg Health Center: .60 Full Time Equivalent Physician .60 Full Time Equivalent Family Nurse Practitioner Eliminate Following Clinics: Monday Urgent Care 8:00 a.m. - 12:00 Noon Monday Allergy 1:00 p.m. - 5:00 p.m. Monday Family Practice 8:00 a.m. - 5: 00 p.m. Tuesday Family Practice 1:00 p.m. - 5:00 p.m. Wednesday Family Practice 8:00 a.m. - 5:00 p.m. Thursday Urgent Care 8:00 p.m. - 5:00 p.m. Thursday Family Practice 1:00 p.m. - 5:00 p.m. Friday Family Practice 8:00 a.m. - 5:00 p.m. Attachr^ent 2 (cont. ) • -- -, -- _ =------_ ---_------ October 9 , 19110 �--J Page 2 Richmond Health Center: .70 Full Time Equivalent Family Nurse Practitioner Eliminate Following Clinics: Monday Family Practice 1:00 p.m. - 5: 00 p.m. Tuesday Family Practice 8:00 a.m. - 5:00 p.m. Tuesday Urgent Care 8:00 a.m. - 12:00 Noon Wednesday Family Practice 8:00 a.m. - 5: 00 p.m. .Thursday Family Practice 1:00 p.m. - 5:00 p.m. Martinez Health Center: .70 Full Time Equivalent Physician .70 Full Time Equivalent Family Nurse Practitioner 1.6 Full Time Equivalent Nurses Eliminate Following Clinics: Monday Family Practice 8:00 a.m. - 5:00 p.m. Monday Family Practice 5:30 p.m. - 9:30 p.m. Tuesday Family Practice 8:00 a.m. - 5:00 p.m. Wednesday Family Practice 1:00 p.m. - 5:00 p.m. Wednesday Family Practice 5:30 p.m. - 9:30 p.m. Friday Family Practice 8:00 a.m. - 5:00 p.m. ,Specialty Services: .50 Full Time Equivalent Physician (Note: Effective January 1, 1991) Eliminate Following Clinics at Sites Noted: Martinez Tuesday Rehab 8:00 a.m. - 12:00 Noon Wednesday EMG 8:00 a.m. - 12:00 Noon Thursday Rehab 8:00 a.m. - 12:00 Noon Friday Low Back 8:00 a.m. - 12:00 Noon Richmond Monday Low Back 8:00 a.m. - 12:00 Noon patients Affected: Approximately 400 patients currently seen at the reduced clinics will be assigned to other physicians and FNP's throughout the system. Patients will continue to be seen at the primary care site of services, e.g. , Brentwood, Concord, Martinez, Pittsburg, and Richmond. In addition, the department may choose to adjust these reductions among the health centers depending on the impact. Expected annual savings: $ 325,000.