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HomeMy WebLinkAboutMINUTES - 12131994 - 2.2 ro:.. BOARD OF SUPERVISORS Contra FROM: _ Costa Act-Hoc Committee on Consultant Selection (Supervisor Tam Torlakson and Supervisor Mark DeSaulnier '�� .�r� County DATE: tra t)t7 December 6, 1994 SUBJECT: Status Report on Selection of Consultants and other actions with Regard to Merrithew Memorial Hospital Replacement SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATIONS: 1. Approve the selection of Henry W. Zaretsky, Ph.D. as the consultant for health care policy with regard to hospital and health care alternatives. 2. Approve and authorize the County Administrator to negotiate a contract with either Peat Marwick or Ernst & Young for the financial component of a study of alternatives depending on availability, timing and cost. 3. Approve and authorize the County Administrator to negotiate a contract with either Orrick, Herrington & Sutcliffe or O'Melveny & Myers for the legal component of a study of alternatives depending on availability, timing . and cost. 4. Approve the selection of Kaplan, McLaughlin & Dias (KMD) as the, consultant for architectural issues with regard to alternatives. 5. Authorize the Chairman of the Board to sign letters to all of the County's State and Federal legislative representatives requesting assistance in obtaining waivers for the use of SB1732 and eligibility for 855 funding without a County hospital. 6. Direct that all district and private hospitals in the County be asked to submit proposals for the care of County patients on the basis of the County continuing to operate Merrithew Memorial Hospital and a similar proposal with the assumption that the County does not continue to operate a County hospital. 'ONTINUED ON ATTACHMENT: YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER IIGNATURE S ;C710N R BOARD ON December 13 1994 APPROVED AS RECOMMENDED X OTHER X APPROVED the recommendations set forth above as presented. (Ayes: 1,2,3,4,5; Noes: None) REQUESTED staff to review the utilization of specialty beds (geriatrics, psychiatry, tuberculosis, and AIDS) and to seek bids on the reconstruction project for a better assessment of the cast of the project. (Ayes: 1,2,5; Noes: 3,4) See Attachment A for list of speakers on this matter. VOTE OF SUPERVISORS (See above) 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 December 13, 1994 I ;ontact• PHIL BATCHELOR.CLERK OF THE BOARD OF c: Health Services Director SUPERVISORS AND COUNTY ADMINISTRATOR County Administrator BY_ r-'— �'" DEPUTY 7. Authorize and direct the Committee to meet with the Trustee in Bankruptcy, John Connelly, for the Los Medanos Community Hospital to discuss options for the County acquisition of the hospital asserts and the skilled nursing facility. 8. Authorize Supervisor Tom Torlakson to continue with meetings with the Los Medanos Hospital Board on reopening that facility. 9. Direct that the Board receive a report and recommendation on the consultant findings by January 17, 1995. BACKGROUND: The Ad-Hoc Committee on consultant selection and a second opinion on defeasance of the Merrithew Hospital Replacement Project financing met on December 1, 1994 with staff and members of the public to discuss the scope of consultant services with regard to the alternatives for hospital services. Aside from Committee members and County staff the following persons were in attendance: Kevin Degnan, , Paul O'Roark, Neal Gilbert, Grace Ellis and Paul Katz. The Committee discussed the scope of duties for a health care consultant in relation to alternatives for the construction of Merrithew and alternatives including all or part of the Merrithew Replacement Project. Suggestions were made for expansion of the scope to include a broad look at alternatives with detailed financial analysis. Staff were directed to meet with the selected consultants and discuss scope, cost and timing. The study scope was expanded to include contracting with other hospitals in the County. The Committee asked that letters be sent to all hospitals in the County asking for proposals for contracting for the care of County patients under the assumption that the County would continue to operate Merrithew and with the assumption that Merrithew was closed. The Committee directed that a completed report be returned to the Board by January 17, 1995. Committee members and staff reported on the most recent information available on the decision process for disposition of the Los Medanos Hospital. It was reported that the deadline for submittal of proposals to the Trustee has been extended to January 31, 1995. Staff were directed to arrange a meeting for the Committee with the Bankruptcy Trustee to further discuss the County proposal and current actions as well as the status of the skilled nursing facility. It was recommended that a letter be sent to all of the County's state and federal legislators requesting their assistance in obtaining waivers for the use of health and hospital revenues to allow more flexibility in their use. Waivers would be needed so that SB1732 reimbursement could be used for acquisition rather then just for construction and SB 855 funds could be obtained without operating a County hospital. Attached to this report are materials prepared by staff outlining ideas for a study scope and an executive summary of the options with pros and cons of each as has been discussed in prior reports and studies. These items as well as others discussed by the Committee including review of operational costs for the various alternatives will be discussed with the consultants. The next meeting of the Ad-Hoc Committee is scheduled for December 15, 1994 at 3:00 p.m. in the office of Supervisor Mark DeSaulnier. Contact: DeRoyce Bell 646-4093 cc: County Administrator Health Services Director Auditor-Controller County Counsel December 13, 1994 Agenda Item # 2 .2 ATTACHMENT A The following persons spoke relative to the report of the Ad Hoc Committee on Consultant Selection: Brian Uhlir, Mt. Diablo Medical Center, 2540 East Street, Concord; Ray Davis 20 Zander Drive, Orinda; Mike Lawson, Brookside Hospital, 2000 Vale Road, San Pablo; Neal Gilbert, Republican Party of Contra Costa County, 4478 Deer Ridge Road, Danville; Susan Prather, (no address given) ; Rev. Curtis A. Timmons, P. O. Box 8213, Pittsburg; Bruce Oberlander, P. 0. Box 31, concord; and David Ammann, 1121 Detroit Avenue, Concord. OFFICE OF THE COUNTY ADMINISTRATOR CONTRA COSTA COUNTY Administration Building 651 Pine Street, 11th Floor Martinez, California 94553 TO: Supervisor Mark DeSaulnier, District IV FROM: Phil Batchelor, County Administrator DATE: December 8, 1994 SUBJECT: Executive Summary of Options Regarding Merrithew Replacement Hospital In response to your request for an Executive Summary of the different options available to the County regarding replacing Merrithew, I have outlined in the attached the various pros and cons associated with each significant option. The outline was prepared from available reports and materials without additional research since the response to your request was needed within 24 hours. PB:lmj Attachment i OPTION 1 -- REPLACING MERRITHEW PROS CONS 1. Capital financing secured. 1. Political resistance. 2. Centrally-located facility. 2. Empty beds at District Hospitals. 3. Maintains residency program. 3. Inpatient services centralized. 4. Maintains disproportionate share 4. Possibility for legislative changes to funding• alter financing scheme. 5. Keeps health care Wtem intact. 6. County maintains control. 7. Title VI challenge defeated at administrative &judicial levels. 8. Proven experience in & commitment to serving poor. 9. Hospital busy & popular with target population despite dilapidated conditions. 10. Consolidation of inpatient services in central place preferable for economic and quality reasons. 11. Staff-model HMOs universally own & operate their own facilities (e.g., Kaiser). 12. No large county without U.C. Medical Center has closed its county hospital. 13. Ensures continued viability of trauma care system. 13. likely to attract new members to CCHP. Executive Summary— County Hospital Options Page I 1 OPTION 2 CONTRACTING WITH DISTRICT HOSPITALS PROS CONS 1. Available beds. 1. Historical and current_unreliability in contracting (witness-tl�e.recent 2. Potential long-term savings. cancellation of contract with Delta). 3. Districts interested in contracting. 2. Costs to defease bonds for 4. Regional hospitalization available Merrithew project. to County patients. 3. Labor/employee rights issues. 5. Same services are & should be contracted out, as is the current 4. County employee layoffs. practice. 5. Potential legal challenges (e.g., Legal Services)f Beilenson. b. No District Hospital is currently operating in East County. 7. Potential financial exposure. 8. Barriers to medical staff integration. 9. Uncertain physical/financial stability of District Hospitals (e.g., Brookside has been noted as a going concern). 10. Patient care issues (e.g., no neurosurgery, ENT, & other specialty services available at Brookside). 11. Imprudence of contracting for all services. 12. Assuming no change in governance, high risk involved in surrendering control to institutions with limited understanding of current & future market trends. Executive Summary— County Hospital Options Page 2 ` ' I OPTION 3A -- BUYIN LOS MEDANOS FOR USE AS THE COUNTY HOSPITAL PROS CONS 1. Facility currently available. 1. Too small. 2. Possibility of local community 2. Experience as acute care`facility a support. failure/low East county census. 3. Non-central location. 4. Defeasance costs. 5. County employee layoffs. 6. Merrithew project funds unavailable to purchase facility. 7. Preferences of creditors (4000+) & corporations with a voice in disposition of facility uncertain. 8. Potential for labor clash between former LMCH employees & layed- off County employees. 9. Lack of support from physician community. Executive Summary— County Hospital Options Page 3 t OPTION 3B -- BUYING LOS MEDANOS OR OTHER FACILITIES FOR USE AS PART OF THE COUNTY HEALTHCARE SYS'T'EM PROS CONS 1. Permits transfer of inpatient 1. Purchase costs unknown. psychiatric services to improved facility. 2. Community concern about perceivrd risks associated with 2. Permits relocation of ambulatory transfer of psychiatric services and care services to improved loss of ER. _ facility/saves funds otherwise needed to update outmoded facility. 3. Recycles existing inventory of acute care beds to better meet health care needs of community. 4. Community support likely. S. Los Medanos facility currently available. 6. Potential for increased CCHP enrollment. Erecutive Summary — County Hospital Options Page 4 OPTION 4 -- CONSOLIDATION OF THE THREE HOSPITAL DISTRICTS PROS I CONS 1. Establishes uniform administration. 1. Fierce resistance from District Hospitals certain. 2. Potential cost savings. 3. Better regional health planning. 4. Greater consolidation of specialty services. 5. Can be initiated by LAFCO. 6. Supported by Contra Costa Times editorial staff. 7. May receive strong community support. 8. Potential for increased enrollment of Medi-Cal recipients in CCHP. 9. Access to inpatient care closer to home for some patients. Executive Summary— County Hospital Options Page 5 . w OPTION 5 -- JOINT POWERS AGREEMENT PROS CONS 1. Establishes uniform administration. 1. Governance issues. 2. Potential cost savings. 2. Some resistence from District Hospitals likely. 3. Better regional health planning. _ 4. Greater consolidation of specialty services. 5. Potential for strong community support. 8. Potential for increased enrollment of Medi-Cal recipients in CCHP. Executive Summary— County Hospital Options Page 6 OFFICE OF THE COUNTY ADMINISTRATOR CONTRA COSTA COUNTY Administration Building 651 Pine Street, 11th Floor Martinez, California 94553 TO: Board of Supervisors FROM: Phil Batchelor; County Administrator DATE: December 8, 1994 SUBJECT: Merrithew Memorial Hospital Replacement Project, Bid Package No. 2 The Board asked for a response to questions on what work remains to be done on the existing construction contract for the Hospital and a range of cost if the contract were to be cancelled without allowing the contractor to complete the remaining work. The Construction Manager has reviewed the contract and provided the attached report on the circumstances. The report indicates that at the time the Court injunction was imposed 510 of the contract had been completed out of a total of $1,760,206. The Site Safety and Winterization work authorized by the Court in September included additional contract work up to a total of 86% by the end of November. The remaining contract balance of $239,439 represents 140 of the total contract. The remaining work consists primarily of finishing essential site utility work, installation of fire hydrants, storm drain work, paving, shoring and earthwork. If the Hospital project were to be abandoned most of the remaining work would need to be done as well as additional work to permanently stabilize the site and improve the pedestrian and vehicle traffic patterns and parking on the Hospital campus. The Construction Manager has indicated a range of potential cost for cancellation of the remaining contract work. Due to the fact that only 14% of the work remains, much of which would be required in any case, and considering the potential contractor claims, cancellation of the contract may not result in any substantial cost savings. PB:lmj Attachment Brien-Krel" yz pOr�`10 M E M O R A N D U M C O N F I D E N T I A L To: DeRoyce Bell From: John Campbell Date: December 7, 1994 Subject : Termination of Contract; Bid Package No. 2 The Board of Supervisors has requested the following: 1 . What is the balance of the contract value for Bid Package No . 2? 2 . What is the scope and value of the remaining tasks of Bid Package No. 2? 3 . What is the estimated range of costs for termination of the contract with the Bid Package No. 2 contractor? 1 . Contract value balance of Bid Package No. 2 : The total contract value for Bid Package No. 2 is $1, 760, 203 : a) As of July 27 , 1994 the contractor had billed for and completed 510 of the contract work in an amount of $889, 874; leaving a balance of 49%, or $870, 332 . 1 b) As of November 30, 1994 the contractor had completed the "Site Safety and Winterization" work as ordered in the Stipulation to the Preliminary Injunction from the Federal Court and has billed for and completed 860 of the contract work in an amount of $1, 513 , 775;*-.this leaves a balance of 140, or $239,439 . c) In addition to the contract balance there are change orders pending in the amount of approximately $10, 000, creating a revised balance of .$249,439 . 2 . Scope and value of the remainincf tasks of Bid Package No. 2 are as follows: Item of Work Estimated Value to Complete Site Utilities $102, 000 Storm Drain $ 31, 000 Shoring $ 12 , 000 Demolition $ 20, 000 Earthwork $ 63 , 000 Concrete $ 13 , 000 , Asphalt Paving $ 8, 000 Joe Carone, Inc. , the general contractor, has prepared a schedule for the completion of the contract work and has commenced with the installation of the water service, Site Utilities, on B Street to conform with requirements of City of Martinez Water District and the Contra Costa County Fire Protection District. 3 . Estimated range for termination of the contract and resolution of potential claims is : $34,000 to $177, 000 As your project manager I strongly suggest that these estimates remain confidential. If it is the decision by the County Board of Supervisors 'to "terminate for convenience" the Bid Package No. 2 contract with Joe Carone, Inc. this information could impact our ability to negotiate favorably. 2 CONTRA COSTA COUNTY HEALTH CARE POLICY CONSULTANT SCOPE OF SERVICES LOS MEDANOS REVIEW 12/1/94 Los Medanos Hospital located in East County is currently closed. Potentially, two major options may exist: A. Continue with the replacement project and utilize Los Medanos as an ancillary campus of Merrithew in conformance with the master building plan; or B. Close Merrithew and utilize Los Medanos as the full service County Hospital. From a strategic planning perspective: 1. Review past studies which have been conducted on the future of publicly-sponsored health services in Contra Costa County. 2 . Review the County's programmatic plan for use of Los Medanos as an extension of Merrithew. 3. Assess the impact of the State's Managed Care Initiative under both options. 4 . Determine the Hospital needs of the anticipated populationto be served based on demographic characteristics, economic status, and health status. 5. Assess the marketability of the Contra Costa Health Plan under both options. 6. Render an opinion as to the viability of both options. CONTRA COSTA COUNTY FINANCIAL CONSULTANT SCOPE OF SERVICES LOS MEDANOS REVIEW 12/1/94 The County's financial plan for Capital Construction is based upon revenues from. three sources: The Hospital Construction/Renovation Reimbursement Program (SB 1732) , Medi- Cal Disproportionate Share Hospital Payments (SB 855) and Medicare capital. 1. Provide an analysis of the three revenue sources with a risk assessment regarding the probability of the funding continuing over the life of the project. 2 . Determine if SB 1732 can be used for Acquisition through a Capital lease or through an out right purchase. 3 . Determine through a nation wide search if waivers have been granted regarding the manner in which SB 855 funds can be or.are available e.g. through contracted days. The cost of defeasance (project abandonment) is estimated at $25 million. 4 . Determine if SB 1732, SB 855, or Medicare reimbursement principles consider project abandonment costs as a reimbursable expense. 5. Identify any other third-party revenue source which could be utilized to offset the cost of defeasance. CONTRA COSTA COUNTY ARCHITECTURAL CONSULTANT SCOPE OF SERVICES LOS MEDANOS REVIEW 12/1/94 Final plans for the replacement 144 bed medical/surgical facility have been completed. If a chinge to these plans is required: 1. Determine the cost of re-programming the facility to include 46 acute psychiatric beds and reducing the number of medical/surgical beds. 2. Determine the time to accomplish the re-programming. 3. Determine what if any savings would occur if 25 medical/surgical beds where "shelled in" rather than fully constructed. 4. Determine what steps are necessary to accomplish item CONTRA COSTA COUNTY LEGAL CONSULTANT SCOPE OF SERVICES LOS MEDANOS REVIEW - _ - 12/1/94 The County's ability to utilize Los Medanos is contingent upon = securing the physical asset free from legal entanglements. 1. Determine/describe the steps required by the Bankruptcy Court in selecting a new operator of Los Medanos Hospital. 2. Determine/describe the role of the court-appointed Receiver. 3. Determine/describe the role of Cal-Mortgage 4. Determine/describe the role of the Elected Hospital District Board vrs. the Los Medanos Hospital Corporation Board. 5. Identify any significant legal barriers or concerns the County should address in the event acquisition is desired. CONTRA COSTA COUNTY CONSULTANTS LOS MEDANOS REVIEW 12/1/44 HEALTH CARE POLICY o Henry R. 2aretsky, Ph.D. a Henrik Blum, M.D. o Robert Tranquada, M.D. l i I FINANCIAL �I o Peat Marwick o Ernst & Young ARCHITECTURAL o Kaplan, Mc Laughlin, Diaz (KMD) LEGAL o Orrick, Herrington & Suttcliff o O'Melveny & Meyers TIME FRAME Thirty (30) Days COST $5,000 - $10,000 OFFICE OF THE COUNTY ADMINISTRATOR CONTRA COSTA COUNTY Administration Building 651 Pine Street, 11th Floor Martinez, California 94553 TO: Board of Supervisors FROM: Phil Batchelor, County Administrator DATE: December 8, 1994 SUBJECT: Potential Impact of Cost of Defeasance of Merrithew Financing on County Budget Supervisor Powers, at the December 6, 1994 Board meeting, asked for information on the potential impact on the County budget if the cost of defeasance of the Merrithew Hospital financing, estimated at $25 million, had to be paid directly out of the budget. There are several ways such a cost apportionment could be accomplished. Following are two examples of the impact of different methods of apportionment. A. An across the board apportionment of the $25.0 million to the net County cost of departments results in a 13% cut in departments. Some of the major departmental impacts would be as follows: Assessor $ 939,000 District Attorney 450,000 General Services 1,600,000 Health Services 6,520,000 Probation 2,037,000 Public Defender 1,085,000 Sheriff 2,972,000 Social Service 3,590,000 Courts 435,000 B. 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Q-2 A5- 100('.- NAME OF ORGANIZATION CHECK ONE: FX I wish to speak on Agenda Item # My comments will be: X General ❑ For ❑ Against ❑ I wish to speak on the subject of: ❑ I do not wish to speak but leave these comments for the Board to consider: Date: / -31� REQUEST TO SPEAK FORM (Two [2] Minute Limit) Complete this form and place it in the box near the speakers' rostrum before addressing the Board. Name: -TI� lf���� �V LY— 1 Phone: ��° t � ��1 C) Address: City: 7-*"" . 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Name: Phone: C,:5/qJ 77e-lz qs- Address: city: I am speaking for: Myself OR Organization NAME OF ORGANIZATION CHECK ONE: El I wish to--q-- on Agenda Item My comments will be: F-1 General D For E-1 Against El I wish to speak on the subject of: DI do not wish to speak but leave these comments for the Board to consider: REQUEST TO SPEAK FORM Date: 3 (Two [2] Minute Limit) Complete this form and place it in the box near the speakers' rostrum before addressing the Board. Name: ) ,u�r.�c, /mow�,-�,- Phone: ?/1.�1s' Address: 1/99' hmll m Al d- � City: � I am speaking for: ❑ Myself OR ❑ Organization: NAME OF ORGANIZATION CHECK ONE: ❑ I wish to speak on Agenda Item # My comments will be: ❑ General ❑ For ❑ Against ❑ I wish to speak on the subject of: ® I do not wish to speak but leave these comments for the Board to consider: ,,QA,10�� y Date: 1.--13` g BEQUEST TO SPEAK FORM (Two [2] Minute Limit) Complete this form and place it in the box near the speakers' rostrum before addressing the Board. Name: CC,.,-w Phone: JS-Y— /97y Address: SIO LJ,3110Lr, Rive city: ou, 1001 el+ I am speaking for: d Myself OR ❑ Organization: NAME OF ORGANIZATION CHECK ONE: ❑ I wish to speak on Agenda Item # My comments will be: ❑ General ❑ For ❑ Against ❑ I wish to speak on the subject of: I do not wish to speak but leave these comments for the Board to consider: SLM,,rl' Date: REQUEST TO SPEAK{ FORM (Two [2] Minute Limit) Complete this form and place it in the box near the speakers' rostrum before addressing the Board. Name:,, C-1 Phone: N Address• l��a�� City: I am speaking for: Ej; yself OR ❑ Organization: NAME OF ORGANIZATION CHECK ONE: ❑ I wish to speak on Agenda Item # My comments will be: ❑ General ❑ For ❑ Against ❑ II wish to speak on the subject of: t? I do not wish to speak but leave these comments for the Board to consider: S� VftlA Date: REQUEST TO SPEAK FORM (Two [2] Minute Limit) Complete this form and] place it in the box near the speakers' rostrum before addressing the Board. Name: _ JV 0 NNO Phone: Address: City: I am speaking for: Myself OR ❑ Organization: NAME OF ORGANIZATION CHECK ONE: ❑ I wish to speak on Agenda Item # My comments will be: ❑ General ❑ For ❑ Against ❑ I wish to speak on the subject of: I do not wish to speak but leave these comments for the Board to consider: S © � ® �S C� 1 Date: REQUEST TO SPEAK FORM (Two [2] Minute Limit) Complete this form and place it in the box near the speakers' rostrum before addressing the Board. Name: S�a �ln� r'' Phone: Address• 5 /D (J 0 �•• a.we. City: C4- b �� I am speaking for: 0-Myself OR ❑ Organization: NAME OF ORGANIZATION CHECK ONE: ❑ I wish to speak on Agenda Item # My comments will be: ❑ General ❑ For ❑ Against ❑ I wish to speak on the subject of: I do not wish to speak but leave these comments ents for the Board to consider: ( Date: REQUEST TO SPEAK FORM (Two [2] Minute Limit) Complete this form and place it in the box near the speakers' rostrum before addressing the Board. Name: S/ i r/�`' GtJe.Id, Phone: s9 /,2 79 Address: City: &A�- I am speaking for: Myself OR ❑ Organization: NAME OF ORGANIZATION CHECK ONE: ❑ I wish to speak on Agenda Item # My comments will be: ❑ General ❑ For ❑ Against ❑ I wish to speak on the subject of: I do not wish to speak but leave these comments for the Board to consider: Cn S,,0 fa Rl$ TO: BOARD OF SUPERVISORS Contra FROM: Supervisor Tom Torlakson ' Costa County DATE: December 6, 1994 SUBJECT: ENDORSE PLAN TO REOPEN LOS MEDANOS COMMUNITY HOSPITAL AND RECONFIGURE MERRITHEW HOSPITAL SPECIFIC REQUEST(S)OR RECOMMENDATION(S)8 BACKGROUND AND JUSTIFICATION RECOMMENDED ACTION: (A) Endorse Supervisor Tom Torlakson's proposal (attached) to re-open Los Medanos Community Hospital and reconfigure Merrithew Memorial Hospital . (B) Authorize the County Administrator to initiate the .following actions : ( 1) Direct the County Administrator and Health Services Department to communicate with the receiver and the Board of Directors of the Los Medanos Community Hospital District and the District's non-profit corporations to inform them of the Board of Supervisors's desire to initiate immediate discussions regarding this plan to reopen Los Medanos Community Hospital. ( 2) Direct the County Administrator and Health Services Director to evaluate a reconfigured Merrithew Hospital based on the new plan. ( 3) Direct the County Administrator and Health Services Director to develop a focused 30-day timeline, beginning with the . Board's action to endorse this plan, outlining the necessary actions/decisions necessary to fully evaluate and implement the plan. (4 ) Authorize Supervisor Torlakson to convene meetings between the county and representatives of the following agencies and organizations to discuss and further develop the details of the new plan and the parameters of the agency partnerships : CONTINUED ON ATTACHMENT: x YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIONATURE(SI• " ACTION OF BOARD ON Tl P r Pmh P r 1 1 4 Q d APPROVED AS RECOMMENDED �_ OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE X UNANIMOUS(ABSEN1- - - - ) 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. cc : Health Svcs . Dir. ATTESTED December 13, 1994 County Administrator PHIL BATCHELOR,CLERK OF THE BOARD OF SUPERVISORS AND COUNTY ADMJNISTRATOR M382 (10188) BY- " `A°�� ,DEPUTY Proposal to Re-Open Los Medanos Hospital and Reconfigure Merrithew December 6 , 1994 Page TWO Delta Memorial Hospital Gordon Gravelle, President, Board of Directors Linda Horn, Administrator Kaiser Permanente Medical Center David Pockell, President/Chief Executive Officer Vivian Rittenhouse, Area Manager/Vice President Los Medanos Community Hospital District Jerry Rice, President John Connolly, Receiver A representative of Congressman Bill Baker A representative of Senator Dan Boatwright A representative of Assemblyman Bob Campbell A representative of Congressman George Miller A representative of Assemblyman Richard Rainey Health Care Employee Organizations California Nurses Association Public Employees Local 1 Local 250 Health Care Worker' s Union Union of American Physicians and Dentists Physicians Union Mental Health Commission Wayne Simpson, Chair Representatives of Non-Profit Corporations associated with Los Medanos Community Hospital BACKGROUND INFORMATION: The Board of Supervisors unanimously voted on May 24, 1994, to pursue the re-opening of Los Medanos Community Hospital and authorized the County Administrator and Health Services Director to submit a proposal to the Los Medanos Hospital Board of Directors and Receiver. Several months passed with no response from the Los Medanos Board or the receiver. On August 24, 1994, I joined a coalition of citizens in a press conference to urge the receiver to move forward with reopening Los Medanos Hospital and negotiating with the county. I convened a meeting of the Board of Supervisors' Hospital Alternatives Subcommittee on October 27, 1994, to review with the receiver items of concern in the first offer and in preparation for the finalization of the submittal of a second proposal on October 31, 1994 . Throughout the Summer and Fall, I met with numerous citizen groups and community leaders, to share the county's proposals and receive input. The second proposal deals mainly with financial considerations but does include more flexibility in program components and references the desirability of implementing an obstetrics program such as a birthing center. The program and business components have been open for negotiation and discussion. The county and I, as the Board's designated representative, have been anxious to move forward. Let's get off dead center and move forward! As part of our ongoing effort to open Los Medanos Hospital, the recommendations above are a further effort to have all parties that can assist in reopening Los Medanos come forward at this time with their financial commitment and/or commitment of patients to support a viable business plan for Los Medanos Community Hospital. Tom Torlakson > 300 East Leland Road Supervisor, District Five Suite 100 Contra Costa County Pittsburg,California 94565-4961 Board of Supervisors x' 40 (510)427-8138 �o� •cT Srd cooK`� November 28, 1994 STATEMENT REGARDING NEW PLAN FOR REOPENING LOS MEDANOS CONNUNITY HOSPITAL While a small group has, in fact, been misleading voters with regards to my involvement with the Los Medanos Community Hospital, this has not deterred my efforts to ensure vital hospital access for my constituents . I have developed a new plan for Los Medanos Community Hospital and will immediately initiate renewed discussions with the district and other health providers in East County. In developing this new plan, I have focused on providing the community with improved access to health care and configuring the health care facility in such a way as to maintain financial viability. Any solution must recognize a fundamental/ principle: The county general fund which provides critical funding for other life protecting health services and law enforcement must not be placed at greater risk. Any solution must also recognize the valuable services of our county hospital employees and the need to provide for the continuity of their service and care. - I 'mdst reiterate the strong need for more intensive efforts to reopen Los Medanos Community Hospital. I am pushing for a focused 30-day timeline to closely analyze all possible alternatives. I call on other health providers, community physicians, our legislative delegation, and city officials to join in strong partnerships for the common goal of providing quality health care for our citizens . I will invite board members and administrators of Los Medanos Hospital, Delta Memorial Hospital, Kaiser Permanente, the receiver, CalMortgage and community physicians to examine all partnership possibilities to Page TWO reopening Los Medanos with as complete a combination of services as possible--including acute, in-patient care. I will vote to commit our general acute care average daily census of approximately 25 patients to an East County hospital solution and towards the goal of reopening Los Medanos with Med-Surgery and obstetrics as part of services provided to the community. I continue to be vitally concerned over the provision of services and facilities for our mental health patients . I have asked the Health Services Department to examine a reconfiguration of Merrithew that would include 40 to 60 in-patient psychiatric beds--guaranteeing care in the Merrithew replacement hospital. I will appeal to our legislative delegation to assist with legislation that will provide some flexibility in how SB 855 and SB 1732 funds can be utilized. Such legislation could offer other possible alternatives which heretofore have not been considered in addressing this health care debate. To assist in facilitating and expediting a resolution to the reopening of Los Medanos Hospital, I will request that the Board of Supervisors retain a health care systems analyst serve as a resource and provide a fresh perspective in the discussions with Los Medanos Hospital and East County health care .providers . Attached is a floor-by-floor breakdown of my proposal to reconfigure the Los Medanos Community Hospital . ori Tom Torlakson Supervisor, District Five TT:gro ul d) 0 G.0 V�- .0 %Lo Ira 0 N 0 On Dt 'o, V- kt c y N 0- U3 21, Q. ZJ Ck. �o o. N cn tom? Z O N � � W 2 °o. 04 N 00 a a 02 ;,r lo (p (p i -- z 0 W S Cf) U.