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Home My WebLink AboutMINUTES - 12112001 - SD.2 TO:' BOARD OF SUPERVISORS �_ Contra FROM: John Sweeten _ _ ``- County Administrator x ilr;4, z Costa DATE: December 11, 2001 County r�A- i;y�` SUBJECT: Progress Update on the Management Audit of the Health Services Department SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDED ACTION I. DIRECT the Auditor—Controller to detennine approved net County costs, including carry over and supplemental appropriations, and to compare these to year-end actual net County cost for the 1998- 99 through the 2000-01 fiscal years. Il. AUTHORIZE the County Administrator to issue a Request For Proposals to engage professional services from independent consultants and/or CPA firms for contract(s)totaling up to $200,000 to: A. Assess the strengths and weaknesses of the organizational structure of the Health Services Department in relation to the legal and fiscal environment in which it operates. B. Review the Hospital Medicare and Medi-Cal cost report to identify ways, if any, by which revenues may be enhanced. C. Review Department medical staffing ratios at the Martinez Detention facility. D. Assess the Department's collaborative efforts to secure and maintain the enrollment of children in the Healthy Families Program, and to maximize revenue in this program. III.DIRECT the County Administrator to: A. Work with the Health Services Department and the Purchasing Manager on a review of group purchasing practices for pharmaceutical and medical supplies. B. In coordination with the Mental Health Division and the County's Director of Capitol Facilities and Debt Management,perforin a comprehensive review and document Department efforts to avoid out-of-county placements in trental health facilities. IV.DIRECT the County Administrator to include status and outcome findings in upcoming quarterly budget status reports. CONTINUED ON ATTACHMENT: X YES SIGNA R ---'-".. - ------ ............ - -- RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE APPROVE OTHER SIGNATURE(S): ---------------------------------- - -------------------------------------------------------------------------------------------------------------------------------------- ACTION OF BOARD ON, {�C�1I�Pil l I �� APPROVE AS RECOMMENDED pC OTHER APPROVED as above to return to the Board no later than the last meeting in February. VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE �( AND CORRECT COPY OF AN ACTION TAKEN ►^ UNANIMOUS(ABSENT ) AND ENTERED ON THE MINUTES OF THE BOARD OF SUPERVISORS ON THE DATE AYES: NOES: SHOWN. ABSENT: ABSTAIN: 'l� ^ / ATTESTER��-L Q� /I o�-�� / CONTACT: JOHN SWEETEN,CLEOF THE B ARD OF SUPERVISORS AND COUNTY ADMINISTRATOR CC: William Walker,MD,Director,Health Services Pat Godley,CFO,Health Services BY DEPUTY SD.2 (December 11, 2001) We .have Dr. Walker and we have Dorothy Sansoe —and welcome you. Good Morning Chair, Supervisors, we were here on 11/6 with a recommended audit package for you. During discussion it was decided that we would go back and re-look at the package. The County Administrator's office has taken into account the recent increase in expenses due to investigating different bioterrorist events in the County, and keeping that in mind we thought what we,,antvto do would be to go back and look at what were the things that the County Administrator's office did not feel that we would be able to do and trying to get the biggest, basically.bang for the buck out of our dollars for this audit-go the new proposal in front of you -has now the Auditor Control will address item no.1 whip includes looking at prior year appropriations and expenditures°\hb are proposing to go forward with a consultant to assess the organizational structuredhe Health Services Department review the Hospital Medicare and Medical cost reports-bp ways where revenues can be enhanced, review departmental medical staffing ratios"of the Martinez Detention Facility and to assess the Department's efforts in maintaining children enrolled int'lealthy Families Program. Those & the areas be4h& afea we thought would be best addressed by an outside consultant. The-last_p.art of=this-package'.iiio direct the County Administrator's office to look at the purchasing practices for pharmaceuticals within the Department and to perform a comprehensive review and document the department's efforts to avoid out of County placements in Mental Health facilities, o-we-have-broken-it_now-into three areas-- jone�whenEcth.e`�.Auditor_-Controller would .look at-issues.,--when we vi oq[q-have an-outside-Consultant Look at issues.and hird.:ar._ea where-.. ft-would-have the-County Administrators:.Office look-'at the issues. So that's the new proposal in front of you. At the 11/6 meeting you requested that Dr. Walker and Pat Godley come before you to �\ answer any questions. Supervisor Uillkema Thank you — Supervisors are there questions? SupervisoCLGe br er — Madam Chairtl-would�-just-move-theme recom`m-endatioh�—I think that this focuses our efforts in trying to answer some questions relative to Health Services budget, I think it I think we will be coming back as soon as possible. However, the part the the Consultant will be doing will take longer than the part the auditor will be doing o course. So what we are proposing is to come back with the Fn-0xt_quarterlybudg_e_t_report;on the first piece of it - and then once we get the ...out and authorized by the Board it will be based on the Contra or's time lines in when they feel they can get back to you - Do you have a proposed date when this Board is expected to look at this item again? If we don't set a date I've learned that things have a tendency to go off the clip or out of our memory- so we have been working very hard so there's a proper follow up - so I am going to fix a date when we would expect to hear something from you -even if you said two more weeks. We anticipate coming back to the Board the middle to the end of February on the first part of the order with the Contractor and then back to the Board in March for approval of the Contract with the Consultant. Supervisor Uilkema -So we will hear from you - wewill_expect_no Iater-than the_last-meeting-.irvFebruary Correct - With-that amendment—would-the-maker-of_the_mo.tion-accept-that? Supervisor Gerber "Yes" There is a motion and a second. Any further discussions All in favor say "aye". It is unanimous Supervisor Uilkema Thank you very much addresses the major concerns that were raised by the Grand Jury report and it's within a reasonably budget – so I would move the recommendation. Supervisor Glover ~Seconds? There is a motion and a second but we do have a speaker on this item – at least one speaker. Mr. Wolf– and let me ask –Mr. Pringles –did you want to speak on the last item, the presentation item. After we finish this item –1 have so many speaker cards from you that I got confused. So I apologize. Mr. Wolf-Madame Chair, Members of the Board, my name is John Wolf, I am Executive Vice President of the CC Taxpayers Association, I would just like to encourage you to accept the recommendations on the audit – there were several members of my association that were quite disturbed by the County Grand Jury report on 0103 came out and not withstanding all of the careful words been wrapped around the issues the basic concern was the incredible increase in the net county cost for Health Services in this County and that huge increase over the last three to four years needs to be slowed down and turned around simply because every million dollars that is spent on Health Services means that there is a million dollars that can not be spent on other services.cThe_r_ecommendati_on=to> engage-an-indegerident-adv_isor and-cost-of_$200,000-to_come_in_and- l.ook-at-this_.se_e.ms_to_be_a_good_on&J 1 recognize that there are other places the $200,000 could arguably also be spent to get some leverage –on the other hand coming from a business background it never hurts to get independent outside review and I would only ask that the auditor be given every latitude to come up with as many recommendations as possible and not be too foreclosed or circumscribed by the people that work there so that we do get our money's worth –the $200,000 –that being said on behalf of my association I would recommend that you approve the recommendations in front of you. We think it would be a good idea. Thank you. Is there anyone else who would like to address the Board on this item? I have one more question. When do we expect to have you come back=with-the fin:dings?,, I am sure it's here and