HomeMy WebLinkAboutMINUTES - 05151984 - 2.5 THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Adopted this Order on May 15, 1984 , by the following vote:
AYES: Supervisors Powers, Fanden, Schroder, McPeak, Torlakson
NOES: None
ABSENT: None
ABSTAIN: None
SUBJECT: Proposed Reductions in Mental Health Programs
In a May 14, 1984, letter to the Board, C. E. Dixon,
interim County Administrator, summarized the deficit situation in
the Health Services Department, discussed the provisions of the
AB-8 funds and the "Beilenson" hearing requirements as they relate
to decisions regarding the Health Services deficit, an outline of
options available to the Board, a recommended process to be
followed to eliminate the deficit, and recommended actions for the
Board to take this day.
Board members considered the recommendations of the County
Administrator and commented on issues relative to the method of
determining indirect and overhead charges in the hospital applicable
to mental health, alcohol, and drug abuse programs; reference to the
methodology utilized by Alameda County in separating their mental
health division from medical services, and the direction to the
County Administrator to obtain information that may be useful to
Contra Costa County; concern relative to a reduction in the mental
health subsidy and the potential impact on the Social Service
Department because of the necessity of shifting work assignments;
the possibility of closing the county hospital; the drastic cuts in
state mental health subsidies to counties in the last few years and
the lack of access to beds in state hospitals; the potential of
a 60/40 match versus a 50/50 match of AB 8 funds; and the need to
make the public aware of the funding problem.
The Chairman then invited persons who have expressed a
desire to speak to come forward. The following persons presented
comments relative to closure of mental health clinics in Richmond and
Pittsburg; the impact of the proposed reductions on staff as well as
the population served; opposition to the proposed reductions in mental
health programs; a request to delay holding the Beilenson hearing
pending receipt of information determining where the cuts will
occur ; an inquiry on giving a cost-of-living adjustment to County
employees at this time; the need to increase the allocation to the
reserve funds for contingencies; the layoff and the notification
process; the financial assistance provided to the County by the
Retirement Board; the need to fund alcohol and drug abuse programs;
the proposed impact on local jurisdictions and school districts if
Jarvis IV is approved by the electorate in November; a request that
all County departments share in the responsibility of reducing the
deficit in the Health Services Department; the feasibility of
establishing a separate department and/or budget unit for mental
health programs; a proposal to close I and J Wards at the County
Hospital and contract with other hospitals for the confinement of
patients normally assigned to said wards; the ability of the County
Hospital to compete with private hospitals in attracting private
patients with the financial capability of paying for their health
care needs; a proposal to allow job sharing; and treatment of
children' s mental health disorders in the school environment as
opposed to a clinic environment and the inconsistencies in the reim-
bursement for the same services offered at the different sites:
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David Post, M.D. , Pittsburg Mental Health Clinic;
Fred Behrens, M.D. Department of Psychiatry and
Psychology, County Hospital;
Steven Tremain, M.D. , County Hospital and the Physicians
Union;
Tenki S. Tenduf-La, M.D. , Richmond Mental Health Clinic;
William R. Taylor, Sr. , Martinez;
Jeanne Gibbs, Constituency of Citizens for Prevention;
Center for Human Development
Ben Russell, Phoenix Programs;
Henry L. Clarke , Executive Director, Contra Costa County
Employees Assn. , Local 1;
Barbara Cross, Health Services Department, Richmond;
Deborah Tupper, SEIU, Local 535;
Donna Gerber, California Nurses Assn. ;
Stanley T. Hutter, Ph.D. , Contra Costa County Employees
Assn, Local 1;
Donald Goldmacher, M.D. , E1 . Cerrito;
John Lee, M.D. , Medical Staff, Health Services Department;
Kimberly LaCroix, Children' s Mental HeAlth Services,
Pittsburg Clinic;
William Walker, M.D. , Acting Health Services Director,
requested the Board to defer action on the recommendation of the
County Administrator relative to scheduling the hearing on June 19,
1984, pending information from the State on AB-8 funds and the
actual determination where the reductions will occur .
In responding to Dr . Walker's concern, Mr. Dixon expressed
a desire to meet immediately with representatives of the State
Department of Health Services, the need to explore and keep all
options open to minimize the impact of the present budget deficit on
the 1984-1985 budget, and the need to seek legislative assistance in
obtaining additional state funds for mental health programs. Since
there are too many uncertainties with respect to acquiring the
needed funds as well as the implementation of procedures to offset
the deficit, he strongly recommended that the hearing be scheduled
for June 19, 1984.
Supervisor T. Powers voiced the concerns of the Board on
the proposed reductions in mental health programs. However , he
pointed out that the County' s fiscal condition, particularly the
drop in its bond rating, has placed the County in the vulnerable
position of borrowing money at a higher interest rate. He commented
on the necessity of increasing the reserve funds in order for the
county to attract investors for its securities. Supervisor Powers
also referred to the Jarvis IV initiative which, if approved,
would further impede a county' s ability to provide even minimal
services with the reduced financial resources available.
There being no further discussion, IT IS ORDERED that
the following actions are APPROVED:
1. FIXED Tuesday, June 19, 1984, at 2: 30 p.m. in the
Board Chambers for public hearing pursuant to Health
and Safety Code Sections 1442 and 1442. 5;
2. ADOPTED the attached hearing .notice for the June 19,
1984, hearing with the understanding that the scope of
the proposed reductions exceeds the reductions which
are required and that this action is being taken in
order to give the Board the maximum flexibility;
3. DIRECTED the Action Health Services Director to have
the notice of the hearing posted as is required by Law;
4. AUTHORIZED the County Administrator or his designee to
meet with the Director, State Department of Health
Services, to discuss the options outlined in the
letter of May 14, 1984, and obtain his input on which
direction appears most feasible, given the County' s
financial situation;
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5. AUTHORIZED the County Administrator to contact offi-
cials in Alameda County to inquire as to the factors
used in computing indirect . and overhead costs of their
mental health programs; and
6. DIRECTED staff to delay issuance of termination noti-
ces prior to receiving final information as to where
the total reductions will occur in the Health Services
Department.
.cc: County Administrator
State Department of Health Services
Acting Health Services Director
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