Santa Cruz County Grand Jury • 2005-2006

Where There’s Smoke, There’s Funding: Expenditure of Proposition 99 and Proposition 10 Funds in Santa Cruz County

12 pages
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Findings and Recommendations 23 findings

F1
The Santa Cruz County Health Services Agency, Community Health and Prevention Programs, acting as the Local Lead Agency (LLA), receives Proposition 99 funds in three-year funding cycles. In the present funding cycle for Fiscal Years 2004-05, 2005-06 and 2006-07, a total of $450,000, or $150,000 per year, is projected. This amount is based on population, with $150,000 being the smallest amount a county could receive. Response: Santa Cruz County Board of Supervisors AGREES.
No recommendations for this finding
F2
The budget for the present three-year funding cycle is outlined as follows:2 Budget Section FY 04-05 FY 05-06 FY 06-07 Total Personnel Costs $ 75,622 $ 89,336 $ 90,859 $ 255,817 Fringe Benefits @35-42% $ 30,249 $ 35,734 $ 35,435 $ 101,418 Operating Expenses $ 2,000 $ 1,500 $ 500 $ 4,000 Equipment Expenses $ 2,700 $ 0 $ 0 $ 2,700 Travel/Per Diem and Training $ 4,000 $ 2,169 $ 3,900 $ 10,069 Subcontracts and Consultants $ 12,000 $ 1,000 $ 0 $ 13,000 Other Costs $ 5,762 $ 1,500 $ 362 $ 7,624 Indirect Expenses @14-15% $ 17,667 $ 18,761 $ 18,944 $ 55,372 Total Expenses $150,000 $150,000 $150,000 $450,000 Table 1. Budget for Fiscal Year 2004-05 through Fiscal Year 2006-07 for the Tobacco Education Program. Response: Santa Cruz County Board of Supervisors AGREES.
No recommendations for this finding
F3
The California Department of Health Service’s document titled “Local Lead Agency Guidelines for a 2004-2007 Comprehensive Tobacco Control Plan, January 6, 2004” sets forth strict operating, program and budget guidelines for LLAs.3 Response: Santa Cruz County Board of Supervisors AGREES. Tobacco Education Program, Budget Justification for Santa Cruz County Health Services Agency. California Department of Health Services, Tobacco Control Section, “Local Lead Agency Guidelines for a 2004-2007 Comprehensive Tobacco Control Plan, Issued January 6, 2004.” Where There’s Smoke, There’s Funding: - 27
No recommendations for this finding
F4
The Tobacco Education Program in Santa Cruz County must follow the state’s strict budget and spending guidelines in order to receive funding and be reimbursed for expenditures. Any tobacco education activity funded by Proposition 99 must be approved in advance by the state. The LLA then sends a cost report to the state for reimbursement. The state oversees spending of the funds, which must be spent on required objectives. Response: Santa Cruz County Board of Supervisors AGREES.
No recommendations for this finding
F5
Santa Cruz County has not been formally audited for its expenditures of Tobacco Education Proposition 99 monies. Response: Santa Cruz County Board of Supervisors AGREES.
No recommendations for this finding
F6
The “Scope of Work” of the Santa Cruz Tobacco Education Program for the term 7/1/04 to 6/30/2007 includes well-defined activities, start and end dates for each activity, responsible parties for each activity and tracking measures. Its objectives are to: • reduce exposure to secondhand smoke in public places; • reduce retail availability of tobacco; • review the extent to which LLA and TCS-funded projects address specific objectives of cultural or ethnic/minority communities or populations; and • counter pro-tobacco influences such as tobacco sponsorships of public, private and sporting events; tobacco company contributions to education, research, public health, cultural and intellectual activities. Response: Santa Cruz County Board of Supervisors AGREES.
No recommendations for this finding
F7
The Tobacco Education Program is the repository for tobacco information for the community, and it: • recruits, maintains and organizes the Tobacco Education Coalition. The Coalition takes action on tobacco industry activities in the community, proposes legislation and advocates for Proposition 10 monies to be spent on tobacco-related issues. The Tobacco Education Coalition meets monthly. • stays current on local and statewide tobacco-related events. The Tobacco Education Program makes public statements and answers questions and concerns from the public, media and other agencies regarding tobacco issues. • fields calls from the public, sends materials, maintains a list of current cessation services in the county, stays current with tobacco-related laws or policies in the five jurisdictions and creates anti-tobacco curriculum ideas for teachers. Response: Santa Cruz County Board of Supervisors AGREES. - 28 Where There’s Smoke, There’s Funding:
No recommendations for this finding
F8
The Tobacco Education Coalition, formed in 1985, is an advocacy group that promotes a tobacco-free lifestyle and environment. The Tobacco Education Coalition membership includes the following government and community non-profit agencies:4 American Cancer Society American Heart Association American Lung Association Cabrillo College Student Health Center Central Coast Alliance for Health Children and Families First City of Santa Cruz Parks and Recreation City of Santa Cruz Police Department Community Connections ETR Associates Front Street, Inc. Individual community members at large (10 members) Katz Cancer Resource Center Medical Works Mental Health Client Action Network Mountain Community Resources Pajaro Valley Prevention and Student Assistance (three members) Planned Parenthood Salud Para la Gente San Lorenzo Valley Unified School District Santa Cruz City Schools District (two members) Santa Cruz County Medical Society Santa Cruz County Office of Education Santa Cruz County Parks and Recreation Santa Cruz County Sheriff’s Department (two members) Substance Abuse Prevention Program Tobacco Education Clearinghouse of California 4 Santa Cruz County Health Services Agency, Tobacco Education Program, “Coalition Membership.” Where There’s Smoke, There’s Funding: - 29 Tobacco Education Program (three members) University of California, Santa Cruz Alcohol and Other Drug Prevention Program Response: Santa Cruz County Board of Supervisors AGREES.
No recommendations for this finding
F9
Some of the recent accomplishments of the Tobacco Education Coalition are: • promoting compliance with smoke-free workplace laws; • working with the Seaside Company to make the Santa Cruz Beach Boardwalk a smoke-free environment; • conducting surveillance of local newspapers for print tobacco advertisements and writing letters, when appropriate, to ask each organization to adopt a smoke-free advertising policy; • conducting media campaigns about smoke-free playgrounds, cigarette sales to minors and other tobacco issues; • supporting Pajaro Valley Prevention and Student Assistance efforts to create 100 percent smoke-free parks in Watsonville via letters to the editor and letters to Watsonville City Council members; • working with local jurisdictions on smoking ordinances; • writing letters to various agencies to discourage acceptance of tobacco industry grant monies; • reducing the number of stores that sell tobacco to minors and providing education materials to discourage self-service tobacco displays. In 2002, the Coalition supported a self-service tobacco display ban that was adopted in the City of Capitola; and • surveying Santa Cruz County bars regarding compliance with smoking ordinances. Response: Santa Cruz County Board of Supervisors AGREES.
Related Recommendations (1)
R1
Santa Cruz County’s Tobacco Education Program is to be commended for its success in reducing tobacco use and lessening exposure to secondhand smoke. Response: Santa Cruz County Board of Supervisors AGREES. The county concurs with the Grand Jury’s commendation.
F10
California’s adult smoking rate dropped to a historic low of 15.4 percent in 2004, compared to 22.8 percent in 1988 (a 32.5 percent decrease) when California voters passed Proposition 99.5 Response: Santa Cruz County Board of Supervisors AGREES.
No recommendations for this finding
F11
Comprehensive local and school-based tobacco education programs have been credited as key factors in statewide smoking reductions.6 5 News Release: “California Smoking Rates Drop 33 Percent Since State’s Anti-Tobacco Program Began,” February 2005, http://www.dhs.ca.gov. News Release: “California Smoking Rates Drop 33 Percent Since State’s Anti-Tobacco Program Began,” February 2005, http://www.dhs.ca.gov. - 30 Where There’s Smoke, There’s Funding: Response: Santa Cruz County Board of Supervisors AGREES.
No recommendations for this finding
F12
From 1994 to 2002, student tobacco use has decreased in Santa Cruz County as illustrated in the following table:7 Percentage of Age Group Stating That They Year Have Used Tobacco 9th Graders 11th Graders 1994 65% 64% 2002 31% 40% Table 2. Percentages of Santa Cruz County 9th and 11th Graders Stating That They Have Used Tobacco. Response: Santa Cruz County Board of Supervisors AGREES.
No recommendations for this finding
F13
Surveys done in 2002 and 2003 show adult smoking rates continue to decrease in Santa Cruz County.8 Do you now smoke cigarettes every day, some days or not at all? Everyday Some Days Not At All 2002 19.5% 6.9% 73.6% 2003 18.9% 6.2% 74.8% Table 3. Adult Cigarette Smoking Rates, Santa Cruz County. Response: Santa Cruz County Board of Supervisors AGREES. CHIP Funds
No recommendations for this finding
F14
In order to receive California Healthcare for the Indigent Program (CHIP) funds from the state, Santa Cruz County must submit an application to the California Department of Health Services and agree to abide by strict state guidelines. Response: Santa Cruz County Board of Supervisors AGREES.
No recommendations for this finding
F15
In 1998-99, Santa Cruz County Health Services Agency received over $1.1 million in Proposition 99 monies that went to CHIP. By 2002-03, that amount had dwindled to $314,111, then dropped to $68,933 in 2003-04. Response: Santa Cruz County Board of Supervisors AGREES. 7Community Assessment Project, Comprehensive Report, 2004, http://www.appliedsurveyresearch.org/products/CAP10_Health.pdf. Community Assessment Project, Comprehensive Report, 2004, http://www.appliedsurveyresearch.org/products/CAP10_Health.pdf. Where There’s Smoke, There’s Funding: - 31
No recommendations for this finding
F16
CHIP funds received by Santa Cruz County from Fiscal Year 2001-02 to Fiscal Year 2003-04 are summarized as follows:9 Fiscal Year Allocation CHIP Account 2001-02 2002-03 2003-04 Total Hospital $363,822 $233,984 $64,500 Total Physician $14,624 0 0 Total Other $56,970 $80,127 $4,433 Total CHIP $435,416 $314,111 $68,933 Table 4. CHIP Allocations for Santa Cruz County for Fiscal Year 2001-02 through Fiscal Year 2003-04. Response: Santa Cruz County Board of Supervisors AGREES.
No recommendations for this finding
F17
For Fiscal Year 2004-05, the CHIP allocation from Proposition 99 for Santa Cruz County was $77,214. These funds were appropriated in April 2005 and were not anticipated in the current year’s budget. Response: Santa Cruz County Board of Supervisors AGREES.
No recommendations for this finding
F18
According to health services personnel, due to the strict, cumbersome and staff- intensive state reporting requirements, receiving a CHIP allocation of less than $35,000 would not be cost effective for the county. Response: Santa Cruz County Board of Supervisors AGREES.
No recommendations for this finding
F19
The State of California deposits money into county revenue accounts and/or trust funds. When claims are made, the money is pulled from the trust fund accounts, goes into the general fund, then is paid out. Charges are made before money comes out of the trust fund. Response: Santa Cruz County Board of Supervisors AGREES.
No recommendations for this finding
F20
The Medi-Cruz Program within the Health Services Agency pays for indigent care, and CHIP money is expended from that division’s budget. The Health Services Agency receives claims from the hospitals and physicians for indigent care. Available CHIP funds are used to help pay the claims until the funds are exhausted. Response: Santa Cruz County Board of Supervisors AGREES. California Healthcare for Indigents Program, CHIP Funding History, provided by Santa Cruz County Health Services Agency, May 4, 2005. - 32 Where There’s Smoke, There’s Funding:
No recommendations for this finding
F21
CHIP funds going to Dominican Santa Cruz Hospital and Watsonville Community Hospital and physicians involve contracts. Some contracts are blended and may contain some Proposition 99 money as well as other funding sources. Response: Santa Cruz County Board of Supervisors AGREES.
No recommendations for this finding
F22
The current budget for the Medi-Cruz program is $4.5 million. Although the current $77,214 CHIP allocation is a small part of that budget, county health officials felt it would still be beneficial to receive the money. Response: Santa Cruz County Board of Supervisors AGREES.
No recommendations for this finding
F23
Despite the continuing decrease in CHIP allocation, Santa Cruz County has used county overmatch and realignment funds to keep the Medi-Cruz program viable. Approximately 8,000 to 9,000 patients annually receive care paid by Medi-Cruz funds. Response: Santa Cruz County Board of Supervisors AGREES. Conclusions
Related Recommendations (1)
R2
Santa Cruz County is to be commended for successfully using Proposition 99 funds for indigent medical care and for its efforts to keep the Medi-Cruz program intact. Response: Santa Cruz County Board of Supervisors AGREES. The county appreciates the Grand Jury’s commendation. Where There’s Smoke, There’s Funding: - 33

Conclusions 4

No Responses Found 2

Government entities assigned to respond to this report. No response documents have been linked in our database.

County Service Area No. 4 (Santa Cruz) Special District
Santa Cruz County County