Score: +2 (2/7/0)

Contra Costa County Grand Jury • 2017-2018

Contact: Mario Gutierrez Foreperson

Published: April 25, 2018 13 pages

View Original PDF

⚠️ Translation Notice: This content has been automatically translated. The original English text is the official version. Translation may contain errors.

⚠️ Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.

Findings and Recommendations 6 findings

LMCHD website lacked data addressing the public health needs of the community or measurable outcomes of the grant programs targeting the population served.

No recommendations for this finding

LMCHD used obsolete data rather than the current health needs assessments to prioritize grants.

No recommendations for this finding

The Grand Jury found no evidence LMCHD collaborated with the County, non- profit hospitals, or other local districts to avoid duplication of services.

Related Recommendations (1)

LAFCO should consider dissolving the LMCHD by December 2018 and assigning all the assets, rights, and responsibilities to the County as the successor to LMCHD.

LMCHD’s level of administrative costs is high compared to other government agencies that fund grants.

Related Recommendations (1)

LAFCO should consider dissolving the LMCHD by December 2018 and assigning all the assets, rights, and responsibilities to the County as the successor to LMCHD.

As the County already has a grant administration program in place, and has some of the same grantees as the District, there is potential for administrative cost savings through elimination of redundancies.

Related Recommendations (1)

LAFCO should consider dissolving the LMCHD by December 2018 and assigning all the assets, rights, and responsibilities to the County as the successor to LMCHD.

LMCHD did not maximize cash assets as large balances were left in non-interest bearing account.

No recommendations for this finding

Additional Recommendations 2

These recommendations are not explicitly linked to specific findings.

R2

The Board of Supervisors should consider maintaining grant funding levels for healthcare programs upon dissolution of LMCHD.
R3

The Board of Supervisors should consider using any savings from LMCHD dissolution to improve and expand healthcare programs once appointed as the successor to LMCHD.

Conclusions 2

CL1 Page 10

To shift the current healthcare landscape in the community and offer more preventative healthcare services, dissolution of the LMCHD is recommended. Any cost savings can be directed toward enhancing current healthcare preventive services provided by the grantees, and exploring new programs and possible creation of an urgent care facility.
CL2 Page 11

The community agrees and the Grand Jury’s research validates the need for improvement of health services and urgent care in the area. The County health system may be in the best position to offer those services at a lower cost.

Agency Responses 3

Government agencies' official responses to this report's findings and recommendations. Click on a response to see the structured breakdown.

Board of Supervisors

July 05, 2018 • 2 pages • 9 responses • Score: +1 (+1, 2, 0) View Details ▾

PDF

9 responses to findings and recommendations

LMCHD website lacked data addressing the public health needs of the community or measurable outcomes of the grant programs targeting the population served.

Response: Unknown Score: 0

LAFCO should consider dissolving the LMCHD by December 2018 and assigning all the assets, rights, and responsibilities to the County as the successor to LMCHD.

Response: Unknown

Score: 0

LMCHD used obsolete data rather than the current health needs assessments to prioritize grants.

Response: Unknown Score: 0

This recommendation has been implemented. As discussed above, the County has adopted proposed terms and conditions that it will be asking LAFCO to impose on the County as successor to the District, including a condition requiring development of a grant program to be administered for the benefit of the community within the District boundaries. In addition, the County is requesting a condition that the County form an advisory body composed of community members and healthcare professionals tasked with carrying out the grant program outlined above. Specifically, the County is requesting the follow...

The Board of Supervisors should consider maintaining grant funding levels for healthcare programs upon dissolution of LMCHD.

Response: Implemented

Score: 0

The recommendation has been implemented. County Resolution No. 2018/218, in part, requests the Local Agency Formation Commission (LAFCO) to impose certain terms and conditions (Attachment B to Resolution No. 2018/218) on the County, as successor to the Los Medanos Community Healthcare District (the District), should LAFCO approve the application for dissolution of the District as proposed. Specifically, the County is recommending that LAFCO impose the following condition upon the County as successor to the District: "Grant Program. From and after the Effective Date, the County shall develop an...

The Grand Jury found no evidence LMCHD collaborated with the County, non- profit hospitals, or other local districts to avoid duplication of services.

Response: Unknown Score: 0

The Board of Supervisors should consider using any savings from LMCHD dissolution to improve and expand healthcare programs once appointed as the successor to LMCHD.

Response: Implemented

Score: 0

LMCHD’s level of administrative costs is high compared to other government agencies that fund grants.

Response: Unknown Score: 0

Response: Agree Score: +1

Agree. RECOMMENDATIONS - California Penal Code Section 933.05(b) requires a response to the designated recommendations of the Grand Jury. R2. The Board of Supervisors should consider maintaining grant funding levels for healthcare programs upon dissolution of LMCHD. Response: The recommendation has been implemented. County Resolution No. 2018/218, in part, requests the Local Agency Formation Commission (LAFCO) to impose certain terms and conditions (Attachment B to Resolution No. 2018/218) on the County, as successor to the Los Medanos Community Healthcare District (the District), should LAFCO...

LMCHD did not maximize cash assets as large balances were left in non-interest bearing account.

Response: Unknown Score: 0

Contra Costa Local Agency Formation Commission

July 11, 2018 • 4 pages • 6 responses • Score: +1 (+1, 5, 0) View Details ▾

PDF

6 responses to findings and recommendations

LMCHD website lacked data addressing the public health needs of the community or measurable outcomes of the grant programs targeting the population served.

Response: Disagree Partially Score: 0

The respondent partially disagrees with the finding. The LMCHD website includes the District's 2017 Health Profile, 2017-2022 Strategic Plan and Strategic Goals that address community needs and utilize data contained in various health needs assessments, most of which are recent. The District's Strategic Plan identifies health disparities within the District. The Strategic Plan also contains an "LMCHD Health Profile (2017)" and performance measurement tools. The District's 2017 Health Profile references recent Community Health Needs Assessments (CHNAs). As noted in the 2017-18 LAFCO MSR, the Di...

LAFCO should consider dissolving the LMCHD by December 2018 and assigning all the assets, rights, and responsibilities to the County as the successor to LMCHD.

Response: Requires Analysis

Score: 0

The recommendation requires further analysis. In November 2017, the County submitted an application to LAFCO to dissolve the LMCHD. Presently, the application is incomplete. The County Board of Supervisors is expected to take action in July to complete the application. Once LAFCO has a complete application, the matter will be scheduled for a public hearing before the Commission, at which time the Commission will review the County's proposal, conduct a public hearing and render a decision on the proposed dissolution. Should you have questions or need additional information, please contact us.

LMCHD used obsolete data rather than the current health needs assessments to prioritize grants.

Response: Disagree Partially Score: 0

The respondent partially disagrees with the finding. In developing its 2017 Strategic Plan and the "LMCHD Health Profile", the District relied on various data sources including several CHNAs such as those prepared by Sutter Delta Medical Center (2016), Kaiser Foundation Hospital Antioch (2016), Contra Costa Behavioral Health (2016), and Contra Costa Health Services (2010), along with data from the American Community Survey, U.S. Census Bureau and various other sources. The LMCHD Strategic Plan was developed to address health needs within the District and to reduce existing health disparities. ...

The Grand Jury found no evidence LMCHD collaborated with the County, non- profit hospitals, or other local districts to avoid duplication of services.

Response: Disagree Partially Score: 0

The respondent partially disagrees with the finding. As noted in the LAFCO MSR, LMCHD participated in the Healthy and Livable Pittsburg Collaborative which also includes the County, City of Pittsburg and other entities. In 2013, the County Health Services Department produced a report describing health issues related to obesity in the Antioch, Bay Point and Pittsburg areas. The report provided an impetus for the formation of the Healthy and Livable Pittsburg Collaborative which includes the LMCHD as a member. The Collaborative produced a Community Action Plan that includes, as described by the ...

LMCHD’s level of administrative costs is high compared to other government agencies that fund grants.

Response: Disagree Partially Score: 0

The respondent partially disagrees with the finding. As presented in its FY 2018-19 budget, the District's administrative costs have been reduced to 25%, which is significantly lower than prior year costs, and is now in line with other healthcare districts (HCDs). The 2017-18 LAFCO MSR noted that there is no absolute standard for establishing overhead factors due to differences among agencies' budgets and operations. The MSR included the following comparisons: Concord Pleasant Hill HCD administrative costs were at 20%, Peninsula HCD's overhead was approximately 23% of its expenditures for heal...

Response: Agree Score: +1

Agree One of the factors LAFCO considers in its review of local agencies is "opportunities for shared facilities." LAFCO encourages agency collaboration and sharing of facilities and resources. RECOMMENDATIONS R1. LAFCO should consider dissolving the LMCHD by December 2018 and assigning all the assets, rights, and responsibilities to the County as the successor to LMCHD. Response: The recommendation requires further analysis. In November 2017, the County submitted an application to LAFCO to dissolve the LMCHD. Presently, the application is incomplete. The County Board of Supervisors is expect...

Los Medanos Community Healthcare District

∼ June 30, 2018 View Details ▾

PDF