Score: +6
(7/2/1)
Stanislaus County Grand Jury
• 2003-2004
Reason for Investigation To examine the preparation, approval and monitoring of agreements that Stanislaus County
⚠️ 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 9 findings
F1
The County approved an agreement with DMC entitled the Omnibus Agreement concurrently with four subordinate agreements. Two of the subordinate agreements, the Facility Lease Agreement and the Facility All Risk Management Agreement, provide for the continuation of mental health services at SBHC. The term of all agreements is twenty years, commencing in 1997.
No recommendations for this finding
F2
SBHC is an inpatient mental health facility operated by BHRS, and is owned in fee title by Stanislaus County.
No recommendations for this finding
F3
The Facility Lease Agreement provides that all buildings, grounds, equipment and other improvements at SBHC are leased to DMC for lease consideration of $35,583.00 per month.
No recommendations for this finding
F4
The Facility All Risk Management Agreement provides that DMC will contract the operation of SBHC back to the County, and that in consideration of that contractual arrangement, the County will assume all financial responsibilities of the operation, including lease payments. The County has also indemnified and held harmless DMC from all tort liability. The sole remaining responsibility of DMC is the control of the manner in which medical services are provided at SBHC.
No recommendations for this finding
F5
All of the agreements were prepared by private attorneys retained by the County who consulted with DMC attorneys in the preparation of the agreements. County Counsel did not participate in the preparation of the agreements.
No recommendations for this finding
F6
Key County officials, who were intimately involved in the negotiations leading to the approval of the agreements, have left County service. Those key personnel include the former Chief Executive Officer, the former Director of the Health Services Agency (HSA) and the former Director of the Behavioral Health and Recovery Services.
No recommendations for this finding
F7
Prior to the review of the agreements by the Civil Grand Jury, no one in the Office of County Counsel had reviewed the various agreements with DMC.
Related Recommendations (5)
R1
Initiate periodic reviews of the agreements with DMC to include staff from HSA, BHRS, the CEO’s office, County Counsel and Risk Management to monitor the performance of the agreements and the parties to the agreements. Utilize the reviews to identify areas of concern, or potential problems that may affect the continued delivery of services, levels of service or costs.
R2
Utilize the first staff review as an opportunity for County Counsel to conduct training on the terms and conditions of the agreements. 22
R3
Ensure that all agreements presented for consideration of the Board of Supervisors have been thoroughly reviewed by County Counsel.
R4
Require that County Counsel be signatory to every agreement approved by the Board of Supervisors, and that each such agreement shall be inscribed to signify “approval as to form” by County Counsel.
R5
At least annually, prepare a report to the Board of Supervisors summarizing the
F8
BHRS personnel did not have knowledge of the language in the Facilities Lease Agreement, or the contents of the Facility All Risk Management Agreement CONCLUSIONS
Related Recommendations (3)
R1
Initiate periodic reviews of the agreements with DMC to include staff from HSA, BHRS, the CEO’s office, County Counsel and Risk Management to monitor the performance of the agreements and the parties to the agreements. Utilize the reviews to identify areas of concern, or potential problems that may affect the continued delivery of services, levels of service or costs.
R2
Utilize the first staff review as an opportunity for County Counsel to conduct training on the terms and conditions of the agreements. 22
R5
At least annually, prepare a report to the Board of Supervisors summarizing the
F9
All agreements for services should be thoroughly reviewed by the Office of County Counsel before they are submitted to the Board of Supervisors for action. Further, each agreement should be executed by County Counsel to signify “approval as to form”, whether or not the agreements are prepared by County Counsel or contracted legal counsel.
No recommendations for this finding
Conclusions 9
-
CL1 Page 3All agreements for services should be thoroughly reviewed by the Office of County Counsel before they are submitted to the Board of Supervisors for action. Further, each agreement should be executed by County Counsel to signify “approval as to form”, whether or not the agreements are prepared by County Counsel or contracted legal counsel.
-
CL2 Page 2The Omnibus Agreement and its subordinate agreements are complex. They have effectively created a process that permits the County to continue to receive reimbursement from Medicare and Medi-Cal for mental health services rendered to County residents. In that regard, the agreements are beneficial to the County and its residents. 21
-
CL3 Page 3There has been a loss of knowledge relative to the terms of the various agreements that occurred with the departure of the key personnel referenced above. Persons presently occupying those positions do not possess full knowledge and understanding of the agreements.
-
CL4 Page 3After the completion of the work by private counsel, the Board of Supervisors was left with no legal staff who had participated in the construction of the agreements.
-
CL5 Page 3There is a need for training on the agreements given the fact that many of the management personnel in the affected agencies did not occupy those positions when the County entered into the agreements with DMC.
-
CL6 Page 2The Omnibus Agreement and its subordinate agreements as they apply collectively to HSA and BHRS represent one of the largest contracts for services that Stanislaus has ever entered into, in terms of the financial resources involved. Therefore, it is troubling that so little effort has been made by anyone outside of HSA and BHRS to familiarize themselves with the agreements, or to monitor the performance of the agreements.
-
CL7 Page 3The County should not be in a position of having to rely on an agency with which it has contracted for explanations and interpretations of the agreements.
-
CL8 Page 3The County is placed at risk of financial loss any time that it enters into agreements that are not thoroughly understood by management personnel.
-
CL9 Page 3When management personnel do not thoroughly understand agreements, it is impossible for them to monitor the performance of the contracting parties relative to the terms of the agreements.
Agency Responses 2
Government agencies' official responses to this report's findings and recommendations. Click on a response to see the structured breakdown.
No Responses Found 2
Government entities assigned to respond to this report. No response documents have been linked in our database.
County of Stanislaus
Agency
Stanislaus County Board of Supervisors
Elected County Office