Board of Supervisors Richard Valle President Board of Supervisors November 25, 2020 Honorable Tara Desautels Presiding*

Published: November 25, 2020 10 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 14 findings

20-7 Page 1

The friction between AHS's responsibility for operational control and Alameda County's health service mandate and allegiance to other constituencies continues to frustrate both parties, exacerbate their mutual distrust, and interfere with their ability to communicate and implement long-lasting solutions to AHS's financial crises. Response to

20-8 Page 1

AHS's narrow focus on a balanced operating budget and EBIDA does not adequately represent the actual financial position of AHS. Response to

20-9 Page 1

Even with transparent and efficient management, an average annual EBIDA Margin of 3% to 5% is not sufficient for AHS to pay off its outstanding debt and buffer against any future financial crises. Response to 20-9: The Board of Supervisors wholly disagrees with this finding. The Board of Supervisors has never required that the entire line of credit balance be paid at once. A margin of 3% - 5% EBIDA would allow incremental savings and incremental decrease of the balance consistent with the long range plan of reducing it by 2034. This current approved agreement requires the net Negative Balance maximum to decrease by only $5 million per year.

20-10 Page 1

AHS and Alameda County do not agree on whether AHS can establish a cash reserve to pay prior- year liabilities. The lack of a cash reserve exacerbates the long-term financial stability of AHS and its ability to comply with the Permanent Agreement, leading to further distrust between AHS and Alameda County. [1] ALAMEDA COUNTY RESPONSE TO THE 2019-2020 GRAND JURY FINAL REPORT Response to

20-11 Page 1

AHS does not provide its financial reports to county supervisors and staff sufficiently in advance of regularly scheduled meetings between the parties to allow county supervisors and staff time to familiarize themselves with those reports prior to being presented by AHS. Response to

20-12 Page 1

AHS and Alameda County acknowledge the need for flexibility in the use of Measure A funds to take advantage of matching-fund opportunities. However, they often disagree on how AHS should specifically allocate Measure A funds to support its operations. This disagreement magnifies and exacerbates the distrust between AHS and Alameda County. Response to

20-13 Page 1

Political pressure from some Alameda County supervisors has interfered with AHS operations and efforts to control costs. [2] ALAMEDA COUNTY RESPONSE TO THE 2019-2020 GRAND JURY FINAL REPORT Response to

20-14 Page 1

Negotiating separate contracts with 18 different labor unions is both time consuming and expensive for AHS and limits AHS's negotiating flexibility. AHS's negotiations with labor have been further compromised by public support of negotiating labor unions from some county supervisors. Response to

20-15 Page 1

AHS and Alameda County agree that the governance structure of AHS is problematic and needs to be revisited and strengthened in order for the parties to better understand and respect each other's governance and operational roles. Response to

20-25 Page 1

GSA has a culture of poor communication with its client departments, which contributes to unnecessary delays and increased project costs. Response to

20-26 Page 1

Poorly developed and disseminated Capital Program and procurement procedures result in inconsistent project management within GSA. Response to

20-27 Page 1

GSA's redefinition of professional requirements for project managers and its inability to sufficiently staff project manager positions contribute to poor control over the delivery of capital projects. Response to

20-28 Page 1

GSA's failure to update as-needed professional contracts results in unnecessary bidding, which contributes to unwarranted delays in project delivery. Response to

20-29 Page 1

Alameda County's failure to prioritize long-range planning and site safety assessments has set county government capital construction on a rudderless course oftentimes guided by litigation and emergency needs. Response to

Recommendations 12

20-6
Page 1

If resources prove insufficient to adopt and maintain a balanced AHS budget, AHS and the county must identify and agree on the scope of services and on the least politically damaging way to provide them—by cutting back on services, increasing the county's financial support, or some combination of the two. Both parties then must present a uniform public face in support of that decision. Response to
20-8
Page 1

AHS must, by September 30, 2020 and in consultation with Alameda County supervisors and staff, develop and regularly report a cash flow statement of sufficient scope and detail to provide an early warning system as to the approach of another cash crisis. Response to
20-9
Page 1

Alameda County and AHS must collaboratively resolve how to pay for AHS's long-term debts with the county. Response to
20-10
Page 1

AHS and Alameda County must develop a procedure whereby AHS has the ability to set aside cash to pay prior-year liabilities. Response to
20-12
Page 1

AHS and Alameda County must agree on how AHS allocates its share of Measure A funds as part of its budget. [4] ALAMEDA COUNTY RESPONSE TO THE 2019-2020 GRAND JURY FINAL REPORT Response to
20-13
Page 1

Individual members of the Board of Supervisors must not interfere in the day-to-day operations and management of AHS including labor negotiations and structure of service delivery. Response to
20-22
Page 1

The Alameda County General Services Agency must provide sufficient staff or consultant resources to accomplish its capital program workload efficiently. Response to
20-23
Page 1

The Alameda County General Services Agency must improve communication with clients throughout all stages of a project to build a strong and informed project team. GSA should place staff within client departments as needed during the project planning and design stages. Response to
20-24
Page 1

The Alameda County General Services Agency must establish well-defined policies and procedures to guide staff work and to help clients understand the capital project development and bidding processes. Both existing and new staff and managers must be trained in these procedures. Response to
20-25
Page 1

The Alameda County General Services Agency management must provide staff with work plans to track workload, progress, schedules, budgets to timely project completion. Response to
20-26
Page 1

The Alameda County General Services Agency must establish or renew as-needed professional services contracts to ensure that project managers can quickly access a variety of expert services. Response to
20-27
Page 1

The Alameda County Board of Supervisors and the General Services Agency must complete updates to long-range and master plans, such as the Facilities Condition Assessment and Real Estate Master Plan, to better manage competing capital investment demands for staffing and funds. Response to

* This report's PDF did not contain easily extractable text and required Optical Character Recognition (OCR) for analysis. There may be minor errors in the extracted findings and recommendations due to OCR limitations with scanned documents.