Response Review Report

Recommendations 3

• R1

  Page 22
  This year’s Grand Jury reaffirms last year’s Grand Jury recommendation that Aid to Fire, as it is currently structured, continues to be a tax distribution and fairness issue. This requires a majority of property owners in the County to pay for their own fire districts operations, and support through the General Fund, fire services in eight other fire districts in the County. We recommend that the Board of Supervisors cancel the Aid to Fire contract with the fire districts, and distribute the trust fund monies for Fiscal Year 2009-2010 consistent with current contract funding agreements. The Grand Jury recognizes the Board of Supervisors may have made this decision during budget negotiations as this Grand Jury report is being prepared. If not, we recommend this contract be cancelled for next fiscal year 2010-2011.
• R2

  Page 22
  The Grand Jury recommends that the Board of Supervisors authorize an outside qualified consulting firm to analyze, evaluate, and make recommendations relative to the structure of our County fire service operations. This analysis should include mutual aid agreements, emergency medical services, and the ability of fire departments to operate without Aid to Fire funding. All fire district concerns should be brought out in the open for discussion and resolution as part of the analysis.
• R3

  Page 22
  We recommend that the cost of this independent analysis be paid by the current Aid to Fire funding. Based on interviews by the Grand Jury with two independent fire consulting firms we believe this analysis could be accomplished for an investment of under $100,000, which is only 7.7% of the current Aid to Fire funding. Not performing an independent analysis keeps the status quo and perpetuates the same problem of tax fairness and distribution. NOTE: It should be noted that the Board of Supervisors – as this report was going to press – at their June 2, 2009 meeting, addressed this Aid to Fire issue, and did, in fact, make the very changes recommended in this report. Below is that segment to those minutes from the June 2nd meeting. We applaud the BOS for their actions. “Chief Administrative Office recommending the Board discuss Supplemental Funding to Fire Districts (Aid to Fire) and take the following actions: 1) Adopt Resolution 111-2009 terminating Supplemental Funding for Fire Districts, making findings to support that termination, and providing for an additional appropriation of $335,537 in Fiscal Year 2009-2010; 2) Authorize staff to work with Local Agency Formation Commission (LAFCO) to initiate a request for qualifications for a Fire Service Consultant and prepare a Memorandum of Understanding with LAFCO for the administration of a Fire Service Consultant Agreement; and 37 3) Bring Fire Service Consultant findings and recommendations back to the Board prior to the Fiscal Year 2010/2011 budget. FUNDING: General Fund A motion was made by Supervisor Santiago, seconded by Supervisor Knight, as follows: 1) Adopt Resolution 111-2009; 2) Authorize staff to work with Local Agency Formation Commission (LAFCO0; And 4) Bring the draft findings and recommendations from the Fire Service Consultant back to the Board on or before January 26, 1020. Yes: 4 - Knight, Sweeney, Briggs and Santiago Noes: 1 Nutting” Grand Jury Report 07-030 Use of County Vehicles – County (CAO Office) Response The 2007- 2008 Grand Jury reported eight Findings and four Recommendations. The County responses met the requirements of the penal code. The Grand Jury recognizes the work of the CAO’s office following Board Policy #D4 to review permanent assignment and overnight retention of vehicles on an annual basis to continue or rescind authorization. The recent annual review has reduced the number of take home vehicles by County employees and cost savings will follow. Grand Jury Report 07-06 Audit of Human Services and Mental Health Medi-Cal Revenue Department Responses The 2007-2008 Grand Jury commissioned a respected and experienced firm, Harvey M. Rose Associates, LLC, to conduct an audit of our County Human Services and Mental Health Departments. This action was prompted by prior Grand Juries’ investigations that had identified problems in the proper management of Medi-Cal billing practices. The purpose of the audit was to determine how much loss in State reimbursement was occurring based on those departments’ operations. The audit did in fact show some serious process deficiencies, and the projected substantial dollar losses to the County were realized. The responses from the Board of Supervisors (BOS), presumably using input from the Mental Health and Human Services Departments, attacked the credibility and methods of the audit. The head of the Mental Health Department at that time publicly (at an open BOS meeting) denounced the audit findings, and indicated that all was well in his department. The BOS response focused on statistical methods and techniques, and virtually ignored the key findings and 38 recommendations of the audit and subsequent Grand Jury report. It should be noted that when the responses to that audit from the BOS were approved and given to the Grand Jury on September 30, 2008, the BOS had already approved the transfer of $3,319,000 from the County General Fund to cover the Mental Health Department’s 2007-2008 fiscal budget shortfall due to uncollected Medi-Cal payments. Time has certainly exonerated the damaged credibility of that audit. As indicated above, at the end of last fiscal year (2007-2008), the Mental Health Department needed over $3,000,000 to supplement its budget shortfall due to uncollected revenues from the State. Much of that shortfall can never be collected, as strict time rules exist between the State and Counties to recover past submission errors. And, per the County Auditor-Controller, it appears that the negative budget balance in the Mental Health Department will occur again this fiscal year (2008- 2009). In October of 2008 the Board of Supervisors changed the management of the Mental Health Department placing that department under the umbrella of the County Department of Public Health. This Grand Jury has met with members of the Public Health Department management team as well as our County Auditor/Controller to review the status of those fiscal problems. The Mental Health Department, under this new management, has recognized and embraced these problems, analyzed where the problems are, and, we believe, is taking steps to solve them. The Mental Health Department (under the supervision of the Public Health Department) has indicated that they are taking the following actions: • An electronic “bridge” is being placed between the two electronic systems designed to bill the State in a proper and timely manner • Payroll has been consolidated into one operation • The contract process has been consolidated • The purchasing function has been consolidated • There is an ongoing attempt to change the culture in order to place the proper priority on the billing and reimbursement process According to the new management team at Public Health, the statewide average disallowance rate (non-reimbursed funds) is approximately 7%. The County is now running at 10%, which is down from 16% last year. This marked improvement in the disallowance rate still has much room to improve. The Mental Health Department will still require County “bailout” funds to balance the Mental Health Department budget this year. According to our County Auditor/Controller, at least 2.5 million dollars of General Fund money will again be needed this fiscal year (2008-2009) to cover the budget shortfall of the Mental Health Department.