Mendocino Coast Health Care District Sick, but Returning to Health

F1

The Mendocino County Civil Grand Jury finds that: The Board struggled with the basics of organizational management and a lack of any significant progress on achieving core district goals for several years. However, the Grand Jury found that beginning in 2024 they turned a corner and improvements are happening quickly. The Board is to be commended for these improvements.

Related Recommendations (1)

R18

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Provide a Municipal Service Review on MCHCD on a priority basis. Complete by December 2024 (F11) RESPONSES Pursuant to California Penal Code §§ 933 and 933.05, the Civil Grand Jury requests each entity or individual named below to respond to the enumerated Findings and Recommendations within specific statutory guidelines. Responses to Findings shall be either: • The respondent agrees with the finding. • The respondent disagrees wholly or partially with the finding, in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons therefore. Responses to Recommendations shall be one of the following: • The recommendation has been implemented, with a summary regarding the implemented action. • The recommendation has not yet been implemented, but will be implemented in the future, with a time frame for implementation. • The recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a time frame for the matter to be prepared for discussion by the officer or head of the agency or department being investigated or reviewed, including the governing body of the public agency where applicable. This time frame shall not exceed six months from the date of the publication of the Civil Grand Jury report. • The recommendation will not be implemented because it is not warranted or is not reasonable, with an explanation therefore. REQUIRED RESPONSES - MCHCD Board of Directors: (F1-F10, F12-F20) and (R1 - R17) Mendocino LAFCo: F11 and R18 Responses are to be sent to: The Honorable Judge Ann Moorman Mendocino County Superior Court 100 North State Street, Dept. E Ukiah CA 95482 21 Office of the County Counsel County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 Mendocino County Civil Grand Jury County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 IMPORTANT NOTE ABOUT CIVIL GRAND JURY

F2

The Mendocino County Civil Grand Jury finds that: All versions of the Bylaws found contained a section that stated, “At least three signed copies of the Bylaws shall be maintained on file in the District office and a current copy maintained on the district website. Each director shall be given a copy of the Board Bylaws and Policy Manual.” It was clear that Directors had neither received the Bylaws nor the Policy Manual.

Related Recommendations (3)

R1

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Update Bylaws, vote for approval and document in minutes, sign, date, and post on the MCHCD website. Distribute to all Board Directors. Complete by: August 31, 2024. (F2, F3, F4)

R3

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Update or create MCHCD Policies, including, but not limited to: IT and Security, Document Retention and Handling, Financial Record Keeping and Reporting, Board Administration, and Comity. Approve, sign, date, post on the website, and distribute to all Board Directors. Complete by: November 30, 2024. (F2, F5)

R18

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Provide a Municipal Service Review on MCHCD on a priority basis. Complete by December 2024 (F11) RESPONSES Pursuant to California Penal Code §§ 933 and 933.05, the Civil Grand Jury requests each entity or individual named below to respond to the enumerated Findings and Recommendations within specific statutory guidelines. Responses to Findings shall be either: • The respondent agrees with the finding. • The respondent disagrees wholly or partially with the finding, in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons therefore. Responses to Recommendations shall be one of the following: • The recommendation has been implemented, with a summary regarding the implemented action. • The recommendation has not yet been implemented, but will be implemented in the future, with a time frame for implementation. • The recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a time frame for the matter to be prepared for discussion by the officer or head of the agency or department being investigated or reviewed, including the governing body of the public agency where applicable. This time frame shall not exceed six months from the date of the publication of the Civil Grand Jury report. • The recommendation will not be implemented because it is not warranted or is not reasonable, with an explanation therefore. REQUIRED RESPONSES - MCHCD Board of Directors: (F1-F10, F12-F20) and (R1 - R17) Mendocino LAFCo: F11 and R18 Responses are to be sent to: The Honorable Judge Ann Moorman Mendocino County Superior Court 100 North State Street, Dept. E Ukiah CA 95482 21 Office of the County Counsel County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 Mendocino County Civil Grand Jury County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 IMPORTANT NOTE ABOUT CIVIL GRAND JURY

F3

The Mendocino County Civil Grand Jury finds that: It is unacceptable that a copy of the Bylaws, properly approved by Board vote, signed and dated by the Secretary, and documented in the minutes, could not be found.

Related Recommendations (2)

R1

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Update Bylaws, vote for approval and document in minutes, sign, date, and post on the MCHCD website. Distribute to all Board Directors. Complete by: August 31, 2024. (F2, F3, F4)

R18

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Provide a Municipal Service Review on MCHCD on a priority basis. Complete by December 2024 (F11) RESPONSES Pursuant to California Penal Code §§ 933 and 933.05, the Civil Grand Jury requests each entity or individual named below to respond to the enumerated Findings and Recommendations within specific statutory guidelines. Responses to Findings shall be either: • The respondent agrees with the finding. • The respondent disagrees wholly or partially with the finding, in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons therefore. Responses to Recommendations shall be one of the following: • The recommendation has been implemented, with a summary regarding the implemented action. • The recommendation has not yet been implemented, but will be implemented in the future, with a time frame for implementation. • The recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a time frame for the matter to be prepared for discussion by the officer or head of the agency or department being investigated or reviewed, including the governing body of the public agency where applicable. This time frame shall not exceed six months from the date of the publication of the Civil Grand Jury report. • The recommendation will not be implemented because it is not warranted or is not reasonable, with an explanation therefore. REQUIRED RESPONSES - MCHCD Board of Directors: (F1-F10, F12-F20) and (R1 - R17) Mendocino LAFCo: F11 and R18 Responses are to be sent to: The Honorable Judge Ann Moorman Mendocino County Superior Court 100 North State Street, Dept. E Ukiah CA 95482 21 Office of the County Counsel County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 Mendocino County Civil Grand Jury County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 IMPORTANT NOTE ABOUT CIVIL GRAND JURY

F4

The Mendocino County Civil Grand Jury finds that: All the versions of the MCHCD Bylaws the Grand Jury viewed contained most of what is needed; however, the Bylaws still need work and do not meet the current role and structure of the District.

Related Recommendations (2)

R1

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Update Bylaws, vote for approval and document in minutes, sign, date, and post on the MCHCD website. Distribute to all Board Directors. Complete by: August 31, 2024. (F2, F3, F4)

R18

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Provide a Municipal Service Review on MCHCD on a priority basis. Complete by December 2024 (F11) RESPONSES Pursuant to California Penal Code §§ 933 and 933.05, the Civil Grand Jury requests each entity or individual named below to respond to the enumerated Findings and Recommendations within specific statutory guidelines. Responses to Findings shall be either: • The respondent agrees with the finding. • The respondent disagrees wholly or partially with the finding, in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons therefore. Responses to Recommendations shall be one of the following: • The recommendation has been implemented, with a summary regarding the implemented action. • The recommendation has not yet been implemented, but will be implemented in the future, with a time frame for implementation. • The recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a time frame for the matter to be prepared for discussion by the officer or head of the agency or department being investigated or reviewed, including the governing body of the public agency where applicable. This time frame shall not exceed six months from the date of the publication of the Civil Grand Jury report. • The recommendation will not be implemented because it is not warranted or is not reasonable, with an explanation therefore. REQUIRED RESPONSES - MCHCD Board of Directors: (F1-F10, F12-F20) and (R1 - R17) Mendocino LAFCo: F11 and R18 Responses are to be sent to: The Honorable Judge Ann Moorman Mendocino County Superior Court 100 North State Street, Dept. E Ukiah CA 95482 21 Office of the County Counsel County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 Mendocino County Civil Grand Jury County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 IMPORTANT NOTE ABOUT CIVIL GRAND JURY

F5

The Mendocino County Civil Grand Jury finds that: Without a usable Policies Manual, significant issues with finances, recordkeeping, comity, etc. hampered the Board from completing their duties to the public.

Related Recommendations (2)

R3

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Update or create MCHCD Policies, including, but not limited to: IT and Security, Document Retention and Handling, Financial Record Keeping and Reporting, Board Administration, and Comity. Approve, sign, date, post on the website, and distribute to all Board Directors. Complete by: November 30, 2024. (F2, F5)

R18

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Provide a Municipal Service Review on MCHCD on a priority basis. Complete by December 2024 (F11) RESPONSES Pursuant to California Penal Code §§ 933 and 933.05, the Civil Grand Jury requests each entity or individual named below to respond to the enumerated Findings and Recommendations within specific statutory guidelines. Responses to Findings shall be either: • The respondent agrees with the finding. • The respondent disagrees wholly or partially with the finding, in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons therefore. Responses to Recommendations shall be one of the following: • The recommendation has been implemented, with a summary regarding the implemented action. • The recommendation has not yet been implemented, but will be implemented in the future, with a time frame for implementation. • The recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a time frame for the matter to be prepared for discussion by the officer or head of the agency or department being investigated or reviewed, including the governing body of the public agency where applicable. This time frame shall not exceed six months from the date of the publication of the Civil Grand Jury report. • The recommendation will not be implemented because it is not warranted or is not reasonable, with an explanation therefore. REQUIRED RESPONSES - MCHCD Board of Directors: (F1-F10, F12-F20) and (R1 - R17) Mendocino LAFCo: F11 and R18 Responses are to be sent to: The Honorable Judge Ann Moorman Mendocino County Superior Court 100 North State Street, Dept. E Ukiah CA 95482 21 Office of the County Counsel County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 Mendocino County Civil Grand Jury County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 IMPORTANT NOTE ABOUT CIVIL GRAND JURY

F6

The Mendocino County Civil Grand Jury finds that: Some agendas and many meeting minutes were missing from the website and Board records. This delayed and could jeopardize the audits and, therefore, the retrofit project.

Related Recommendations (3)

R5

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Complete all tasks needed to enable auditors to complete audits for the last three years (this includes providing all missing minutes and agendas, approved, signed, and posted on the website). Complete by: November 31, 2024. (F6, F7)

R8

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Post minutes and agendas in a timely manner, and adhere to Brown Act requirements regarding agendas, and meetings. Complete by: August 1, 2024. (F6, F10) 19

R18

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Provide a Municipal Service Review on MCHCD on a priority basis. Complete by December 2024 (F11) RESPONSES Pursuant to California Penal Code §§ 933 and 933.05, the Civil Grand Jury requests each entity or individual named below to respond to the enumerated Findings and Recommendations within specific statutory guidelines. Responses to Findings shall be either: • The respondent agrees with the finding. • The respondent disagrees wholly or partially with the finding, in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons therefore. Responses to Recommendations shall be one of the following: • The recommendation has been implemented, with a summary regarding the implemented action. • The recommendation has not yet been implemented, but will be implemented in the future, with a time frame for implementation. • The recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a time frame for the matter to be prepared for discussion by the officer or head of the agency or department being investigated or reviewed, including the governing body of the public agency where applicable. This time frame shall not exceed six months from the date of the publication of the Civil Grand Jury report. • The recommendation will not be implemented because it is not warranted or is not reasonable, with an explanation therefore. REQUIRED RESPONSES - MCHCD Board of Directors: (F1-F10, F12-F20) and (R1 - R17) Mendocino LAFCo: F11 and R18 Responses are to be sent to: The Honorable Judge Ann Moorman Mendocino County Superior Court 100 North State Street, Dept. E Ukiah CA 95482 21 Office of the County Counsel County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 Mendocino County Civil Grand Jury County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 IMPORTANT NOTE ABOUT CIVIL GRAND JURY

F7

The Mendocino County Civil Grand Jury finds that: There were no audits conducted for several years, placing the District in a precarious legal and financial position, and contributing to significant public distrust because of the lack of transparency.

Related Recommendations (2)

R5

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Complete all tasks needed to enable auditors to complete audits for the last three years (this includes providing all missing minutes and agendas, approved, signed, and posted on the website). Complete by: November 31, 2024. (F6, F7)

R18

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Provide a Municipal Service Review on MCHCD on a priority basis. Complete by December 2024 (F11) RESPONSES Pursuant to California Penal Code §§ 933 and 933.05, the Civil Grand Jury requests each entity or individual named below to respond to the enumerated Findings and Recommendations within specific statutory guidelines. Responses to Findings shall be either: • The respondent agrees with the finding. • The respondent disagrees wholly or partially with the finding, in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons therefore. Responses to Recommendations shall be one of the following: • The recommendation has been implemented, with a summary regarding the implemented action. • The recommendation has not yet been implemented, but will be implemented in the future, with a time frame for implementation. • The recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a time frame for the matter to be prepared for discussion by the officer or head of the agency or department being investigated or reviewed, including the governing body of the public agency where applicable. This time frame shall not exceed six months from the date of the publication of the Civil Grand Jury report. • The recommendation will not be implemented because it is not warranted or is not reasonable, with an explanation therefore. REQUIRED RESPONSES - MCHCD Board of Directors: (F1-F10, F12-F20) and (R1 - R17) Mendocino LAFCo: F11 and R18 Responses are to be sent to: The Honorable Judge Ann Moorman Mendocino County Superior Court 100 North State Street, Dept. E Ukiah CA 95482 21 Office of the County Counsel County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 Mendocino County Civil Grand Jury County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 IMPORTANT NOTE ABOUT CIVIL GRAND JURY

F8

The Mendocino County Civil Grand Jury finds that: There are several versions of the Mission Statement on the website and in Board documentation. It’s not clear what the current approved Mission and Vision statements are, and none of them properly reflect the MCHCDs current role, hindering its ability to function cohesively.

Related Recommendations (2)

R4

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Agree and vote upon the mission statement of MCHCD. Post it on the website and include it in the MCHCD Bylaws and in the Policies Manual. Complete by: October 31, 2024. (F8, F9)

R18

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Provide a Municipal Service Review on MCHCD on a priority basis. Complete by December 2024 (F11) RESPONSES Pursuant to California Penal Code §§ 933 and 933.05, the Civil Grand Jury requests each entity or individual named below to respond to the enumerated Findings and Recommendations within specific statutory guidelines. Responses to Findings shall be either: • The respondent agrees with the finding. • The respondent disagrees wholly or partially with the finding, in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons therefore. Responses to Recommendations shall be one of the following: • The recommendation has been implemented, with a summary regarding the implemented action. • The recommendation has not yet been implemented, but will be implemented in the future, with a time frame for implementation. • The recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a time frame for the matter to be prepared for discussion by the officer or head of the agency or department being investigated or reviewed, including the governing body of the public agency where applicable. This time frame shall not exceed six months from the date of the publication of the Civil Grand Jury report. • The recommendation will not be implemented because it is not warranted or is not reasonable, with an explanation therefore. REQUIRED RESPONSES - MCHCD Board of Directors: (F1-F10, F12-F20) and (R1 - R17) Mendocino LAFCo: F11 and R18 Responses are to be sent to: The Honorable Judge Ann Moorman Mendocino County Superior Court 100 North State Street, Dept. E Ukiah CA 95482 21 Office of the County Counsel County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 Mendocino County Civil Grand Jury County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 IMPORTANT NOTE ABOUT CIVIL GRAND JURY

F9

The Mendocino County Civil Grand Jury finds that: The Board has done little to educate and inform the public about the Board’s new role and mission since the affiliation with Adventist Health, causing confusion and contributing to mistrust in the public.

Related Recommendations (3)

R4

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Agree and vote upon the mission statement of MCHCD. Post it on the website and include it in the MCHCD Bylaws and in the Policies Manual. Complete by: October 31, 2024. (F8, F9)

R6

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Complete an educational campaign for the public to help them understand the Mission and scope of authority of MCHCD. Complete by: December 31, 2024. (F9)

R18

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Provide a Municipal Service Review on MCHCD on a priority basis. Complete by December 2024 (F11) RESPONSES Pursuant to California Penal Code §§ 933 and 933.05, the Civil Grand Jury requests each entity or individual named below to respond to the enumerated Findings and Recommendations within specific statutory guidelines. Responses to Findings shall be either: • The respondent agrees with the finding. • The respondent disagrees wholly or partially with the finding, in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons therefore. Responses to Recommendations shall be one of the following: • The recommendation has been implemented, with a summary regarding the implemented action. • The recommendation has not yet been implemented, but will be implemented in the future, with a time frame for implementation. • The recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a time frame for the matter to be prepared for discussion by the officer or head of the agency or department being investigated or reviewed, including the governing body of the public agency where applicable. This time frame shall not exceed six months from the date of the publication of the Civil Grand Jury report. • The recommendation will not be implemented because it is not warranted or is not reasonable, with an explanation therefore. REQUIRED RESPONSES - MCHCD Board of Directors: (F1-F10, F12-F20) and (R1 - R17) Mendocino LAFCo: F11 and R18 Responses are to be sent to: The Honorable Judge Ann Moorman Mendocino County Superior Court 100 North State Street, Dept. E Ukiah CA 95482 21 Office of the County Counsel County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 Mendocino County Civil Grand Jury County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 IMPORTANT NOTE ABOUT CIVIL GRAND JURY

F10

The Mendocino County Civil Grand Jury finds that: Violations of Brown Act: Meeting agendas did not have an appropriate level of detail and attachments were missing. There were also concerns by the public that serial meetings between 17 some of the Board members were happening. There has been a clear effort by the Board in 2024 to address these issues and they are to be commended.

Related Recommendations (2)

R8

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Post minutes and agendas in a timely manner, and adhere to Brown Act requirements regarding agendas, and meetings. Complete by: August 1, 2024. (F6, F10) 19

R18

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Provide a Municipal Service Review on MCHCD on a priority basis. Complete by December 2024 (F11) RESPONSES Pursuant to California Penal Code §§ 933 and 933.05, the Civil Grand Jury requests each entity or individual named below to respond to the enumerated Findings and Recommendations within specific statutory guidelines. Responses to Findings shall be either: • The respondent agrees with the finding. • The respondent disagrees wholly or partially with the finding, in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons therefore. Responses to Recommendations shall be one of the following: • The recommendation has been implemented, with a summary regarding the implemented action. • The recommendation has not yet been implemented, but will be implemented in the future, with a time frame for implementation. • The recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a time frame for the matter to be prepared for discussion by the officer or head of the agency or department being investigated or reviewed, including the governing body of the public agency where applicable. This time frame shall not exceed six months from the date of the publication of the Civil Grand Jury report. • The recommendation will not be implemented because it is not warranted or is not reasonable, with an explanation therefore. REQUIRED RESPONSES - MCHCD Board of Directors: (F1-F10, F12-F20) and (R1 - R17) Mendocino LAFCo: F11 and R18 Responses are to be sent to: The Honorable Judge Ann Moorman Mendocino County Superior Court 100 North State Street, Dept. E Ukiah CA 95482 21 Office of the County Counsel County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 Mendocino County Civil Grand Jury County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 IMPORTANT NOTE ABOUT CIVIL GRAND JURY

F11

The Mendocino County Civil Grand Jury finds that: The reinvention of MCHCD, post affiliation, and the significant and public financial and administrative issues with the District, along with the fact that an MSR has not been completed in 10 years, should have initiated a LAFCo MSR.

Related Recommendations (1)

R18

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Provide a Municipal Service Review on MCHCD on a priority basis. Complete by December 2024 (F11) RESPONSES Pursuant to California Penal Code §§ 933 and 933.05, the Civil Grand Jury requests each entity or individual named below to respond to the enumerated Findings and Recommendations within specific statutory guidelines. Responses to Findings shall be either: • The respondent agrees with the finding. • The respondent disagrees wholly or partially with the finding, in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons therefore. Responses to Recommendations shall be one of the following: • The recommendation has been implemented, with a summary regarding the implemented action. • The recommendation has not yet been implemented, but will be implemented in the future, with a time frame for implementation. • The recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a time frame for the matter to be prepared for discussion by the officer or head of the agency or department being investigated or reviewed, including the governing body of the public agency where applicable. This time frame shall not exceed six months from the date of the publication of the Civil Grand Jury report. • The recommendation will not be implemented because it is not warranted or is not reasonable, with an explanation therefore. REQUIRED RESPONSES - MCHCD Board of Directors: (F1-F10, F12-F20) and (R1 - R17) Mendocino LAFCo: F11 and R18 Responses are to be sent to: The Honorable Judge Ann Moorman Mendocino County Superior Court 100 North State Street, Dept. E Ukiah CA 95482 21 Office of the County Counsel County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 Mendocino County Civil Grand Jury County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 IMPORTANT NOTE ABOUT CIVIL GRAND JURY

F12

The Mendocino County Civil Grand Jury finds that: After two years of struggling to complete the volume of work required of them, the present Board voted 4-1 to hire or contract with an agency administrator (general manager), and contracted with a financial expert as a temporary CFO. This staff support has made clear improvements in progress toward the district goals.

Related Recommendations (2)

R9

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Provide adequate professional staffing (i.e., a full-time general manager, and part time admin and finance support) to support the Board. This could be accomplished using a consultant model, hiring support staff, or some combination of the two. Complete by: December 31, 2024. (F12)

R18

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Provide a Municipal Service Review on MCHCD on a priority basis. Complete by December 2024 (F11) RESPONSES Pursuant to California Penal Code §§ 933 and 933.05, the Civil Grand Jury requests each entity or individual named below to respond to the enumerated Findings and Recommendations within specific statutory guidelines. Responses to Findings shall be either: • The respondent agrees with the finding. • The respondent disagrees wholly or partially with the finding, in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons therefore. Responses to Recommendations shall be one of the following: • The recommendation has been implemented, with a summary regarding the implemented action. • The recommendation has not yet been implemented, but will be implemented in the future, with a time frame for implementation. • The recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a time frame for the matter to be prepared for discussion by the officer or head of the agency or department being investigated or reviewed, including the governing body of the public agency where applicable. This time frame shall not exceed six months from the date of the publication of the Civil Grand Jury report. • The recommendation will not be implemented because it is not warranted or is not reasonable, with an explanation therefore. REQUIRED RESPONSES - MCHCD Board of Directors: (F1-F10, F12-F20) and (R1 - R17) Mendocino LAFCo: F11 and R18 Responses are to be sent to: The Honorable Judge Ann Moorman Mendocino County Superior Court 100 North State Street, Dept. E Ukiah CA 95482 21 Office of the County Counsel County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 Mendocino County Civil Grand Jury County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 IMPORTANT NOTE ABOUT CIVIL GRAND JURY

F13

The Mendocino County Civil Grand Jury finds that: The budgets have no written guidelines that could be shared with the Grand Jury and there was a lack of clarity about use of funds.

Related Recommendations (2)

R12

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Define and vote on the guidelines for using funds from all budgets. Complete by: December 31, 2024. (F13)

R18

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Provide a Municipal Service Review on MCHCD on a priority basis. Complete by December 2024 (F11) RESPONSES Pursuant to California Penal Code §§ 933 and 933.05, the Civil Grand Jury requests each entity or individual named below to respond to the enumerated Findings and Recommendations within specific statutory guidelines. Responses to Findings shall be either: • The respondent agrees with the finding. • The respondent disagrees wholly or partially with the finding, in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons therefore. Responses to Recommendations shall be one of the following: • The recommendation has been implemented, with a summary regarding the implemented action. • The recommendation has not yet been implemented, but will be implemented in the future, with a time frame for implementation. • The recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a time frame for the matter to be prepared for discussion by the officer or head of the agency or department being investigated or reviewed, including the governing body of the public agency where applicable. This time frame shall not exceed six months from the date of the publication of the Civil Grand Jury report. • The recommendation will not be implemented because it is not warranted or is not reasonable, with an explanation therefore. REQUIRED RESPONSES - MCHCD Board of Directors: (F1-F10, F12-F20) and (R1 - R17) Mendocino LAFCo: F11 and R18 Responses are to be sent to: The Honorable Judge Ann Moorman Mendocino County Superior Court 100 North State Street, Dept. E Ukiah CA 95482 21 Office of the County Counsel County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 Mendocino County Civil Grand Jury County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 IMPORTANT NOTE ABOUT CIVIL GRAND JURY

F14

The Mendocino County Civil Grand Jury finds that: The Board has not proactively reached out to the general public in an open forum for their input and discussion regarding the public needs, the future of healthcare at the coast, or the role of the MCHCD.

Related Recommendations (3)

R7

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Initiate community outreach as outlined in Discussion to gain insight into public priorities and needs. Initiate by: December 31, 2024. (F14)

R13

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Create a public advisory committee of 10-20 members of the public as described in the Discussion section. Complete by: December 31, 2024. (F14)

R18

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Provide a Municipal Service Review on MCHCD on a priority basis. Complete by December 2024 (F11) RESPONSES Pursuant to California Penal Code §§ 933 and 933.05, the Civil Grand Jury requests each entity or individual named below to respond to the enumerated Findings and Recommendations within specific statutory guidelines. Responses to Findings shall be either: • The respondent agrees with the finding. • The respondent disagrees wholly or partially with the finding, in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons therefore. Responses to Recommendations shall be one of the following: • The recommendation has been implemented, with a summary regarding the implemented action. • The recommendation has not yet been implemented, but will be implemented in the future, with a time frame for implementation. • The recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a time frame for the matter to be prepared for discussion by the officer or head of the agency or department being investigated or reviewed, including the governing body of the public agency where applicable. This time frame shall not exceed six months from the date of the publication of the Civil Grand Jury report. • The recommendation will not be implemented because it is not warranted or is not reasonable, with an explanation therefore. REQUIRED RESPONSES - MCHCD Board of Directors: (F1-F10, F12-F20) and (R1 - R17) Mendocino LAFCo: F11 and R18 Responses are to be sent to: The Honorable Judge Ann Moorman Mendocino County Superior Court 100 North State Street, Dept. E Ukiah CA 95482 21 Office of the County Counsel County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 Mendocino County Civil Grand Jury County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 IMPORTANT NOTE ABOUT CIVIL GRAND JURY

F15

The Mendocino County Civil Grand Jury finds that: The Board has struggled to create from scratch what has already been successfully implemented in other health care districts.

Related Recommendations (2)

R14

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Review other health care district’s websites and open dialogue with other health care district boards and the CSDA regarding ideas for policies, bylaws, and best practices. Complete by: May 1, 2025. (F15)

R18

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Provide a Municipal Service Review on MCHCD on a priority basis. Complete by December 2024 (F11) RESPONSES Pursuant to California Penal Code §§ 933 and 933.05, the Civil Grand Jury requests each entity or individual named below to respond to the enumerated Findings and Recommendations within specific statutory guidelines. Responses to Findings shall be either: • The respondent agrees with the finding. • The respondent disagrees wholly or partially with the finding, in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons therefore. Responses to Recommendations shall be one of the following: • The recommendation has been implemented, with a summary regarding the implemented action. • The recommendation has not yet been implemented, but will be implemented in the future, with a time frame for implementation. • The recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a time frame for the matter to be prepared for discussion by the officer or head of the agency or department being investigated or reviewed, including the governing body of the public agency where applicable. This time frame shall not exceed six months from the date of the publication of the Civil Grand Jury report. • The recommendation will not be implemented because it is not warranted or is not reasonable, with an explanation therefore. REQUIRED RESPONSES - MCHCD Board of Directors: (F1-F10, F12-F20) and (R1 - R17) Mendocino LAFCo: F11 and R18 Responses are to be sent to: The Honorable Judge Ann Moorman Mendocino County Superior Court 100 North State Street, Dept. E Ukiah CA 95482 21 Office of the County Counsel County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 Mendocino County Civil Grand Jury County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 IMPORTANT NOTE ABOUT CIVIL GRAND JURY

F16

The Mendocino County Civil Grand Jury finds that: It is unacceptable that there is no Bylaws or Policy requirement to take AB1234 Brown Act and Ethics training, or official record that all Board directors had taken the required AB1234 training.

Related Recommendations (2)

R2

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Include in MCHCD Bylaws or Policies a requirement that all Board members take a Brown Act and Ethics training that meets AB1234 requirements upon taking office, and post verification of completion on the website. Complete by: August 31, 2024. (F16)

R18

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Provide a Municipal Service Review on MCHCD on a priority basis. Complete by December 2024 (F11) RESPONSES Pursuant to California Penal Code §§ 933 and 933.05, the Civil Grand Jury requests each entity or individual named below to respond to the enumerated Findings and Recommendations within specific statutory guidelines. Responses to Findings shall be either: • The respondent agrees with the finding. • The respondent disagrees wholly or partially with the finding, in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons therefore. Responses to Recommendations shall be one of the following: • The recommendation has been implemented, with a summary regarding the implemented action. • The recommendation has not yet been implemented, but will be implemented in the future, with a time frame for implementation. • The recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a time frame for the matter to be prepared for discussion by the officer or head of the agency or department being investigated or reviewed, including the governing body of the public agency where applicable. This time frame shall not exceed six months from the date of the publication of the Civil Grand Jury report. • The recommendation will not be implemented because it is not warranted or is not reasonable, with an explanation therefore. REQUIRED RESPONSES - MCHCD Board of Directors: (F1-F10, F12-F20) and (R1 - R17) Mendocino LAFCo: F11 and R18 Responses are to be sent to: The Honorable Judge Ann Moorman Mendocino County Superior Court 100 North State Street, Dept. E Ukiah CA 95482 21 Office of the County Counsel County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 Mendocino County Civil Grand Jury County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 IMPORTANT NOTE ABOUT CIVIL GRAND JURY

F17

The Mendocino County Civil Grand Jury finds that: The public has continually expressed concerns with transparency and with the financial management capabilities of the Board.

Related Recommendations (2)

R10

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Take advantage of CSDA certification programs: (F17) A. Get CSDA Transparency Certificate of Excellence, and a District of Distinction Accreditation. Complete by: April 1, 2025. B. Encourage at least one member of the Board annually to get a Certificate of Special District Governance to serve as a resource for the Board. Complete by: Ongoing. C. If a permanent General Manager (Director) is hired, encourage them to get a Special District Essential Leadership Skills Certificate. Complete by: Ongoing.

R18

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Provide a Municipal Service Review on MCHCD on a priority basis. Complete by December 2024 (F11) RESPONSES Pursuant to California Penal Code §§ 933 and 933.05, the Civil Grand Jury requests each entity or individual named below to respond to the enumerated Findings and Recommendations within specific statutory guidelines. Responses to Findings shall be either: • The respondent agrees with the finding. • The respondent disagrees wholly or partially with the finding, in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons therefore. Responses to Recommendations shall be one of the following: • The recommendation has been implemented, with a summary regarding the implemented action. • The recommendation has not yet been implemented, but will be implemented in the future, with a time frame for implementation. • The recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a time frame for the matter to be prepared for discussion by the officer or head of the agency or department being investigated or reviewed, including the governing body of the public agency where applicable. This time frame shall not exceed six months from the date of the publication of the Civil Grand Jury report. • The recommendation will not be implemented because it is not warranted or is not reasonable, with an explanation therefore. REQUIRED RESPONSES - MCHCD Board of Directors: (F1-F10, F12-F20) and (R1 - R17) Mendocino LAFCo: F11 and R18 Responses are to be sent to: The Honorable Judge Ann Moorman Mendocino County Superior Court 100 North State Street, Dept. E Ukiah CA 95482 21 Office of the County Counsel County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 Mendocino County Civil Grand Jury County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 IMPORTANT NOTE ABOUT CIVIL GRAND JURY

F18

The Mendocino County Civil Grand Jury finds that: Incoming Board members are not expected to have the knowledge necessary to run a health care district, but little training or support is provided to bring them up to speed.

Related Recommendations (3)

R11

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Gather and provide training options to new Board members upon election or appointment, as outlined in Discussion. Complete by: Ongoing (F18)

R17

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Develop an onboarding process and manual that outlines the expectations of Board members (roles and responsibilities), requirements (such as Brown Act and Ethics), and resources available (such as training). Complete by: April 30, 2025. (F18) 20 The Grand Jury recommends that Mendocino LAFCo:

R18

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Provide a Municipal Service Review on MCHCD on a priority basis. Complete by December 2024 (F11) RESPONSES Pursuant to California Penal Code §§ 933 and 933.05, the Civil Grand Jury requests each entity or individual named below to respond to the enumerated Findings and Recommendations within specific statutory guidelines. Responses to Findings shall be either: • The respondent agrees with the finding. • The respondent disagrees wholly or partially with the finding, in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons therefore. Responses to Recommendations shall be one of the following: • The recommendation has been implemented, with a summary regarding the implemented action. • The recommendation has not yet been implemented, but will be implemented in the future, with a time frame for implementation. • The recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a time frame for the matter to be prepared for discussion by the officer or head of the agency or department being investigated or reviewed, including the governing body of the public agency where applicable. This time frame shall not exceed six months from the date of the publication of the Civil Grand Jury report. • The recommendation will not be implemented because it is not warranted or is not reasonable, with an explanation therefore. REQUIRED RESPONSES - MCHCD Board of Directors: (F1-F10, F12-F20) and (R1 - R17) Mendocino LAFCo: F11 and R18 Responses are to be sent to: The Honorable Judge Ann Moorman Mendocino County Superior Court 100 North State Street, Dept. E Ukiah CA 95482 21 Office of the County Counsel County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 Mendocino County Civil Grand Jury County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 IMPORTANT NOTE ABOUT CIVIL GRAND JURY

F19

While due focus has been given to the retrofit, the Board does not have a comprehensive facilities plan and therefore have been more reactive than proactive in their maintenance responsibilities as a landlord.

Related Recommendations (2)

R15

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Clarify and develop the facilities plan before lease negotiations begin later this year. Complete by: before signing of new lease (F19)

R18

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Provide a Municipal Service Review on MCHCD on a priority basis. Complete by December 2024 (F11) RESPONSES Pursuant to California Penal Code §§ 933 and 933.05, the Civil Grand Jury requests each entity or individual named below to respond to the enumerated Findings and Recommendations within specific statutory guidelines. Responses to Findings shall be either: • The respondent agrees with the finding. • The respondent disagrees wholly or partially with the finding, in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons therefore. Responses to Recommendations shall be one of the following: • The recommendation has been implemented, with a summary regarding the implemented action. • The recommendation has not yet been implemented, but will be implemented in the future, with a time frame for implementation. • The recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a time frame for the matter to be prepared for discussion by the officer or head of the agency or department being investigated or reviewed, including the governing body of the public agency where applicable. This time frame shall not exceed six months from the date of the publication of the Civil Grand Jury report. • The recommendation will not be implemented because it is not warranted or is not reasonable, with an explanation therefore. REQUIRED RESPONSES - MCHCD Board of Directors: (F1-F10, F12-F20) and (R1 - R17) Mendocino LAFCo: F11 and R18 Responses are to be sent to: The Honorable Judge Ann Moorman Mendocino County Superior Court 100 North State Street, Dept. E Ukiah CA 95482 21 Office of the County Counsel County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 Mendocino County Civil Grand Jury County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 IMPORTANT NOTE ABOUT CIVIL GRAND JURY

F20

The lack of a five-year strategic plan has contributed to public confusion regarding the role and mission of the MCHCD, and the lack of a clearly outlined future path has prevented the public from having faith that the Board is leading the district in the right direction. 18

Related Recommendations (2)

R16

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Develop a five-year MCHCD Strategic Plan. Complete by: April 30, 2025. (F20)

R18

The Mendocino County Civil Grand Jury recommends that the MCHCD Board: Provide a Municipal Service Review on MCHCD on a priority basis. Complete by December 2024 (F11) RESPONSES Pursuant to California Penal Code §§ 933 and 933.05, the Civil Grand Jury requests each entity or individual named below to respond to the enumerated Findings and Recommendations within specific statutory guidelines. Responses to Findings shall be either: • The respondent agrees with the finding. • The respondent disagrees wholly or partially with the finding, in which case the response shall specify the portion of the finding that is disputed and shall include an explanation of the reasons therefore. Responses to Recommendations shall be one of the following: • The recommendation has been implemented, with a summary regarding the implemented action. • The recommendation has not yet been implemented, but will be implemented in the future, with a time frame for implementation. • The recommendation requires further analysis, with an explanation and the scope and parameters of an analysis or study, and a time frame for the matter to be prepared for discussion by the officer or head of the agency or department being investigated or reviewed, including the governing body of the public agency where applicable. This time frame shall not exceed six months from the date of the publication of the Civil Grand Jury report. • The recommendation will not be implemented because it is not warranted or is not reasonable, with an explanation therefore. REQUIRED RESPONSES - MCHCD Board of Directors: (F1-F10, F12-F20) and (R1 - R17) Mendocino LAFCo: F11 and R18 Responses are to be sent to: The Honorable Judge Ann Moorman Mendocino County Superior Court 100 North State Street, Dept. E Ukiah CA 95482 21 Office of the County Counsel County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 Mendocino County Civil Grand Jury County of Mendocino 501 Low Gap Road, Room 1030 Ukiah CA 95482 IMPORTANT NOTE ABOUT CIVIL GRAND JURY

Mendocino Coast Health Care District Sick, but Returning to Health

Findings and Recommendations 20 findings

No Responses Found 1