Agenda

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D. 5

To:	Board of Supervisors
From:	William Walker, M.D., Health Services Director
Date:	November 15, 2016

Contra

Costa

County

Subject:

Consider accepting report and recommendation from Health Service Department on the LAFCO Special Study of Governance Options (Study) for the WCCHD

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 11/15/2016

APPROVED AS RECOMMENDED

OTHER

Clerks Notes:

See Addendum

VOTE OF SUPERVISORS

AYE:

John Gioia, District I Supervisor
Candace Andersen, District II Supervisor
Mary N. Piepho, District III Supervisor
Karen Mitchoff, District IV Supervisor
Federal D. Glover, District V Supervisor

Contact:	William Walker, 925-957-5403
cc:	Tasha Scott Marcy Wilhelm Pat Frost

I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown.
ATTESTED: November 15, 2016
David Twa,

BY:	, Deputy

RECOMMENDATION(S):

Consider accepting a report and recommendation from Health Service Department and providing direction on the LAFCO Special Study of Governance Options (Study), for the West Contra Costa Healthcare District (WCCHD), as recommended by the County Health Services Director, William B. Walker, MD.

FISCAL IMPACT:

No fiscal impact, information report only.

BACKGROUND:

West County Health Care District operated Doctor’s Medical Center (DMC) San Pablo, which suffered long standing fiscal difficulties beginning in the mid 1990’s, and after numerous efforts to save the hospital, closed on April 21, 2015. DMC was the largest of two hospitals in West County, leaving only Kaiser Richmond Medical Center to serve a community of over 250,000. The closure not only eliminated 154 hospital medical surgical beds, 25 emergency department beds and 35 ICU beds, it also impacted the community by reducing the availability of essential outpatient and urgent care medical and surgical services associated with the treatment of cancer, renal disease, diabetes and heart disease.

BACKGROUND: (CONT'D)

In 2016, because the WCCHD no longer operated a hospital, and does not provide any other health-related services, LAFCO undertook a special study to evaluate district dissolution, consolidation or reorganization. The special study evaluated a range of alternatives which might allow the continued use of the ad valorem property tax proceeds for healthcare purposes in West Contra Costa County.

The LAFCO study reiterated that: “Residents of West Contra Costa are faced with numerous challenges in achieving levels of heath care that are more common in other parts of the County. The closure of Doctor’s Medical Center (DMC) eliminated an important community resource.”

On September 14, 2016 the Contra Costa Local Agency Formation Commission (LAFCO) received the Public Review Draft of the “Special Study of Governance Options for the West Contra Costa Healthcare District (WCCHD).” The Commission expressed the desire to preserve existing healthcare funding to meet the needs of West County residents.

Several options were put forth in the report (see attached WCCHD Study Report), along with public comment provided by representatives from West County Health Care District, cities of Richmond and San Pablo, County Health Services, along with the West County Supervisory District I (Supervisor Gioia) who expressed strong support for continuing funding to address the health disparities in West County. Such funding could not be preserved with dissolution of the WCCHD.

On September 27, 2016 LAFCO submitted a letter to County Health Services Director requesting to know which of the options presented in the study County Health Services might be interested in pursuing, along with any preliminary ideas the County may have for providing enhanced health services should the County wish to supersede the WCCHD.

Contra Costa Health Services agrees with sentiments expressed by the Cities of San Pablo and Richmond and Supervisor Gioia that the County Service Area Governance Option: LAFCO Process: Reorganization with Creation of New County Service Area (CSA), would preserve funding of health care services for the residents of West County that they would be interested in. This critical funding should promote and optimize access to all levels including primary care, urgent and emergent care. Please see attached WCCHD Study Report, for more information on this option, as well as the other governance options proposed by the study.

CONSEQUENCE OF NEGATIVE ACTION:

The community of West Contra Costa County known for significant disparities in emergency department beds as compared to Central and West County, would no longer benefit from enhanced healthcare funding to maintain and expand vital healthcare services. Access to health care services including primary care, urgent and emergency care would not be optimized.

CLERK'S ADDENDUM

ACCEPTED the report; EXPRESSED support for preserving the use of revenues for the health care needs in West County; RESERVED final recommendations on the vehicle best suited to achieve that goal until bankruptcy proceedings are completed; and REQUESTED LAFCo to withhold making final determinations at it's December 2016 meeting.