The fiscal impact is described in the Fiscal Year 2009-10 Recommended Budget and attached line-item changes (Attachment B).

On March 17, 2009, the Board opened and conducted concurrent public hearings on the Recommended Budget and the Beilenson Notice. The hearings began with an overview of the recommendations in the FY 2009-10 Budget by the County Administrator. The County Administrator reminded the Board that the bound copy of the budget (available on the internet at www.cccounty.us) contains details on individual department budgets, programs, goals, and recommendations. The overview (also available on the internet) included a review of the Board’s previously provided goals and direction for the budget, an economic outlook – state of the economy nationally and locally, significant impacts expected in 2009, reserve status update, information on where expenditures and revenues occur, continued structural imbalance, other post employment benefit liability, mandatory versus discretionary expenditures, recommended actions required to balance the budget, and additional and future fiscal challenges still facing the Board.  
  
At the conclusion of the County Administrator’s presentation, four department heads were asked to address the Board on issues specific to their departments: Joseph Valentine, Director of Employment and Human Services; Dr. William Walker, Director of Health Services; Warren Rupf, Sheriff-Coroner; and Robert Kochly, District Attorney. The Board then asked for and received public comment.   
  
Taking into consideration the testimony it had received from staff and the public, the Board deliberated regarding the Recommended Budget. The Board discussed the difficult decisions it was facing and the desire to continue to look for solutions. It was noted that, in a previous action, the Board had directed the Finance Committee to pursue the possibility of increasing revenues, including the possibility of pursuing a Utility Users Tax. At the conclusion of the deliberations, the Board continued the public hearings for the limited purposes of receiving additional information on the following subjects: the Cooperative Extension Program, the Arts and Culture Commission, the Library, and the Basic Health Care Program for undocumented adult aliens. The Board directed the County Administrator to return to the Board on March 31, 2009, for a continuation of these hearings and adoption of the FY 2009-10 County and Special District Budgets, as adjusted.  
  
  
Line Item Changes  
  
  
Today’s action is required to align FY 2009-10 appropriations and revenues in the Proposed Budget with the Recommended Budget as adjusted. Attachment B shows line-item changes which align the Recommended Budget with the ‘placeholder’ Proposed Budget adopted on March 17, 2009. At the time of the preparation of the Proposed Budget the Recommended Budget had not yet been completely finalized. The difference between the Proposed and Recommended budget General Fund net County cost is zero; however, there is a total non-General Fund cost difference of $2,272,742. No line-item changes are required to the Proposed County’s Special District budgets.   
  
The following adjustments/follow-up information was requested during the March 17, 2009, hearings:   
  
Arts and Culture Commission of Contra Costa County  
  
  
The Board requested the County Administrator to review the recommended budget for the Arts and Culture Commission of Contra Costa County to determine if approximately $15,000 in funding could be redirected to match funding anticipated to be received from the State of California.  
  
The County Administrator has located the requested amount in its own consultant services allocation by renegotiating two contracts with the County’s State and federal lobbyists. In addition to the $15,000 funding for FY 2009-10, the County will provide the Arts and Culture Commission with office space in a County owned building, at a cost of approximately $15,000 per year.  
  
Cooperative Extension  
  
The County Administrator previously recommended eliminating all funding provided to the Cooperative Extension as it is a totally discretionary program. There are no legal mandates to provide these services and, if provided, there are no requirements regarding the level of services to be provided.  
  
As requested at the Budget Hearing, staff has reviewed what the minimum amount necessary might be to maintain some level of continued funding from the University of California. The County Administrator has reviewed available funding possibilities and is recommending funding the full cost of the office space currently occupied by Cooperative Extension at a cost of approximately $71,000 and the cost of telephones and related telecommunications expenses. This recommendation would require a 2009-2010 fiscal year General Fund allocation of $83,154, but would allow the University to keep a presence in Contra Costa County that might be grown in the future.  
  
Cooperative Extension currently has two full time positions and one part-time position. All of these positions will be included for elimination on the April 7, 2009, layoff resolution. Two of the position reductions will be effective April 30, 2009. To provide for a period of time to smoothly transition workload to University staff, it is recommended that the elimination of the position handling 4-H duties be delayed until June 30, 2009. The County Administrator’s Office and Board members will continue to explore possible outside funding sources for the 4-H program.  
  
District Attorney  
  
An additional $400,000 in appropriations and revenues is being recommended for the District Attorney to allow for the limited prosecution of certain misdemeanors including domestic violence and driving under the influence (DUI), assuming favorable cooperation of the Superior Court. The appropriations are being balanced with an increase of $400,000 in Proposition 172 sales tax revenues within the budget of the District Attorney. Should the economy begin to recover in the next fiscal year, it is anticipated that sales taxes will be one of the first revenues to experience growth. This revenue will be closely monitored, if the growth is not realized other adjustments will be made at mid-year.  
  
Health Services  
  
Basic Health Care Program  
(Eliminate non-emergency medical services to undocumented adult aliens)  
  
During the March 17, 2009, Beilenson Hearing, the Board of Supervisors directed the Health Services Department to return with additional information and possible options for the proposed change to the Basic Health Care Program. The Board directed the Health Services Department and the County Administrator to meet with local Hospitals and Community Clinics to explore options for the provision of medical care services to undocumented adult aliens.  
  
On March 23, 2009, the Health Services Department convened a meeting on Access to Health Care with local representatives of the health care community. A total of approximately 40 individuals attended the two hour facilitated meeting, including representatives of Kaiser Permanente, John Muir Health, Sutter-Delta Medical Center, The Community Clinic Consortium, the Alameda Contra Costa Medical Association, the Public and Environmental Health Advisory Board (PEHAB), and the Contra Costa Interfaith Support Community Organization (CCISCO).  
  
An active discussion took place regarding the services provided, how they are provided and by whom, and possible changes that could be made to the delivery of services. The Health Services Department reiterated that it would continue to provide some health care services – emergency services, services to pregnant women, tuberculosis (TB) and human immunodeficiency virus (HIV) screening and treatment, cervical and breast cancer screening and treatment, advice nurse services, and primary care services for children. A total of sixteen proposals for possible service changes and cost reductions were made by the attendees and briefly discussed. These proposals are being reviewed in depth by the Department’s executive and fiscal staff to determine their feasibility and potential savings to the County.   
  
Both County staff and attendees have committed to continue to meet and discuss these proposals and possible future partnerships. The Contra Costa Interfaith Support Community Organization (CCISCO) is coordinating three town hall meetings in Richmond, Concord and Oakley, which will take place on March 26, 27, and 29, 2009.  
  
A concern was raised at both the Beilenson Hearing on March 17, 2009, and at the Access to Health Care meeting on March 23, 2009, about clinic staff assisting with the Medi-Cal application process. Employment and Human Services Department (EHSD) staff is available to provide technical assistance on the completion of Medi-Cal applications for the Community Clinics' clients and has offered to train the Community Clinics' staff on the completion and submission of the Medi-Cal application. EHSD staff has contacted the Community Clinic Consortium to arrange such staff trainings.  
  
Due to time requirements and the need to obtain additional information and receive feedback from the attendees, additional information and recommendations are not available to include herein. A detailed report and recommendations on the continued provision of health care to undocumented adult aliens under a new model will be provided orally to the Board of Supervisors and to the public at the March 31, 2009, meeting of the Board of Supervisors.  
  
Detention Medical  
  
Pursuant to the Board’s direction on March 17, 2009, Health Services Department staff, in coordination with the Sheriff-Coroner, Human Resources, and the County Administrator, will renew previous efforts to pursue the possibility of providing medical services to inmates of the County's detention facilities through a public-private partnership.  
  
Charity Ordinance  
  
The County Counsel's Office is in the process of drafting an ordinance, in consultation with the Health Services Department, similar to that implemented by the City and County of San Francisco, regarding the transparency of charity medical care provided by non-profit hospitals and clinics in Contra Costa County, for presentation to the Board of Supervisors at a later date.  
  
Library  
  
  
The Recommended Budget included a $538,786 reduction based on closing library facilities a total of 12 furlough days during FY 2009-10. In lieu of closing all Library facilities 12 days during FY 2009-10, the Library is addressing the $538,786 reduction by eliminating nine positions (6.0 FTE) and reducing Temporary Salaries $27,000. The positions include: five Librarians (3.5 FTE); two Library Assistant Journey Level (1.0 FTE); one Clerk Experienced (.5 FTE); and one Library Specialist (1.0 FTE) all of which are vacant. The impact of these position eliminations is currently being evaluated by the Library as part of an ongoing realignment of base service levels. After working with the cities, the Library will provide an update to the Board of Supervisors in April regarding actual library hour reductions.   
  
Questions arose regarding the Adult Literacy Program during Budget Hearings. The Adult Literacy Program proudly assists approximately 150 – 200 adults annually. Each adult is paired with a volunteer tutor. It is intended that this program will remain intact. Administrative costs have been included in the Recommended Budget.   
  
Federal Economic Stimulus Funding  
  
Contra Costa County anticipates receiving funding through the American Recovery and Reinvestment Act of 2009 – the federal economic stimulus package. Departments are in the process of reviewing information to determine what funding may be available and what the funds may be used for. The table below displays current funding estimates and use of the funding. The amounts shown in the table are estimated based on current funding models and may not be the actual amounts received. Departments will return to the Board of Supervisors for approval once amounts are verified and plans for the use of the funds have been developed. It is important to note that this funding is for a three year period only – and is not permanent.  
  

Mr. Twa, County Administrator, presented the staff report. He noted that the anticipated federal stimulus funds for the Vasco Road Overlay Project (page 7) should be corrected to read $10 million. He said the position resolution scheduled to come before the Board on April 7, 2009 in accordance with the recommended budget contains the elimination of 499 positions of which slightly over 200 are funded positions and approximately 120 are filled positions. He added that the hiring freeze will continue.

He said the state had recently concluded that the $10 billion trigger amount of federal stimulus funds it formulated would be necessary to prevent further reductions in funding would not be achieved, resulting in cuts to programs such as SSI and InHome Social Services. He said that, while these reductions did not immediately impact the County, there will be future impacts to the hospital due to the reduction in Medi-Cal reimbursement rates.

Dr. Walker, Health Services Director, said the reduction will amount to approximately $1.5 million and when it goes into effect on July 1, 2009, optional Medi-Cal benefits, including all adult dental care, optometry services, audiology and chiropractic and various other services, will cease to be available throughout the state of California. He said he will return to the Board to propose further reductions and layoffs in the affected clinics.

Dr. Walker noted that the $1 million annually over six years pledged by Chevron would begin to be distributed in a few weeks, but that it will require county funding to get through to next year. He requested the Board consider one-time funding in the amount of $1.5 million from reserves to fund increased access to the community clinics from May 2009 to June 2010, at which time the Chevron monies will be fully implemented.

Chair Bonilla requested that Dr. Walker return to the Board with a written report on how the requested $1.5 million dollars would be utilized.

Chair Bonilla called for public comment. The following people spoke:

On Basic Health Care for immigrants: Father Donald MacKinnon, GRIP; Jeff O.; Janet Marshall Wilson, Mental Health Consumer Concerns, Inc.; Linda Salinas, resident of CCC; Carolina Garcia on behalf of Pablo Cardenas Jr., CCISCO; Teresa Flores, Executive Board member of CCISCO; Andres Soto, Concilio Latino; Antonio Medranos, West County School Board; Lee Lawrence, American Civil Liberties Unio n; Roberto Reyes, Concord Clinic; Tanir Ami, Community Clinic Consortium; Charles Rachis, resident of CCC; Mariana Moore, Contractors’ Alliance of Contra Costa; Valerie Jameson, Macehvalli; Rudeen Monte, Sutter Delta Medical Center; Angel G. Luevano, League of United Latin American Citizens; Argentina Davila-Luevano, League of United Latin American Citizens; Maria Alegria, for Richmond Vision. On the University of California Cooperative Extension (UCCE): Al Courchesne, BALT and Frog Hollow Farm, Agricultural Extension program; Peggy Hauk, Ph.D, UCCE; Steve Nation, UCCE; Janet Caprile, Vice Chair, County Agricultural Task Force; Bethallyn Black, manager of urban horticultural program; Jodi Cassell, UCCE Sea Grant marine advisor; Mark Maggiore, Maggiore and Sons; Robert Whalen, 4-H volunteer; Mary Louise Williams, Master Gardener Program; Harriett Burt, Master Gardner Program; Patrick McKenzie, MidValley Ag Service, Inc.; John Veitch, Contra Costa Farm Bureau; Thomas Brumleve, Cattlemen’s Association; John Viano, resident of CCC.

General: Rollie Katz, Public Employees’ Union Local 1

Written material provided by the following: Robert Whalen: (brochures from UCCE) Robert J. and Jeanne M. Lewis, resident of Moraga (letter) Alice E. Schofield, Master Gardener (letter) Art Hatchett, Co-chair, Richmond Vision (letter) Robert Taylor, Mayor, City of Brentwood (letter) Lee Helena, Mt. Diablo Chapter, American Civil Liberties Union of Northern California (letter); Teresa Flores (copy of letter from Gene Rogers, M.D. dated 3-17-09); Karen Luckhurst, Briones 4H Club (letter) Jeff O.: (comments, list of related information resources, and DVD “Illegal Immigration Crisis-Correlation to Budget Crisis) Fidela Cardenas, comments; Juana Sanches, comments; Isaac Menashe, California Immigrant Policy Center, comments; Maria Diaz, comments; Eneyda Rivera, comments; Blanca Collin, comments.

Chair Bonilla invited Sheriff-Coroner Warren Rupff to comment.

Sheriff Rupf noted that there is little that can be done about declining property values and the resulting loss of revenue to the County, and encouraged the Board to consider all sources of savings and revenue.

Mr. Twa said that in regard to the use of reserves that, in addition to the Board’s policy decision limiting the use of reserves, there is little available and the County Administrator’s Office would not recommend its use.

Supervisor Uilkema said she believes the Board needs to move forward today although she expects to revisit the budget many times in the future due to shifts and refinements in reductions and possible revenues.

Supervisor Piepho requested the support of the Board in amending today’s action to continue funding the Cooperative Extension program through June 30, 2009, to provide the program time to seek alternative funding.

Chair Bonilla said that the budget is an ongoing process. She said that it was important to recognize the there is a crisis in regard to the hospital and clinic system and that it was questionable whether that system was sustainable. She requested direction be added to today’s actions to perform a sustainability audit.