RECOMMENDATION(S): (CONT'D)
5. AUTHORIZE and REQUEST the Auditor-Controller to adjust FY 2015-16 appropriations and revenues by reallocating and balancing budgeted and actual expenditures and revenues as needed for various budget units and special districts, subject to Board approval in September; and
6. AUTHORIZE the Auditor-Controller to make technical adjustments to the FY 2016-17 Recommended Budget when actual amounts are known and return to the Board on September 20 for adoption of the Budget as Finally Determined.
FISCAL IMPACT:
The fiscal impact is described in the Fiscal Year 2016-17 Recommended Budget, which is available on-line at http://www.co.contra-costa.ca.us/DocumentCenter/View/40612.
BACKGROUND:
On April 19, 2016, the Board of Supervisors adopted the County's FY 2016-2017 State Controller's Office Recommended Budget Schedules for Countywide Funds and Special Districts. These schedules meet the requirements of State law. State law requires that local government adopt a FY 2016-2017 Recommended Budget for Countywide funds and Special Districts prior to June 30, 2016 in order to spend monies for the coming fiscal year. State law also requires that the Recommended Budget be adopted prior to holding Budget Hearings. These schedules serve as a placeholder until the Board approves a Final budget. The schedules are in a State-required "line item" format as opposed to the program budget format used by the Board during budget hearings. The schedules incorporated the same total net County cost level as is presented in the County Administrator's Recommended Budget. Adoption of these schedules ensured that your Board met the requirements of State law and in no way constrain your discretion with respect to the FY 2016-17 budget.
After adoption of the State Schedules, the Board of Supervisors opened the public hearing on the FY 2016-17 Recommended Budget. The hearings began with an overview of the recommendations in the FY 2016-17 Budget by the County Administrator. The County Administrator advised the Board that the Recommended Budget and the County Administrator's Budget Message contain details on individual department budgets, programs, goals, and recommendations.
The Budget and message represented a work plan to achieve the County's mission and priorities in the coming year. A number of key issues that have informed the development of the Budget were included in the Budget and presentation, such as property tax projections, employment benefits and retiree health care/other post employment benefits, pension benefits, General Fund reserves, infrastructure/facilities maintenance, the status of Labor Negotiations, and the status of various high-level position recruitments. Following the County Administrator's presentation, the following department heads made presentations: District Attorney, Public Defender, Sheriff-Coroner, County Probation Officer, Health Services Director, and Employment and Human Services Director. At the conclusion of the presentations, the Board 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. At the conclusion of the deliberations, the Board directed the County Administrator to return to the Board on May 10, 2016 for adoption of the FY 2016-17 Recommended Budget.
The Board of Supervisors did not recommend any changes to the Proposed Budget at the Hearings on April 19, 2016. However, there were a number of items that the Supervisors and members of the public commented on during the Hearings. The Board specifically requested follow-up information regarding:
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An official Sheriff response regarding ICE Revenues in the FY 2016/17 Budget (included as Attachment A).
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The savings associated with Proposition 47 reductions in detention (included in Attachment A).
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Upcoming reductions in funding from the First Five Commission and the negative impact the loss of funding would have on the Family Shelters. The Health Services Department concurs with this assessment. The Department is in the process of developing a multi-million dollar proposal for the Whole Person Care (WPC) component of the recently approved Medi-Cal 2020 Waiver. The Shelters are a complementary component of the grant proposal and play a significant role in the overall health of the community. Accordingly, Health Services has identified $250,000 of one time revenue that will fund the Family Shelters and the Homeless Outreach Team. This action will have no impact on County General Purpose revenue. This is one time funding; future funding is contingent on the WPC grant award.
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How we could find out how the State is adjusting to the increased need for State Hospital Mental Health beds. The question was brought up during the Public Defender testimony. The Health Services Department responded that the Felony Incompetent to Stand Trial cases are evaluated by MHM, Services Inc. for placement recommendations, e.g. state hospital beds. The Contra Costa Behavioral Health Division has no responsibility regarding these beds and no ability to increase capacity. The authority for determining Felony State hospital bed availability resides with the California Department of State Hospitals.
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The process for increased billing rates for Early Periodic Screening, Diagnostic, and Treatment (EPSDT). Health Services responded that EPSDT is a Medi-Cal service that is paid based on the County Maximum Allowance (CMA) rates. The CMA establishes the unit price the Behavioral Health Division will pay for services provided by all contracted Community Based Organizations (CBO). The CMA applies to services rendered to the entire client population (Adult and Children's services). No age distinction and no distinction by funding source exist within the CMA. The Behavioral Health Division can increase the CMA rates as service demand and finances allow. The FY 2016/17 Recommended Budget includes a 3% cost-of-living (COLA) adjustment for the CBO's. The CMA rates before and after the COLA are provided in the table below.
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How much EPSDT revenue Mental Health receives. Mental Health has received (or is anticipated to receive) the following EPSDT revenue: FY 2012/13 $36.4 million; FY 2013/14 $42.1 million; FY 2014/15 $45.2 million; FY 2015/16 projected $49.4 million; FY 2016/17 budget $52.3 million.
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If the EPSDT rates are at the maximum we can claim. The CMA rates are established at the maximum amount the Division can afford to fund across all service lines (Adult and Child). The CMA rates are not established by funding source; the Division does not charge or pay for services differently based on the payor (note that this is a consistent practice throughout the Health Services Department). See attached March 16, 2016 letter to the Human Services Alliance further explaining the process (Attachment B).
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Identifying any unspent State budget dollars. The Health Services Department responded that they are unaware of any unspent or available State funding that has not already been included in the Departments 2016/17 Budget Request (inclusive of the EPSDT Realignment allocation).
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IT projects and how they are evaluated for County-wide interoperability. The Department of Information Technology’s latest computer data system projects have included in their design and implementation objectives interoperability with related department data systems. We currently do not, however, have a single data portal to the myriad specialized data systems used throughout County departments. Development of such a data portal would be a new large scale project that would require additional funding and technical expertise, which would need to be quantified by a Request for Proposals (RFP) process. Prior to issuing such an RFP, the County would need to set practical goals for interoperability of projects going forward.
Position Resolution
A position resolution is required to effectuate the position modifications, additions and deletions identified in the Recommended Budget. The resolution is provided to the Board as a companion item (Resolution No. 2016/134) on today's agenda. Resolution No. 2016/134 includes positions in the Risk Management, Clerk-Recorder, County Counsel, District Attorney, Employment and Human Services, Human Resources, Public Defender, Public Works, Sheriff-Coroner, Treasurer-Tax Collector, Veterans' Services, and Contra Costa County Fire Protection District departments. Additional positions in various departments will be held vacant in order to achieve prescribed vacancy factor dollar savings.
CONSEQUENCE OF NEGATIVE ACTION:
Changes to any recommended programs will require an equivalent reduction in funds from other County priorities in order to adhere to the Budget Policy to adopt a balanced budget.
CLERK'S ADDENDUM
Speakers: Leslie Gleason, SHELTER Inc. (handout attached); Dan Geiger, Director Human Services Alliance of Contra Costa; Edith Pastrano, Health4All; Juan Vazavez, Richmond; Emilia Bermudez, resident of Richmond; Isidora Sabaria Ramos, resident of Richmond; Written commentary provided by Peter R. Cotton.
Director of Health Services to meet with the Human Services Alliance of Contra Costa to discuss reimbursements under the EPDST (Early State Periodic Screening, Diagnosis and Treatment Program (Mental Health) ) program.
ADOPTED the recommendations as presented.