June 6, 2005
NOTICE
OF PUBLIC HEARING
The
Board of Supervisors of the County of Contra Costa will conduct a PUBLIC HEARING
pursuant to Health and Safety Code Section 1442.5, on the elimination of and/or
reductions in the level of medical services provided by the County, and/or the
closing of County health facilities.
The hearing will be held at the following time and
place:
Tuesday,
June 21, 2005, at 1:00 p.m.
Board
of Supervisors Chambers
Room
107, County Administration Building
651
Pine Street
Martinez,
CA 94553
At
the hearing, the Contra Costa County Board of Supervisors will consider the
impact on the health care needs of the County’s indigents of the implementation
of the changes set forth in the attached notice.
The
Board does not consider all of the program changes in the attached notice to be
within the required coverage of Health and Safety Code Section 1442.5. Its scheduling of this Hearing, giving
this Notice of Public Hearing, the holding of a Hearing, and the making of any
findings, shall not be construed as an admission by the County of Contra Costa,
or the Board of Supervisors, that any of the actions included in the attached
notice are subject to the hearing provisions of Health and Safety Code
Section 1442.5.
BEILENSON
NOTICE
FISCAL
YEAR 2005/06
1. REDUCE PUBLIC HEALTH OUTREACH AND
EDUCATION COLLABORATION (PHOEC)
PROGRAM
(Item #10
on HSD Program Reduction List)
PHOEC
staff work with high-risk communities and key Health Services programs to
improve patient access to health services and build community skills to utilize
county health services and address community health
problems.
Site:
Countywide
Nature
of change:
Reduce
community improvement and health care access outreach
services
Staff
reductions:
0.4
FTE Community Health Worker
II
Patient
services affected:
Approximately
500 community residents will receive less community building assistance in
addressing community health problems
Expected
annual savings:
$52,000
2. REDUCE CALIFORNIA CHILDREN’S SERVICES
(CCS) PROGRAM
(Item # 11 on the HSD Program Reduction list)
Occupational
and physical therapists in the CCS program provide occupational and physical
therapy services to children with physical disabilities who qualify for this
program.
Site:
Castro
Medical Therapy Unit
1435
Lawrence St.
El
Cerrito
Nature
of change:
Eliminate
30 hours of Occupational and physical therapy treatment at the Castro Medical
Therapy Unit.
Staff
reductions:
0.5
FTE Occupational Therapist I
0.15
FTE Occupational Therapist
II
0.5
FTE Physical Therapist
I
1.0
FTE Occupational Therapist II
Patient
services affected:
Currently,
the Castro Medical Therapy Unit sees an average of 100 children per week. It will be necessary to establish a
waiting list for services, should the remaining staff be unable to treat all the
children who need therapy services.
Expected
annual savings:
$74,000
3. CANCEL NON-EMERGENCY TRANSPORTATION
CONTRACTS
(Item #14 on the HSD Program Reduction List)
The
Health Services Department contracts with West Contra Costa Transit Authority,
Eastern Contra Costa Transit Authority dba Tri-Delta Transit, Concord Yellow Cab
Inc., Medic-Mobile, Inc., and Bay Medic Transportation for non-emergency
transportation services (taxicab, ambulance transport, and public
transportation). These
non-emergency transportation services are used to help patients access medical
care at the hospital and health centers and return home.
Sites:
Contra
Costa Regional Medical Center
Brentwood
Health Center
Antioch
Health Center
Pittsburg
Health Center
Bay
Point Health Center
Concord
Health Center
Martinez
Health Center
North
Richmond Health Center
Richmond
Health Center
Nature
of change:
Cancel
the non-emergency transportation contracts with West Contra Costa Transit
Authority, Eastern Contra Costa Transit Authority dba Tri-Delta Transit, Concord
Yellow Cab Inc., Medic-Mobile, Inc., and Bay Medic
Transportation.
Staff
reduction:
None
Patient
services affected:
It
may be more difficult for some patients to access medical care and return
home.
Expected
annual savings:
$175,000
4. REDUCE TEENAGE PROGRAM
(TAP)
(# 19 on HSD Program Reduction List)
TAP
staff provide health education presentations in high schools focusing on
responsible decision making, substance abuse prevention, tobacco use prevention,
reproductive health, drinking/driving risks, and communication skills. TAP provides mentoring to high school
students in health and legal fields.
TAP has a Junior Health Facilitator Program that provides intensive job
training and economic development skills to high school
youth.
Site:
Countywide
Nature
of change:
Reduce
the number of health presentations at high schools. Eliminate the Mentor Program and the
Junior Health Facilitator Program.
Staff
reductions:
4
FTE Student
workers
3
FTE Administrative
Interns
Patient
services affected:
Presentations
to approximately 9,000 high school students will be eliminated. Mentoring services on health issues to
approximately 75 high school students will be eliminated. The Junior Health Facilitator Program
will be eliminated.
Expected
annual savings:
$240,000
5. REDUCE PUBLIC HEALTH CLINIC
SERVICES
(Item #20 on HSD Program Reduction List)
The
Health Services Department operates mini-Family Planning Clinics for low income,
underserved, medically vulnerable women and teenagers in order to provide access
to medical care. Patients are given
information on birth control and disease prevention. Services are provided to young women on
the prevention of unwanted pregnancies and other female health
issues.
A.
PITTSBURG HEALTH CENTER
Site:
Pittsburg
Health Center
2311
Loveridge Road
Pittsburg
Nature
of change:
Eliminate
Pittsburg mini-Family Planning Clinics on Mondays, Tuesdays, Wednesdays,
Thursdays, and Fridays, 9am - noon.
Staff
reduction:
0.4
FTE RN
0.4
FTE Clerk Experienced
level
Patient
services affected:
Birth
control information and disease prevention information will not be provided to
approximately 800 women and teenagers.
Expected
annual savings:
$50,201
B.
RICHMOND HEALTH CENTER
Site:
Richmond
Health Center
38th
and Bissell
Richmond
Nature
of change:
Eliminate
Richmond mini-Family Planning Clinics on Mondays, Tuesdays, Wednesdays, and
Fridays, 9am - noon.
Staff
reduction:
0.4
FTE RN
0.4
FTE Clerk Experienced
level
Patient
services affected:
Birth
control information and disease prevention information will not be provided to
approximately 800 women and teenagers.
Expected
annual savings:
$50,201
C. BAY
POINT HEALTH CENTER
Site:
Bay
Point Health Center
215
Pacifica Ave
Bay
Point
Nature
of change:
Eliminate
Bay Point mini-Family Planning Clinics on Wednesdays, 9am -
noon.
Staff
reduction:
0.1
FTE RN
0.1
FTE Clerk Experienced
level
Patient
services affected:
Birth
control information and disease prevention information will not be provided to
approximately 200 women and teenagers.
Expected
annual savings:
$12,702
D.
BRENTWOOD HEALTH CENTER
Site:
Brentwood
Nature
of change:
Eliminate
Brentwood mini-Family Planning Clinics on Tuesdays, 9am -
noon.
Staff
reduction:
0.1
FTE RN
0.1
FTE Clerk Experienced
level
Patient
services affected:
Birth
control information and disease prevention information will not be provided to
approximately 200 women and teenagers.
Expected
annual savings:
$12,702
Total
$125,806
6. REDUCE CHILDREN’S ORAL HEALTH
PROGRAM
(Item # 21 on HSD Program Reduction List)
The
Children’s Oral Health Program currently provides dental prevention and
educational services to approximately 20,000 children, and dental screening
services to approximately 16,000 children, annually, in pre-schools and
elementary schools. Most of the
services are provided to low income children who may have no other source of
dental care.
Site:
Countywide
Nature
of change:
Reduce
staff in the Children’s Oral Health program, which will reduce the number of
dental screenings and dental referrals.
Staff
reduction:
1.0
FTE Sr. Public Health Dental
Assistant
1.0
FTE Sr. Health Education Specialist
– Project
Patient
services affected:
Eliminate
9,000 annual dental screenings.
Eliminate dental health education sessions to 10,000 children,
annually.
Expected
annual savings:
$164,000
7. REDUCE CHILD HEALTH AND DISABILITY
PREVENTION (CHDP) PROGRAM
(Item #22 on HSD Program Reduction List)
The
CHDP Program provides outreach services and assistance to families with children
who do not have medical insurance
or a health care source in order to obtain access to health care for their
children. CHDP also provides
education on health care and resources.
Many of these families are mono-lingual Spanish
speaking.
Site:
Countywide
Nature
of change:
Reduce
assistance to low income families in obtaining necessary health care for their
children. Eliminate Spanish
language interpreters who assist with health care access for mono-lingual
Spanish speaking families.
Staff
reduction:
4.0
FTE Community Health Worker
I
1.0
FTE Clerk Experienced
level
Patient
services affected:
Approximately
600 children who do not have medical care resources will lose assistance in
enrolling in health care insurance coverage and receiving linkage to health care
providers. Health care assistance
for children in non-English speaking families will be limited and the wait time
for this assistance will increase.
Expected
annual savings:
$200,000
8. REDUCE TUBERCULOSIS (TB) CONTROL
PROGRAM
(Item #26 on HSD Program Reduction List)
The
Tuberculosis (TB) Control Program provides TB case management to persons with
active tuberculosis, including home testing and treatment of TB contact, and
daily monitoring of persons taking their TB medications.
Site:
All
services in the cities of Richmond, El Cerrito, San Pablo, Pinole, and
Hercules.
Nature
of change:
Eliminate
one public health nurse. Reduce
monitoring of patients with tuberculosis.
Staff
reduction:
1.0
FTE Public Health
Nurse
1.0
FTE Sr. Disease Intervention
Technician
Patient
services affected:
Approximately
134 people who are at highest risk for tuberculosis will not be provided
education, testing, or preventive TB treatment by a Public Health Nurse. Approximately 110 patients with TB
infection will not receive directly observed therapy, monitoring assurance, or
educational services.
Expected
annual savings:
$248,801
9. REDUCE IMMUNIZATON PROGRAM
OVERSIGHT
( Item #27 on HSD Program Reduction List)
The
Immunization Program provides technical assistance to childcare centers and
schools on immunization requirements for children, technical assistance to
public and private medical providers, outreach to under-immunized populations,
and educational campaigns to promote immunizations for children and
adults.
Site:
Countywide
Nature
of change:
Eliminate
education and technical assistance to schools and childcare providers. Reduce outreach services, technical
assistance, and immunization education/promotion to childcare providers. Reduce outreach services to
under-immunized populations.
Potential overall reduction in immunization rates for children in Contra
Costa County.
Staff
reduction:
1.0
FTE Public Health Nurse
Program Manager
Patient
services affected:
Approximately
10,000 children will not have their immunization records reviewed, with follow
up outreach on needed immunizations.
Approximately 150 physicians will not receive immunization education and
expert consultation on vaccine preventable diseases.
Expected
annual savings:
$152,659
10. INCREASE FEES FOR IMMUNIZATION
CLINICS
(Item #28 on HSD)
Immunization
clinics provide childhood immunizations to children throughout the county for
school and day care entry and to travelers needing immunizations to enter
foreign countries. Many children
who do not have health care coverage and children whose health care providers do
not stock vaccines receive services at these clinics.
Site:
Concord (Stanwell Clinic)
2355
Stanwell Circle
Concord
Nature
of change:
Increase
fees to cover the costs of administering and consulting on vaccines for
travelers and of administering immunizations to children.
Staff
reduction:
None
Patient
services affected:
Families
will pay higher fees for vaccine administration for their children and travelers
will pay higher fees for needed vaccines and a fee for vaccine
consultations.
Expected
annual savings:
$100,000
11. REDUCE MEDICALLY VULNERABLE INFANT
PROGRAM (MVIP)
(Item #29 on HSD Program Reduction List)
Pediatric
nurses of MVIP provide long-term home visiting and infant health monitoring and
care coordination to infants throughout the County. These infants have been cared for in
neonatal intensive care units after birth and are at highest risk for
developmental and neurological disabilities. MVIP also provides parenting and bonding
education to parents of these special needs children.
Site:
Countywide
Nature
of change:
Eliminate
one public health nurse.
Staff
reduction:
1.0
FTE Public Health
Nurse
Patient
services affected:
Approximately
50 special needs infants will not receive health monitoring and care
coordination. Approximately 50
families with special needs children will not receive parenting/bonding
educational services.
Expected
annual savings:
$100,000
12. REDUCE MEDICALLY VULNERABLE INFANT
PROGRAM (MVIP)
(#31 on HSD Program Reduction List)
Pediatric
nurses of MVIP provide long-term home visiting and infant health monitoring and
care coordination to infants throughout the County. These infants have been cared for in
neonatal intensive care units after birth and are at highest risk for
developmental and neurological disabilities. MVIP also provides parenting and bonding
education to parents of these special needs children.
Site:
Countywide
Nature
of change:
Eliminate
the full time equivalent of 2.8 Public Health Nurses.
Staff
reduction:
2.8
FTE Public Health
Nurse
Patient
services affected:
Approximately
150 special needs infants will not receive health monitoring and care
coordination. Approximately 150
families with special needs children will not receive parenting/bonding
educational services. The
elimination of these Public Health Nurses will result in a dramatic reduction in
health care monitoring and care coordination for high risk infants and a
correspondingly dramatic reduction in parenting/bonding educational services to
families with special needs children.
As a practical matter, this reduction, if implemented, will result in the
closure of MVIP and the loss of $250,000 in state matching
funds.
Expected
annual savings
$162,000
13. REDUCE CHILD HEALTH AND DISABILITY
PREVENTION (CHDP) PROGRAM
(Item #32 on HSD Program Reduction List)
CHDP
provides outreach services and assistance to families with children who do not
have medical insurance or a health
care source, in order to obtain access to health care for their children. CHDP also provides education on health
care and resources. Many of these
families are mono-lingual Spanish speaking.
Site:
Countywide
Nature
of change:
Reduce
assistance to low income families in obtaining necessary health care. Eliminate Spanish language interpreters
who assist with health care access for mono-lingual Spanish speaking
families.
Staff
reduction:
3.0 FTE Community Health Worker
I
Patient
services affected:
Approximately
400 families with children who do not have medical care resources will lose
assistance in enrolling their children in health care insurance coverage and
receiving linkage to health care providers. Approximately 400 non-English speaking
families will lose health care assistance for their
children.
Expected
annual savings:
$86,000
14. REDUCE PUBLIC HEALTH CLINIC
SERVICES
(#34 on HSD Program Reduction List)
Public
Health Clinic Services staff provide language translation for non-English
speaking patients in the pediatric clinic and the women’s health clinics. In addition, these staff provide
education and clerical support in the pediatric clinic, the women’s health
clinics, the sexually transmitted disease(STD) clinics, and the mini-Family
Planning Clinics. RN staff are used
to provide patient education on pregnancy prevention, disease prevention, and
family planning methods.
Site:
Brentwood
Health Center
Bay
Point Health Center
Pittsburg
Health Center
Concord
Health Center
Richmond
Health Center
Nature
of change:
Reduce
language translation services.
Staff
reduction:
3.0
FTE Community Health
Worker
0.5
FTE RN
1.0 Clerk (contract)
Patient
services affected:
Appointments
for approximately 400 patients needing translation services will be
delayed. Provider assistance in
obtaining medical information from non-English speaking patients will be reduced
and/or delayed.
Expected
annual savings:
$280,519
15. REDUCE LIMITED ENGLISH ACCESS PROGRAM
(LEAP)
(# 36 on HSD Program Reduction List)
LEAP
staff provide translations, health education, and outreach services to
newly-arrived refugees and immigrants, and others with limited English skills,
to insure needed health care access and coordination. Staff work in clinics at CCRMC, Public Health, and in the
community.
Site:
Countywide
Contra
Costa Regional Medical Center
Martinez
Health Center
Pittsburg
Health Center
Richmond
Health Center
Concord
Health Center
Nature
of change:
Reduce
translation services in clinics and reduce outreach and coordination of care to
persons who speak Laotian, Khmu, Vietnamese, Mien, and
Spanish.
Staff
reductions:
3.0
FTE Community Health Worker
II
Patient
services affected:
There
will be a decrease in the ability to provide timely health services to
approximately 300 non-English speaking people. Approximately 300 non-English
speaking patients will not receive outreach and client navigation services. Appointment times for patients with
translation needs will be delayed in the health centers.
Expected
annual savings:
$200,000
16. LOWER ELIGIBILITY INCOME CEILING FOR
BASIC HEALTH CARE (BHC) PROGRAM
(Item #38 on the HSD Program Reduction List)
The
County’s indigent health care program is called the Basic Health Care (BHC)
Program. The eligibility standards
for the BHC Program currently provide that residents of Contra Costa County
whose income is less than 300% of the Federal Poverty Guidelines may be eligible
for the BHC Program, so long as they meet all other eligibility
requirements.
Site:
Countywide
Nature
of change:
The
income ceiling for the BHC Program will be reduced from 300% of the Federal
Poverty Guidelines to 200% of the Federal Poverty
Guidelines.
Staff
reduction:
None
Patient
services affected:
Approximately
1,200 individuals who now qualify for the BHC Program will no longer
qualify.
Expected
annual savings:
$2,000,000