01-07-2020

Discussion and Possible Action Including Possible Direction to Executive Office to Perform Assessment of Economic Development and Financing Corporation (EDFC), Documenting Total County Contributions and Return on Investment
(Sponsor: Supervisor Williams)

RECOMMENDED ACTION/MOTION:
Direct the Executive Office to perform assessment of EDFC, documenting total County contributions and return on investment.

SUMMARY OF REQUEST:
EDFC was founded in 1995 through the efforts of the County of Mendocino and the four incorporated jurisdictions: Willits, Ukiah, Point Arena, and Fort Bragg. Mendocino County has maintained significant monetary contributions. $883k from the County combined with sizable contributions from the cities justify an analysis of return on investment. For the greater than $1M of local public funds utilized since EDFC inception, what have we accomplished? Has EDFC met our condition of satisfaction? If not, what needs to change in the partnership and charter? Is EDFC mature enough to stand on its own and if not, what’s the roadmap for reaching this critical milestone?

Discussion and Possible Action Including Direction to Executive Office to Return with a Plan to Make Most Mendocino County Business Licenses Optional
(Sponsor: Supervisor Williams)

RECOMMENDED ACTION/MOTION:
Direct Executive Office to return with a plan to make most Mendocino County business licenses optional.

Administration of business licenses likely operates at a loss. To champion a culture of people working and to fulfill our pledge to make Mendocino County a small business friendly environment, we should adopt a rebuttable presumption that businesses are operating legally. Annual registration, fees and plan checks impede small business. Except circumstances where local businesses benefit from documentation of a business license, the requirement should be deprecated. Unnecessary government intrusion is a detriment to our local economy.

01-21-2020

Discussion and Possible Action Regarding Formal Request for a Subsidy Price Estimate from Mendocino Coast Healthcare District (MCHD), Transferable to Adventist Health, for One Advanced Life Support (ALS) Ambulance To Be Used Primary for the 101 Corridor in Collaboration with Coastal Valleys EMS Agency, for 911 Responses and Inter-Facility Transfers, as Appropriate

(Sponsor: Supervisor Williams)

Recommended Action/Motion:

Direct Executive Office to formally request a subsidy price estimate from Mendocino Coast Healthcare District (MCHD), transferable to Adventist Health to the extent it assumes MCHD ambulance operation, for one Advanced Life Support ambulance, staffed full-time, positioned primarily for response to the 101 corridor, location to be determined dynamically by Howard Forest dispatch in collaboration with Coastal Valleys EMS Agency, for 911 response and inter-facility transfers as appropriate.

Summary of Request:

Ambulance coverage is dangerously low, subjecting residents to pain, death and preventable bodily damage. Private ambulance companies struggle to operate with stability and at adequate staffing levels, in great part because of inadequate reimbursement rates from insurance, including government sponsored programs. One additional Advanced Life Support ambulance, positioned based on greatest need, will progress us towards greater coverage while proving a model for future extension. Mendocino Coast Healthcare District operates a public ambulance with a track record of stability, employee satisfaction, safety and patient approval. MCHD owns adequate ambulance apparatus and can use a pool of resources for staffing a pilot program. On the coast, the service operates at slightly better than break even.

Projecting exact profit or loss in a new area will not be feasible, because financials depend greatly on unknowns including patient volume, insurance mix, transport distances and participation by other minimally regulated providers. By using County General fund to cover potential losses for Emergency Medical Services, a statutory responsibility of the county, we’ll enable a pilot program which has potential to improve ambulance stability county-wide.

Discussion and Possible Action Including Direction to County Counsel to Author Ordinance Amendment to Raise County Code Section 15.28.010 Vehicle Abandonment to a Misdemeanor Offense

(Sponsor: Supervisor Williams)

Recommended Action/Motion:

Direct County Counsel to author Ordinance amendment to raise County Code section 15.28.010 Vehicle Abandonment to a misdemeanor offense.

Previous Board/Board Committee Actions:

Ordinance No. 3770 created Sec. 15.28.010 Vehicle Abandonment Prohibited.

Summary of Request:

Unwanted vehicles are frequently disposed on public right of way shoulders and private property without authorization. County funds are used to abate through clean-up and hauling. Even where a Vehicle Identification Number can identify the owner of record, our District Attorney is unable to adequately punish the party responsible for the dumping. We should not tolerate scrap vehicle litter. The existing violation is only an infraction and has proven to be an insufficient deterrent. Maximum penalty should be six months in jail or a $1,000 fine.

02-25-2020

Discussion and Possible Action Including Possible Direction to Director of Health and Human Services to Request Aggregate Patient Outcome Data from Redwood Quality Management Company (RQMC) and Subcontractors, Pursuant to the Scope of Work under the County’s Various Contracts with RQMC, and Disseminate with Related Trends Analysis and Direction to the Director of Health and Human Services to Initiate Request For Proposal Process

(Continued from the February 25, 2020, Board of Supervisors Meeting)

(Sponsor: Supervisor Williams)

Recommended Action/Motion:

Direct Mendocino County Director of Health and Human Services to request aggregate patient outcome data from Redwood Quality Management Company and subcontractors, pursuant to the scope of work under the County’s various contracts with RQMC, and disseminate with trends analysis; and direct the Director of Health and Human Services to initiate Request For Proposal Process.

Previous Board/Board Committee Actions:

The County of Mendocino initiated a contract with RQMC in April of 2016 Prepare the Infrastructure for the Adult System of Care during the transition from Ortner Management Group (OMG) to RQMC.  Additionally, RQMC is under contract with the County for the delivery of special mental health services to children and youth under the age of twenty-five.  Most recently, in July of 2019, the Board approved an $18,976,733 contract for Redwood Quality Management Company (RQMC) to provide specialty mental health care to Medi-Cal beneficiaries and the indigent on behalf of the County.

Summary of Request:

County administration and the public lack data necessary to gauge outcome success of Redwood Quality Management Company and its array of sub-contractors. In order to contemplate future contract terms and to develop a feedback loop for catalyzing continuous improvement, it’s important that we analyze population data and determine trends. Raw data, sanitized of confidential patient information through redaction, can be independently analyzed by county staff and the public. More eyes on the data will provoke questions, engage the public and build trust. To meet our analysis condition of satisfaction, the data must be structured adequate to quantify the count of unduplicated persons served, duration served and cost per case, count of release plans prepared, count of times particular individuals have returned for further treatment and most importantly, how many patients are more self sufficient due to the millions of dollars we spent. The data should be sufficient for generating histograms of varied outcome bins over 1 year, 3 years, 5 years and since program inception. Today, we lack transparency in regard to success trends relative to our past efforts, across programs and as compared to our geographic region. We are unable to say with confidence that the program has improved year over year or that we’re exceeding services of other counties per dollar spent. The request for data in and of itself does not cast doubt on the effectiveness of any of our contractor’s programs, but rather, offers us a tool for ensuring we trend towards greater success and spot areas for improvement early. Assuming data has been captured, this request should require nominal effort by our contractors and staff. If we can’t measure it, we can’t manage it. The competitive bidding process is an essential part of a County’s budgeting and creates a transparent environment that is open and fair. The process allows public benefit beyond price negotiation by catalyzing discussion about conditions of satisfaction, regular progress reporting and specific service parameter expectations. The County of Mendocino Policy No 1. Section 3.2 captures the spirit of this request by specifying, “Departments shall obtain competitive bids for personal and professional services contracts (defined in section 6.0) over $25,000.” The RQMC contract has been approved by the BOS several times since inception without engaging in the competitive bid process. The board is urged to request staff to return with multiple Request

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