Title
a. Direct the creation of a patient centered, unified and sustainable Monterey County Health System;
b. Direct the Director of the Health Department, CEO of Natividad, County Administrative Officer (CAO), and Assistant CAO to form the Monterey County Unified Planning Committee (MCUP);
c. Create and appoint two members of the Board of Supervisors to the Unified Health System Ad Hoc Committee; and
d. Direct the MCUP to report regularly to the Ad Hoc Committee of the Board of Supervisors for further direction.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Direct the creation of a patient centered, unified sustainable Monterey County Health System;
b. Direct the Director of the Health Department, CEO of Natividad, Chief Administrative Officer (CAO), and Assistant CAO to form the Monterey County Unified Planning Committee (MCUP);
c. Create and appoint two members of the Board of Supervisors to the Unified Health System Ad Hoc Committee; and
d. Direct the MCUP to report regularly to the Ad Hoc Committee of the Board of Supervisors for further direction.
SUMMARY/DISCUSSION:
Monterey County has provided high quality health care to its community since the nineteenth century. The County Health Department (MCHD) and Natividad are all committed to the mission to enhance, promote and protect the health of Monterey County individuals, families, communities and environment. They are committed to continually monitor and improve the health of the people, including the vulnerable, in Monterey County through coordinated, affordable, high-quality healthcare and to creating a legacy of health together. The Board of Supervisors is critical in the ability to support and make this vision a reality for the County. In that spirit, the County Administrative Officer (CAO), Director of the Health Department, and the CEO of Natividad recommend that the Board of Supervisors direct the creation of a patient centered, unified, and sustainable Monterey County Health System committed to improving the health of the entire community with emphasis on our vulnerable residents.
MCHD Clinic Services Bureau and Natividad have always collaborated and worked together to provide for its patients and for the community, but they have done so as separate organizations under the broader County of Monterey umbrella. By integrating the systems and operations of these two organizations, the patients and community will benefit well into the future. An integrated system will optimize patient care quality resulting in improved health outcomes, health equity, staff and patient satisfaction; is consistent with state and national trends that are pushing payers and providers toward higher levels of coordination and performance; and will result in healthcare transformation and population health management. An integrated system puts the patient in the center resulting in seamless access to patient health information, care coordination and referrals within the County’s primary care clinics, specialty care clinics, or hospital-based services. Systems integration activities during the pandemic, such as sharing of resources and tools, demonstrated the effectiveness, efficiency and population impacts that are achievable.
In anticipation of future discussions on integration, significant communication has ensued at both organizations to assess stakeholder interest and concerns in furthering alignment efforts. Governance and labor groups have been briefed including the Community Health Center Board, Natividad’s Board of Trustees, SEIU, CNA and CEMA. Leadership and staff at both County organizations have also been briefed at “All Hands” staff meetings and individual clinic site discussions. In general, stakeholders are interested in discussions ensuing and some staff have even expressed interest in being actively involved in discussions and actions.
Conversely, the Board of Supervisors could direct County staff to continue the current trajectory on an incremental path which would result in less organizational change and disruption, and service delivery reform will likely not happen quickly enough resulting in patients migrating and our County health system eventually eroding. Alternatively, the Board of Supervisors could direct staff to not undertake any action which would result in little to no organizational change or disruption, and rapid erosion of the Monterey County Safety Net.
If the Board agrees to move forward with an integrated and unified health system, the MCUP group would benefit from regular communication with a Board of Supervisors ad hoc committee.
Based on the foregoing, we recommend that the Board of Supervisors: a) direct that we continue moving forward on health system integration and unification; b) direct the creation of MCUP; c) direct the creation of an ad hoc committee and appoint two Supervisors and; d) direct that MCUP regularly report to the ad hoc committee on progress.
OTHER AGENCY INVOLVEMENT:
The County has engaged Health Management Associates (HMA) as a consultant partner to help guide alignment activities.
FINANCING:
There is no direct impact to the County General Fund from receipt of this report or approval of staffs’ recommendations. The Agreement with HMA is currently being funded by the Natividad Enterprise Fund. As discussions and work plans evolve, staff will return to the Board of Supervisors with an updated financial plan for further direction.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Mark a check to the related Board of Supervisors Strategic Initiatives
__Economic Development
• Through collaboration, strengthen economic development to ensure a diversified and healthy economy.
__Administration
• Promote an organization that practices efficient and effective resource management and is recognized for responsiveness, strong customer orientation, accountability and transparency.
_X Health & Human Services
• Improve health and quality of life through County supported policies, programs, and services; promoting access to equitable opportunities for healthy choices and healthy environments in collaboration with communities.
__Infrastructure
• Plan and develop a sustainable, physical infrastructure that improves the quality of life for County residents and supports economic development results.
__Public Safety
• Create a safe environment for people to achieve their potential, leading businesses and communities to thrive and grow by reducing violent crimes as well as crimes in general.
Prepared and Approved by:
______________________________________ Date:_____________
Dr. Chad Harris, CEO, Natividad, 783-2553
___________________________________________ Date:_____________
Elsa Mendoza Jimenez, Director of Health, 755-4526
___________________________ Date:_____________
Charles McKee, CAO, 755-5312
Attachments:
Board Report
Health System Alignment Presentation