Mendo’s Health Insurance Plan Is Bankrupt
What started as a dry discussion of the County’s audit of the 2020-2021 fiscal year on Tuesday, snowballed into summary of a perfect storm of factors leading to a surprisingly large $5.7 million deficit in the County’s “self-insured” health plan. (And that’s after several million American Rescue Plan dollars were added in.)
The discussion started with an attempt to understand why the Board wasn’t informed of the health care deficit until only recently and what kind of reports may or may not be available and how up to date they are. But it soon became clear that the number is much larger than anybody expected factoring in the existing deficit with this year’s (July 2022-June 2023) additional deficit.
It appears that a perfect storm of factors have landed on Mendocino County’s health plan: Skyrocketing medical costs (with providers charging full dollar rates, as opposed to the lower rates insurance companies and the government negotiate); inflation, covid, an increase in high-cost employee medical claims, staff turnover, and a plan that has been more or less neglected in the past because claims were within predictable parameters.
As a result, the County and the employees face potentially significant increases in their contributions to the health plan which will put a hole in the County’s budget and offset whatever payments, raises, or cost of living increases may be under consideration.
The only thing we didn’t hear discussed — which has been mentioned in previous health plan presentations — is the so-called “stop-loss” re-insurance that we thought the County paid for which was supposed to cover health care cost spikes stemming from high-cost individual claims.
If that no longer applies, it’s not hard to imagine that during covid the County probably incurred abnormally costly health care claims which at this point nobody knows how absorb.
In an ideal world, management would stay on top of such a large and volatile budget item by staying on top of claims, underlying employee health factors, sick leave, disability, etc. But we don’t see any evidence of that.
Then, because of management turnover and confusion about who is supposed to manage the “self-insured” health plan, nobody in the current crop of Mendo officials has been paying much attention.
Supervisor Dan Gjerde thought the County should transfer to some kind of “pooled” plan instead of Mendo’s self-insured plan as soon as possible, plus explore any remaining ARPA funding.
To add insult to fiscal injury, CEO Antle later confirmed that the County has not incorporated health care costs into their billing for state grants, meaning that the County has to absorb employee health care costs that could have been reimbursed if health insurance costs had been factored into the grant salary rates.
In an upcoming meeting, the Board expects to invite somebody from the previous financial cadre, perhaps retired Auditor Lloyd Weer, to explain how this deficit ballooned so quickly without being noticed.
Measure B Hypocrisy & Dissembling
At their September 13 meeting the Supervisors approved a series of Grand Jury report responses, one of which was a response to the Grand Jury’s review of Measure B.
Reverting to the days when the Board didn’t just disagree with or ignore the Grand Jury, the Supes couldn’t resist insulting the Grand Jury before responding. Their response opened:
“The Board of Supervisors welcomes this opportunity to respond to the Grand Jury report titled ‘Measure B: Re-Examined.’ Current Grand Jury procedures state: ‘findings are the conclusions or judgements that logically flow from the verified facts.’ In that regard, the Board of Supervisors encourages the Grand Jury to focus on verified facts and avoid unsubstantiated opinions that tend to inflame instead of inform discussion of this critical issue.”
The Board’s response then proceeded to agree with almost every Grand Jury finding except a minor clarification about why the last century’s Psychiatric Health Facility was closed.
As we have pointed out before, most recently at the top of our list of Mendo’s Major Failures, Mendo hasn’t even tried to address non-reimbursable mental health and drug-addled residents as Measure B called for, choosing instead to overpay for the Whitmore Lane demolition and rebuild for more much than a new facility would cost.
The Grand Jury correctly found that “There has been no direct funding for Substance Abuse Treatment as recommended in the Measure B Ordinance and the Kemper Report. The GJ determined this to be a serious oversight. … The GJ and service providers are concerned that Substance Abuse Treatment programs will not receive adequate attention and funding under Measure B.”
The Grand Jury recommended: “The BOS fund substance abuse treatment programs as required by Measure B.”
The Supervisors agreed with the findings that there has been “no direct funding” of substance abuse treatment. However, they chose obfuscation and disingenuousness for their response to the Grand Jury Recommendation.
BOS Response: “This recommendation requires further analysis. Measure B funds have been provided indirectly for Substance Abuse Treatment through Respite Care, the Crisis Residential Treatment Center and other programs. The Board and Committee will consider additional funding for Substance Abuse Treatment programs in their future meetings.”
And they have the gall to tell the Grand Jury to stick to “verified facts”?
Pretending that business as usual constitutes “indirect” use of Measure B funds for Substance Abuse Treatment is absurd. And we can guarantee that there will be no “further analysis,” nor will the Board “consider additional funding for Substance Abuse Treatment programs in their future meetings.”
We have seen this kind of BS before. The pot tax advisory measure, Measure AJ, for example, said that a significant amount of the pot tax revenues were to go to “increased fire protection.” But the Board, at the underhanded suggestion of Supervisor Dan Gjerde, took the position that their business as usual spending on Calfire Dispatch and Coast Valley EMS (admin) constituted spending on “increased fire protection.” In fact, not one cent of the over $20 million of new pot tax money has gone to “increased fire protection” and if the Grand Jury ever points that out, you can be sure that they will be insulted again.
The Supervisors, and the Fifth District's arrogant Ted Williams is the most egregious, get away with this crap because nobody is paying attention, including the local fire agencies which have never pressed the Board for any of the pot tax money that the voters told the Board to fork over, choosing instead to back another Board promise that Measure P will finally — finally! — be honored. (Given their history, we are skeptical.)
We’d like to hope the Grand Jury revisits this unacceptable response next year. And maybe even looks at the millions and millions of dollars of Measure B money wasted on grotesquely overpriced buildings which should have gone to Substance Abuse Treatment. But…
Mendo’s Water Priorities
“Five Priority Water Projects for Mendocino County” was the title of last Wednesday’s meeting of the Board’s “Public Health, Safety, and Resources Committee” made up of Supervisors Glenn McGourty and John Haschak.
• Consolidation of the Upper Russian River Water Agency
• Winter ground water recharge in flood plain areas (in Ukiah)
• Delineating and Mapping the Ground Water Basins of Little Lake, Round and Long Valleys
• Increasing Surface Water Storage for the City of Ft. Bragg:
• Modernization of Mendocino City Wastewater Treatment Plant
Would it be unseemly of us to point out that three of these “projects” have absolutely nothing to do with actual water? Or that the “winter ground water recharge” idea is nothing but another subsidy for grape growers by diverting “winter flows” — i.e., rain — from the Russian River into another — albeit very large underground — vineyard pond? The fourth “project,” if it is to happen at all, will only happen if the City of Fort Bragg does it and it certainly won’t help the drought much. And if Anderson Valley’s experience is any guide, the “modernization” of the Mendocino City Wastewater Treatment Plant will take at least ten years — if they’re lucky.
Did their “priorities” include developing any new water storage facilities?
Did they address conservation at all?
Did they mention. Redwood Valley, perhaps the most water starved area of Mendocino County?
Are we to assume that there are other “priorities” after the “top five” that were considered? If so, what were they?
Is the word “pathetic” too strong as a summary of their water priorities?
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Mendo’s allegedly “expanding” pot bureaucracy is moving north to the nearly abandoned Willits Courthouse. Schedule to be announced, but probably sometime this year. How the pot bureaucracy can be “expanding” to the point they need the empty space at the old Willits “Justice Center” while the pot “industry” has collapsed and nobody is even applying for their punitive “permits” anymore was left unasked.
* * *
The Ukiah Courthouse is scheduled to be abandoned in four years when the Judges and their legal minions move a few blocks east down Perkins Street to a new concrete bunker over by the (abandoned) railroad tracks, newly renamed the Great Redwood Hobo Trail. The Supervisors mused about what to do with the current downtown courthouse on Tuesday without much substance. General Services Honcho Janelle Rau said the building is in decent shape, that the courtrooms in the upper floors are seldom used, and the DA’s staff is kinda cramped in their basement offices. Nobody wondered why the new courthouse needs nine courtrooms if the courtrooms in the top floor of the current courthouse are seldom used. One possibility mentioned in passing was to buy the current courthouse from the State — apparently the “state,” whoever that is (unofficially, preliminarily, of course), has said they would want some money from Mendo for it — but nobody knows the cost. They casually considered the option of moving the DA’s office across the street (cattycorner) to the Deadbeat Dad building which is underutilized. That move would give the DA more space, but wouldn’t do much to address the problem of still being a few blocks from the new Judicial bunker. Nobody knew where to move the Deadbeat Dad office if that happened. The DA wasn’t on hand for the meeting and so far, nobody has asked the DA what he thinks about moving to the Deadbeat Dad building.
And nobody remembered that back when this judicial boondoggle was first announced more than a decade ago, the nice professional lady from the San Francisco court admin office promised the Supervisors that the Courts would reimburse Mendo for the impact of the move on the County.