Grand Jury Report: Contra Costa County Healthcare

The Grand Jury has issued a report (available here) encouraging Contra Costa County to pursue partnerships with the private sector to meet the surging demand for healthcare.  

This report concerns the County entering into partnerships with other healthcare providers in the County as a means of meeting the surge in healthcare demand from the Affordable Care Act.  Final implementation of the Affordable Care Act begins January 1, 2014.  This presents both a challenge and an opportunity to develop a comprehensive plan for an integrated healthcare delivery system in Contra Costa County.  With federal healthcare reform, many more county residents will become eligible for insurance, including Medi-Cal.  It is estimated that over 40,000 will remain uninsured.  The increase in demand will further strain a county system that currently lacks the capacity to adequately serve the vulnerable population in our county.

Research shows that coordination is vital among healthcare providers in order to provide access to quality care.  Strategic partnerships among public and private healthcare providers are being formed throughout California and the nation to plan for the imminent changes.  Their goal is to provide cost-effective, quality care to an expanded population and re-design systems to improve health outcomes to meet the increase in demand.

The Board of Supervisors commissioned a sustainability Audit of the Contra Costa County Health Services Department, and in 2011 the consultants published their report.  One of the recommendations is for the County to take the lead in developing partnerships among public and private healthcare providers.  The comprehensive Audit completed by a consultant, Health Management Associates, in September, 2011, and titled “Contra Costa County-Health Care Sustainability 2011”, begins with the statement:

“It is doubtful that our public health system alone will be able to meet future medical needs of vulnerable populations in Contra Costa County without assistance from the private sector.  Public/private partnerships will continue to need exploration and development when health care reform provides access to care for people who will be newly or more adequately insured and those who remain without health insurance.”

Two years have passed since the Audit recommendation was presented to the County Board suggesting that the County Health Services Department take the lead in discussions to expand the number and scope of such partnerships.  While some effort has been made to explore a few possibilities, there has been little meaningful change achieved during that time, and now time is running out.  The County should bring a sense of urgency to its leadership efforts and a willingness to take steps to seriously engage private sector stakeholders in the challenge to prepare for the coming change in demand for healthcare services.

This report is not about the Contra Costa County healthcare operation’s current governance structure, nor is it an analysis of the pros and cons of possible mergers between the County and private or public sector entities, although both would be worthy of future Grand Jury investigations.