HomeMy WebLinkAboutAGENDA REPORT 2000 1018 CC REG ITEM 10EITEM 10. E •
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OPPOSlnON 70 MEASURE "o"
MOORPARK CITY COUNCI Y: =I l
AGENDA REPORT
TO: Honorable City Council
FROM: Deborah S. Traffenstedt, ATOM /City Clerk
DATE: October 9, 2000 (CC Meeting of 10/18/00)
SUBJECT: Consider a City Council Position on Measure "O ",
Safeguard Tobacco Settlement Healthcare Program
Background
At the City Council's meeting on October 4, 2000,
Councilmember Harper asked for an item on the October 18
agenda pertaining to Measure 110" on the November 7, 2000
ballot. Councilmember Harper indicated that he would like
the Council to consider taking a position on Measure "0 ".
Staff has attached to this report the County Counsel
impartial analysis, fiscal impact analysis, and arguments
in favor of and against Measure "O" from the sample ballot,
as well as the full text of the measure.
Staff Recommendation
Direct staff as deemed appropriate.
Attachments:
Sample Ballot Information on Measure 110"
Measure "0" full text
C Ij3A.0
COUNTY OF VENTURA
IMPARTIAL ANALYSIS BY COUNTY COUNSEL'
MEASURE "0"
"This measure would appropriate now and in the future to certain
private hospitals and doctors, then to skilled nursing and in -home services
for qualifying elderly, if any, then to immunization services, and then to
nursing scholarships, all of the revenue received by the County of Ventura
( "County") from the settlement of its lawsuits against tobacco manufacturers.
That revenue is expected to average $10 million or more per year. The
initiative would specifically prohibit payment of any of the money to any
County medical program or to the Ventura County Medical Center.
"The revenue would be appropriated first to the qualifying private
hospitals in Ventura County for a part of their bad debts, as distinguished
from charity care, they incur and report to the State for assistance in
meeting the acute health care needs of the elderly, working poor, children,
indigent and other nonpaying patients. An additional 20 percent would be
added to each qualifying hospital's appropriation for doctors' services to the
indigent and working poor. To qualify for indemnification, a private hospital
would have to report at least 360 "self -pay adjusted patient days" to the
State. A private, independent auditor would be appointed to audit the private
hospitals' reports containing the qualification data. There is no audit
provided to monitor how the hospitals would actually spend the money.
"If any money remained after the payments to private hospitals, it
would be appropriated to pay for nursing and in -home care for qualifying
elderly. Then, if any money remained, up to $1 million would be
appropriated for immunization of eligible children, and if any money
remained after that, up to $500,000 would be appropriated for nursing
scholarships. $175,000 would be appropriated annually to the County to
administer the program claims and payments and to pay for the audit of
qualification data. If any money remained after all appropriations, it would
be used for smoking prevention programs in grades 7 through 12. These
are the exclusive uses for which the money can be spent. The money
cannot be used for any other programs regardless of any need identified by
the Board of Supervisors as part of its budget or appropriation processes.
"An oversight commission would be created which could employ a staff
of up to three persons. The source for payment of the staff's salaries and
other commission expenses is not identified. The commission would be
composed of two representatives from each of the acute care hospitals in
Ventura County, would meet publicly at least quarterly, would review the
impact of the program on the elderly, working poor, children and indigents,
and would report at least annually to the Board of Supervisors on operation
of the program.
"County Counsel for the County of Ventura has reviewed the measure
and has concluded that the measure is invalid for several reasons. Counsel
for the proponent of this initiative have reviewed the measure, and have
concluded that the measure is legally valid. Any challenge to the measure
will be decided by the court after the election."
"The above statement is an impartial analysis of Measure "0 ". If you desire
a copy of the measure, please call the Elections Official's office at
(805) 654 -2664, and a copy will be mailed at no cost to you."
'Section 9160 of the Cahloma Elections Code alvws the County Counsel to prepa: a an enpar, al anatysis inr
each county measure appearing on the ballot
FISCAL IMPACT FOR MEASURE "0"
This fiscal impact statement is prepared at the direction of the Board of
Supervisors in accordance with Elections Code section 9160(c).
If passed, this measure will have a detrimental budgetary impact in the
current and future years. Reductions will be required to Ventura County s
fiscal year 2000 -2001 adopted budget.
Tobacco manufacturers entered into an agreement with most of the states,
including California, to settle a wide range of lawsuits pursued by the states.
The County of Ventura, along with the other 57 California counties, entered
into a memorandum of understanding with the state of California to receive
a share of the settlement proceeds on a per capita basis.
The agreement calls for payments to be made by the tobacco companies
into perpetuity. Ventura County's share of the payment will be approximately
$10 million per year; an estimated $250 million over the next 25 years.
Passage of this measure will direct any and all proceeds from the
tobacco settlement to certain private hospitals and others not subject to
fiscal oversight by the County. The measure prohibits the County from
receiving any funds from the tobacco settlement, except $175,000 per year
for administration.
As of August 9, 2000, the County of Ventura has received $10.5 million and
has spent $3.1 million in the prior fiscal year. The County of Ventura's
current fiscal year budget includes tobacco settlement funds in the amount
of $15.3 million. Since the adoption of the current fiscal year 2000 -2001
budget, the Board of Supervisors has approved a staff recommendation for
allocating this funding source to health - related needs of the County.
Passage of this measure will require the County of Ventura to decrease the
current year budget in the amount of $15.3 million. In addition, since the
initiative is retroactive, an additional expenditure of $3.1 million would have
to be made from the General Fund to reimburse the tobacco settlement
fund as designated in the initiative. This will require the County to reduce
expenditures in the current year budget by a total of $18.4 million.
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ARGUMENT IN FAVOR OF MEASURE "0"
California's settlement of its lawsuit against tobacco companies over the
cost of treating smoking related illnesses will result in approximately $10 million
per year for Ventura County. Measure 0 will safeguard the tobacco settlement
money for healthcare and ensure that future uses of this money must be decided
by the people, not the politicians.
Unfortunately, the Board of Supervisors cannot be trusted to use the
tobacco settlement funds for healthcare. Since the tobacco settlement, they
haven't spent a penny of the money on healthcare. Instead, they've
squandered the initial money - using it not for healthcare, but to pay for Ventura
County's fiscal mismanagement, including the first $3 million of a $15 million
fine for years of illegally over billing Medicare. When citizens signed
petitions to safeguard the tobacco settlement money for healthcare, the
Supervisors even refused to put the measure on the ballot!
Measure 0 requires the tobacco settlement money go to healthcare
services. The Board of Supervisors must seek voter approval of any other
proposal to spend the money in the future.
Measure 0 provides funds for:
• Healthcare services provided by hospitals to the working poor, elderly
and children who are uninsured or cannot afford care.
• Nursing and in -home care for needy senior citizens.
• Immunization of children.
• Smoking prevention programs in grades 7 through 12.
A diverse coalition throughout the county supports Measure 0, including
senior citizens, taxpayer advocates, physicians, Healthcare Association of
Southern California representing nongovernmental hospitals, nurses,
educators and parents.
Safeguard tobacco settlement money for healthcare. Ensure that voters
decide how this money will be spent in the future. Help children, the working
poor and senior citizens receive healthcare services. Please vote Yes on
Measure 0.
s/Michael D. Bakst
Executive Director - CMH
s/Kathryn M. Woodburn
Citizens Committee to Safeguard the Tobacco Settlement for Healthcare
s/Leonard B. Ortiz
Small Business Owner
s/Dr. Joseph P. Spirito
Superintendent VUSD
s/Richard A. Reisman, M.D.
Medical Director
REBUTTAL TO ARGUMENT IN FAVOR OF MEASURE "0"
MEASURE "0" DOESN'T DO WHAT THEY SAY!
• They claim it will guarantee the money for healthcare, but Community
Memorial Hospital's own attorney STATED IN COURT THE INITIATIVE
HAS NOTHING TO DO WITH HEALTHCARE AS SUCH. "It's just a
claims bill. We are reimbursing the hospitals." (LA Times 7/25/2000)
• They say their initiative is legal, but SUPERIOR COURT JUDGE
HENRY WALSH HAD "GRAVE DOUBTS" about the legality of the
initiative. (LA Times 7/2912000)
They say private hospitals of Ventura County support their initiative, but
JUST ONE HOSPITAL, COMMUNITY MEMORIAL, PAID $520,000 TO
TOBACCO INDUSTRY LAWYERS AND PAID PETITION CIRCULATORS
to get this self- serving initiative on the ballot.
This scam is an embarrassment to other healthcare organizations. Not one
hospital or healthcare organization besides Community Memorial signed
their argument.
HERE'S THE TRUTH!
• Measure "0" gives the money to private hospitals to pay off their bad
debts.
• Measure "0" raises barriers to smoking - prevention programs.
• Measure "0" won't share a dime of the tobacco settlement with the
County Medical Center or clinics.
• Measure "0" creates a self - appointed commission with no power to
guarantee the hospitals will spend any of the funds for new health
services.
MEASURE "0" ISN'T WHAT IT CLAIMS TO BE.
VOTE NO ON THEIR PHONY SAFEGUARD!
s /Deborah K. Weeks
Executive Director, American Lung Association of Santa Barbara
and Ventura Counties
s /Lillian F. Goldstein
President, League of Women Voters of Ventura County
s /Chris Mahon
President, Ventura County Professional Firefighters Association, Local 1364
s /Chris Landon
Executive Director Landon Pediatric Foundation
s /Martina Melero
Chief Nurse Representative California Nurses Association
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ARGUMENT AGAINST MEASURE "0"
Measure "0" isn't what it claims to be.
What's at stake is $250,000,000 from the tobacco settlement, money won
by Ventura County taxpayers from the tobacco companies.
• Private hospitals sponsored Measure "0" to control all this money.
Measure "0" says THE COUNTY MEDICAL CENTER GETS NOTHING.
The County Medical Center treats 83% of the uninsured in Ventura
County. It deserves a share, but doesn't get one dime.
• The hospitals claim they will use the money for healthcare for the elderly
and the poor but READ THE FINE PRINT. The money actually goes to
pay off the private hospitals' BAD DEBTS.
• Measure "0" makes sure smoking prevention programs are the last
priority.
• The private hospitals would set up a commission to oversee the money,
but the FINE PRINT MAKES THEM THE COMMISSIONERS. This
self- appointed commission won't audit how the hospitals spend the
money. It cannot force them to fulfill their promises.
This money should be shared among ALL health care providers, public and
private. It should increase funding for smoking prevention programs.
Measure "0" doesn't do that. It gives your money to private hospitals to pay
off their BAD DEBTS, and raises barriers to smoking prevention programs.
VOTE NO on the plan that prohibits sharing with the county medical center.
VOTE NO on settlement money for private hospital BAD DEBTS,
VOTE NO on this sweetheart deal for the tobacco industry.
VOTE NO on the self - appointed oversight commission, flimsy audits and
empty promises.
VOTE NO on the private grab of public money!
VOTE NO ON MEASURE "0 "!
s/Deborah K. Weeks
Executive Director, American Lung Association of Santa Barbara and Ventura
Counties
s/Lillian F. Goldstein
President, League of Women Voters of Ventura County
s/Chris Mahon
President, Ventura County Professional Firefighters Association, Local 1364
s /Martina Melero
R.N., P.H.N., M.P.H., Chief Nurse Representative California Nurses Association
s /Chris Landon
M.D., Executive Director Landon Pediatric Foundation
REBUTTAL TO ARGUMENT AGAINST MEASURE "0"
Opponents of Measure 0 use a smokescreen of misinformation to cloud the
truth about this important measure. Let's clear the smokescreen:
Since the tobacco settlement, the Ventura County Supervisors have not
spent A SINGLE PENNY of tobacco settlement money on healthcare or
smoking prevention programs. Instead, they've squandered the money.
Measure 0 isn't forever. It safeguards tobacco settlement money for
healthcare and smoking prevention, requiring the Supervisors to seek voter
approval to spend the money on other programs. Measure 0 can be
changed anytime - -with voter approval.
The county hospital doesn't receive direct funding under Measure 0
because they already receive $42 million annually for treating just 54% of
Ventura County's poor. Nongovernmental hospitals receive virtually nothing
now, but will get partial payment for healthcare to the other 46% of Ventura
County's uninsured and poor.
Measure 0 authorizes funds for smoking prevention programs, and
allocates funds for healthcare for seniors, children and the poor.
Opponents say the money might not be used as promised but Measure 0
GUARANTEES funding to healthcare- -and it's backed by an independent
audit.
Unbelievably, opponents imply that supporters are in league with tobacco
companies. Campaign reports PROVE that is false.
Safeguard the tobacco settlement for healthcare and smoking prevention.
Put voters in charge of these important funds.
Vote Yes on Measure 0.
s/Michael D. Bakst
Executive Director
s/Kathryn M. Woodburn
Citizens Committee to Safeguard the Tobacco Settlement for Healthcare
s/Leonard B. Ortiz
Small Business Owner
s/Dr. Joseph P. Spirito
s /Richard A. Reisman, M.D.
Medical Director
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MAR 23 7 0
TO THE BOARD OF SUPERVISORS, VENTURA COUNTY
;;ep;:ty Caart� Cfetf
We the undersigned, registered, qualified voters of Ventura County, California,
hereby propose amendments to The Codified Ordinances of the County of Ventura,
providing for the appropriation and allocation of national tobacco settlement fiords
to assist in the provision of healthcare services for the elderly, working poor,
children, indigent and other non - paying patients, and petition the Board of
Supervisors to submit the same to the voters of Ventura County, Cahform -a for their
adoption or rejection at the next succeeding general election or at any special
election held prior to that general election or otherwise provided by law.
THE PEOPLE OF THE COUNTY OF VENTURA BEREBY ORDAIN AND
ENACT AS FOLLOWS:
SECTION 1. FINDINGS AND DECLARATIONS.
a. This measure may be cited as the Safeguard Tobacco Settlement Healthcare
Program.
b. The purpose is to safeguard tobacco settlement funds for the benefit of the
people of Ventura County in meeting county healthcare needs.
c. The County is expected to receive over $10 million per year as its share of
the settlement from the lawsuits filed against the major tobacco
manufacturers.
d. Thus, it is fitting and proper that these funds should be used for the benefit of
the residents of Ventura County to proinote healthcare and not be used by
county government to fund other government programs.
e. Because Ventura County is facing severe financial problems, there will be a
temptation to spend funds from the tobacco settlement for general
governmental purposes, instead of for the health purposes that are necessary.
f. To safeguard the Tobacco Settlement Fund, a Commission to Safeguard the
Tobacco Settlement is being created. The commission shall be composed of
two persons from each acute care hospital in Ventura County: the physician
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Chief of Staff and a representative of the public serving as the President or
Chair of the hospital board or hospital community advisory board. If the
President or Chair is also Chief Executive Officer of the hospital, he or she
may not serve on the commission and instead a representative of the hospital
board or hospital community advisory board will serve as the hospital's other
representative on the commission.
g. To avoid the waste or diversion of tobacco settlement funds for other non-
health related govemmeut purposes, this initiative preserves the funds for the
exclusive purpose of assisting the delivery of services to meet the following
healthcare needs of Ventura County:
1. Acute care programs and acute hospitalization to care for the elderly,
working poor, children, indigent and other non-paying patients.
2. Nursing and unskilled in -home care services to the elderly who can
better be served in their own homes.
3. Immunization against disease for children not otherwise eligible for
coverage.
4. Nursing scholarships to maintain a needed level of nursing care
throughout Ventura County.
5. To the extent that funds remain after meeting the health care programs
above, for smoking prevention programs in school grades 7 through 12.
h. 'fhe proceeds of the national tobacco settlement should be dedicated to the
health needs of the residents. These funds should be safeguarded and not
used for any other purpose.
SECTION 2. Chapter 10, Article 1 of Division 4 (commencing with section 4101-
0) of The Codified Ordinances of the County of Ventura is added to read:
CHAPTER 10. TOBACCO SETTLEMENT FUNDS
ARTICLE 1. SAFEGUARD TOBACCO SETTLEMENT HEALTHCARE
PROGRAM
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Section 4101.0. This Article shall be known as the Safeguard Tobacco Settlement
Healthcare Program.
Section 4101 -1. Tobacco Settlement Fund
The Ventura County Tobacco Settlement Fund ( "the Settlement Fund ") is
hereby created in the County Treasury. unmediately upon adoption of this Article,
all funds previously received or to be received in the future by the County pursuant
to Master Settlement Agreement of November 23, 1998 allocating the tobacco
settlement monies between the states, the Memorandum of Understanding of August
S, 1998 setting forth the formula for allocation of the tobacco settlement monies
among the state, counties and cities and the Agreement Regarding Interpretation of
the Memorandum of Understanding of February 7, 2000 shall be deposited in the
Settlement Fund.
Section 4101 -2. Commission to Safeguard the Tobacco Settlement
(a) There is created the Commission to Safeguard the Tobacco Settlement
(the "Commission"). The Commission shall consist of the following members
appointed by the Board of Supervisors meeting the following qualifications-
(1) The Presidents or Chair of each acute care hospital board or acute
care hospital community advisory board in Ventura County. Provided, however, no
person who serves as both Chief Executive Officer of a hospital and President or
Chair of a board may serve on the Commission. In that event another member of
the board shall be appointed to the Commission.
(2) The physicians serving as Chiefs of Staff for each acute care
hospital in Ventura County.
(b) In the event any person declines to serve on the Commission, the Board of
Supervisors shall appoint a member of the applicable acute care hospital board or
hospital community advisory board.
(c) Commission members shall receive no compensation for their services-
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(d) The Commission may appoint a full time Secretary and support staff of no
more than three persons whose salaries shall be commensurate with that paid
County personnel with equivalent responsibilities and who meet the County's
personnel hiring requirements.
Section 4101 -3. Apprgpriation and Use of Tobacco Settlement Funds
All funds deposited or required by this Article to be deposited in the
Settlement Fund are continuously appropriated annually by this Article exclusively
for the following purposes and in the following priority:
(a) Acute care programs for the treatment and acute care hospitalization in
Ventura County to assist in meeting the healthcare needs, including those associated
with tobacco products, of the elderly, working poor, children, indigent and other
non - paying patients who contribute to the creation of annual unreimbursed costs for
the hospitals.
(b) Provision of nursing and unskilled in -home care services to the elderly
who are not otherwise eligible for coverage under any private insurance or local,
State or Federal program.
(c) Up to one million dollars ($1,000,000) annually for immunization of
children not otherwise eligible for coverage under any private insurance or local,
State or Federal program.
(d) Up to five hundred thousand dollars ($500,000) annually for nursing
scholarships and the offset of living expenses for individuals enrolled in an
accredited nursing program who would agree to work and live in Ventura County
for a period of two years after graduation. To the extent there is any balance
remaining, it shall be used to provide similar financial assistance for other healthcare
professionals, who agree to work in Ventura County after graduation, during periods
when there is a recognized and defined shortage of such professionals.
Section 4101 -4. Commission Responsibility
The Commission shall meet at least quarterly to review the operation of the
program and its impact upon the elderly, working poor, children and indigent. Each
Ell
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meeting shall be public and conducted in accordance with Government Code
sections 54950 et seq.. The County shall provide a facility readily accessible to the
public for this purpose.
The Commission shall report annually to the Board of Supervisors, or more
frequently as the Commission deems necessary, on the operation of the program.
Section 4101 -5. County Responsibility
The County shall administer the claims program for reimbursing hospital
providers, non -profit clinics, in -home nurses and unskilled care givers for services
provided for under this Article. The County shall be allocated $175,000 annually
from the Settlement Fund to administer the claims program and fund the annual
audit required by section 4101 -8 of this Article:
Section 4101 -6. Payment for Services
Payment for services covered by this Article shall be as follows:
(a) Hospital providers having a minimum 360 self-pay adjusted patient days
per year shall be paid their annual unreimbursed costs as defined in section 4101 -10
of this Article, provided however that no hospital may receive more than fifty
percent of the total amount deposited in the Settlement Fund for the calendar year of
the program.
Because the Ventura County Medical Center, unlike the other acute care
hospitals in Ventura County, receives on an ongoing basis substantial funds from the
state from sources like the California Healthcare for Indigents Program to provide
healthcare services to the elderly, working poor, children, indigent and other non-
paying patients, neither the Ventura County Medical Center nor any other County
medical program shall be entitled to receive any funds from the Settlement Fund.
(b) In addition to the amount reimbursed acute care hospital providers under
subsection (a) of this section, acute care hospital providers shall be reimbursed an
additional twenty percent of that amount for the purpose of reimbursing physician
providers for services to the indigent and worldng poor performed in the acute care
hospital at the rates paid by Medicare for such services.
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(c) For payment to organizations and individuals providing such services,
skilled nursing and unskilled in -home care services shall be reimbursed as
determined by the County but at no less a rate than that for in -home supportive care
services. In-home nursing services shall be reimbursed at a level determined by the
County.
(d) Payment for immunization services for children shall be made to non
profit clinics providing such services and shall be the cost of the vaccine, supplies
and personnel pursuant to area norms and subject to audit pursuant to section 4101-
8 of this Article.
Section 4101 -7. Simalus
To the extent there are funds in excess of those necessary for payment under
section 4101 -6 of this Article, the County shall use the funds for smoking prevention
programs in grades 7 through 12.
Section 4101 -8. Annual Audit
(a) To ensure that each hospital seeking reimbursement from the Settlement
Fund is correctly reporting the "self -pay adjusted patient days (excluding
newborns)" component of the "armual unreimbursed costs" calculation set forth in
section 4101 -10 of this Article, the Board of Supervisors shall appoint a private,
independent auditor to conduct an annual audit of the Discharge Data Report filed
annually by each hospital with the California Office of Statewide Health Planning
and Development.
(b) Preliminary audits shall be provided to each hospital on a confidential
basis. Final audits shall be transmitted to the Commission for disclosure to the
public and transmission to the County. By accepting funds from the Settlement
Fund each hospital agrees to this audit.
(c) Audits of the "provision for bad - debts" and "cost -to- charge ratio"
components of the "annual unreimbursed costs" calculation set forth in section 4101-
10 of this Article shall continue to be conducted by the state as part of the state's
Medi -Cal audit of the Annual Disclosure Reports filed by all hospitals statewide
with the California Office of Statewide Health Planning and Development.
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Section 4101 -9. Prohibitions
The purposes for which monies from the Settlement Fund shall be expended
under this Article are exclusive. No monies from the Settlement Fund or monies
required by this Article to be deposited in the Settlement Fund may be expended by
the County for the payment of fines, debt service, the acquisition or lease of
property or equipment, or the construction, modification or improvement of any
structures.
Section 4101 -10. Definitions
Annual Unreimbursed Costs. "Annual unreimbursed costs" means the amount
computed as follows:
(a) Based on the most recent publicly available Annual Disclosure Report
filed by a hospital with the California Office of Statewide Health Planning and
Development multiply the "provision for bad - debts" by the "cost to charge ratio."
(b) Divide the amount derived pursuant to subsection (a) by the hospital's
"self -pay adjusted patient days (excluding newborns)" for the same period set forth
in subsection (a) as shown in the hospital's Discharge Data Report for the same
period set forth in subsection (a) filed annually with the California Office of
Statewide Health Planning and Development.
(c) MtAtiply the amount derived pursuant to subsection (b) by the "self pay
patient days."
Section 4101 -11. Severability
If any provision of this Article, or part thereof, is for any reason held to be
invalid or unconstitutional, the remaining provisions shall not be affected, but shall
remain in full force and effect, and to this end the provisions of this Article are
severable.
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