Like other regional health care providers throughout California, Ventura County Medical Center in Ventura is still awaiting funding it is owed from the state.
About 75% of the patients the medical center serves are insured by Medi-Cal, which means the state and federal government cover the costs of procedures and check-ups for those who are eligible.
An ongoing backlog of payments to local medical centers, though, has created a budget problem for counties statewide. Ventura County Health Care Agency officials estimate that the county medical center is owed up to $215 million in funding dating back to 2008.
Although the county has requested expedited funding from the state, it is unknown when it will be reimbursed for the monies it is owed.
To help pay the center pay its bills in the interim, the Ventura County Board of Supervisors has regularly transferred money from its general fund to the medical center’s operating fund, formally called an enterprise fund, in order to cover the deficit.
Although the practice is standard and legal, the Ventura County grand jury took issue with the way many supervisors and members of the public described the interbudget transfers. During board meetings, some referred to the cash advances as “loans,” a practice the grand jury says needs to change.
A months-long investigation by the grand jury’s oversight panel, which was released April 2, found that the payments to the medical center were not loans and that they did not have any expectation of being repaid with interest.
The grand jury recommended that the Board of Supervisors develop a written policy that requires representatives from the county Auditor-Controller’s Office, Board of Supervisors and Ventura County Medical Center to meet with one another before disclosing any projected financial information.
Investigation
The grand jury’s investigation into the financial relationship between the county and the medical center began in August 2019 after several news reports indicated that large sums of money were being moved from the general fund to the medical center’s operating fund on an ongoing basis, according to Foreperson Anida Margolis.
A specific point of concern for the grand jury was a June 18, 2019 meeting in which a public speaker recommended that the board create a repayment schedule and oversight process for the medical center to follow.
“The issue of those outstanding sums was a matter of vigorous board discussion during open sessions and during the public comment session of one of those meetings a speaker had criticized the board for failing to have a repayment schedule and failing to charge interest,” Margolis said.
So the grand jury began reviewing county financial documents and medical center documents to determine the nature of the cash advances and to review the medical center’s procedures to get reimbursement from state and federal programs.
The investigation found that the state’s “lengthy process to make full repayments of the amounts owed to the medical center” has led to the increased need for transfers between the county funds. The practice, though, does not accrue interest and does not require the medical center to repay the monies.
The grand jury also found that the medical center is taking “appropriate actions” to receive funding from the state. The organization was expected to receive $18 million before the end of the fiscal year, according to the report.
As a result of the investigation, the Board of Supervisors must not refer to the inter-fund transfers as “loans” and the county must develop a policy for disclosing financial information about the medical center.
While the jury, which serves as a “watchdog” by investigating and reporting on the affairs of local government, has no enforcement power, it can compel a response from public agencies, which it then makes public.
The Board of Supervisors has until the beginning of July to respond to the report.
Moorpark Acorn
Christina Cox
June 12, 2020
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