Report 2013-116 Recommendation 5 Responses
Report 2013-116: Los Angeles County: Lacking a Comprehensive Assessment of Its Trauma System, It Cannot Demonstrate That It Has Used Measure B Funds to Address the Most Pressing Trauma Needs (Release Date: February 2014)
Recommendation #5 To: Los Angeles County
To ensure that it allocates Measure B funds to address the most significant needs of residents within its trauma system, the board should reinstate a Measure B oversight committee, with participation from departments with trauma, EMS, and bioterrorism preparedness expertise, as well as representatives of the public. The oversight committee should review trauma system and other county needs annually and advise the board on Measure B expenditures. As part of its responsibilities, the oversight committee should reevaluate the Measure B allocation approach, taking into consideration the results of Los Angeles's comprehensive assessment and the effects of the Act, and issue a report on its findings no later than December 2015.
Annual Follow-Up Agency Response From October 2019
The LA County Board of Supervisors (Board) will continue to serve as the advisory and approval body with respect to the distribution of Measure B funds. The County will not implement the recommendation as written, but did establish a Measure B Advisory Board (MBAB) to make recommendations on potential projects that could be funded using unallocated Measure B funds.
On January 10, 2018, the first meeting of the MBAB was held. During this meeting the MBAB Bylaws and the mechanism to take requests for Measure B unallocated funds were discussed. Subsequently, a process, which includes the submission of funding proposals, was developed and implemented.
On Oct. 9, 2018, the MBAB reviewed and discussed 14 funding proposals. On Nov. 26, 2018, the MBAB met to prioritize the funding proposals. On March 12, 2019 a Board memo was filled recommending to the Board to fund 12 projects (2 of the originally submitted proposals were withdrawn by the entity who submitted them). These recommendations were approved on April 4, 2019 and have all been funded.
On April 15, 2019 the Measure B Proposal Process and Proposal Form for 2019 was distributed and posted on the EMS Agency website and the EMS Agency accepted proposals for consideration (http://file.lacounty.gov/SDSInter/dhs/1040988_MABA071018.pdf.
On September 16, 2019 the proposals were reviewed by the MBAB and a priority ranking was done. A Board Memo will be prepared with the MBAB recommendations for 2019 and be submitted to the Board later this year for their consideration.
The MBAB will continue to utilize this process to review and prioritize and make recommendations to the Board, as additional unallocated funds become available.
California State Auditor's Assessment of Annual Follow-Up Status: Will Not Implement
Annual Follow-Up Agency Response From November 2018
The LA County Board of Supervisors (Board) will continue to serve as the advisory and approval body with respect to the distribution of Measure B funds. The County will not implement the recommendation as written, but the following activities were undertaken in response to the audit and its findings.
On May 2, 2017, the Board directed the Chief Executive Office (CEO) to work with the Dept. of Health Services (DHS) to report on a) a countywide strategy for ensuring objective, needs-based allocation of future unallocated Measure B funds that will ensure the maximum impact on LA County residents; and b) the feasibility of establishing a County advisory body for future unallocated Measure B funds, which shall consist of, but not be limited to the CEO, DHS, Emergency Medical Services (EMS) Agency, Dept. of Public Health (DPH), and other external stakeholders at the discretion of the CEO.
On July 3, 2017, the CEO filed the report addressing the above, and recommended the County create a Measure B Advisory Body (MBAB).
On July 11, 2017, the Board approved a motion by Supervisors Kathryn Barger and Janice Hahn to adopt recommendations in the July 3, 2017 report and direct the CEO to implement the MBAB to advise the Board on options or recommendations for spending unallocated Measure B funds.
On January 10, 2018, the first meeting of the MBAB was held. During this meeting the MBAB Bylaws and the mechanism to take requests for Measure B unallocated funds were discussed. Subsequently, a process, which includes the submission of funding proposals, was developed and implemented.
On Oct. 9, 2018, the MBAB reviewed and discussed 14 funding proposals. On Nov. 26, 2018, the MBAB will meet to prioritize the funding proposals and then will make recommendations to the Board based on this prioritization. The MBAB will continue to utilize this process to review and prioritize and make recommendations to the Board as additional unallocated funds become available.
California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented
The Board's actions have partially addressed our concern because the advisory body provides options or recommendations for spending unallocated Measure B funds. However, the advisory body has not re-evaluated the Measure B allocation approach.
Annual Follow-Up Agency Response From October 2016
The Los Angeles County Board of Supervisors will continue to serve as the advisory and approval body with respect to distribution of Measure B funds.
As a follow-up to last year's response regarding distribution of funds to non-County trauma hospitals, Los Angeles County, through its Department of Health Services, has met regularly with hospital representatives to collaboratively share ideas and concepts for allocating available funds, including Measure B, to support the trauma network. The group has developed guiding principles centered around preserving and supporting the County-wide trauma network for the uninsured and underinsured population, providing assistance with covering fixed costs for trauma-related infrastructure, and taking into account patient acuity and managed care changes. The group feels it is necessary to maintain a stable allocation of funds to ensure the stability of the trauma network instead of trying to reallocate funds annually, which could serve to undermine long-term planning efforts for the trauma network participants. This group will continue to meet on an ongoing basis and will serve as an important voice in developing overall recommendations to the LA County Board of Supervisors.
California State Auditor's Assessment of Annual Follow-Up Status: Will Not Implement
Annual Follow-Up Agency Response From September 2015
Los Angeles County - Department of Health Services is working with the Board regarding the preferred process for evaluating, establishing, and reporting on the Measure B allocation approach, including consideration of a proposed revised methodology to allocate Measure B dollars to non-County hospitals, and analysis of the impact of the new methodology on the trauma system.
The reason for not fully implementing the recommendation is that additional time is needed to collect and validate relevant data from trauma hospitals, complete the analysis of data submitted, discuss findings with trauma hospitals, and develop and present potential recommendations to the LA County Board of Supervisors.
- Estimated Completion Date: December 2015
California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented
1-Year Agency Response
LA County Dept. of Health Services will discuss with the Board the preferred process for evaluating, establishing, and reporting on the Measure B allocation approach, including consideration of the impact of the Affordable Care Act (ACA) on such allocation.
- Estimated Completion Date: August 2015
- Response Date: February 2015
California State Auditor's Assessment of 1-Year Status: No Action Taken
6-Month Agency Response
DHS will discuss with the Board the preferred process for evaluating, establishing, and reporting on the Measure B allocation approach, including consideration of the impact of the Affordable Care Act on such allocation.
- Estimated Completion Date: November 2014
- Response Date: August 2014
California State Auditor's Assessment of 6-Month Status: No Action Taken
60-Day Agency Response
The County's Health Services Department will work with the Board to consider establishment of an Advisory Committee to evaluate and advise Measure B allocation, assess the impact of the Patient Protection and Affordable Care Act on the trauma care system, and prepare reports as requested by the Board.
- Estimated Completion Date: TBD
- Response Date: April 2014
California State Auditor's Assessment of 60-Day Status: No Action Taken
All Recommendations in 2013-116
Agency responses received are posted verbatim.