TABLE OF CONTENTS

General Information

Members of the 2003- 2004 Grand Jury ( inside front cover on hard copy)

Committee Chairs and Members ( inside back cover on hard copy)

Photograph of 2003- 2004 Kern County Grand Jury................................... iv

Dedication.................................................................................................... v

Grand Juror’s Oath...................................................................................... vi

Presiding Judge for the Superior Court ( hard copy only) ....................... vii

Support Staff ( hard copy only) ............................................................. viii

Foreman’s Photographs .............................................................................. ix

Foreman’s Letter to Judge ........................................................................... x

Grand Jury Statement of Position .............................................................. xii

Kern County Grand Jury Statement, “ Response Required” ..................... xiv

Grand Jury Officers................................................................................... xvi

Oversight Responsibilities of Grand Jury Committees............................. xvii

Supervisorial District Map ....................................................................... xviii

Administration and Audit

Committee Photograph ( hard copy only)

Area of Responsibilities

Board of Trade ............................................................................................. 3

Response ............................................................................................. 6

Kern County Fire Department and other Fire Services in Kern County ..... 8

Response ........................................................................................... 27

Medical Transportation Services in Kern County..................................... 30

Board of Supervisors Response ( Web site only)

Lamont Pesticide Drift, “ Emergency Preparedness”................................. 35

Kern County Hispanic Chamber of Commerce ......................................... 39

Kern Medical Center, “ A Struggle for Solvency” ..................................... 43

County Clerk - Elections Division, Electronic Voting .............................. 48

Air Pollution Control Districts ( Web site only)

Response ( Web site only)

Cities and Joint Powers

Committee Photograph ( hard copy only)

Area of Responsibilities

City of Arvin.............................................................................................. 57

Response ........................................................................................... 66

City of Arvin 2 ( Web site only)

City of Bakersfield..................................................................................... 79

Response ........................................................................................... 83

City of California City............................................................................... 86

Response ........................................................................................... 91

City of Delano ............................................................................................ 93

City of Maricopa ........................................................................................ 96

Response ........................................................................................... 99

Independent Accountant’s Report................................................... 101

City of McFarland .................................................................................... 104

Response ......................................................................................... 110

City of Ridgecrest .................................................................................... 124

Response ......................................................................................... 128

City of Shafter.......................................................................................... 129

City of Taft .............................................................................................. 133

Response ......................................................................................... 138

City of Tehachapi .................................................................................... 143

Response ......................................................................................... 148

City of Wasco .......................................................................................... 150

Response ......................................................................................... 155

Community Action Partnership of Kern.................................................. 157

Housing Authority of the County of Kern............................................... 160

Kern Council of Governments ................................................................. 163

Kern County Local Agency Formation Commission.............................. 166

Ralph M. Brown Act, “ Closed Session”.................................................. 169

Ridgecrest Redevelopment Agency and Habitat for Humanity .............. 173

County Service and Special Districts

Committee Photograph ( hard copy only)

Area of Responsibilities

Kern County Environmental Health Department:

Glennville Groundwater Contamination Saga ......................................... 178

Response ( Web site only)

Rand Communities Water District........................................................... 182

West Side Recreation and Park District................................................... 184

Response ......................................................................................... 186

Kern Mosquito and Vector Control District ( Web site only)

Operations

Committee Photograph ( hard copy only)

Area of Responsibilities

Publicity

Committee Photograph ( hard copy only)

Area of Responsibilities

Proclamation Letter ................................................................................. 191

Grand Jury Awareness Week Proclamation Certificate .......................... 192

Edit

Committee Photograph ( hard copy only)

Area of Responsibilities

Committee Final Report Summary.......................................................... 194

Continuity and Tracking

Committee Photograph ( hard copy only)

Area of Responsibilities

Tracking Summary .................................................................................. 200

Health, Education, and Social Services

Committee Photograph ( hard copy only)

Area of Responsibilities

Bakersfield Association for Retarded Citizens ( BARC) ......................... 205

Buttonwillow Union School District ....................................................... 207

Greenfield Union School District ( Web site only)

Foster Parent Recruitment and Retention................................................ 209

Kern County Animal Control .................................................................. 213

Kern County Mental Health Department, Contracting Policies .............. 216

Kern County School Districts Trustees’ Compensation.......................... 227

Kern High School District, Arvin High School....................................... 230

Kern High School District, Police Department ....................................... 232

Kern High School District, Bakersfield Adult School............................. 234

Valley Achievement Center..................................................................... 237

Law and Justice

Committee Photograph ( hard copy only)

Area of Responsibilities

Bear Valley Police Department ............................................................... 241

Response ......................................................................................... 248

CDC Medical Facility- Mercy Hospital ................................................... 256

Camp Erwin Owen.................................................................................. 259

City of Ridgecrest Police Department ..................................................... 262

Kern County Sheriff’s Department – Central Receiving Facility ........... 264

Kern County Sheriff’s Department Substation – Rosamond................... 267

Response ......................................................................................... 270

Board of Supervisors Response ( Web site only)

Kern County Sheriff’s Office Substation – Ridgecrest ........................... 271

Response ......................................................................................... 274

Board of Supervisors Response ( Web site only)

Ad Hoc

Committee Photograph ( hard copy only)

Area of Responsibilities

Kern County District Attorney’s Office .................................................. 278

Response ......................................................................................... 285

Library

Committee Photograph ( hard copy only)

Area of Responsibilities

Also served:

Barbara Jeanne Gardiner – Nominated by Frank A. Hoover

Robert Schilly – Nominated by Gary Freidman

O. Doyle Miller, Deceased – Nominated by John Quinlen

Presiding Judge – Honorable Stephen P. Gildner

MEMBERS OF THE 2003– 2004

GRAND JURY

Name Terms Served City Nominating Judge

Gerald Alderete 92- 93, 94- 95, 95- 96, 00- 01, 03- 04 Bakersfield Arthur Wallace

John Baird 03- 04 Bakersfield Arthur Wallace

Harold Casper 00- 01, 03- 04 Bakersfield John Kelly

Joseph Corn 90- 91, 00- 01, 03- 04 Bakersfield James Stuart

Earl Ennis 03- 04 Tehachapi John Oglesby

Richard Escudero 03- 04 Bakersfield Robert Tafoya

David Hashim 03- 04 Bakersfield Roger Randall

William McLean 03- 04 Bakersfield Jon Stuebbe

Paula Miller 03- 04 Bakersfield Robert Tafoya

Richard Morales 03- 04 Bakersfield Robert Tafoya

Raymond Mortimer 99- 00, 01- 02, 03- 04 Taft Craig Phillips

Dan Neal 99- 00, 03- 04 Bakersfield Roger Randall

Anthony Noce 01- 02, 03- 04 Bakersfield John Kelly

Joyce Ramos 03- 04 Bakersfield Robert Tafoya

Mary Rostad 03- 04 Bakersfield Romero Moench

Ronald Talbot 03- 04 Bakersfield L. Bryce Chase

S. Cynthia Tonkin 03- 04 Maricopa Romero Moench

GRAND JURY 2003 – 2004

COMMITTEE CHAIRS & MEMBERS

AD HOC – DISTRICT ATTORNEY’S OFFICE

Chairperson - Anthony W. Noce Joseph B. Corn

David L. Hashim

Richard H. Morales

Raymond R. Mortimer

ADMINISTRATION & AUDIT

Chairperson – Ronald C. Talbot Harold D. Casper

Richard N. Escudero

CITIES & JOINT POWERS

Chairperson - Anthony W. Noce Richard H. Morales

Raymond R. Mortimer

COUNTY SERVICES & SPECIAL DISTRICTS

Chairperson - Dan O. Neal Earl E. Ennis

Joseph B. Corn

GRAND JURY OPERATIONS

Chairperson – Mary A. Rostad

CONTINUITY & TRACKING

Gerald M. Alderete

Joyce F. Ramos

EDIT/ FINAL REPORT

Harold D. Casper

David L. Hashim

William J. McLean

PUBLIC RELATIONS & RECRUITING

Richard N. Escudero

Richard H. Morales

Dan O. Neal

HEALTH, EDUCATION & SOCIAL SERVICES

Chairperson - Dan O. Neal S. Cynthia Tonkin

LAW & JUSTICE

Chairperson - Paula K. Miller John P. Baird

William J. McLean

LIBRARY

Chariperson – Anthony W. Noce Gerald M. Alderete

Harold D. Casper

Raymond R. Mortimer

Joyce F. Ramos

Mary A. Rostad

GRAND JUROR’S OATH

The following oath is administered to Grand Jurors:

“ I do solemnly swear ( affirm) that I will support the Constitution

of the United States and of the State of California, and all laws

made pursuant to and in conformity therewith, will diligently

inquire into, and true presentment make, of all public offenses

against the people of this state, committed or triable within this

county, of which the grand jury shall have or can obtain legal

evidence. Further, I will not disclose any evidence brought before

the grand jury, nor anything which I or any other grand juror may

say, nor the manner in which I or any other grand juror may have

voted on any matter - before the grand jury. I will keep the charge

that will be given to me by the court.”

( Section 911, Penal Code, Amended June 2, 1983)

FORMAL STATEMENT OF POSITION

2003- 2004 KERN COUNTY GRAND JURY

Each year, nineteen citizens of Kern County stand before the Presiding Judge of the Superior

Court and swear to uphold the Grand Juror’s Oath. They will be active Grand Jurors for one

year and will serve over 700,000 residents of Kern County.

All Grand Juries are an independent judicial body. Present day responsibilities include

investigating all aspects of County government, special districts, and its cities to insure that these

bodies are being governed effectively. To fulfill these responsibilities, the Grand Jury may

subpoena persons and/ or records to obtain information on subjects under investigation. To

protect the constitutional rights of the parties being investigated, the Grand Jury as a group and

as individuals are sworn to complete confidentiality. The Grand Jury conducts criminal hearings

and can issue accusations against public officials, that if upheld by the courts, may result in

removal from office. Secrecy and confidentiality assure the protection and privacy of everyone

coming before the Grand Jury.

At the end of its one year term, the Grand Jury issues a Final Report to the Presiding Judge.

Portions of this document pertaining to investigation results during the year, may have been

previously released to encourage action on urgent matters. These reports include findings and

recommendations of each committee and are available to the general public, the media, and

Grand Jury website ( www. co. kern. ca. us/ grandjury ).

Any action taken during the year is to be considered official Grand Jury action and must be

approved by at least twelve of nineteen grand jurors. The decision will appear in the Grand Jury

minutes as a vote taken and rejected/ accepted. Those minutes will be destroyed at the end of

Grand Jury’s tenure. Rejected matters are no longer Grand Jury issues.

In some cases involving an issue that could not be completed within the year, the Presiding

Judge can hold over the evidence gathered for the next Grand Jury ( if the previous Grand Jury

requests it).

Once a week, the Grand Jury conducts business at a general meeting. On other days during the

week, members are engaged in committee work. They investigate complaints, meet with city

officials, and visit county and city facilities. They examine management, revenue accounts and

records to assure compliance with applicable laws.

The 2003- 2004 Grand Jury received numerous communications from citizens, civic groups, and

government employees relating to real or perceived grievances. The Jury could, and frequently

did, look into these complaints as part of its duties.

All complaints were submitted in writing by completing and signing a Grand Jury complaint

form. The Foreman determines that:

• The complaint deals with an area, agency or problem that falls within the purview of the

Grand Jury by law

• The complaint has merit and sufficient information is provided to make a determination to

proceed with an investigation

• The complaint is without merit or does not come under the jurisdiction of the Grand Jury. In

this case it would be returned without action and the complainant so notified

• Which committee of the Grand Jury will be assigned responsibility to investigate and report

on the complaint

Through the course of the 2003- 2004 year, the Grand Jury received a total of sixty- three

complaints. The distribution of these complaints is as follows:

Administration and Audit Committee 2

Cities and Joint Power Committee 12

County Services and Special Districts Committee 6

Health, Education, and Social Services Committee 17

Law and Justice Committee 26

When the Grand Jury year is concluded, they present a Final Report to the Presiding Judge. The

report includes all releases issued during the year. This concludes their responsibilities as jurors

for the County of Kern and the Superior Court. Unlike regular case jurors, they must not

disclose any information that was obtained while they were active Grand Jurors. Disclosure is a

misdemeanor.

The 2003- 2004 Kern County Grand Jury hopes that its citizens have learned how a Grand Jury

functions and the meaning of the Grand Juror’s Oath. The Grand Jury service is a personally

enriching experience and a significant public service. Applicants are recruited yearly at County

functions. We encourage citizens of Kern County to apply to the Grand Jury.

KERN COUNTY GRAND JURY STATEMENT

“ RESPONSE REQUIRED”

PURPOSE OF INQUIRY:

To help define to public agencies within the County of Kern what is required when a

“ Response Required” is included in a Grand Jury Final Report.

Section 933 ( b)( c)( d) of the California Penal Code states:

“( b) One copy of each final report, together with the responses thereto, found to be in

compliance with this title shall be placed on file with the county clerk and remain on file

in the office of the county clerk. The county clerk shall immediately forward a true copy

of the report and the responses to the State Archivist who shall retain that report and all

responses in perpetuity.

( c) No later than 90 days after the grand jury submits a final report on the operations of

any public agency subject to its reviewing authority, the governing body of the public

agency shall comment to the presiding judge of the superior court on the findings and

recommendations pertaining to matters under the control of the governing body, and

every elected county officer or agency head for which the grand jury has responsibility

pursuant to Section 914.1 shall comment within 60 days to the presiding judge of the

superior court, with an information copy sent to the board of supervisors, on the findings

and recommendations pertaining to matters under the control of that county officer or

agency head and any agency or agencies which that officer of agency head supervises or

controls. In any city and county, the mayor shall also comment on the findings and

recommendations. All of these comments and reports shall forthwith be submitted to the

presiding judge of the superior court who impaneled the grand jury. A copy of all

responses to grand jury reports shall be placed on file with the clerk of the public agency

and the office of the county clerk, or the mayor when applicable, and shall remain on file

in those offices. One copy shall be placed on file with the applicable grand jury final

report by, and in the control of the currently impaneled grand jury, where it shall be

maintained for a minimum of five years.

( d) As used in this section “ agency” includes a department.”

Section 933.05 ( a)( b)( c) of the California Penal Code states:

“( a) For purposes of subdivision ( b) of Section 933, as to each grand jury finding, the

responding person or entity shall indicate one of the following:

( 1) The respondent agrees with the finding.

( 2) The respondent disagrees wholly or partially with the finding, in which case the

response shall specify the portion of the finding that is disputed and shall include an

explanation of the reasons therefor.

( b) For purposes of subdivision ( b) of Section 933, as to each grand jury

recommendation, the responding person or entity shall report one of the following

actions:

( 1) The recommendation has been implemented, with a summary regarding the

implemented action.

( 2) The recommendation has not yet been implemented, but will be implemented in the

future, with a timeframe for implementation.

( 3) The recommendation requires further analysis, with an explanation and the scope and

parameters of an analysis or study, and a timeframe for the matter to be prepared for

discussion by the officer or head of the agency or department being investigated or

reviewed, including the governing body of the public agency when applicable. This

timeframe shall not exceed six months from the date of publication of the grand jury

report.

( 4) The recommendation will not be implemented because it is not warranted or is not

reasonable, with an explanation therefor.

( c) However, if a finding or recommendation of the grand jury addresses budgetary or

personnel matters of a county agency or department headed by an elected officer, both

the agency or department head and the board of supervisors shall respond if requested by

the grand jury, but the response of the board of supervisors shall address only those

budgetary or personnel matters over which it has some decisionmaking authority. The

response of the elected agency or department head shall address all aspects of the

findings or recommendations affecting his or her agency or department.”

COMMENTS:

1. The comments of public agencies in response to the Grand Jury report are an

important part of the process and the Grand Jury looks forward to receiving the

response from your agency. HOWEVER, IF THE REQUIRED RESPONSE IS

NOT RECEIVED WITHIN 90 DAYS, THE GRAND JURY WILL PROCEED

WITH ITS LEGAL OBLIGATION TO COMPEL THE SUBMISSION OF A

RESPONSE.

2. RESPONDING TO A GRAND JURY FINAL REPORT IS A LAW, NOT AN

OPTION.

3. Response should be sent to the Presiding Judge of the County of Kern Superior Court,

not to the Grand Jury.

SUMMARY:

It is the 2003- 2004 Kern County Grand Jury’s hope that the preceding “ Statement” will

help explain the legal responsibility pertaining to a Grand Jury Final Report “ Response

Required”.

Note: Present and past Kern County Grand Jury Final Reports and responses can be

accessed at the County Library and on the Kern County Grand Jury web- site:

www. co. kern. ca. us/ grandjury

OVERSIGHT RESPONSIBILITIES OF GRAND JURY COMMITTEES

BY COUNTY DEPARTMENT, AGENCY, CITY, & SPECIAL DISTRICT

ADMINISTRATION & AUDIT COUNTY SERVICES &

SPECIAL DISTRICTS

HEALTH, EDUCATION, &

SOCIAL SERVICES

LAW & JUSTICE CITIES & JOINT POWERS

Admin. Office ( CAO) Resource Mgt. Agency Aging & Adult Services District Attorney ( E) Cities

General Services Environmental Health Child Support Services D. A. Crime Lab Arvin

Construction Services Animal Control Emergency Med. Services Probation Bakersfield

Communications Engineering & Survey Employers’ Train. Resources Public Defender California City

Information Tech. Building Inspection Farm & Home Advisor Sheriff/ Coroner ( E) Delano

Insurance Programs Code Compliance Human Services Dept. Maricopa

Property Management Planning Dept. Kern Medical Center City Police Depts. McFarland

Purchasing Division Roads Dept. Libraries Jails & Prisons Ridgecrest

Revenue Sharing Prog. Mental Health Shafter

Taft

Agriculture Commissioner Parks & Rec. Dept. Public Health Dept. Tehachapi

Airports Dept. Waste Management Veterans Services Wasco

Airport Districts

Air Quality Districts Special Districts Hospital Districts Joint Powers

Assessor/ Recorder ( E) Cemetery School Districts County/ City Fire

Auditor/ Controller ( E) Comm. Service Dist. County Super. of Schools Housing Authorities

County Clerk – Elections Irrigation Dist. Museum KernCOG

Board of Supervisors ( E) Mosquito Abatement Local Agency Form

Comm. ( LAFCO)

Clerk of the Board Public Utility Districts Redevelopment Agencies

Board of Trade Park & Rec. Districts

County Counsel Resource Conservation

Risk Management Sanitation Districts

Economic Development Water Districts

GRAND JURY

OPERATIONS

COMMITTEE

Fire Dept. Water Storage Districts Tracking

Misc. Districts Continuity/ Manual

Public Relations LIBRARY COMMITTEE

County Service Areas 2004- 2005 Training

Manual

Maintain/ Update

Final Reports & Responses

for past Grand Juries

Personnel Dept. Lamont Final Report

Retirement Assoc. Oildale

Treasurer/ Tax Collector ( E) Rosedale

Rosamond

Non- Profit Corps.

Grand Jury Budget

( E) Elected 04/ 28/ 04

ADMINISTRATION AND AUDIT COMMITTEE

AREAS OF RESPONSIBILITIES

The Administration and Audit Committee is responsible for reviewing and overseeing County

Departments in their management, performance, and execution of fiscal responsibilities to the

taxpayers of Kern County pursuant to Penal Code Section 925. Section 925 authorizes this

Committee to investigate and report on the operations and accounts of County Departments and

Officers. The Committee also has the charge to assist other Grand Jury Committees with

managerial and fiscal issues to improve financial accountability and management of all County

Departments.

SUMMARY OF COMMITTEE ACTIVITIES

1. Five complaints of County Departments from residents were investigated.

2. Fifteen County Departments were visited and/ or reviewed:

Agriculture Department Board of Supervisors Kern Medical Center ( KMC)

Air Pollution Agency Board of Trade County Administrative Office

Auditor- Controller Fire Department Mental Health Department

County Counsel Personnel Department Environmental Health Department

Elections Division EMS Department Aging and Adult Services Department

3. Eight reports were written by the Committee and the Committee assisted other Grand Jury

Committees in writing two additional reports.

SUMMARY OF COMMITTEE’S MAJOR RECOMMENDATIONS

1. Increase the Transient Occupancy Tax from 6% to 12% within the County of Kern.

2. Develop a Visitor Center at the base of the Grapevine.

3. Continue Out- of- County Fire Fighting Activities.

4. Consolidate Fire Stations

5. Increase funding for the Fire Department – Cities to pay fair share.

6. Explore the development of Paramedic Services within the Fire Department.

7. Conduct a Management Audit of the Fire Department.

8. Agriculture Department to expedite communications with emergency “ First Responders”

with respect to pesticide exposure.

9. The County should replace its “ Operational Area” permits with “ Exclusive Operating Areas”

for ambulance services.

10. The Board of Supervisors must find and provide adequate funding for indigent medical care

at KMC.

11. Medical care of County Jail inmates should continue at KMC with adequate funding to cover

actual costs.

12. The physician residency programs should be continued at KMC.

13. KMC should not be sold, privatized, or closed.

14. The Board of Supervisors should consider creating a Department of Elections, similar to

other larger counties.

BOARD OF TRADE

ENHANCING KERN COUNTY’S ECONOMY

PURPOSE OF INQUIRY

Pursuant to Penal Code sections 925 and 933 the Administration & Audit committee

selected the Kern County Board of Trade as one of the county departments for oversight

review this year. This inquiry was conducted through interviews with the director of the

Board of Trade, the County Administrative Office, and information provided by the

County Elections Division.

BACKGROUND

The Kern County Board of Trade is the County’s public relations agency, responsible for

promoting and marketing Kern County. Founded in 1888 with the mission to “ EXTOL

THE VIRTUES OF KERN COUNTY TO THE EAST”. The Board of Trade Department

with a staff of seven and a budget of $ 481,000 administers:

• Kern County’s official tourism bureau, providing visitor information and promoting

Kern County as a travel- tourism destination.

• The Kern County Film Commission, providing permits and services for film,

television and commercial productions, as well as marketing Kern County as a

location for filming.

• The County’s efforts to promote Kern County as a retirement destination.

• The County’s special events, including the annual Kern Film Festival and the Kern

Products Dinner.

FINDINGS

• Publications of the Board of Trade include:

“ Kern County Business”, a monthly newsletter

“ Discover Kern County”, Kern County Visitor & Tourism Guide

Various specialty brochures: Golf, Camping, Museums, etc.

• Travel spending by tourists and business visitors amounts to approximately $ 940

million annually in Kern County. This spending generates $ 240 million in earnings

( profit) to various Kern County businesses, $ 22.5 million in local tax revenue, and

15,000 local jobs. Travel spending is tracked using an annual report prepared for the

California Division of Tourism by Dean Runyan & Associates. This report describes

the direct economic impacts of travel to and through the state of California and each

of its counties.

• Film production companies spent $ 13.6 million in the county during 2002- 03 while

shooting on location resulting in 221 Filming permits issued and 545 production days.

The Board of Trade and Film Commission produce an excellent guide to on- location

filming in Kern County, “ Kern County Film Production Directory”.

• The Board of Trade administers the Tourism Promotion Grant of $ 100,000, which is

distributed to various non- profit organizations including local chambers of

commerce to promote tourism.

• The Transient Occupancy Tax ( TOT), commonly called hotel room or bed tax, is the

tax which visitors or tourists pay when they stay in Kern County, as Kern County

residents pay to other city or county governments when they stay out of the county.

This tax rate ranges from 6% to 12% for incorporated cities in Kern County.

Bakersfield City has the highest rate of 12%. Usually some of this tax is used by

local governments to promote tourism and attract businesses. Until April 2002 Kern

County TOT rate in the unincorporated areas was 10% for a period of about ten years

( 1992- 2002). The State Supreme Court ruled in 2001 that Kern County must roll

back this tax to its 1991 rate of 6%, since the increase to 10% was not approved by

the voters. Measure “ D” was placed on the March 2002 ballot, as requested and

supported by KERNTAX, to approve the rate of 10%; but it failed due to lack of

promotion and possible misunderstanding of the public. This roll back of the TOT

from 10% to 6% results in about a $ 700,000 loss in tax revenue to county

government each year. For 2002 Kern County collected $ 1 million at the 6% rate.

The City of Bakersfield collected about $ 6 million in tax at the 12% rate.

• The Board of Trade has experienced, during the last two years, about a 50% reduction

in its tourism marketing budget which will have a negative affect on tourism tax

revenue generation.

• The Board of Trade is not able to assess dues or fees to businesses or Chambers of

Commerce that benefit from its tourism promotion services.

• A website ( www. retireinkern. com) is being developed to entice retirees to Kern

County.

• Signage directing traffic from Hwy 99 to the Board of Trade Visitor Center on Oak

Street is not adequate, or easy to follow.

• The Board of Trade has interest in developing a Visitor Center at the base of the

Grapevine with assistance from both Southern and Northern counties, cities and

businesses that might benefit from tourists that would stop there for information.

This center would require a 365 days a year operation schedule, if the state approves

it as an official visitor center.

COMMENTS

The Board of Trade presents itself as a very professional and efficient operation in which

the residents of Kern County should have great pride in having it represent the county in

the tourism and business arena. However, with reductions in marketing funds available

to the Board of Trade it is difficult for the board to reach potential tourists and enhance

the travel spending in Kern County and related tourism tax revenue. Now is not the time

to be “ Penny wise and pound foolish” with dollars that produce tourism earnings and

taxes. Therefore, the following recommendations are offered:

RECOMMENDATIONS

1. Consider resubmitting to the voters a ballot measure with a convincing argument to

increase the Transient Occupancy Tax ( TOT) in the unincorporated areas of the

county from 6% to a rate of 12%, which conforms with the City of Bakersfield TOT

rate. The additional revenue ($ 1 million) generated by this tax increase should then

go to marketing and promoting tourism in the county.

2. Research the possibility of placing a surcharge on hotel room rates to be used for

marketing tourism.

3. Research the possibility of assessing fees or dues to businesses and Chambers of

Commerce that benefit from Board of Trade activities.

4. Develop adequate signage, starting at the city edges, directing tourists from Hwy. 99

to the Visitor Center on Oak Street.

5. Continue to develop programs that attract retirees to the county.

6. Pursue the development of a state approved Visitor Center at the base of the

Grapevine with support from businesses and other California counties and cities, both

North and South of us, that might benefit. Determine if private funds might be

obtained to construct the facility.

RESPONSE REQUIRED

RESPOND WITHIN 90 DAYS

TO PRESIDING JUDGE

KERN COUNTY SUPERIOR COURT

1415 TRUXTUN AVENUE

BAKERSFIELD, CA 93301

Stephen Gildner, Presiding Judge

Kern County Superior Court

1415 Truxtun Avenue

Bakersfield, CA 93301

Dear Judge Gildner:

Transmitted herewith is the Board of Supervisors' response to the findings and recommendations

within the 2003- 2004 Grand Jury’s Final Report on the Board of Trade.

The Board of Supervisors thanks the Grand Jury for its review and report on this important

County function.

PHP: ACK: POLGJBOTB. doc

Attachment

Kern County Board of Supervisors

Response to Grand Jury Final Report

BOARD OF TRADE

Response to Findings:

The Board of Supervisors notes that the findings are substantially correct.

Response to Recommendations:

In March 2002 the Board of Supervisors approved placing Measure D on the ballot, which would have

retroactively increased the Transient Occupancy Tax ( TOT) in the unincorporated areas of the County.

The measure was defeated, with 64.3% of the electorate voting against the measure. This is the second

time an increase in the TOT has been voted down. While it is possible that a concerted effort could

narrow the vote margin, it is also noted that the County, by law, may only provide information and cannot

advocate for a measure placed on the ballot by the Board of Supervisors. No County funds can be

expended to promote support for such a measure. Therefore, the identification and clear commitment of

non- County, community advocacy groups for another TOT ballot measure would be critical for passage.

If an increase in the TOT were to be dedicated to a specific purpose, the increase is then a " special tax"

and under the provisions of Proposition 62 and Proposition 218 would require a two- thirds majority vote

of the electorate, rather than a simple majority. Likewise a surcharge on hotel room rates would require a

two- thirds majority vote. This statutory voter approval threshold would make it extremely difficult to

pass a local ballot measure providing for an increase in the TOT rate or a surcharge on room rates

dedicated specifically for tourism promotion. Clearly, the timing for submittal of another TOT ballot

measure to voters in the unincorporated area is an extremely important consideration. Other local tax

proposals ( local option sales tax for transportation), as well as a variety of State- level tax proposals aimed

at mitigating the State Budget deficit, create a climate where voter receptivity to a TOT rate increase or a

hotel room rate surcharge is even more doubtful than under normal circumstances.

The Board of Trade is developing a Tourism Marketing Voluntary Self- Assessment Program wherein

business benefiting from tourism will be asked to make a voluntary quarterly or annual contribution to a

marketing fund. Participating businesses will elect a Tourism Advisory Council that will approve the

marketing plan and related expenditures.

The Board of Trade will work with CalTrans to investigate additional locations for signage, and if

available will add signs as funding permits.

As noted in the Grand Jury's findings, the Board of Trade is developing a new website for retirees and

with Bakersfield Magazine annually publishes a retirement guide entitled Life at 55+. The Board of

Trade is also developing a plan to increase media coverage of the County's advantages for retirees.

A State- approved visitor center has long been discussed. The Board of Trade continues to investigate

sites, operational issues, and potential offsetting revenue. Unfortunately, the analysis continues to show a

need for County General Fund support. Given the County's funding constraints, serious consideration

would be required prior to initiating a new program when existing programs are in funding jeopardy.

2003- 2004 KERN COUNTY GRAND JURY

FINAL REPORT

KERN COUNTY FIRE DEPARTMENT

AND OTHER FIRE SERVICES IN KERN COUNTY

Pursuant to Penal Code Sections 925 and 933, the Administration and Audit Committee

of the 2003- 2004 Kern County Grand Jury reviewed the Kern County Fire Department

and other fire services in Kern County.

KERN COUNTY FIRE DEPARTMENT

&

OTHER FIRE SERVICES IN KERN COUNTY

PURPOSE OF INQUIRY

Pursuant to Penal Code sections 925 and 933, the Administration & Audit Committee of

the 2003- 2004 Grand Jury selected the Kern County Fire Department as one of the

County Departments for oversight review this year. This was due to the public’s interest

caused by news media articles on Firefighters’ overtime earnings. Additionally, this

report identifies other fire service agencies and their integrated operations within Kern

County.

PROCESS

The Administration and Audit Committee members started the inquiry by interviewing

the Kern County Fire Chief, the Bakersfield City Fire Chief and Officers. Firefighters’

union representatives were interviewed as were firefighters during the Committee’s visits

to several of the County fire stations. Information was collected from the County

Administrative Office, the County Auditor Controller, the Emergency Medical Services

Department and from members of the Board of Supervisors. With the help of several fire

service agencies within the County and other county Grand Juries, the Committee

collected comparable information from the following agencies and fire departments:

Bakersfield City Fire Department Fresno County Fire Department/ District

California City Fire Department Riverside County/ California Department of

Forestry Fire Department

Taft City Fire Department San Bernardino County Fire Department

Tehachapi City Fire Department Tulare County/ California Department of

Forestry Fire Department

California Department of Forestry ( CDF) Ventura County Fire Department/ District

Bureau of Land Management ( BLM) United States Forest Service

BACKGROUND

The Kern County Fire Department ( KCFD) is the eleventh largest fire department in the

State. The Department provides fire prevention, fire protection and suppression services

for structures and watershed areas, hazardous materials control and incident response,

emergency rescue and medical aid, and arson investigation. These services are provided

countywide. The Cities of Bakersfield, Taft, Tehachapi, and California City operate their

own fire departments.

Kern County is the third largest county in the State and covers a wide variety of climates

and terrain from wildlands to urban areas. The Fire Department staffs 45 full- time fire

stations throughout the County with a staff of 544 ( 474 firefighters) and with an annual

budget of approximately $ 77 million. Kern County is one of six counties that contracts

with the California Department of Forestry and Fire Protection to provide its own

wildfire suppression services. These contracts and agreements with the Federal

Government and the State of California allow the Kern County Fire Department to fight

wildfires within the County and throughout the State. This action helps the Department

reduce its Net County Cost by about $ 6 million for fiscal year 2003- 2004.

FINDINGS

OVERVIEW OF FIRE SERVICES

• In reviewing the operations and organizational structures of several county and city

fire departments, it is obvious that there is a variety of operational structures and

functions among these agencies. The Kern County Fire Department, Ventura County

Fire Department, Santa Barbara County Fire Department, Los Angeles County Fire

Department, and Orange County Fire Department contract with the California

Department of Forestry and Fire Protection ( CDF) to provide their own wildfire

suppression services within their respective counties. Other counties, such as

Riverside and Tulare, have integrated fire protection services with the California

Department of Forestry. In some counties, the county provides the equipment

( engines) and fire station facilities, and the CDF provides the fire fighting staff.

Several counties have fire districts and many county fire departments rely on Paid

Call- Volunteer firefighters to supplement their professional fire fighting staff.

• The following are the largest fire department staffs in California:

1. Los Angeles County ................... 4,428 ( 3,618 firefighters)

2. Los Angeles City ........................ 3,165

3. . San Francisco City...................... 2,000

4. Orange County ........................... 1,230

5. . San Diego City ........................... 1,032

6. Riverside County – CDF ............ 1,050

7. San Bernardino County ................. 970 ( includes 431 Paid Call-volunteer

firefighters)

8. San Jose City ............................... 808

9. Sacramento Metro ........................ 684

10. Sacramento City ............................ 550

11. KERN COUNTY......................... 544 ( 474 firefighters)

12. Ventura County ............................ 544 ( 417 firefighters)

• Within Kern County, the U. S. Forest Service staffs nine fire stations and the Bureau

of Land Management ( BLM) staffs five stations, with mostly seasonal firefighters

from May to November. Of the four city fire departments within the County, the

Bakersfield City Fire Department is the largest, with a staff of 203 which includes

176 firefighters and 13 fire stations.

The locations and staffing of the above agencies’ fire stations within Kern County are

found in Attachments A, B, & C at the end of this report.

• The City of Bakersfield and Kern County have a Joint Powers Agreement ( JPA) to

provide joint fire services in metropolitan Bakersfield. This agreement provides for

joint dispatching and training facilities. Under this agreement the closest agency

responds to fires and emergencies. The JPA was established in 1980 and the last

major update was in 1994.

• In 1995- 1996, a study was conducted by TriData Corporation for the City of

Bakersfield and the County of Kern to evaluate existing fire services in metropolitan

Bakersfield and to make recommendations on the most cost- effective system to

provide future fire services. The recommendations were to either merge the

Bakersfield City Fire Department with the Kern County Fire Department or create a

Fire Authority with its own fire department and board of directors separate from the

City and County elected officials. These recommendations were rejected since the

potential savings from the consolidation of the two fire departments would be minor.

FIREFIGHTERS

• The term firefighter is applied to the following ranks: Battalion Chief, Captain,

Engineer, and Firefighter. Each work 24 or 48 hour shifts and participate in the

suppression of fires. Battalion Chiefs and Captains are commanding officers.

• The KCFD Battalion Chiefs ( 22) supervise 6 to 9 fire stations during one of three

shifts. Each fire station usually has one fire engine with a Captain, an Engineer, and

one Firefighter per 48- hour shift. Seventeen of the County’s forty- six stations have

only a Captain and an Engineer per shift. Additionally, three of the larger fire

stations ( Norris, Virginia Colony, and Taft) have a ladder truck with a crew of a

Captain, an Engineer, and one Firefighter per shift.

• Each KCFD firefighter works an average of ten 24- hour days per month, or 56 hours

per week ( 2- 1/ 3 days/ week). The firefighter is paid at the 40- hour weekly rate of pay

for 56- hours of duty each week. Essentially, the firefighter is not paid for the 16

hours of sleep time during the 48- hour shift when compared to the standard forty hour

work week.

• The work schedule for a County firefighter consists of a 28- day cycle for each of

three shifts. The number of On- Duty- Days in a work cycle averages 10 days per

month with a schedule of 2 days on, 2 days off, 2 days on, 2 days off, 2 days on, and

then 8 days off. Each work shift is 48 hours, beginning at 8 AM and ending at 8 AM

48 hours later.

• The work schedule for a Bakersfield City firefighter consists of a 24- day cycle for

each of three shifts. Each shift is 24 hours for an average of 10 days per month. An

example of a work schedule is: work Monday, Wednesday, Friday, Sunday, then 4

days off; work Friday, Sunday, Tuesday, Thursday, and then 6 days off.

Work Days are Shaded

• The daily duties of a firefighter for an average 24- hour day are as follows:

1. Responding to fires or emergencies - 3- 5 hours

2. Fire prevention and preparation activities - 3- 5 hours

3. Maintenance and administration activities - 4- 6 hours

4. Sleep, cleanup, and meals - 10 hours

• Firefighters must stay physically fit to avoid injuries. Although injuries have been

few in the fire department, firefighters are at risk for injuries or even death due to the

dangers of their work in protecting the public. About 25% of the firefighters retire

with a disability retirement. A majority are eligible for a lump- sum payment upon

retirement from Workers’ Compensation Insurance for “ Cumulative Trauma”.

• College education is increasing among firefighters. All firefighters have the

equivalence of an Associate of Arts Degree with their required fire fighting

certifications. Many have Bachelors ( 15%) and Masters Degrees ( 1%).

• The family life of a firefighter is usually chaotic due to the variable work schedule

and the 48 hours away from home every few days. Firefighters miss many of the

activities and events in their children’s lives because of their scheduled work days

and emergency overtime call outs.

FIREFIGHTERS’ UNIONS

• County firefighters are represented by the Kern County Firefighters’ Union and the

Bakersfield City firefighters are represented by the Bakersfield City Firefighters’

Union. The California Professional Firefighters’ Association provides guidelines and

support to firefighters’ unions throughout California.

• The Kern County Firefighters’ Union is the most powerful of all the County

employee unions with which the Board of Supervisors must negotiate contracts. This

union has the major influence on the Fire Department’s operations, budget

expenditures, and safety issues. The Union gives campaign contributions to most of

the County and local State elected officials.

• The Union has given concessions in past years to balance the County budgets when

revenue was lacking. A 5% raise was exchanged for benefits and they agreed to cut

60 plus firefighter positions when minimum/ constant staffing was granted in the 1992

contract.

• The current County contract ( Memorandum of Understanding) with the fire union

expired in September 2002 and there has not been a pay raise for firefighters since

July 2001. Their salary surveys show that they lag behind other comparable counties

( 9th of 10 counties) and even the City of Bakersfield firefighters.

• The Union supports overtime pay instead of adding new firefighters, since most of the

overtime is seasonal ( summer) and the new firefighters may not be able to be used

cost effectively throughout the year. However, if approval was given to add a fourth

firefighter to each engine to meet national fire protection guidelines, the Union would

support recruiting an additional 100 firefighters to meet the guidelines.

• In addition to the Union’s disagreement with the County Board of Supervisors over

salaries, overtime pay, and meeting national fire protection guidelines, they believe

that the Fire Department’s budget needs to be much larger by millions of dollars each

year to replace engines, fire station facilities, and to develop a paramedics program.

The Board of Supervisors’ concern is how to provide the most cost- effective fire

services to the taxpayer.

• The two firefighters’ unions, County and Bakersfield City, have played an important

role in the development of the current Joint Powers Agreement ( JPA) between the

two government agencies. However, neither union wants to give up fire service areas

or stations to the other when there may be a need to do so for the benefit of the

taxpayer. There has been an informal agreement through the years between the

unions that fire service areas north of the Kern River are the County’s, and fire

service areas south of the Kern River are the City’s. There is no mechanism within

the JPA that addresses the extension of the City’s limits to north of the river,

especially in the River Lakes area around the County’s Greenacres Fire Station.

FUNDING OF FIRE SERVICES

• The majority of funding for the Kern County Fire Department comes from the Fire

Fund which is part of the “ 1% General Local Government” tax assessment on our

property tax bill each year. For 2002- 2003, the total of the “ 1% General Local

Government” tax collected for all local governments or districts within Kern County

was $ 432 million. The Fire Fund received $ 37 million or 8.6% of this $ 432 million.

As a comparison, the Ventura County Fire Department/ District received 10% ($ 65

million) of their “ 1% General Local Government” tax.

• The Fire Fund usually covers less than half of the Fire Department’s operating budget

each year. The following recap lists the other funds and revenue received for fiscal

years 2002- 2003 and 2003- 2004 as well as expenditures for the Kern County Fire

Department:

EXPENDITURES ( in millions)

2002- 2003 2003- 2004 ( Estimated)

Salaries ( Regular) $ 29.9 $ 31.3

Salaries ( other) 2.3 2.0

Overtime Pay 12.4 7.2 +$ 5.3? ( Wildfires)

Benefits ( Total) 20.6 20.9

Retirement 12.6 12.0

Health Insurance 4.6 5.2

Workers’ Comp 2.9 3.2

Other Benefits 0.5 0.5

Services & Supplies 7.2 10.0

Other 2.6 2.4

Fixed Assets ( Equipment) 0.4 2.9

TOTAL $ 75.4 Million $ 76.7 +$ 5.3? ( Wildfires)

Million

REVENUE

Fire Fund ( Structural) $ 30.0 $ 48.0

Local Public Safety Fund 3.3 4.0

CA Dept. of Forestry 8.4 9.0

Fire Cost Reimbursements 8.4 3.7 + 5.3?( Wildfires)

Other 10.7 4.0

Net County Cost ( General Fund) 14.6 8.0

TOTAL $ 75.4 Million $ 76.7 Million

+$ 5.3 Million ( Wildfires)

• The Kern County Fire Department provides fire services for eight of the incorporated

cities in the County. The Fire Fund dollars from these cities are transferred to the

County. However, in all cases except the City of Delano, this transfer of funds covers

less than one- fourth of the operational costs of a fire station within that city. It is our

understanding these cities do not pay additional funds for these fire services, except

for Shafter, which pays the additional cost of three Fire Engineer positions. The

KCFD contracts with the City of Delano to provide fire services for the City ( two fire

stations) for $ 1.2 million a year. It costs about $ 1 million to operate a fire station for

a year.

• County Fire Fund contributions by City for fiscal year 2002- 2003:

Arvin $ 193,000 Ridgecrest $ 495,000

Bakersfield 2,800,000 ( JPA) Shafter 138,000

Maricopa 22,000 Tehachapi 215,000

McFarland 131,000 Wasco 235,000

OVERTIME POLICY AND PRACTICES

• There are three types of overtime within the KCFD:

1. Regular Overtime – Scheduled Fair Labor Standards Act ( FLSA)

2. Emergency overtime

3. Constant staffing overtime

• Regular overtime is generated when personnel are assigned to special projects or

activities that require them to work on days off. The Fair Labor Standards Act

requires that a firefighter on a 56- hour week, be paid time and a half ( 1.5 times) for

three hours each week.

• Emergency overtime is seasonal ( May through November) and can be earned in three

ways. The first is by callbacks to staff shortages caused by personnel being assigned

to major incidents within Kern County ( e. g. structure fires or wildfires). The second

is by personnel assigned to incidents outside of Kern County ( e. g. the McNally forest

fire and the recent Southern California wildfires). The third is personnel hired back

to cover for those assigned out- of- county.

• Emergency overtime costs are controlled by selectively leaving stations vacant when

they are assigned to long- duration incidents. Some less active stations’ personnel and

equipment are also used to provide cover for busier stations by moving them to the

busier station when it is vacant.

• On most out- of- county and some in- county wildfires, overtime costs plus an

administrative fee ( 16%) and fees for use of equipment ( engines, etc.), are billable to

the requesting agency ( e. g. United States Forest Service, California Department of

Forestry, etc.). This billing allows the KCFD to recover the costs generated by

assisting other agencies for all personnel assigned to the incident plus those covering

behind them. When a firefighter is assigned to an out- of- county wildfire, the

firefighter is paid at a time and a half rate by the requesting agency for all days

assigned. If this firefighter is scheduled to work at a fire station back home in Kern

County for part or all of these days, this time and a half rate paid by the requesting

agency is essentially given to the firefighter who covers the position at the home

station. The firefighter at the out- of- county wildfire is paid straight time by the

County for those days, as if the firefighter were on duty at the home station.

• The County is therefore reimbursed for all overtime costs for out- of- county wildfires.

For 2002- 2003 the Fire Department estimates it collected 97.6% of all overtime costs

incurred and 137% of its total costs. The Department had total costs for labor,

overtime, equipment use, and overhead of $ 6.2 million and collected $ 8.5 million in

reimbursements for fiscal year 2002- 2003. The County gained a windfall of $ 2.3

million in unanticipated revenue. However, this is not easily confirmed. The County

Administrative Office states, “ to determine if all eligible fire- fighting costs are fully

reimbursed by various out- of- county agencies would be far beyond the scope of the

typical bi- annual audit conducted by the Auditor- Controller. Such an audit would be

costly. The Auditor- Controller’s office conducts financial and transaction audits.

That, combined with the budget oversight provided by the County Administrative

Office has insured that the Fire Department meets its projections for out- of- county

expenditure reimbursements, while not exceeding its appropriations.”

• Constant staffing overtime is generated when personnel are absent from work due to

vacation, sick leave, industrial injury, or training. The overtime is paid to those

firefighters who are hired back to staff the stations. They are staffed at the minimum

and constant standards as addressed in the Union’s Memorandum of Understanding

( M. O. U.), which can be found in “ Attachment A”, “ Fire Services in Kern County -

2003”, showing the locations and staffing of the County fire stations.

• Constant/ minimum staffing overtime is a standard in many of the larger fire

departments in the State and Country. This provides a basic level of safety for the

public and the firefighters by maintaining a required staffing level and specific ranks

of firefighters at each station. Most fire stations have one Captain, one Engineer, and

one Firefighter. When Captains or Engineers are absent due to vacations, sick leave,

or out- of- county wildfires, Captains must replace Captains, and Engineers must

replace Engineers. Lesser ranks can not fill- in for the higher ranks in most situations.

The Fire Chief must attempt to maintain this minimum staffing level, except for

“ short terms”, to accommodate emergency activity or extenuating circumstances.

• In 1992 this constant/ minimum staffing policy was first incorporated into a M. O. U.

between the County and the Kern County Firefighters’ Union. This was the result of

negotiations that provided for relief staffing to be accomplished via voluntary

overtime. This allowed the County to delete the relief crew of 63 Captain, Engineer,

and Firefighter positions. This voluntary overtime started at straight time in 1992. It

was increased to 1.15 times the regular hourly rate in 1995, to 1.25 times the hourly

rate in 1996, and then to 1.5 times the hourly rate in 2000.

• Overtime costs for the KCFD have increased from 25% ($ 6.5 million) of the total

regular salary costs in fiscal year 1998- 1999 to 41% ($ 12.4 million) in fiscal year

2002- 2003 due mostly to an increase in emergency overtime. The following table

shows total budgets and overtime costs of all three types, compared as a percentage to

the total regular salary costs from 1998 to 2003. In this table, the Ventura County

Fire Department/ District is used as a comparison since its operations and staffing are

very similar to the KCFD. Also, this fire department participates in suppressing

many out- of- county wildfires. The Ventura County Fire Department had overtime

costs of $ 12 million or 38% of its total regular salary costs for 2002- 2003.

• In 2002- 2003 the KCFD had emergency overtime costs of $ 5.5 million ( 18%), and

billed other agencies for about $ 8.5 million. This included all costs for labor

( overtime), equipment usage, supplies, and an administrative fee. The other overtime

costs for scheduled FLSA, and constant staffing overtime during 2002- 2003 totaled

$ 6.9 million or 23% of the total regular salary costs for the department. From the

information available this compares to a range of 15% to 19% for similar overtime

costs of six other city or county fire departments in California.

• In 2002, the average overtime earnings for the KCFD’s 467 firefighters was about

$ 18,000 each. Six earned over $ 60,000 and more than 90 earned over $ 30,000 in

overtime. These numbers included 14 Battalion Chiefs, 63 Captains, 11 Engineers,

and 2 Firefighters. The Battalion Chiefs and Captains have more opportunity to work

overtime than the junior ranks, since they are in demand as commanders in the

Incident Management Teams ( strike teams) for out- of- county wildfires. Other

Battalion Chiefs and Captains must then work overtime to provide coverage at the

home stations for these individuals.

KERN COUNTY FIRE DEPARTMENT

BUDGET AND OVERTIME COSTS 1998- 2003

Millions of Dollars

Years

Total

Budget

$

Net

County

Cost

$

Overtime

Scheduled

& FLSA

$

Overtime

Emergency

$

Overtime

Constant

Staffing

$

Total

Overtime

$

Total

Regular

Salary

$

%

Overtime

of Salary

98- 99 56.9 10.3 0.9 0.8 4.8 6.5 25.5 25%

99- 00 62.4 13.5 1.1 3.2 5.6 9.9 27.1 36%

00- 01 73.0 13.4 1.3 3.3 6.0 10.6 30.0 35%

01- 02 70.2 17.8 1.0 3.3 6.2 10.5 30.5 34%

02- 03 75.4 14.6 0.9 5.5 6.0 12.4 30.0 41%

03- 04 76.7 8.0 0.8 ? 6.0 ? 31.3 35- 40%

Estimated

Cost

So. Calif.

Wildfires

VENTURA COUNTY FIRE DEPARTMENT/ DISTRICT

02- 03 $ 76.0 0 1.0 11.0 * 12.0 32.0 38%

NOTES: 1. Net County Cost ( General Fund money), is reduced by an estimated $ 6.6 million for 03- 04

2. Constant/ Minimum Staffing Overtime was reduced by $ 200,000 for 02- 03

3. The $ 5.5 Million in Emergency Overtime for 02- 03 was largely affected by the McNally Fire

4. The Oct. 03 Southern California Wildfires will affect the Emergency Overtime for 03- 04

5. All Emergency Overtime for Out- of- County Fires is reimbursed by the State or the Feds

6. The Ventura County Fire Department and the Kern County Fire Department have similar

operations & Budgets

* Ventura County Overtime for Out- of- County fires and Constant staffing is included in their

Emergency Overtime costs

• To qualify as members of a National Incident Management Team, firefighters of any

rank must obtain training from the U. S. Forest Service on their own time and

expense. This training leads to certification or a “ Red Card” which makes them

eligible to become members of a “ strike team”. The firefighter must then be selected

for a team and agree to a five- year commitment to participate in wildfires around the

United States. During this five- year period, the firefighter may be committed to work

70- 100 days each summer.

• In order to reduce staffing overtime in 2000, the KCFD hired 24 entry- level

Firefighters as a “ relief pool” to fill in for long- term vacancies, but not for day- to- day

absences due to vacation or sick leave ( by M. O. U.). Since these relief firefighters are

at the Firefighter rank, they could not fill in for the upper ranks, who earn the most

vacation time. It is unclear how effectively the “ relief pool” could be used, since

most overtime is seasonal and they are not permitted to fill in for short- term absences.

• Other county fire departments have reduced overtime costs by using Paid- Call

Firefighters. They are volunteers paid for the hours worked. In one small county, the

fire department has reduced its professional staff to only one firefighter per station, a

Captain. When a fire occurs, the Captain calls several Paid- Call Firefighters, and

then drives the engine to the scene of the fire or emergency. The hope is that some of

the Paid- Call firefighters will respond in a timely manner.

• Hiring more firefighters to reduce overtime costs may not be effective. With the

increasing costs of employee benefits for health insurance, Workers’ Compensation

and retirement contributions, it costs less to pay overtime at the time and a half rate

than to pay the salary and benefits for a new firefighter ( 1.57 overtime vs. 1.92 new

hire, Attachment “ D”).

• There are some benefits to the County by permitting our firefighters to participate in

these out- of- county wildfires each year. The KCFD’s firefighters receive training and

experience in fighting wildfires, which can be used within the County. This makes

them better prepared to deal with emergencies or disasters. Firefighters that provide

coverage at the home stations gain experience in working at different stations with

different terrain and fire risks. The KCFD is reimbursed for the use of its engines,

trucks, dozers, and helicopter. These funds are then used in replacing obsolete fire

engines. Most importantly, is the goodwill the KCFD creates with the other counties

that need their services. This helps when the County needs “ Mutual Aid” during an

emergency or disaster in our county.

BASIC LIFE SUPPORT VERSUS ADVANCED LIFE SUPPORT

• Basic Life Support ( BLS) is the level of competency to which Emergency Medical

Technicians ( EMT’s) are trained. The training includes first aid, CPR, oxygen

therapy, extrication devices, and Automatic External Defibrillators. All firefighters

of the Kern County Fire Department ( KCFD) and the Bakersfield City Fire

Department ( BCFD) are trained and authorized to function at the BLS level.

• Advanced Life Support ( ALS) is the level of competency to which Paramedics are

trained. This training includes all of the BLS training plus the administering of life

saving drugs during emergencies ( e. g.: heart attacks, allergic reactions, asthma

attacks, seizures and other medical emergencies). In Kern County, only the

California City firefighters are trained and authorized to function at the ALS level

pending ambulance arrival. The California City Fire Department does not charge for

this paramedic service.

• A survey of 200 large fire departments by the “ Journal of Emergency Medical

Services” found that 95% ( 191) of fire departments provided ALS ( paramedic)

services as first responders. Only 37% ( 74) provided medical transportation

( ambulance) services.

• Both the KCFD and the BCFD are interested in providing ALS ( paramedic) services

to the public as “ first responders” and not as providers of medical transportation.

These fire departments believe that they can save lives, since they often arrive at the

scene of an accident or emergency prior to the ambulance.

• The cost for adding this ALS ( paramedic) service to the KCFD would be

approximately $ 25,000 for equipment per fire engine ($ 1 million), and a 5%- 7%

increase in salary for each Paramedic- certified firefighter ($ 1- 2 million). There

would be an additional unknown cost of extensive and on- going training. Grants may

be available to offset the cost of the equipment and training.

CONCLUSIONS

• After months of investigation, research, and interviews with 13 fire departments, the

Grand Jury concludes that there is nothing improper with the overtime policy and

practices of the Kern County Fire Department ( KCFD). The total overtime costs

( 41% of the total regular salary) for the KCFD are excessive when compared to other

safety officers employed by Kern County. However, these overtime costs compare

favorably with other fire departments with similar operations and out- of- county fire

fighting services.

• Approximately half the overtime costs are due to the KCFD’s “ Mutual Aid”

agreements with the U. S. Forest Service, the California Department of Forestry, and

other counties to assist them in fighting out- of- county wildfires ( like the recent

Southern California wildfires). Kern County is reimbursed for these overtime costs

and the County benefits from the experience and training of these firefighters. This

better prepares the KCFD to respond to emergencies and disasters within Kern

County.

• The firefighters should be commended for volunteering for a five year commitment to

risk their lives and sacrifice family time each summer fighting wildfires throughout

the State.

• Overall, the Grand Jury was impressed with the KCFD’s operations, efficiency, and

coordination with other fire departments within the County and State. However, the

Grand Jury believes that there are areas where changes could be made to reduce costs

or increase efficiency without jeopardizing the safety of the public or the firefighters.

RECOMMENDATIONS

1. Continue Out- of- County Fire Fighting Activities - The Kern County Fire

Department ( KCFD) should be authorized to continue its “ Mutual Aid” agreements

and contracts to provide out- of- county fire fighting services. Not only are all costs

reimbursed, but the County receives an approximate $ 2 million windfall in revenue

each year that should be used to replace obsolete fire engines and equipment. The

County also benefits from the training and experience our firefighters receive in

providing these services.

2. Create an Annual Report of Out- of- County Fire Fighting Activities - The KCFD

should create a summary report annually of its out- of- county fire fighting activities

for taxpayers and the Board of Supervisors. This report should be in a simple format

showing categorized total costs versus reimbursement revenues when all

reimbursements are collected for that fiscal year.

3. Modify the Minimum/ Constant Staffing Policy – The KCFD and its Union need to

work together to modify this policy to permit more flexibility in staffing for vacation

relief and sick leave coverage. This flexibility in staffing should provide the lower

ranks with more of an opportunity to share in providing this overtime coverage.

Currently, about 80% of the overtime pay goes to the senior ranks.

4. Increase the Relief Pool of Firefighters - Overtime costs could be reduced by

increasing the size of the relief pool of firefighters to include Paid Call ( volunteer)

firefighters, or part- time recently retired firefighters. Also, allowing this relief pool to

provide short term coverage for vacation relief could reduce overtime costs.

5. Consolidate Fire Stations – A study should be performed to determine if some fire

stations could be consolidated without jeopardizing the public’s safety. Within a few

miles of each other, the Taft ( Westside) area has five fire stations with 43 firefighters.

The Bureau of Land Management is interested in acquiring the McKittrick fire

station.

6. Increase Funding for the Fire Department - Of the eight cities for which the

KCFD provides fire protection services, only the City of Delano pays about half of

the costs for the service. The other cities pay much less. New contracts need to be

created with these cities based on the percent of fire and emergency incident calls

within the incorporated cities. This could result in an additional $ 2- 3 million for the

KCFD. Also, the Fire Fund portion of the “ 1% General Local Government” tax

needs to be reviewed and compared with other counties.

7. Update the Joint Powers Agreement - This 1980 Joint Powers Agreement between

the City of Bakersfield and Kern County to provide coordinated fire protection

services in metropolitan Bakersfield, was last updated in 1994. Due to annexation, it

needs to be reviewed and revised to reflect the growth of the City. This review

should take place before additional fire stations are planned or constructed in

metropolitan Bakersfield. The subject of how and when fire stations are added, and

who will build and staff them needs both short and long term clarification.

8. Explore the development of ALS ( Paramedic) Services within the KCFD - An

Advanced Life Support ( paramedic) program within the KCFD, similar to the

California City Fire Department’s ALS services, could provide an added measure of

protection to the public without jeopardizing the operations of the medical

transportation ( ambulance) companies. Funding for this program would be

expensive. This funding could be obtained by reducing constant staffing overtime,

consolidating fire stations, city governments paying their fair share for the KCFD’s

fire protection services within their cities, and grant funding. City residents would

benefit the most from these enhanced paramedic services.

9. Conduct a Management Audit of the KCFD - To evaluate and determine the

validity and effectiveness of the above eight recommendations, and to address issues

of disagreement with the Firefighters’ Union, the Grand Jury recommends that the

County Board of Supervisors contract with a fire- services consulting agency to

perform an audit of the KCFD’s operations and services. The last Grand Jury

requested audit of the KCFD was conducted in 1985.

10. The Kern County Fire Department should post a copy of this report and response, if

required, where it would be available for public reviewing.

Note: Present and past Kern County Grand Jury Final Reports and Responses can be

accessed at the County Library and on the Kern County Grand Jury web- site:

www. co. kern. ca. us/ grandjury

RESPONSE REQUIRED

WITHIN 90 DAYS

TO PRESIDING JUDGE

KERN COUNTY SUPERIOR COURT

1415 TRUXTUN AVENUE

BAKERSFIELD, CA 93301

ATTACHMENT “ A”

FIRE SERVICES IN KERN COUNTY - 2003

COUNTY FIRE DEPT., CITY FIRE DEPTS.,

U. S. FOREST SERVICE ( USFS), and

BUREAU OF LAND MANAGEMENT ( BLM)

AREA POPULATION # OF STATIONS # OF FIREFIGHTERS

In Three Shifts

ARVIN – LAMONT 32,800

Arvin 14,200 1 9 ( 3/ shift)

Lamont 18,600 1 9

BAKERSFIELD METRO 414,500

Bakersfield City Fire Department 260,000 13 176

Bakersfield - County Fire Department

Edison 2,500 1 9

Greenacres 23,300 1 9

Greenfield 9,000 1 9

Highland - Oildale 12,900 1 9

Landco - Haz. Mat. 600 1 15

Meadows Field 0 1 6 ( 2/ shift)

Niles 32,500 1 9

Norris 18,400 1 18 ( 6/ shift)

Old River 1,500 1 6

Riverview - Oildale 17,000 1 9

Rosedale 13,800 1 9

Virginia Colony 23,000 1 18

BLM 1 43 seasonal

DELANO 53,200

Delano 23,300 1 9

Delano West 18,400 1 6

McFarland 11,000 1 9

Glennville 300 1 6

Woody 200 1 6

Fulton – US Forest Service 1 20 seasonal

Wildlife Refuge - BLM/ USFS 1 0 seasonal

FRAZIER PARK 8,100

Mettler 1,100 1 6

Lebec 1,600 1 9

Frazier Park 3,900 1 6

Pine Mt. 1,500 1 6

US Forest Service 2 20 + seasonal

LAKE ISABELLA 14,400

Lake Isabella 5,300 1 9

Weldon 4,800 1 9

Kernville 4,300 1 9

US Forest Service 6 97 seasonal

Bureau of Land Mgt. 3 11 seasonal

ATTACHMENT “ A” ( continued)

MOJAVE DESERT 32,000

Mojave 4,300 1 9

Rosamond 15,400 1 9

Boron 3,300 1 6

California City Fire Department 9,000 1 9

RIDGECREST 31,400

Ridgecrest 11,800 1 9

Ridgecrest Hts. 15,000 1 9

Inyokern 4,200 1 6

Randsburg 400 1 6

TAFT 19,500

Taft City Fire Department 8,400 1 7

Taft - County Fire Department 9,000 1 18 ( 6/ shift)

Maricopa 1,300 1 6

Fellows 600 1 6

McKittrick 200 1 6

TEHACHAPI 26,800

Tehachapi - County Fire Department 14,400 1 9

Tehachapi City Fire Department 1 3 (+ 12 vols.)

Keene 900 1 9

Bear Valley 9,100 1 6

* Stallion Springs ( May- Nov.) 1,500 1 6 seasonal

Caliente- Piute 900 1 6

WEST COUNTY 43,200

Buttonwillow 2,700 1 9

Lost Hills 2,800 1 9

Wasco 22,100 1 9

* Shafter 15,600 1 9

BLM - Midway 1 9 seasonal

TOTALS 675,900 76 586 Plus

seasonal &

Mgt. staff

STATIONS TOTAL STAFF

KERN COUNTY FIRE DEPT. 46 544

BAKERSFIELD CITY FIRE DEPT. 13 203

CALIFORNIA CITY FIRE DEPT. 1 11

TAFT CITY FIRE DEPT. 1 7

TEHACHAPI CITY FIRE DEPT. 1 3

U. S. FOREST SERVICE 9 120 +

BUREAU OF LAND MANAGEMENT 5 63

NOTE: The Taft area, Frazier Park, and Woody/ Glennville have the highest number of fire stations and

firefighters per population.

Attachment D

March 30, 2004

Stephen Gildner, Presiding Judge

Kern County Superior Court

1415 Truxtun Avenue

Bakersfield, CA 93301

Dear Judge Gildner:

Transmitted herewith is the Board of Supervisors' response to the findings and recommendations

within the 2003- 2004 Grand Jury's Final Report on the Kern County Fire Department.

The Board of Supervisors appreciates the Grand Jury's attention to this important County

function.

Kern County Board of Supervisors

Response to Grand Jury Pinal Report

KERN COUNTY FIRE DEPARTMENT

Response to Findings:

The Board of Supervisors notes that the findings are substantially correct.

Response to Recommendations:

The Board of Supervisors is supportive of the Fire Department's mutual aid activities with other agencies

throughout the State and is also supportive of the department providing fire services in State

Responsibility Areas, so long as the department if fully reimbursed for all related costs. The Fire

Department has forwarded a report to the Board of Supervisors documenting its costs and reimbursements

thus far for Fiscal Year 2003- 04.

The minimum/ constant staffing levels for each fire station are contained within the memorandum of

understanding between the County and the Kern County Fire Fighters Union. Any change to these

provisions is subject to meet and confer with this Union.

As the Grand Jury noted, over the last 10 years, the memoranda of understanding with the Kern County

Fire Fighters Union has resulted in negotiated increases of the rate paid for overtime. Approximately

three years ago, a study was conducted to determine the most cost effective way of covering for staff on

vacation, sick leave, jury duty and the like. The results of the study revealed that it was more cost

effective to hire additional fire fighters to cover for regular absences, than to pay the negotiated overtime

rate. In Fiscal Year 1999- 2000, the department was authorized 24 additional fire fighter positions,

thereby re- creating the relief fire fighter pool that was eliminated in the early 1990s when the negotiated

overtime rate was equivalent to the straight time rate.

The Fire Department is developing budget contingency plans due to the State's fiscal crisis and the

potential impact on the County's General Fund. The department has been requested to develop plans for

incremental reductions, up to and including a plan that would address an elimination of the General Fund

contribution ($ 8.09 million) as a funding source. As a part of this plan, the department will likely

consider station consolidation as a cost saving measure. The Board of Supervisors has already requested

that the Fire Department work with the City of Taft to determine if cost savings would result from the

County Fire Department serving all of the Taft area, as opposed to portions being served by the County

and portions being served by the City's Fire Department. Along with determining ways to decrease costs,

the department is researching measures to increase revenues. A review of the contracts the County has

with various cities to provide fire protection services will be one of the measures reviewed. It is also

noted that the Fire Fund allocation of the 1 % general government property tax was established by statute,

more commonly known as the " AB 8 apportionment", following the passage of Proposition 13. The

apportionment rate cannot be altered.

The Fire Services Joint Powers Agreement ( JPA) with the City of Bakersfield has provisions covering

areas annexed by the City. The boundaries of the JPA service area are automatically expanded to include

areas annexed by the City. The City and County fire chiefs have met to review and discuss other

provisions within the JP A that may need to be updated.

Kern County Board of Supervisors

Response to Grand Jury Final Report

Kern County Fire Department

Page 2

Establishing an Advanced Life Support ( ALS) program is a policy decision for the Board of Supervisors.

As noted in the Grand Jury's report, substantial costs are involved in providing ALS level training to fire

fighters. The Fire Chief notes that the most pressing need for an ALS program is in the remote areas of

the County. The more remote fire stations are typically two- person stations and as such the Board has to

consider not only the expense of the ALS training, but also of having to augment staffing. The significant

resources that would be required to establish an ALS program must be evaluated in consideration of the

department's budget priorities, and the overall fiscal constraints facing the County.

The Board of Supervisors conceptually supports the Grand Jury's recommendation to engage a consultant

to audit the Fire Department's operations and services and believes that such a study would be beneficial.

Given the County precarious budget situation, however, this recommendation will need to be evaluated in

consideration of overall budget priorities.

2003- 2004 KERN COUNTY GRAND JURY

FINAL REPORT

MEDICAL TRANSPORTATION SERVICES

IN KERN COUNTY

Pursuant to Penal Code sections 925 and 933, and public concern, the Administration and

Audit Committee of the 2003- 2004 Grand Jury investigated the coordinated efforts of

four Kern County Departments in their oversight responsibilities of Medical

Transportation Service.

MEDICAL TRANSPORTATION SERVICES

IN KERN COUNTY

PURPOSE OF INQUIRY:

Pursuant to Penal Code sections 925 and 933, and public concern, the Administration and

Audit Committee of the 2003- 2004 Grand Jury investigated the coordinated efforts of

four Kern County Departments in their oversight responsibilities of Medical

Transportation Services. This report also attempts to determine the adequacy of various

types of medical transportation services available from private providers in Kern County.

PROCESS:

Officials of the Kern County Emergency Services Department, the Kern County Aging

and Adult Services Department, the Kern County Roads Department, and the Kern

Council of Governments ( Kern COG), were interviewed by the Administration and Audit

Committee. The purpose of the interviews was to determine their role and responsibilities

in regulating and evaluating various private providers of Medical Transportation Services

in Kern County. Also, several private providers of medical care and medical

transportation ( ambulance companies) were interviewed.

BACKGROUND:

Kern County first established a local Emergency Medical Services, ( EMS) agency in

1974 to provide for the development and oversight of Emergency Medical Services

within the County. In 1991, the Board of Supervisors approved regulations and policies

placing permit requirements, performance standards, and ambulance service operational

areas into effect. For more than a decade, the County has used these regulations to

manage the EMS system throughout the County, except for the City of Bakersfield. In

October 2003, the County EMS regulations were extended to cover the City of

Bakersfield. This action allowed the City of Bakersfield to be free of regulating

ambulance permits and rates.

In addition to the EMS Agency that regulates ambulance services, the County has

established other agencies, boards, and advisory committees to oversee, plan, and

develop other types of medical transportation services for senior and disabled persons.

FINDINGS:

·   There is a broad range of medical transportation services in Kern County. These

services range from emergency and non- emergency ambulance services, gurney and

wheel chair transportation, to senior transportation to Doctors’ offices. There are

several for- profit and non- profit agencies including private companies involved in

providing the above range of medical transportation services in Kern County. There

are five private ambulance companies providing emergency services, and more than

twelve agencies providing medical transportation for seniors or the disabled ( wheel-chair

bound patients) throughout the County.

·   The following agencies have oversight responsibilities, planning and evaluation of

community needs for the various types of medical transportation services:

Kern County Emergency Services Department

Kern County Aging and Adult Services Department

Kern Council of Governments ( Kern COG)

·   Social Service Transportation Advisory Committee ( SSTAC)

North Bakersfield Recreation & Park District

·   Consolidated Transportation Service Agency ( CTSA)

Kern County Roads Department

·   Kern Regional Transit

·   Dial- A- Ride Services in various cities

Golden Empire Transit ( GET- A- Lift)

Kern Senior Collaborative ( Transportation) CSU- Bakersfield

Emergency Medical Care Advisory Board

·   In October 2003 a local ambulance company discontinued its wheel chair medical

transport service ( vans) in Bakersfield. How wheel- chair bound patients would be

able to obtain transportation to medical providers has caused public concern.

Fortunately, an out- of- County ambulance company assumed most of the demand for

wheel chair and gurney transportation services within Metro Bakersfield.

·   Agencies such as GET- A- Lift, CTSA, Kern Regional Transit, and city Dial- A- Ride

programs ( that have contracts with the oversight agencies), have also increased

transportation services to wheel chair bound patients and senior/ disabled citizens. In

addition, other Kern County based ambulance companies have increased services to

meet the demand for non- emergency medical transportation, ( not only in Metro

Bakersfield but throughout the County).

·   From the complaints received by the Grand Jury, it does appear that medical

transportation for non- emergency gurney- bound patients is not sufficient in

Metropolitan Bakersfield. This type of medical transportation for gurney- bound

patients falls between the agencies with oversight for ambulance services and

senior/ disabled services ( wheel chair). Therefore, there is no agency responsible for

determining the needs of the Community for this type of medical transportation.

·   The Social Service Transportation Advisory Committee ( SSTAC), under the direction

of the Kern Council of Governments, includes most of the agencies in the County

responsible for medical transportation oversight. This Committee also includes the

agencies and private companies that either have an interest in or are providing

medical transportation to senior/ disabled citizens. This Committee evaluates and

determines community needs for all types of transportation throughout the County,

and makes recommendations.

·   There has been much public concern about the 22% increase in ambulance rates for

emergency responses that occurred the last part of 2003. The base rates for an

emergency response requiring Advanced Life Support ( ALS) and ambulance

transport increased from $ 575 to $ 700 throughout most of the County. There were

several reasons why this was necessary to guarantee the continued availability of

viable ambulance services.

·   Medicare ambulance reimbursement rates have been decreased approximately 20%

over the past two years and will continue to decrease through 2006. The current

inadequate Medi- Cal reimbursement rates will be reduced 15% over the next three

years. The chart below illustrates how Medi- Cal currently pays only 18.4% of the

amount billed, and Medicare pays 54.7% of the amount billed by an ambulance

company.

EXAMPLE OF AN AMBULANCE COMPANY’S COLLECTIONS

BY PAYOR TYPE ( Polaris Group Report – 2003)

Payor Type % Charges Paid % Collected

Private Pay 4.0% $ 869 $ 251 28.8%

Facility Contract 6.9% $ 823 $ 527 64.0%

Private Insurance 26.1% $ 899 $ 705 78.4%

Medi- Cal 25.2% $ 845 $ 156 18.4%

Medicare 26.2% $ 848 $ 464 54.7%

Uncollected 11.7% $ 904 $ 97 10.8%

TOTAL 100%

AVERAGE $ 865 $ 402 46.5%

·   The above chart indicates that this ambulance company was able to collect an average

of 46.5% of its charges from its payors. It also illustrates that over 50% of its

business was Medi- Cal and Medicare patients. According to the 2003 Polaris Group

Report, the average bill countywide for ambulance services was $ 961 and the average

collection per account was $ 549, ( a collection rate of 57%). Therefore, the

inadequacy of Medicare and MediCal payments forces ambulance providers to shift

the cost of services to those payors that do pay more of the entire bill.

·   In April 2003, the Kern County Board of Supervisors contracted with The Polaris

Group to perform an analysis of the County’s EMS system. This included an

evaluation of the ambulance service providers in Kern County. This analysis will be

done in three phases. At this time only the first phase has been completed.

·   In the first phase of the Polaris Report, the ambulance providers within the County

were praised for utilizing creative and cost- effective methods to stretch resources,

including the use of “ on- call” flexible staffing and aggressive “ System Status

Management”.

·   However, the Polaris Report addresses several of the weaknesses of the County’s

EMS system. The current ordinance is not sufficient to protect the integrity of the

EMS system and exposes the County to unnecessary anti- trust liability risk. The

current ordinance does not adequately protect the EMS system from unmanaged

competition from sources within or outside the County.

·   Kern County is a difficult environment in which to deliver high performance

emergency medical services. This is due to the geographical size of the County and

the distribution of calls. Therefore, the Polaris Report recommends the establishment

of State- approved Exclusive Operating Areas ( EOA) Countywide to protect the

integrity of the system.

COMMENTS:

The oversight and regulatory responsibilities for medical transportation providers are

divided between at least four County departments. There appears to be adequate

coordination. The Social Service Transportation Advisory Committee, under the

direction of Kern COG, provides a forum in which discussions, planning, and

coordination of efforts occurs.

With the decrease of Medicare and Medi- Cal ambulance reimbursement rates, the 22%

increase in ambulance base rates appears to be justified. This increase in rates will

guarantee that adequate ambulance services are available in the County to provide

emergency medical services for all residents.

RECOMMENDATIONS:

1. Communications should be enhanced between the various oversight agencies, the

providers of medical transportation services, and the clients. This could be done

through the Social Service Transportation Advisory Committee ( SSTAC) of Kern

COG, by inviting other providers of health care or senior services. For example,

representatives of convalescent hospitals and dialysis centers could participate in this

committee.

2. The Kern County Emergency Medical Services Department should consider

regulating, permitting, and monitoring the services of non- emergency medical

transportation agencies ( wheel chair and gurney vans). Apparently, this is done in

other counties, which helps them determine the adequacy and quality of available

services.

3. The Kern County Aging and Adult Services Department should continue developing

plans through its various committees and the Kern Senior Collaborative, to enhance

senior transportation within the County including Volunteer Driver Reimbursement

programs.

4. Kern County should replace its “ Operational Area” permits with State- approved

Exclusive Operating Areas ( EOA) for both emergency and non- emergency

ambulance service. This would guarantee the integrity of the EMS system by

restricting “ cream skimming” of selective non- emergency medical services by any

permitted provider in Kern County.

5. The aforementioned departments involved should post a copy of this report where it

would be available for public reviewing.

Note: Present and past Kern County Grand Jury Final Reports and Responses can be

accessed at the County Library and on the Kern County Grand Jury web- site:

www. co. kern. ca. us/ grandjury

RESPONSE REQUIRED

WITHIN 90 DAYS

TO PRESIDING JUDGE

KERN COUNTY SUPERIOR COURT

1415 TRUXTUN AVENUE

BAKERSFIELD, CA 93301

Kern County Board of Supervisors

Response to Grand Jury Final Report

MEDICAL TRANSPORTATION SERVICES IN KERN COUNTY

Response to Findings:

The Board of Supervisors notes that the Grand Jury's findings are substantially correct.

Response to Recommendations:

The Board of Supervisors concurs that the Kern Council of Governments' Social Service Transportation

Advisory Committee may be the appropriate entity to enhance communication between medical and

specialty transport oversight agencies, service providers, and clients.

The Emergency Medical Services Department only regulates medical transport providers, those that

provide medical care during transport, as distinguished from specialty transport providers. The

Department will consider the Grand Jury's recommendation to regulate specialty transport providers in the

upcoming Emergency Medical Services system redesign process. This process will include gathering

input from stakeholders to identify unmet needs. If, through this process, a sufficient demand for

regulatory oversight of gurney and wheelchair vans is identified, the matter will be brought before the

Board of Supervisors for its consideration.

The Aging and Adult Services Department will continue to develop plans for enhancing senior

transportation services through its advisory and collaborative groups.

The concept of adopting an Exclusive Operating Area system will be considered during the Emergency

Medical Services redesign process and appropriate recommendations will be made to the Board of

Supervisors.

2003- 2004 KERN COUNTY GRAND JURY

FINAL REPORT

LAMONT PESTICIDE DRIFT

“ EMERGENCY PREPAREDNESS”

Pursuant to Penal Code Sections 925 and 933, the Administration and Audit Committee of the

2003- 2004 Kern County Grand Jury investigated the coordinated responses of three county

departments to a pesticide exposure incident.

LAMONT PESTICIDE DRIFT

“ EMERGENCY PREPAREDNESS”

PURPOSE OF INQUIRY

Pursuant to Penal Code sections 925 and 933, and a citizen’s complaint, the Administration and

Audit Committee of the 2003- 2004 Grand Jury investigated the coordinated responses of three

county departments to a pesticide exposure incident.

PROCESS

Officials of the Kern County Department of Agriculture, the Kern County Fire Department, and

the Kern County Environmental Health Department were interviewed by the Administration and

Audit Committee to evaluate the adequacy and timeliness of their cooperative responses and

actions.

BACKGROUND

On October 4, 2003, over 100 residents of an apartment complex on Sunset Ave. in Lamont were

forced to evacuate their homes. The evacuation was due to the “ drift” of the pesticide

Chloropicrin that had been applied to a fallow field approximately ¼ mile north of the apartment

complex. The Kern County Fire Department, the Kern County Environmental Health

Department, and the Kern County Department of Agriculture responded to this medical

emergency.

FINDINGS

·   Due to their symptoms of eye irritation, respiratory distress, nausea, and vomiting

approximately 50 people were evaluated by the Kern County Fire Department and Hall

Ambulance paramedics. Three people were transported to Kern Medical Center and one to

San Joaquin Hospital for further evaluation. All of the patients were later released.

·   This exposure to Chloropicrin was apparently caused by the improper application of the

pesticide on October 3rd and 4th to a field approximately ¼ mile from the apartments.

Chloropicrin, which is also the chemical used in tear gas, is a fumigant used in treating soil to

kill pests. It can often be smelled at very low concentrations, and can cause eye irritation,

respiratory distress, and burning of nose, throat, and skin. There is no evidence that

Chloropicrin can cause reproductive effects or birth defects.

·   The Fire Department, ( Station 51) first responded to a call for assistance on Friday evening,

October 3rd, when the first incident of this pesticide exposure occurred. On Saturday,

October 4th, a second more serious drift of this pesticide occurred. The Fire Department

arrived at the scene about 8: 00 PM and setup an Incident Command Center. The commander

of the center, a Battalion Chief, assumed that a pesticide exposure had occurred, based on the

symptoms and location of the incident. Therefore, the Agriculture Department and the

Environmental Health Department were immediately contacted, along with the Sheriff’s

Department, the CHP, and Hall Ambulance.

·   The Fire Department and the Environmental Health Department are designated as “ first

responders” in any hazardous materials ( HazMat) spills or exposures in the County. The

Agriculture Department is only designated as a “ stand- by” consultant to these first

responders in an emergency incident.

·   Residents of the apartment complex were evacuated to a nearby market parking lot, under the

direction of the Battalion Chief, to remove them from further pesticide exposure. A triage

was setup by the Fire Department and Hall Ambulance on the SE corner of Weedpatch

Highway and Buena Vista Blvd. in the parking lot. The affected residents were examined

and monitored by paramedics. Spanish speaking personnel were available for interpretation.

·   About 8: 30 PM, personnel from the Environment Health Department and the HazMat

personnel from the Fire Department ( station 66) arrived at the scene. They shortly

determined that the incident was probably caused by exposure to a drift of a fumigant type of

pesticide. Because the fumes were very faint, they were not able to identify the field from

which the drift originated.

·   Sometime after 9: 30 PM, an employee from the Agriculture Department arrived at the scene.

He was able to confirm that Chloropicrin, a fumigant pesticide, was applied to a nearby field.

This employee was on voluntary stand- by ( non- paid). He had to go to the Agriculture

Department Office and check the pesticide application records for permits issued in the

Lamont area for this time period.

·   No “ Medical Emergency” alert was given to the various hospitals, since less than five people

were seriously affected.

·   After a few hours the odor and fumes of the pesticide dissipated and the residents returned

home with precautionary directions from the Battalion Chief. The Fire Department cleared

the scene at about 1: 00 AM Sunday morning.

·   On October 17th, a public hearing was held at the Community Center in Lamont. The

purpose of the hearing was to answer questions from the people involved in this pesticide

exposure incident, concerning health affects or risks from the exposure. Unfortunately, few

people attended.

·   The Kern County Department of Agriculture with the assistance of the California Department

of Pesticide Regulation is continuing an investigation of this incident using the recently ( Dec.

2003) drafted “ Guidelines for Responding to Non- Occupational Pesticide Use- Related

Exposure Incidents”. Applications of Chloropicrin in Kern County are currently suspended

pending further investigations.

COMMENTS

Although there was a delay in obtaining information from the Agriculture Department which

confirmed the exact pesticide responsible, the Fire Department responded in a very effective and

adequate manner. Residents were removed from further exposure to the pesticide and evacuated

to a “ safe haven”. Medical treatment was given for respiratory distress. Had this incident

continued through the night, it would have been necessary to provide more comfortable

accommodations, such as a school, church, or auditorium for the affected residents.

Since this incident occurred after regular working hours for the Agriculture Department,

consultation with the personnel was not immediately available. ( However, it may not be cost

effective to have Agriculture Department personnel on paid- call 24 hours/ 7days a week for

consultation). The Fire Department’s protocol for responding to pesticide exposures and

providing appropriate medical treatment, is not dependent upon knowing immediately which

pesticide is responsible for the incident.

Overall, the Grand Jury was impressed with the coordinated efforts and actions of the three

county departments. They protected the health of the people involved in this pesticide exposure

incident. However, the Grand Jury believes that efficiency can be enhanced.

RECOMMENDATIONS

1. The Kern County Department of Agriculture should explore ways to expedite access to its

pesticide application permits database during off- hours. This could be done by:

a) Restructuring the volunteer on- call system

b) Permitting home access to an office database

c) Through a take- home laptop computer containing daily updated information about

pesticide application permits issued.

2. Develop procedures to enhance rapid communications between the various county and state

departments involved in emergency responses.

3. The Kern County Department of Agriculture should immediately implement the new

( December 2003) “ Guidelines for Responding to Non- Occupational Pesticide Use- Related

Exposure Incidents”. These guidelines were developed by the California Department of

Pesticide Regulations to investigate and respond to exposure incidents.

4. The Office of Emergency Services, a division of the Kern County Fire Department, should

plan additional mock exercises simulating a pesticide exposure to residents of a small

community.

5. The Office of Emergency Services should develop guidelines for the Fire Battalion Chiefs.

The guidelines should indicate the locations of possible overnight emergency- shelter sites

throughout the County. Contact information should be provided to the Fire Battalion Chiefs

regarding county departments to contact for assistance in setting up these shelter sites.

6. The aforementioned departments involved should post a copy of this report where it would

be available for public reviewing.

Note: Present and past Kern County Grand Jury Final Reports and Responses can be

accessed at the County Library and on the Kern County Grand Jury web- site:

www. co. kern. ca. us/ grandjury

RESPONSE REQUIRED

WITHIN 90 DAYS

TO PRESIDING JUDGE

KERN COUNTY SUPERIOR COURT

1415 TRUXTUN AVE.

BAKERSFIELD, CA 93301

Kern County Board of Supervisors

Response to Grand Jury Final Report

LAMONT PESTICIDE DRIFT

Response to Findings:

The Board of Supervisors notes that the findings are substantially correct.

Response to Recommendations

The Agricultural Commissioner is exploring the opportunities for access to a pesticide database through

use of a software system being developed by the California Department of Pesticide Regulations ( DPR) in

collaboration with County Agricultural Commissioners, the Statewide Permitting and Use Reporting

System.

The Fire Department notes that all required agencies were timely notified and responded to the incident

according to established policies and procedures, including dispatch protocols, the Kern County

Hazardous Materials Response Plan, and the Kern County Emergency Preparedness Plan. Interoperable

communications were conducted via radio and cell phones. The Fire Department is using Homeland

Security grants to purchase more radios on common frequencies to increase interoperability capabilities.

The County’s Agricultural Commissioner assisted the DPR in developing the draft " Guidelines for

Responding to Non- Occupational Pesticide Use- Related Exposure Incidents", which were in fact used in

responding to the Lamont incident. Minor changes were made to the Guidelines following the Lamont

incident, and the final Guidelines were issued in December 2003. The Agricultural Commissioner

follows these Guidelines when responding to pesticide incidents.

The Fire Department provided a training packet to its personnel in October 2003 on responding to

pesticide exposure incidents. The battalion chief used the checklist provided in this packet in managing

the Lamont incident. Additional training and exercises will be conducted as needs are identified.

Guidelines and contacts for providing emergency shelters are in the Kern County Emergency

Preparedness Plan. It is not immediately known if an emergency shelter will be needed when an incident

occurs. At a later incident in Shafter, the Fire Department did open an emergency shelter, although it was

not used.

2003- 2004 KERN COUNTY GRAND JURY

FINAL REPORT

KERN COUNTY HISPANIC CHAMBER OF COMMERCE

Pursuant to Penal Code Sections 933.6, the Administration and Audit Committee of the

2003- 2004 Kern County Grand Jury reviewed the functions of the Kern County Hispanic

Chamber of Commerce ( KCHCC).

A grand jury may at any time examine the books and records of any nonprofit

corporation established by or operated on behalf of a public entity the books and records

of which it is authorized by law to examine, and, in addition to any other investigatory

powers granted by this chapter, may investigate and report upon the method or system of

performing the duties of such nonprofit corporation.

KERN COUNTY HISPANIC

CHAMBER OR COMMERCE

PURPOSE OF INQUIRY:

Pursuant to Penal Code section 933.6, the Administration & Audit Committee of the

2003- 2004 Kern County Grand Jury reviewed the functions of the Kern County Hispanic

Chamber of Commerce ( KCHCC). The review was accomplished through interviews of

officers and members of the KCHCC.

BACKGROUND:

The Kern County Hispanic Chamber of Commerce was founded in 1985 by a small group

of Kern County Hispanic business leaders. These leaders felt that the Greater Bakersfield

Chamber of Commerce was not addressing the needs of the Hispanic business

community. Currently, the Greater Bakersfield Chamber of Commerce is a member of

the KCHCC as is the KCHCC a member of the GBCC.

The KCHCC is a non- profit, non- partisan, and non- sectarian business organization.

Their overall goal is promoting improvement in the quality of life in the Hispanic

Community.

The mission of the KCHCC is “ to create, promote and enhance business opportunities for

our membership, and provide business, cultural and resource linkages, with special

emphasis on the Hispanic community”.

The KCHCC brings together Hispanic owned and non- Hispanic owned businesses to

share in the Hispanic market in Kern County. The KCHCC is a diverse organization of

Hispanic, Anglo, Afro- American, and Asian business owners.

FINDINGS:

·   The Hispanic population is growing faster than any other group of people in Kern

County. Currently, Hispanics are 40% of the Kern County population.

·   There are about 5000 Hispanic businesses in Kern County. Bakersfield ranks number

32 of the top 35 Hispanic markets in the United States.

·   California has more Hispanic owned businesses than any other state in the United

States. In California, 28% of all businesses are Hispanic owned. In the San Joaquin

Valley, the counties with the largest number of Hispanic businesses are as follows:

Fresno 8100, Kern 4762, Tulare 3671, and Merced 2024.

·   In the year 2000, Hispanics in Kern County spent over $ 2.5 billion or 26% of all local

spending.

·   For 2001, Hispanics purchased or leased 23% of all vehicles in Kern County. The

amount spent on 5564 new vehicles was $ 117.5 million.

·   Following is the breakdown of expenditures of Hispanic households in 2000 for Kern

County:

$ 300.3 million in groceries

$ 275 million on health care

$ 137 million dining out

$ 66 million on furnishings

$ 450 million on housing ( rent or mortgage)

·   The KCHCC formed a non- profit foundation in 1996. This foundation provides

funds to needy students that continue their education in high school and college,

( including trade school scholarships). The foundation has teamed up with the

Hispanic Excellence Scholarship Fund which matches all funds of the KCHCC to

provide additional scholarships. In the past year, $ 35,000 was distributed to

qualified students.

·   More Hispanic students are seeking higher education in business, teaching, and

technical skills. ( Attachment A)

·   The KCHCC receives its revenue from membership dues, donations, grants, and fund

raisers. The KCHCC receives no funds from the State or local governments as does

the Greater Bakersfield Chamber of Commerce.

·   The KCHCC provides the following services: Business and Marketing Plans,

Business Start- up Assistance, Organizational Development, Workshops and

Seminars, Business Loan Assistance, and Marketing Research. The organization also

publishes a newsletter, The Hispanic Network.

·   The KCHCC has a Board of Directors and officers comprised of approximately

twenty community leaders representing a variety of Hispanic owned businesses in

Kern County.

COMMENTS:

Since over 50% of all school age children in Kern County are Hispanic, the future of

Bakersfield is the Hispanic market. The KCHCC has positioned itself as the largest

Hispanic business organization in the County. The Chamber helps businesses access this

growing Hispanic marketplace.

RECOMMENDATIONS:

1. The KCHCC should enhance its communication with all existing and new businesses

in Kern County.

2. The KCHCC should seek grants from the State or local governments. The KCHCC

should work with the Kern County Board of Trade to encourage development of

Hispanic enterprises.

3. The KCHCC should enhance its ability to assist minority businesses in acquiring

available small business loans.

NO RESPONSE REQUIRED

ATTACHMENT A

70.2%

67.0%

70.2%

71.1%

71.0%

69.7%

69.2%

69.6%

69.0%

66.5%

63.7%

62.6%

60.3%

57.1%

54.6%

52.4%

51.9%

50.6%

49.8%

49.3%

49.4%

47.7%

46.1%

12.8%

11.4%

11.2%

11.4%

12.7%

13.6%

14.6%

15.7%

16.2%

17.6%

19.2%

20.2%

21.8%

23.8%

25.4%

27.8%

29.1%

30.0%

32.6%

33.9%

33.5%

35.5%

36.6%

0%

20%

40%

60%

80%

0%

20%

40%

60%

80%

Percentage

1979

1980

1981

1982

1983

1984

1985

1986

1987

1988

1989

1990

1991

1992

1993

1994

1995

1996

1997

1998

1999

2000

2001

2002

2003

Fall Quarter

Graph 1

California State University, Bakersfield

Percents by Ethnicity of Main Campus Fall Undergraduate Enrollment

White

Latino

Black

Asian/ Filipino

**

** Lines for American Indian and foreign

2003- 2004 KERN COUNTY GRAND JURY

FINAL REPORT

KERN MEDICAL CENTER

“ A STRUGGLE FOR SOLVENCY”

Pursuant to Penal Code Sections 925 and 933, the Administration and Audit Committee, and the

Health, Education and Social Services Committee reviewed the Kern Medical Center ( KMC) due

to the public interest in the financial stability of the institution.

KERN MEDICAL CENTER

“ A STRUGGLE FOR SOLVENCY”

PURPOSE OF INQUIRY

Pursuant to Penal Code Sections 925 and 933, the Administration and Audit Committee and the

Health, Education and Social Services Committee of the 2003- 04 Kern County Grand Jury selected

the Kern Medical Center ( KMC) to review this year due to the public interest in the financial stability

of the institution.

PROCESS

The Committees met on several occasions with Kern Medical Center officers, the County

Administrative Officer, and members of the Board of Supervisors to collect information about the

financial health of the hospital. Previous management- audit reports from 1996 to 2003 were

reviewed.

BACKGROUND

Kern Medical Center ( KMC) which had it beginnings in 1867, is a 222 bed acute care teaching

hospital with a staff of 1480. With an annual budget of approximately $ 176 million, KMC provides

comprehensive emergency, outpatient ( clinics), and inpatient medical services to approximately

15,000 inpatients and 100,000 clinic patients per year. It operates seven graduate medical

education programs affiliated with the University of California Schools of Medicine at Irvine ( UCI),

Los Angeles ( UCLA), and San Diego ( UCSD). Through the medical services provided by KMC,

the County of Kern meets its statutory obligations to provide medical care for indigent residents.

FINDINGS

Ÿ   Kern Medical Center is engaged in a continuing struggle for solvency. Over the past several

years, the average daily patient census has increased. Medi- Cal and indigent patients comprise

nearly 75% of its patients.

Ÿ   The County has the obligation to provide care to the medically indigent under the Welfare and

Institutions Code Section 17000. To comply with this mandate KMC provides medical services

to approximately 2500 indigent inpatients and 25,000 indigent clinic- patients each year. This

represents about 20% of its total patient services.

Ÿ   In 1985, the Board of Supervisors created an enterprise fund for KMC, which separated KMC

from the County’s general fund. This allowed KMC to be self- sustaining and keep all of its

revenue generated from service charges year after year. For many years this KMC Enterprise

Fund increased and was used to fund its annual operational costs and capital improvements at

the hospital. In 1997, the fund had a balance of $ 22 million. Currently, the balance is a negative

$ 30+ million. The decrease in this enterprise fund was due to an increase in the number of

indigent patients and the decrease in Medi- Cal reimbursement rates.

Ÿ   Recently, KMC received a $ 40 million loan from the Kern County General Fund. The loan paid

for KMC’s operational costs until delayed reimbursement payments from MediCal and the

Disproportionate Share Hospital ( DSH) fund are received from the State.

Ÿ   A few months ago KMC officers projected an $ 8 million loss by year’s end. Due to revenue

enhancements and cost reductions, the projected loss is now only $ 4 million or about 2% of

KMC’s budget.

Ÿ   Most of KMC’s financial problems are due to factors beyond its control. Every county hospital

in the Country that serves a large indigent and MediCal eligible population is facing the same

financial dilemma. Although KMC’s MediCal patients have decreased from 60% to 49% during

the last ten years, its indigent patient percent of total patients has increased from approximately

15% to 22% ( 1996 Lewin Report and PowerPoint presentation to Board of Supervisors March

8, 2004).

Ÿ   Below is the current payor mix of KMC patients:

MediCal 49%

MediCare 10%

Private Insurance 15%

Indigent 22% ( State pays $ 19 million - Realignment Trust Fund)

Jail inmates 4% ( County pays $ 5 million)

Ÿ   MediCal pays only 65% of the costs to provide medical treatment. Therefore, KMC receives

additional funds ($ 30 million to $ 40 million per year) from the State DSH funds because of the

large number of MediCal patients served. However, these DSH funds from the State have been

reduced by up to $ 10 million a year during the last few years.

Ÿ   The County of Kern pays KMC $ 5 million per year to provide care to persons ( inmates) in

County correctional facilities. A July 2003 audit report by PricewaterhouseCoopers ( PwC)

estimated the actual cost for KMC to provide this inmate care is $ 9.5 million. The Board of

Supervisors is currently seeking bids from other hospitals to provide this inmate medical care for

next year.

Ÿ   This year, the County of Kern transferred $ 19 million to KMC from the State funded Health

Program Realignment Trust Fund. The revenue in this fund comes from State sales tax and

Vehicle License Fees. These funds are used to pay for indigent patient care. The PwC report

estimates that this $ 19 million is inadequate to cover the cost of indigent and uninsured patient

care.

Ÿ   KMC has a teaching faculty of 65 full time physicians and 90 resident physicians. The PwC

report states that the Medical Education Program is the most cost effective model to provide

medical care. Replacing the resident physicians with attending physicians would be nearly six

times the expense. The teaching program attracts young physicians to Kern County which is a

medically under- served area. Many of our private physicians in Kern County are graduates of

the KMC residency programs.

Ÿ   To the public, the salaries or contracts with the KMC physicians seem excessively high.

However, they are based on MediCal reimbursement rates, which are extremely low for

physicians. Also, the salaries are linked to a “ Faculty Practice Plan” based on pay for

performance ( number of patients examined).

Ÿ   In 2001, KMC became a level II Trauma Center. This gives citizens of Kern County access to

a sophisticated system for treatment of the critically injured. Only 50% of the U. S. population

lives close to a level II Trauma Center. KMC has the only level II Trauma Center within a 100

mile radius. Critically injured patients have an increased survival rate of 50% in a level II facility.

Ÿ   The recent PwC audit report of KMC’s operations and financial health listed the following

conclusions:

1. Given the constraints under which it must operate, KMC is operating quite efficiently.

2. KMC is experiencing poor reimbursement rates and under funding.

3. Adding to the financial challenges, the uninsured ( indigent) population is likely to increase

in Kern County.

Ÿ   The 2003 PwC report lists the following options for the Board of Supervisors to consider:

1. Find and provide sufficient funds to sustain KMC in performing its current services.

2. Change, reduce or eliminate services offered by KMC.

3. Privatize, sell, or affiliate KMC with another hospital system.

4. Create a KMC hospital district with taxing authority.

5. Close KMC, and contract with other hospitals in Kern County to provide indigent care.

Ÿ   In 1996, The Lewin Group, another professional hospital auditing firm, worked with a “ Blue

Ribbon Task Force” of County residents to develop the following options to improve KMC’s

financial health:

1. Downsize particular KMC services and reduce the number of beds.

2. Similar to a hospital district, create a “ Health Authority”,.

3. Join or Affiliate with a private health care system.

4. Close KMC.

Ÿ   It is apparent that the recommended options by the two management- audit firms are very similar.

Fortunately for the County, the Kern County Board of Supervisors in 1996 selected option

number one of the “ Blue Ribbon Task Force”. KMC was downsized by 48 beds ( 270 to 222)

in 1997, and some services were reduced or provided more efficiently.

Ÿ   The other options ( 2- 4), proposed by the Lewin Group have proven to be ineffective and

detrimental to various other county hospitals during the last seven years. Alameda County’s

Board of Supervisors selected the option to create a “ Health Authority” with its own governing

board. The bold experiment is faltering after five years. Five of the eleven trustees have

resigned and the chief executive has been fired. This Health Authority is now facing a $ 63 million

deficit.

Ÿ   The option to affiliate with a private hospital system ( as was done by Merced County, Sonoma

County, and Fresno County) has not been beneficial to these Counties. They are in no better

financial health than KMC. The affiliation of Taft’s Westside District Hospital with Catholic

Health Care West certainly was not beneficial for the City of Taft.

Ÿ   The proposed option of the “ Blue Ribbon Task Force”, and the PwC firm to close KMC is not

viable. Seven years ago, the public did not accept this option, since it would mean the loss of a

teaching hospital in the County. It would also mean the loss of the only Level II Trauma Center

within 100 miles.

Ÿ   Closing KMC would require the County to contract with other hospitals in the area to provide

indigent medical care as mandated by Section 17000. It is unlikely that these hospitals could

provide the services for a lesser cost. According to the PwC report, there are not sufficient

vacant beds in the other hospitals to be able to provide this indigent health care.

COMMENTS

The KMC administration, physicians, and staff are to be commended for their efforts in reducing

costs, improving collections, and finding ways to provide more efficient services. However, with

75% of their patients ( MediCal and Indigent) not paying a sufficient amount to cover the cost of their

medical services, “ belt- tightening” to reduce costs will not provide sufficient savings to insure the

financial health of KMC.

Since all county hospitals in the country are facing a similar financial crisis, there are only two options:

Either the quality of medical care must be reduced for the indigent and MediCal patients to reflect

the inadequate funding available for these services; or, the County, State, and Federal governments

must provide additional funding to fully pay for the medical care. It is no longer possible to charge

the privately insured patients a sufficient amount to cover the costs of the under- funded patients.

The Board of Supervisors should be commended for their decision to meet monthly as the “ KMC

Board of Directors”. Hopefully, this “ hands on” approach by the Board will give them better insights

into the operations and challenges of the hospital. It will be interesting to learn from the “ Requests

for Proposals” regarding jail- inmate medical care, if other hospitals will and can provide medical

services cheaper and more efficiently than KMC.

RECOMMENDATIONS

1. The Board of Supervisors must find and provide KMC adequate funding for indigent medical

care.

2. The Board of Supervisors should make every attempt to keep the County jail- inmate medical

care at KMC with increased funding to cover the actual costs.

3. The KMC Administration and Board of Supervisors must continue their pursuit of enhanced

State and Federal funds ( including rapid payment for services) with our elected representatives.

4. KMC should be one of the choices as a medical provider for County employees, retired County

employees, and for employee physicals and treatment.

5. The Residency Programs for teaching new physicians should be continued at KMC. It attracts

physicians to Kern County and provides needed medical specialties.

6. The option to close KMC should not be considered. KMC is too valuable to the well being of

our Community.

7. Kern Medical Center should post a copy of this report where it would be available for public

reviewing.

Note: Present and past Kern County Grand Jury Final Reports and responses can be accessed

at the County Library and on the Kern County Grand Jury web- site:

www. co. kern. ca. us/ grandjury

RESPONSE REQUIRED

WITHIN 60 DAYS

TO PRESIDING JUDGE

KERN COUNTY SUPERIOR COURT

1415 TRUXTUN AVENUE

BAKERSFIELD, CA 93301

Kern County Board of Supervisors

Response to Grand Jury Final Report

KERN MEDICAL CENTER

Response to Findings:

The Board of Supervisors notes that the findings are substantially correct.

Response to Recommendations

The Board of Supervisors, along with legislative staff and Kern Medical Center’s Chief Executive

Officer, actively advocate at the State and federal level to encourage prompt payment disbursements and

to seek long- term solutions for funding indigent medical care.

In order to determine the most cost effective and efficient manner of providing statutorily required inmate

medical care, the County issued a Request for Proposal. Kern Medical Center responded to the request,

as did external providers. The responses are in the process of being evaluated.

County employees may choose to receive health care at Kern Medical Center. By way of encouragement,

the employee's required co- payment is waived when care is received at Kern Medical Center.

The Board of Supervisors recognizes the benefits Kern Medical Center provides to the community, as

well as the benefit of a local physician residency program. However, those benefits must be weighed

against the County’s fiscal solvency. There are no plans at this time to close the hospital or to terminate

the residency program.

POLGJKMCB

2003- 2004 KERN COUNTY GRAND JURY

FINAL REPORT

COUNTY CLERK – ELECTIONS DIVISION

ELECTRONIC VOTING

Pursuant to Penal Code Sections 925 and 933, the Administration and Audit Committee

of the 2003- 2004 Kern County Grand Jury reviewed the County Clerk – Elections

Division.

COUNTY CLERK – ELECTIONS DIVISION

ELECTRONIC VOTING

PURPOSE:

Pursuant to Penal Code sections 925 and 933, the Administration and Audit Committee

of the 2003- 04 Kern County Grand Jury selected the Elections Division of the Auditor-

Controller/ County Clerk- Registrar of Voters Department to review this year. This

review was initiated due to public concern about the security and accuracy of the

County’s new electronic voting system.

PROCESS:

The Committee and members of the Grand Jury met with, and received information from,

the Kern County Registrar of Voters and other election officials. Input was also received

from the County Administrative Officer and from the California Association of Clerks

and Election Officials. Grand Jury members attended training sessions where the

electronic voting system was demonstrated.

BACKGROUND:

The County Clerk is the Registrar of Voters for Kern County and has responsibility for

all elections within the County. The Office of County Clerk ( an elected position) was

merged with the Office of Auditor- Controller ( an elected position) in 1995. This

consolidation was approved by the Board of Supervisors as an efficiency and cost savings

measure. A single elected position of Auditor- Controller/ County Clerk- Registrar of

Voters was created to direct this consolidated county department.

Kern County successfully rolled out its new electronic voting and tabulation system, the

Diebold AccuVote TSx Touch Screen voting system, countywide for the March 2, 2004

Primary Election. The system proved to be user friendly, fast, accurate, and less

expensive to operate than the previous system. For the first time, many disabled and

visually impaired voters were able to vote unassisted.

FINDINGS:

·   In 2003, the County purchased 1,350 Diebold Touch- Screen voting machines for $ 5

million through a State grant for election modernization. Kern County election

officials selected the Diebold system along with San Diego, San Joaquin, and Solano

Counties as the most accurate, cost effective, and adaptable for our County.

·   The Kern County Registrar of Voters received two letters ( Nov. 2003 and Feb.

2004) from the California Secretary of State authorizing the use of the Diebold

Touch Screen voting system and software in California.

·   While San Diego County experienced major problems with the Diebold system in the

March 2004 election, Kern County experienced only minor problems. Our election

officials attribute their successful election to the following:

1. Planning and training

2. Acceptance testing of the System

3. Conducting a small special election ( Nov. 2003) before the countywide

election

4. Thorough testing of the complete system ( an upgraded version) before the

election

5. Monitoring on election da