SONOMA LOCAL AGENCY FORMATION COMMISSION
Item 5.1
575 ADMINISTRATION DRIVE, ROOM 104A, SANTA ROSA, CA 95403
(707) 565-2577 FAX (707) 565-3778
www.sonomalafco.org
Staff Report
Meeting Date:
September 9, 2015
Agenda Item No:
Item 5.1
Agenda Item Title:
Palm Drive Health Care District: Future Steps
Proposal:
Staff requests that the Commission provide direction regarding
options associated with a study of the Palm Drive Health Care
District.
Environmental
Determination:
Not a project under CEQA
Staff Contact:
Mark Bramfitt
For accessibility assistance with any of the following documents, please contact Sonoma LAFCO at
707) 565-2577 or email us at [email protected].
ANALYSIS
Background
At its July 2015 meeting, the Commission indicated a desire to discuss further the
possibility of conducting a Municipal Service Review (MSR) for the Palm Drive Health
Care District (District, or PDHCD). The staff report from that meeting is attached for
reference; this staff report attempts to further define options the Commission might
consider.
The context for the discussion is the interest of some residents in the Russian River
corridor to have their communities detached from the District because they believe they
are not receiving services from the District, in part due to the changed landscape for
health care service provision in the County. One group of residents has filed a Notice of
Intent with the Commission and is soliciting petition signatures to support a potential
detachment application.
Staff has evaluated regulations regarding changes to Spheres of Influence,
detachments, and requirements for MSRs in Cortese-Knox-Hertzberg, as well as
Commission policy, to inform a series of options for studying the operational
sustainability of the District. Additionally, staff has prepared a preliminary evaluation of
an MSR for the District, presented as an attachment, should the Commission elect that
option.
Requirements
To reiterate, Sonoma LAFCO is not obligated to conduct an MSR unless there is an
application to amend the Sphere of Influence of the District, or if the Commission
initiates a Sphere amendment.
Technically, an application to detach a portion of the District does not, in itself, require
an MSR that meets all of the requirements outlined in CKH, but staff is recommending
that the requirements inform the scope of a study that would support the adjudication of
a detachment application.
Options
From staff’s perspective, the Commission could consider several options:
1. Elect Not to Perform a Study at This Time
As indicated in the July staff report, in 2011, subsequent to staff’s
recommendation and agreement by the District, the Commission confirmed the
District’s sphere of influence; because the sphere was confirmed and not
changed, an MSR was not conducted, pursuant to Commission policy, and as
allowed under state law. The next review of the District’s sphere would occur
Item 5.1 Staff Report
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September 9, 2015
sometime in 2016, as part of the five-year sphere review cycle. In the interim,
should an application relating to the District sphere/boundary be submitted,
typically the cost associated with processing that application, which could include
an MSR, would be at the applicant’s cost. Because there is no pending
application from the District or interested parties for a change to the Sphere of
Influence or boundary of the District (notably, here, detachment), the
Commission is not obligated to prepare an MSR.
There are two sets of circumstances that support this option:
1. The financial and operational circumstances of both the District and the
Sonoma West Medical Center (SWMC) are very much in flux, with the
District anticipating a ruling on its bankruptcy filing, and SWMC in the
midst of seeking approvals for reopening the hospital. In particular, the
relevance of a “snapshot” evaluation of the District at this time may be less
than one taken after the bankruptcy is resolved. Given that the SWMC
business plan expects at least a one-year “launch” period, it will not be
possible to assess long-term viability of the SWMC using actual
performance metrics. A critique of the proposed business plan could be
performed, though the analysis would likely to be largely subjective.
2. Nominally, an applicant, whether it is the District or community members,
is required to fund LAFCO costs for performing an MSR to support a
Sphere of Influence or boundary change (in this case, detachment). It
should be noted that LAFCO can amend an agency’s Sphere (but not
propose a boundary change) on its own initiative, likely performing the
MSR using Commission funding.
The Commission might consider whether a detachment application is
likely to be filed before expending LAFCO resources (if it chooses to do
so) to perform an MSR. One option might be to condition a direction to
staff to conduct an MSR based on a successful petition effort by
detachment proponents. The Commission could decide at that time how
the MSR should be financed (i.e., by the applicants or by the
Commission).
2.
Conduct a “Targeted Study”
In the absence of a requested SOI amendment or detachment application, the
Commission might consider conducting a targeted study of PDHCD in order to
evaluate particular areas of interest and concern. The study might consider many
or all of the “Study Questions Specific to PDHCD” in Attachment 2, as well as
any additional questions requested by the Commission.
Because a targeted study could omit several of the seven subject areas required
by code for an MSR, it may be somewhat less costly to prepare than the
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September 9, 2015
following two options. However, the study would not be suitable for use in
adjudicating a Sphere amendment.
By code, a study to support the adjudication of a detachment does not have to
meet the CKH requirements, but staff believes that addressing all of the CKH
factors (even if noting that a particular area is not applicable) would be prudent;
therefore this option is not recommended.
3. Conduct a “Minimal” MSR
Should the Commission prefer to have a study in hand that would support an SOI
amendment at its initiation, it could direct that an MSR solely focused on making
determinations per the Cortese-Knox-Hertzberg requirements be conducted. It
may be possible in this scenario to limit the scope of the study with a goal of
reducing the cost for performing the analysis.
While this option would satisfy the MSR requirements indicated by regulation for
adjudicating a Commission-initiated Sphere amendment, it is unlikely to address
key questions that the Commission may wish to see addressed and is, therefore,
not recommended by staff.
4. Conduct a “Comprehensive” MSR
In this scenario, an MSR would be conducted that leads to determinations in all
of the categories required by code, as well as addressing additional areas of
inquiry as directed by the Commission.
This option would ensure the ability of the Commission to adjudicate a
detachment application, or to amend the Sphere of Influence of the District at its
own discretion. By ensuring that the scope of the MSR includes all areas of
inquiry of interest to the Commission, it would provide the most complete basis
for adjudicating either matter. Staff has indicated that this is an alternate
recommendation.
RECOMMENDATION
Of the options proffered, staff believes that two are viable courses of action: not
conducting an MSR at this time and further exploration of conducting an MSR.
Of these, staff is recommending that the Commission opt not to conduct an MSR at this
time, given consideration of what actions the Commission might take on the basis of an
MSR and whether it is appropriate to devote resources to that activity.
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Should this option be selected, staff recommends that the Commission determine
whether it would like staff to refine a draft scope for an MSR, and seek review and input
from consultants, PDHCD, and/or the community.
ALTERNATE RECOMMENDATION
If the Commission believes that an amendment to PDHCD’s Sphere of Influence may
be warranted due to the changed landscape of healthcare provision in the County, and
if the Commission might consider amending the sphere, absent a request from the
District, staff recommends that a “comprehensive” MSR be conducted.
Further, if the Commission believes that a complete detachment application is likely to
be filed and wishes to anticipate the need for conducting an MSR to support
adjudication of that application, the Commission might elect this option.
For this option, staff recommends that the Commission direct staff to further define the
scope of the MSR, with an opportunity for comment from PDHCD and the community.
Additionally, staff would solicit feedback from consultants who are familiar with
performing MSRs for health care districts.
Staff would then revisit this matter with the Commission, providing a draft scope and a
work plan for soliciting bids from qualified consultants, for review and approval.
ATTACHMENTS
1. July 2015 Staff Report
2. Initial MSR Scope Preliminary Evaluation
Item 5.1 Staff Report
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September 9, 2015