Cambrian: Opinion

Cambria health district: Wishful budgeting or prudent stewardship?

Cambria Community Healthcare District ambulance.
Cambria Community Healthcare District ambulance.

It seems that two Cambria residents have painted a very bleak and not-so-promising picture of the ongoing budgeting process for the Cambria Community Healthcare District.

The Viewpoint article that appeared in last week’s Cambrian (“Cambria health district can’t afford wishful budgeting,” July 6, by Bill Rice and Iggy Fedoroff) may have generated unfounded concerns and fears in many residents. Not this time gentlemen, not this time.

We would like to reassure the residents of the district that the sky is not falling, as some may suggest. CCHD revenues for fiscal year 2017-18 are projected to be $1,800,636, and projected expenses are $1,800,291. The prepared and approved 2017-18 budget is financially sound, allowing the district to continue providing ambulance service to the residents of the district.

There is a significant difference in the financial accounting and budgeting methods used in a public agency versus those used in private industry and governmental agencies. CCHD revenues are accrued from property taxes, property assessments and reimbursement income from ambulance transports. While our very qualified administrator and competent staff have a very accurate accounting of the amounts that will be coming in each year from property taxes and assessments, it takes a working knowledge of the medical reimbursement system to project exactly how much monies we will recover each month from ambulance transports.

The ambulance transport revenues are dependent upon the number of calls and what types of insurance the patient may or may not have. Reimbursement payments from Medi-Cal and Medicare are slow to come in, and we are only reimbursed approximately $580 for each transport. Private insurance usually reimburses at 85 percent to 90 percent of the billed charges. Depending on the month of the year, the budget analysis could show significant revenues in property taxes, assessments and ambulance income.

All board members and administrative staff take both the budget and financial issues seriously. The monthly board packet includes the monthly financial report, the year-to-date ambulance income report and the ongoing budget analysis, all of which are presented by our administrator to the board members during each monthly meeting.

The budget analysis is only one part of the monthly financial reporting and in years past reflected year end variance of $50,000 to $60,000 of expenditures over revenue. This variance simply means that the budget projected revenues did not cover the projected expenses, not that the money was lost or spent in a foolish manner. Fiscal year 2015-16 reflected a negative variance of $52,400 against revenues of $1,700,946 a .03 percent impact on actual revenues.

The CCHD board has a fiduciary responsibility to the residents of the district to appropriately allocate and spend the property tax and assessment monies collected on their behalf. Currently, the district has no major outstanding debt that is not reflected in the budget. We own the property and the building on Main Street, which is leased and operated by the Community Health Centers, and have substantial assets in ambulances and equipment.

Finally, the residents of the district have voted over the years to increase their property assessments to fund two fully staffed ambulances 24/7, no small feat based on $1,700, 946 from the 2015-16 budget.

We do not do wishful budgeting; it is prudent stewardship based on actual, accurate figures appropriately prepared, presented for discussion and voted on by the board each year.

Mary Anne Meyer was elected to the CCHD board in 2014 and serves as current board vice president. Kristi Jenkins, a 30-year Cambria resident, served for eight years as a trustee on the CCHD Board; she has a master’s degMasters in Healthcare Administration and 50-plus years working in clinical laboratory medicine, with 14 years teaching in Health Occupations Allan Hancock and Cuesta College.