Letter to the Editor - BCHD Has Spent $250Mish of Taxpayer Funding without Program Budgets/Analysis

BCHD never owns up to the fact that its 40 programs have had no budgets, no cost accounting, and no public benefits assessment since the start of the District in 1993. BCHD renamed the failed hospital district in 1993 and Poster has been on the BCHD since 1996. Since 1993, BCHD has spent roughly $250 million in taxpayer funds, including our taxes, renting out taxpayer land and buildings, and keeping all the hospital's taxpayer funded assets.

What BCHD never tells taxpayers is that for all that time, BCHD didn't even bother to create budgets for its programs. How could it spend roughly one-quarter billion taxpayer dollars in programs without budgets, controls, or evaluation? As recently as August 13, 2020 BCHD's official position on program budgets was "the District is working on setting up a system." BCHD finally had a board member, Vish Chatterje, with enough respect for taxpayer funding to force the district to consider budgets and cost accounting. The District has since taken baby steps toward program budgets, and now allocates our taxpayer funding in a convoluted system of voting. Unfortunately, the voters are about 100 BCHD board members, executives, managers, employees, consultants, contractors, volunteers and roughly 5 to 10 members of the actual public.

By not evaluating the public health benefits of programs, BCHD's executives and board have no idea of the value of their programs. If they did evaluate programs for public health value, then BCHD could deploy taxpayer funding to the most valuable health outcomes and reduce programs with less (or no) bang for the buck. In fact, there could be many of the 40 programs that actually harm overall public health by diverting taxpayer funding from other program with high public health benefits. Does BCHD even provide $15 million in public health benefits for the $15 million in taxpayer funding it spends? How many of BCHD programs actually provide less public benefit than they cost taxpayers? Taxpayers don't know.

But the worst part of it is, BCHD doesn't know. And the $2.3 million annual payroll of BCHD's executives don't seem to care about whether or not their programs actually provide public health benefits. In fact, as of April 7, 2022 BCHD's official position on evaluating public health benefits is "that the District has previously explained that calculating a dollar community benefit for each program is beyond the scope of the District’s mission, financial resources and abilities."

Plain English: BCHD doesn't include program evaluation in its mission, budget and has no employees or consultants capable of determining if programs actually generate more public health benefits than they cost taxpayer. BCHD apparently doesn't believe that $250 million of taxpayer funds deserved budgets, cost accounting, or program benefit-to-cost analysis. Ouch.

Last week, BCHD board President Vanessa Poster wrote in to the ER about the programs of BCHD and appropriately thanked the employees. She also wrote an advertisement in her letter for the BCHD programs without budgets, cost accounting and evaluation for the majority of her multi-decade BCHD board career. What she failed to mention, of course, was that she came on the Board in 1996 and has been the longest serving board member member during the expenditure of $250 million (could be more) of taxpayer funding on those programs.

Both the public health and taxpayers of the three beach cities deserved budgets, cost accounting, and program evaluation from the very first day of BCHD's creation from the failure of the South Bay Hospital. We can't afford a replay of failure by the District with its Wealthy Living Campus. The WLC is being created for 80% to 95% non-residents of the District. That's too much money and risk in the hands of a Board and Executives that already blew through $250 million in program expenditures without budgets or evaluation. Go to https://www.stopbchd.com/post/failures to see the full text from BCHD on program budgets, cost accounting, and public health benefits evaluation.