Grand jury unwraps troubling issues in JCF board functions

By R.D. Tucker

For months upon months, Mariposa County’s John C. Fremont Healthcare District (JCFHCD) has been experiencing turmoil at the senior management levels, and many in the community believe the turmoil is an extension of a dysfunctional board of directors.

According to the recently released final report of the Mariposa County Civil Grand Jury (MCCGJ), that body agrees. The grand jury is a volunteer group of 11 Mariposa County citizens who are sworn in by the presiding judge of the Superior Court. As an investigative body it is charged to delve into the functions of county government, special districts (like JCDHCD), public officials, and joint power agencies.

As described in the final report, “The jury is impaneled to respond to citizen complaints, inquire into matters of civil concern, inquire into the condition and management of adult detention centers, and investigate and report on the operations, accounts, and records of County officers, departments, and functions.”

The following is a synopsis of the portion of the final report regarding JCFHCD issued to Superior Court Judge Anita Starchman on June 26 of this year:

“John C. Fremont Healthcare District is governed by a five-member Board of Directors. Each position on the Board is normally held for a four-year term; however, it may be shortened to two years in the event of a vacancy from resignations or other circumstances. In 2022, four (4) individuals were elected in the same election to begin service in January 2023. The main responsibilities for the JCFHD Board of Directors are financial leadership, strategic planning, and oversight of the Chief Executive Officer. Board members receive a monthly stipend of $100. The board of directors meets twice monthly. Meetings are governed by Brown Act guidelines and are open to the public either by attendance in-person or via teleconference.”

“In its inquiry, the 2023-2024 MCCGJ held nine (9) interviews with individuals from the JCFHD and reviewed over 400 pages of documents that included contracts, budgetary journals, letters of correspondence, and board agenda/minutes. Notably, minutes for three board meetings were unavailable for three (3) board meetings from March and April of 2023, which drew the attention of the Civil Grand Jury because these meetings occurred during a period of significant transition for the Healthcare District. The MCCGJ also attended a Board meeting via teleconference,” the report states.

“In their very first meeting together in January 2023, the newly elected board found the meeting full and over capacity because of an announcement that the JCFHD was dropping all hospice and home care services for the County. This announcement was received with great community interest and concern. The year of 2023 got even more challenging for the board of directors as they managed healthcare leave, appointed interim CEOs, C-suite resignations, incomplete mandated audit preparation, and palpable resistance from C-suite leadership to some of the board’s inquiries. The JCFHD received a lot of attention through social media and newspaper articles during this time. Over the course of the year there was a resignation from one board member that led to the appointment of a new one. It wasn’t until the end of 2023 that the board of directors were able to effectively address some of the challenges they had faced earlier. Over the course of two years, beginning in January 2022, the JCFHD had six different Chief Executive Officers. The position was filled mostly on an interim basis and often for as short a time as two weeks or a weekend. By December 2023, the JCFHD completed a search for a new CEO. This search was completed by an outside consultant agency,” reads the report.

“It was determined by the JCFHD Board of Directors in late March 2024 that a very large amount of money (~$4,000,000) had been spent on new hire contracts, union staff bonuses, housing contracts, moving relocation expenses and outside consultants. This led to the decision by the JCFHD Board of Directors to name a new CEO. That decision was effective in the middle of April 2024.”

“Some facts and points of concern that were discovered by the MCCGJ include ineffective board oversight, high rates of Board and JCFHD staff turnover, inconsistent management compliance with operational procedures, financial challenges, and delays in financial reporting. Additionally, policies and procedures have not been revised by board in at least two terms.”

The MCCGJ reported the following findings: 1. Significant instability in Board leadership (3 board resignations, and 6 interim/new Chief Executive Officers since 2022) and Executive C-Suite management led to the public’s diminished confidence in the John C. Fremont Healthcare District. 2. The JCFHD Board of Directors withheld information between themselves leading to individual discontent and poor decision making. 3. The JCFHD Board of Directors did not have an opportunity to vet interim CEO which led to a longer period until issues could be legally responded to and resolved. 4. JCFHD Human Resources did not properly vet executive level positions leading to instability at C-suite level; 5. Multiple CEOs exceeded contractual spending limits without JCFHD Board notification eroding inherent checks and balances in organizational structure and straining the hospital financially. 6. The JCFHD found themselves behind in regular financial audits jeopardizing funding from governmental agencies. 7. Work and dialogue outside of regular, special, and emergency meetings between directors of the JCFHD puts the Board at risk of violating Brown Act practices.

The MCCGJ made the following recommendations in its report: 1. JCFHD Board should be more diligent in vetting CEO candidates. 2. JCFHD Board should be more diligent in financial review of the Healthcare District. 3. JCFHD should review existing vetting procedures for hiring C-suite level management within 6 months. 4. JCFHD Board of Directors should ensure adherence to existing vetting procedures for hiring C-suite level management. 5. Immediately, JCFHD should make it a priority to work together and function cohesively as a team. 6. Immediately, the JCFHD Board of Directors should ensure procedures for financial oversight of the  CEO are being followed at all times. 7. JCFHD Board of Directors should review the organizational structure of the Healthcare District, specifically related to financial responsibilities of the CEO, COO and CFO with the intention of creating more financial oversight within their purview, within 9 months. 8. Immediately, the JCFHD Board of Directors should review and establish mechanisms to guarantee timely production of accurate audits. 9. Immediately, the JCFHD Board of Directors should continue with the reimplementation of the JCFHD compliance hotline. 10. JCFHD Board of Directors should practice due diligence with the Board Clerk to make certain all meeting minutes are recorded and kept as required by law.

The following governing boards are required to respond within 90 days pursuant to Penal Code sections §933 and §933.05: JCFHCD.

Per Penal Code §933.05(a) (I) and (2), responses must include acceptance, refutal, and/or clarification of the findings, and a commitment to implementing the recommendations, as appropriate, per Penal Code §933.5(b)(l)(2)(3) and (4).

The entire 2023-2024 MCCGJ report is available online at mariposacounty.org, under “Grand Jury Reports.”

Members of this grand jury included Michael Henderson (foreman), Richard Crisp, Lisa Henderson, Polina Pivak, John Stewart, Daniel Wilson (secretary), Ronald Greenstein, Frederick Libby, Dylan Shull, and Susan Stonum.