Who sees the Big Picture?

John Taylor: May 31, 20070 Comments

If you stumbled into the special May 30 meeting of the Fresno County Board of Supervisors, you may need treatment for whiplash.

The topic, now nearly five months old: How to come up with just the right arcane language to satisfy county, state and federal bureaucrats and, ultimately, provide as much as $54 million in special federal Medi-Cal money over three years for Community Medical Centers to care for the  needy.

"We are that critical access point for those that don't have resources," Community CEO Tim Joslin told the supervisors.

The Big Picture: Getting the money before deadlines allow it to go someplace else. In a perfect world, the right people would huddle in a conference room, ordering in pizza and coffee, and not come out until a deal was done.

"People of good intentions can figure a way to work this out," said U.S. Rep. Jim Costa. "There is precedent on the federal level ... There is precedent on the state level."

The Whiplash? A tornado of imprecise and obscure legal and fiscal terminology -- waivers, indemnification, audits, IGTs, realignment money -- and talks of unarticulated and vague risks, ethics generalities and finding more opinions and protections.

The supervisors voted to move ahead with a few ideas. Hopefully the legal wrangling will work out pretty darn quick, and dollars will flow where the need is great.

In 1996, Fresno supervisors saw the Big Picture correctly, exiting the hospital business and contracting with Community. Nobody at the May 30 special meeting disputed that things have worked well.

Anybody want to spring for the pizza?