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March 29, 2011 (La Mesa)--A volunteer citizens group that oversees how the taxpayer-supported Grossmont Healthcare District (GHD) is spending millions of dollars in voter-approved funds for infrastructure improvementprojects at Sharp Grossmont Hospital has issued its 2010 Annual Report to the Community.


The citizens group, called the Independent Citizens’ Bond Oversight Committee (ICBOC), consists of volunteers from the local community who are responsible for monitoring bond revenue expenditures by GHD, a public agency that serves as landlord of the hospital’s property and buildings on behalf of local taxpayers. The ICBOC group is required to report annually its oversight activities during the previous year. This is their fourth annual report, which was recently presented to GHD board members by ICBOC chairman Ernest Ewin.


The ICBOC 2010 annual report is available at a publicly accessible website,, which also houses all of the citizens group’s bylaws, annual workplans, reports, memos, agendas, minutes and presentations from previous meetings. The annual report provides updates on construction activity during 2010 and discusses the findings of a Performance Audit Report. The document can be accessed directly at


In 2010, the ICBOC took an extra step in its oversight role on behalf of East County citizens and commissioned a third-party consultant to review the effectiveness of the processes being following regarding the budget, scope of work and schedule for the bond-financed construction projects. The five-month study included a review of all GHD board and ICBOC meeting minutes from program inception to the present, assessed and analyzed the construction project execution methodology and reviewed documentation from the Program Management Team (PMT), including the District’s Policy and Procedures Manual.


Generally, AFC found the Prop. G program to be reasonably well managed and fees
charged by consultants are fair and comparable to industry standards. However, several
recommendations were made. Among the improvements that were implemented:

• The Policy and Procedures Manual was updated with PMT job responsibilities and
organizational chart, along with a “post performance” evaluation on each project.
• It was agreed that future construction documents will be submitted for review to state
regulators prior to bidding.
• Additional detailed information was added to the PMT’s Monthly Report.
• A Risk Management Policy and Procedure Process was developed.
• The need for a Program Director job position was affirmed.
AFC concluded its report with what it described as “several interesting outcomes:”
• Program management costs are normal in comparison to other similar-size projects.
• Testing services as a percentage of total hard costs were 0.98 percent, which falls within
a range normally found on other similar projects of between 1.0 and 2.0 percent.
• The overall ratio of hard costs (construction) to soft costs (administration and services)
was roughly 80/20, which is better than a 70/30 ratio that can be found in many other
similar construction projects. “Therefore, we conclude that the District did not spend
excessive funds on administering the project,” the report said.

The ICBOC group has been meeting since 2006, when voters approved Proposition G, a $247 million bond measure that is providing financing for the infrastructure improvements at the hospital, which opened in 1952. Construction activity on Prop. G-related projects is scheduled to continue until 2014. Prop. G passed by more than 77 percent, well above the two-thirds required. As specified in the ballot measure, ICBOC members include East County residents who are experienced in project management, large-scale construction operations and finance, along with representatives from Sharp Grossmont Hospital, as well as designees from the San Diego County Labor Council and San Diego County Taxpayers Association.


The Grossmont Healthcare District, a public agency that supports various health-related community programs and services in San Diego's East County region, was formed in 1952 to build and operate Grossmont Hospital. In 1991, the District leased the hospital's operation to Sharp HealthCare under a 30-year lease that runs through the year 2021.The District is governed by a five-member board of directors, each elected to four-year terms, who represent nearly 500,000 people residing within the District's 750 square miles in San Diego's East County. GHD also operates the Dr. William C. Herrick Community Health Care Library, a public library specializing in health research information, located at 9001 Wakarusa St. in La Mesa. For more information about GHD, visit


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