To: Board of Supervisors
From: Dr. Grant Colfax, Health Services Director
Report Title: Contract #23-324-23 with Toyon Associates, Inc.
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Health Services Director, or designee, to execute on behalf of the County Contract #23-324-23 with Toyon Associates, Inc., a corporation, in an amount not to exceed $900,000 to provide consultation and technical assistance regarding healthcare finance issues, including Medicare and Medi-Cal auditing and reporting, for the period from January 1, 2026 through December 31, 2028.
FISCAL IMPACT:
Approval of this contract will result in budgeted expenditures of up to $900,000 over a 3-year period and will be funded 100% by Hospital Enterprise Fund I.
BACKGROUND:
Toyon Associates, Inc. provides professional healthcare financial consultation, technical research, and timely advice to Contra Costa Health finance staff. Contractor’s services include providing consultation and advice to finance staff with regard to healthcare financial report preparation, documenting Medicare and Medi-Cal crossover bad debt recoveries, technical research with regard to analyzing cost reports with regard to Medicare Disproportionate Share Hospital (DSH) eligible days, provide DSH Point of Service (POS) to obtain aid codes from the Department of Health Care Services Medi-Cal eligibility database, consultation services to meet annual Medicare and Medi-Cal cost reporting obligations, and assistance with any necessary cost report appeals to overturn adverse audit findings or Uncompensated Care revenue recognition services specific to public hospitals like Contra Costa Regional Medical Center.
As a local small business, this contractor is available to respond immediately, and is able to come onsite for face-to-face meetings if necessary. They have demonstrated the ability to manage and provide accurate guidance, stringent oversight, and timely reporting of all assigned tasks. Contractor’s staff are highly specialized professionals who provide services specific to health care financial cost reporting and other reporting and reimbursement services, enabling the department to achieve optimal funding. This Contractor was approved by Public Works Purchasing in March 2026.
On January 9, 2024, the Board of Supervisors approved Contract #23-324-22 with Toyon Associates, Inc., in an amount not to exceed $575,000, to provide consultation and technical assistance regarding Medicare and Medi-Cal Auditing and Reporting, including technical research and advice, for the period from January 1, 2024 through December 31, 2025.
Approval of Contract #23-324-23 will allow Contractor to continue providing services through December 31, 2028.
CONSEQUENCE OF NEGATIVE ACTION:
If this contract is not approved, the hospital will be unable to complete required Medicare & Medi-Cal cost reports and will be unable to run interim cost reports to ensure that expected revenues are within the funding range included in the annual adopted budget.