County's new chief gears up for job
Many challenges ahead for Smith
By Devin Banerjee
San Jose Mercury News
June 29, 2009 -- Santa Clara County's new chief executive will soon find himself at the helm of a somewhat leaky ship -- and one much larger than the vessel he has commanded in nearby Contra Costa County.
Dr. Jeffrey Smith currently oversees Contra Costa County's medical and health centers, including the county hospital, outpatient clinics and jail health services. But come Sept. 1, the 55-year-old Martinez resident will be responsible for supporting Santa Clara County's board of supervisors and nearly 1.8 million residents.
He also will oversee a $4 billion county budget, many times the size of the $370 million budget for Contra Costa County's medical and health centers.
Smith will take the place of in-house candidate Gary Graves, the longtime county official who became acting executive after Pete Kutras retired from the post in November. Several county officials said the five-member board of supervisors was actively searching for a fresh perspective.
"They made it very clear that they were looking for innovation to solve the county's problems," Smith said. "When I interviewed with them, we just clicked."
Graves, who has held management roles for the county since 1984 and who proved instrumental in closing a $273 million deficit earlier this month, will step back into the assistant executive role he held under Kutras.
Though he was naturally disappointed by the decision, "I'll be there to support the new executive," Graves said, "and I know that he will benefit from the knowledge I have of the organization."
Smith admitted the three biggest challenges he will face are countering the revenue shortfall caused by the national recession, expanding county services for those struggling financially and fighting for state funding. He acknowledged the job won't be easy.
"It's not the situation where somebody rides in on a white horse with answers and solutions," he said. "At this point, my approach is listening quite a bit, watching, learning and talking with the people involved."
Lots of Support
Many in the county, however, are confident that given Smith's education and background, their new executive will indeed fill his expanded shoes.
"We've got a guy I'm very excited about," said Santa Clara Supervisor George Shirakawa Jr. "Jeff brings a unique situation to the table -- a medical doctor, an attorney and an elected official."
A 1983 graduate of the University of Southern California's Keck School of Medicine, Smith served as a staff physician in Contra Costa County for two years before attending law school at the University of California-Berkeley's Boalt Hall.
In 1988, he was elected to the Martinez City Council, and in 1992 he became a Contra Costa County supervisor while continuing to work as a county physician. He remained a supervisor -- while refusing to take the salary -- for four years, during which he voted to build a new county hospital, helped improve access to public records and advocated for an industrial safety ordinance. He took on his current role as executive director of Contra Costa County's health centers in 2002.
Smith and Shirakawa said the two sides had not yet hammered out a final pay package; Kutras in fiscal year 2007 earned $292,000, while the Contra Costa Times in 2005 reported Smith took home $220,000 in salary and bonuses.
While Smith, a father of four, will continue to live in Martinez, it's clear his former co-workers will miss him when he begins work in San Jose come September.
"It's a great loss for us," said Dr. William Walker, director of Contra Costa County Health Services. "I'm glad that he's staying at least within the Bay Area region as an important leader."
David Kahler, a longtime mental health activist and member of the Contra Costa County Mental Health Commission, considers Smith "a good guy" who "ran a good hospital in troubled times."
In 2006, federal officials threatened to cut $360 million in Contra Costa Regional Medical Center's Medicare and Medicaid funding -- 80 percent of its operating budget -- unless safety conditions in the center's psychiatric unit improved. Federal officials eventually withdrew the threat when the hospital submitted a correction plan, but at the time, Smith acknowledged the challenges.
"The thing that's troublesome is, when you have essentially unlimited needs and very limited resources, the system goes tilt," he said in May 2006.
Support of Union
Santa Clara County's largest labor union, SEIU Local 529, also gave Smith its support.
"We have crossed paths in the healthcare community, and our impression of Dr. Smith is he is extremely smart, cooperative and very supportive of public hospitals, an area of great importance for our workers," said Kristina Sermersheim, the union's president, in a statement.
In one of the only specific policy changes he mentioned, the new executive said he plans to move Santa Clara County toward a system of management in which "every activity anyone does has value for the patient or client." Such a system, he added, would include "extensive reviews of all the processes we are doing" to evaluate their effectiveness.
Santa Clara County Assessor Larry Stone praised that approach, saying he was disappointed that Graves had jettisoned performance reviews while serving as interim county executive.
"Practically nothing of consequence gets measured here," Stone said. "When you're underwater is when you need to be able to look at measurements."
Graves, who expects the negative impact of California's budget on Santa Clara County to be between $50 million and $200 million, predicted a smooth transition but issued something of a warning to his successor.
"Obviously," he said, "sitting in the executive chair is a whole different ballgame."
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