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HEALTH SERVICES DEPARTMENT

HEALTH SERVICES DEPARTMENT. FY 2009-10 Budget Worksession July 22, 2009. PRESENTATION OUTLINE. Organization Chart Proposed FY 09-10 Budget Accomplishments Budget Overview Significant Future Issues Summary. PRESENTATION OUTLINE. Organization Chart Proposed FY 09-10 Budget

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HEALTH SERVICES DEPARTMENT

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  1. HEALTH SERVICES DEPARTMENT FY 2009-10 Budget Worksession July 22, 2009

  2. PRESENTATION OUTLINE • Organization Chart • Proposed FY 09-10 Budget • Accomplishments • Budget Overview • Significant Future Issues • Summary

  3. PRESENTATION OUTLINE • Organization Chart • Proposed FY 09-10 Budget • Accomplishments • Budget Overview • Significant Future Issues • Summary

  4. George Ralls M.D., Acting Director Office of the Medical Director, EMS Medical Clinic/PCAN Margaret Brennan, Manager Medical Examiner Dr. Jan Garavaglia, MD Corrections Medical Donna Loyko, Manager Mosquito Control Dr. Tom Breaud, PhD ORGANIZATION CHART

  5. PRESENTATION OUTLINE • Organization Chart • Proposed FY 09-10 Budget • Accomplishments • Budget Overview • Significant Future Issues • Summary

  6. PROPOSED FY 09-10 BUDGET

  7. PROPOSED FY 09-10 BUDGET

  8. BUDGET OVERVIEW Position Changes Deletions • Medical Clinic 2 • EMS 1 • Mosquito Control 1 (Grant Position) Subtotal 4 Transferred Positions2 Net Positions Deleted 2

  9. PROPOSED FY 09-10 BUDGET

  10. PRESENTATION OUTLINE • Organization Chart • Proposed FY 09-10 Budget • Accomplishments • Budget Overview • Significant Future Issues • Summary

  11. ACCOMPLISHMENTS • Innovations in American Government Award Finalist • Services provided to over 106K patients PCAN

  12. ACCOMPLISHMENTS • OCMC: Electronic Medical Record System • Corrections Health Services: Developed partnership with OCHD • Medical Examiner: New building on schedule and under budget

  13. ACCOMPLISHMENTS • EMS: Significant decrease in offload delays • Mosquito Control: GIS based technologies which monitor, track, and report on mosquito control operations electronically

  14. PRESENTATION OUTLINE • Organization Chart • Proposed FY 09-10 Budget • Accomplishments • Budget Overview • Significant Future Issues • Summary

  15. BUDGET OVERVIEW Mandated Other PCAN

  16. BUDGET OVERVIEW PCAN/Medical Clinic • Nationally recognized program • Proven effective in reducing low acuity ER visits (-25%) • $1.4 million annual cost savings

  17. BUDGET OVERVIEW Mandated Costs: • Medicaid • $9M (FY 2007-08 Actual) • Health Care Responsibility Act (HCRA) • $291K (FY 2007-08 Actual) • Medical Examiner

  18. BUDGET OVERVIEW Other: • Emergency Medical Services • County-wide Medical Direction • Mosquito Control • Public Health (State)

  19. PRESENTATION OUTLINE • Organization Chart • Proposed FY 09-10 Budget • Accomplishments • Budget Overview • Significant Future Issues • Summary

  20. SIGNIFICANT FUTURE ISSUES • Medicaid • HCRA • Sustaining the current level of service for PCAN

  21. SIGNIFICANT FUTURE ISSUES Health Services Department Budget - 5.6%

  22. SIGNIFICANT FUTURE ISSUES Legislation Economy Medicaid Eligibilitybased on income • 185% Federal Poverty Level • Family of 4 = $40,792

  23. SIGNIFICANT FUTURE ISSUES Orange County Medicaid Eligible 15% FY09 = ? FY08 = $9M

  24. SIGNIFICANT FUTURE ISSUES Legislation Economy HCRA Shifts cost for emergency care to uninsured on the county in which the patient resides

  25. SIGNIFICANT FUTURE ISSUES 79% Increase

  26. Secondary Services SIGNIFICANT FUTURE ISSUES PCAN Primary Care $60/patient $600/patient

  27. SIGNIFICANT FUTURE ISSUES PCAN Patients in Thousands 37% Increase

  28. SIGNIFICANT FUTURE ISSUES PCAN/Medical Clinic • Addressing increased access with flat budget may require: • Limiting specialist referrals • Reducing provider reimbursement • Consideration of enrollment cap

  29. Reduce Provider Reimbursement Limit Conditions Covered SIGNIFICANT FUTURE ISSUES PCAN Enrollment Cap

  30. Reduce Provider Reimbursement SIGNIFICANT FUTURE ISSUES PCAN

  31. SIGNIFICANT FUTURE ISSUES PCAN Examples: • High Blood Pressure • Heart Disease • Lung Disease • Diabetes • Cancer Limit Conditions Covered

  32. Enrollment Cap SIGNIFICANT FUTURE ISSUES PCAN

  33. Reduce Provider Reimbursement Limit Conditions Covered Enrollment Cap SIGNIFICANT FUTURE ISSUES PCAN Strategies • Health policy consultant • Healthcare reform • Economic conditions

  34. PRESENTATION OUTLINE • Organization Chart • Proposed FY 09-10 Budget • Accomplishments • Budget Overview • Significant Future Issues • Summary

  35. SUMMARY • Ongoing challenges relating to Mandated Expenses • Medicaid/HCRA • PCAN funding challenges • Health Policy Consultant • Upcoming worksession to discuss future of PCAN • Economic conditions will likely increase demand for services

  36. HEALTH SERVICES DEPARTMENT FY 2009-10 Budget Worksession July 22, 2009

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