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Health Services Department (HSD) HEALTH SERVICES DEPARTMENT Largest County Department Fully Integrated Health Care Delivery System Composed of Ten Operating Divisions and Six Special Funds DEPARTMENT OPERATING DIVISIONS Regional Medical Center & Health Centers Health Plan Mental Health

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health services department
HEALTH SERVICES DEPARTMENT
  • Largest County Department
  • Fully Integrated Health Care Delivery System
  • Composed of Ten Operating Divisions and Six Special Funds
department operating divisions
DEPARTMENTOPERATING DIVISIONS
  • Regional Medical Center & Health Centers
  • Health Plan
  • Mental Health
  • Public Health
  • Alcohol and Other Drugs
  • Environmental Health/Hazardous Materials
  • Detention Inmate Care
  • Homeless Programs
  • Conservatorship
  • California Children’s Services
special funds
SPECIAL FUNDS
  • Ambulance Service Area
  • Tobacco Tax Fund
  • Emergency Medical Services
  • Major Risk Insurance
  • Domestic Violence Assistance
  • Substance Abuse & Crime Prevention (Proposition 36)
department s mission
DEPARTMENT’S MISSION
  • Contra Costa Health Services cares for, and improves, the health of all people in Contra Costa County with special attention to those who are most vulnerable to health problems.
contra costa population
CONTRA COSTA POPULATION
  • The population is growing and becoming more diverse. 18-22% increase since 1990.
  • Our patients and clients speak more than 20 different languages.
  • Twenty percent of the County population lives below 200% of the Federal poverty line.
  • African Americans, Latinos/Hispanics and those in low-income communities are at far greater risk for poor health outcomes.
contra costa residents without health insurance
CONTRA COSTA RESIDENTS WITHOUT HEALTH INSURANCE
  • One in ten residents age 18-64 years old does not have health insurance.
  • Hispanic/Latinos and African Americans are 2 to 3 times more likely than Whites to be without health insurance.
  • People without health insurance are more likely to be sicker and die earlier than those who have coverage.
mission mandate
MISSION & MANDATE
  • Section 17000 of the Welfare and Institutions Code places a general duty on the County to provide medical care for indigents.
  • The Conservatorship program is a State mandated function.
  • Hospital staffing ratios are State mandated.
  • The Mental Health Services Act requires county funding at no less than the 2004/05 level.
mission mandate9
MISSION & MANDATE
  • The provision of inmate medical care is a County legal obligation.
  • The California Children’s Services program requires a State-defined county match.
  • Every county in California is required to have a Public Health Program.
hsd 2004 05 budget in millions
HSD 2004/05 BUDGET (In Millions)
  • Total Expenditures All Units $ 687.4
  • Total Revenue All Units (87%)$(596.5)
  • General Fund Contribution $ 90.9
hsd 2005 06 required expenditure increases in millions
HSD 2005/06 REQUIRED EXPENDITURE INCREASES (In Millions)

Wages:

Salary COLA Growth$1.8

Employee Benefits:

Pension 8.5

Health Insurance 1.7

Workers Compensation 3.2

Total Benefit Increase $13.4

Total S&EB COLA Growth $15.2

hsd 2005 06 expenditure increases in millions
HSD 2005/06 Expenditure Increases(In Millions)

Services & Supplies:

Pharmacy & Medical Supplies $6.3

Mental Health – Prop. 63 12.0

Reduction in AB-3632 Services (2.8)

Reduction in payments to outside

providers, Agency Expense, Miller

Centers & Misc.(3.6)

Total Net Services & Supplies Increase $11.9

hsd 2005 06 revenue changes in millions
HSD2005/06 REVENUE CHANGES (In Millions)

Revenue Increases :

Proposition 63 $12

Third Party Payors 6

CCHP Premiums 4

All Other Revenues 1

Less: Miller Centers Revenue Decline(4)

Total Net Revenue Increase $19

2005 06 net county cost requirement in millions
2005/06NET COUNTY COST REQUIREMENT(In Millions)

Cost Increases $27.1

(S&EB $15.2; S&S $11.9)

Less Revenue 19.0

BASELINE SHORTFALL $(8.1)

2005 06 cao recommended net county cost in millions
2005/06CAO RECOMMENDEDNET COUNTY COST(In Millions)

Baseline Shortfall $8.1

CAO Reduction of Existing

2004/05 General Fund Support 6.6

Total HSD Reduction Required $14.7

hsd net county cost comparison in millions
HSD NET COUNTY COST COMPARISON(In Millions)

HSD 2004/05 Budget $91.0

CAO Recommended 84.4

REDUCTION $ 6.6

HSD 2005/06 Baseline $99.1

CAO Recommended 84.4

REDUCTION $14.7

net county cost 2003 04 actual vs 2005 06 recommended budget in millions
NET COUNTY COST2003/04 ACTUAL vs. 2005/06 RECOMMENDED BUDGET(In Millions)

* Includes $10.0 Million Contingency Fund

health services dept proposed reductions
HEALTH SERVICES DEPT PROPOSED REDUCTIONS

Reduction Process Focused On:

  • Preserving legally mandated services
  • Maintaining regulatory compliance
  • Protecting revenue generating programs
  • Reducing non-direct patient care areas to the extent possible
hsd budget balancing plan summary in millions
HSD BUDGET BALANCING PLAN SUMMARY (In Millions)
  • Increase Revenue (#1-5)* $3.0
  • Implement Health Plan Co-Pays (#6,7) .3
  • Reduce Administrative Positions (#8,9) .5
  • Eliminate EHSD nursing support (#10) .1

PAGE TOTAL $3.9

* # refers to pages 274-280 of the Preliminary Recommended Budget

hsd budget balancing plan summary in millions22
HSD BUDGET BALANCING PLAN SUMMARY (In Millions)
  • Reduce Public Health Programs

e.g. Outreach, Clinic Services (#11-14) $.2

  • Eliminate All Hospital Transportation (#15) .1
  • Reduce GSD Requested Maintenance (#16) .6
  • Reduce Public Health & Homeless Programs

e.g. Nutrition, Crisis Hotline (#17-21) .7

PAGE TOTAL $1.6

CUMULATIVE TOTAL $5.5

hsd budget balancing plan summary in millions23
HSD BUDGET BALANCING PLAN SUMMARY (In Millions)
  • Eliminate Juvenile Hall Mental

Health Services (#22) $.3

  • Reduce Public Health Programs,

e.g. Oral Health, CHDP (#23,24) .4

  • Reduce Hospital Housekeeping Staff

by 20% (#25) .8

  • Close West County Detention Medical (#26) 1.4

PAGE TOTAL $2.9

CUMMULATIVE TOTAL $8.4

hsd budget balancing plan summary in millions24
HSD BUDGET BALANCING PLAN SUMMARY (In Millions)
  • Eliminate All Public Safety

Officers (#27) $2.3

  • Reduce the STAND & Comm.

Violence Contracts (#28).2

  • Reduce/Ration clinic appointment

slots for Indigent Patients (#24)2.0

PAGE TOTAL $4.5

CUMMULATIVE TOTAL $12.9

hsd budget balancing plan summary in millions25
HSD BUDGET BALANCING PLAN SUMMARY (In Millions)
  • Reduce Public Health & Homeless Programs e.g. TB, Immunization Clinics, 25 Beds

Concord Shelter (#30-37) $1.4

  • Contract out Detention Medical

Services(#38) 1.0

  • Close the Hospital Pediatric Unit (#39) .5
  • Reduce additional Public Health Programs

e.g. Senior Nutrition, Clinic Services (#40-44) .8

PAGE TOTAL $3.7

CUMMULATIVE TOTAL $16.6

hsd budget balancing plan summary in millions26
HSD BUDGET BALANCING PLAN SUMMARY (In Millions)
  • Close the Homeless Shelters (#45, 46)$1.1
  • Eliminate the Advice Nurses (#47) 1.0
  • PAGE TOTAL $2.1
  • Proposition 36 Proposed State

allocation change; Impact

unknown N/A

GRAND TOTAL $18.7