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FY 2010-11 Budget Challenges February 16 th , 2010

Health Services Department. FY 2010-11 Budget Challenges February 16 th , 2010. Outline. Revenue Outlook Department Expenses Budget Challenges Summary. Outline. Revenue Outlook Department Expenses Budget Challenges Summary. Revenue Outlook. General Fund 99%. $ 45.1 Million.

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FY 2010-11 Budget Challenges February 16 th , 2010

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  1. Health Services Department FY 2010-11 Budget Challenges February 16th, 2010

  2. Outline • Revenue Outlook • Department Expenses • Budget Challenges • Summary

  3. Outline • Revenue Outlook • Department Expenses • Budget Challenges • Summary

  4. Revenue Outlook General Fund 99% $ 45.1 Million Grants 1%

  5. Revenue Outlook • Health Services Divisions • Corrections Health Services • PCAN/Orange County Medical Clinic • Mosquito Control • Medical Examiner • Emergency Medical Services

  6. Outline • Revenue Outlook • Department Expenses • Budget Challenges • Summary

  7. Department Expenses Mandated 43% Other 13% 44% PCAN

  8. Department Expenses • Medicaid (15M) • HCRA (500K) • Medical Examiner (2.7M) Mandated 43%

  9. Department Expenses • PCAN (14.2M) • OCMC (4.5M) • Pharmacy (1M) 44% PCAN

  10. Department Expenses • Mosquito Control (1.7M) • EMS Office (1.4M) • HSD Office (700K) • Public Health Unit (1.8M) Other 13%

  11. Outline • Revenue Outlook • Department Expenses • Budget Challenges • Summary

  12. Budget Challenges $ 44.6 Million 7% Reduction = $ 3.1 Million

  13. Budget Challenges $ 44.6 Million $19M Mandated $ 25.6 Million 3.1M = 12% $19.7M PCAN $ 5.9 Million 3.1M = 53%

  14. Budget Challenges Primary Care Access Network Medicaid

  15. Budget Challenges Medicaid

  16. Budget Challenges

  17. Budget Challenges

  18. Budget Challenges

  19. Budget Challenges Budget Amendment of $ 6M

  20. Budget Challenges Monthly Medicaid Expense in Millions $ 1.4 M

  21. Budget Challenges AHCA proposal: Increase Medicaid nursing home cost to counties $ 3 Million

  22. Budget Challenges • Medicaid • Refugee Medical Assistance • Children & pregnant women • Adults or couples without children

  23. Budget Challenges Medicaid Legislation Economy $ 20 Million

  24. Budget Challenges Primary Care Access Network

  25. Budget Challenges PCAN Patients in Thousands 37% Increase

  26. Secondary Care Budget Challenges Primary Care $ 6M $ 6M

  27. Budget Challenges Other 11% Uninsured 27% 62% PCAN Primary Care

  28. Budget Challenges County Dollars support the uninsured Uninsured 16% of total PCAN primary care funding 62% PCAN Primary Care

  29. Community Health Centers, Inc. Budget Challenges 7% Budget reduction = • Closing of Alafaya clinic • Eliminate almost 10,000 appointment slots • Close some pharmacies • Eliminate physician/ARNP positions

  30. PCAN Clinic Sites

  31. Budget Challenges • Secondary Care • “Expanded exclusion list” implemented in July 2008 due to projected budget shortfall • Fewer patients receiving specialist referrals, diagnostic tests, specialty procedures PCAN Secondary Care (6M)

  32. Budget Challenges Mosquito Control

  33. Budget Challenges • Mosquito Control Budget • 1% reduction = 5.5% reduction in Pesticides 38.5% Reduction in Chemical & Pesticides 7% Reduction

  34. Budget Challenges • First outbreak of Dengue in Florida in 50 years • Disease can range from mild to life threatening

  35. Budget Challenges Malaria

  36. Outline • Revenue Outlook • Department Expenses • Budget Challenges • Summary

  37. Summary • 43% of HSD budget covers mandated expenses • Mandated expenses likely to increase • 7% reduction to overall budget equals 53% if Mandated and PCAN removed • Mosquito Control budget reductions not recommended

  38. Summary • Reducing HSD budget by 7% will require significant reductions in PCAN: • Closure of one or more clinic sites • Loss of approximately 10,000 appointment slots • Limiting coverage to fewer conditions • Reducing provider reimbursement • Enrollment cap

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