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HEALTH SERVICES DEPARTMENT

This presentation outlines the proposed budget for the Health Services Department for fiscal year 2010-11, highlighting the organization chart, key accomplishments, and budget challenges. Key achievements include enhancements to the Orange County Medical Clinic, the establishment of a new state-of-the-art Medical Examiner facility, and effective mosquito control measures. Budget challenges such as decreased funding and potential cuts to primary and secondary care services are discussed. The presentation emphasizes the impact of health insurance reforms and the rising number of Medicaid enrollees.

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HEALTH SERVICES DEPARTMENT

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  1. HEALTH SERVICES DEPARTMENT FY 2010-11 Budget Worksession July 20, 2010

  2. PRESENTATION OUTLINE • Organization Chart • Proposed FY 2010-11 Budget • Accomplishments • Budget Challenges • Summary

  3. PRESENTATION OUTLINE • Organization Chart • Proposed FY 2010-11 Budget • Accomplishments • Budget Challenges • Summary

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

  5. PRESENTATION OUTLINE • Organization Chart • Proposed FY 2010-11 Budget • Accomplishments • Budget Challenges • Summary

  6. PROPOSED FY 2010-11 BUDGET General Fund Only Pictures Pictures

  7. PROPOSED FY 2010-11 BUDGET Pictures Pictures

  8. PRESENTATION OUTLINE • Organization Chart • Proposed FY 2010-11 Budget • Accomplishments • Budget Challenges • Summary

  9. ACCOMPLISHMENTS PCAN/OCMC • Developed a PCAN tool kit for replication in other communities • Secured consultant to evaluate PCAN funding in light of healthcare reform • Improved patient care area at the Orange County Medical Clinic • Increased efficiency using Electronic Medical Record (EMR) and practice management software

  10. ACCOMPLISHMENTS Medical Examiner • Opened new state-of-the-art, 40,000 plus square foot complex • LEED certified complex, designed to save energy and be environmentally friendly • Established a clinical education program for FSU medical students

  11. ACCOMPLISHMENTS Mosquito Control • Investigated complaints calls within two (2) work days 98% of the time • Completed spray missions for adult mosquitoes within five (5) work days 100% of the time • Recently reorganized and cross trained workforce resulting in a workforce multiplier

  12. ACCOMPLISHMENTS EMS Office of the Medical Director • Average EMS offload delay at lowest point in 10 years • Provided direct and indirect medical oversight for nearly 200,000 EMS calls • Registered 3,784 people with special medical needs for shelters • Provided continuing education for 1,692 Paramedics and EMT’s Pictures

  13. PRESENTATION OUTLINE • Organization Chart • Proposed FY 2010-11 Budget • Accomplishments • Budget Challenges • Summary

  14. BUDGET CHALLENGES PCAN/OCMC Mandated Other

  15. BUDGET CHALLENGES FY 09-10 $43.4 Million 7% Reduction = $3 Million

  16. BUDGET CHALLENGES • Decreases in Operating and Personal Services Expenses • Revenue from ME fees • $2.4M decrease in PCAN funding FY 10-11 (Proposed) $41 Million 7% Reduction = $3 Million

  17. BUDGET CHALLENGES Primary Care Access Network $14.3M $11.8M (17%)

  18. BUDGET CHALLENGES Medicaid Expansion Temporary Health Insurance Exchange PermanentHealth Insurance Exchange Pictures Insurance Reforms Accountable Care Organizations Pictures Individual Mandate

  19. BUDGET CHALLENGES Potential Impacts • Primary Care • Closure of a clinic site • Loss of appointment slots • Close some pharmacies • Eliminate positions • Secondary Care • Fewer patients receiving specialist referrals, diagnostic tests, specialty procedures

  20. BUDGET CHALLENGES Primary Care Secondary Care $ $

  21. BUDGET CHALLENGES

  22. BUDGET CHALLENGES Orange County Medicaid Enrollees (in thousands) Apr-08 Apr-09 Apr-10

  23. BUDGET CHALLENGES Mosquito Control • Established Diseases • West Nile Virus • St. Louis Encephalitis • Eastern Equine Encephalitis • Potential to Become Established • Malaria • Dengue

  24. BUDGET CHALLENGES Medical Examiner Fees • Cremation Approval Fee • $35 Proposed Fee • 19 out of 24 ME Districts charge fee • $175,000 in yearly revenue

  25. PRESENTATION OUTLINE • Organization Chart • Proposed FY 2010-11 Budget • Accomplishments • Budget Challenges • Summary

  26. PCAN Funding Challenges Closure of a Clinic Reduced appointment slots Reduced funding for secondary care Medicaid Mandated Expense Orange County enrollees continue to climb Summary Pictures Pictures

  27. HEALTH SERVICES DEPARTMENT FY 2010-11 Budget Worksession July 20, 2010

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