Post on 10-Dec-2015
HEALTH AND FAMILY SERVICES DEPARTMENT
FY 2008-09Budget Worksession
July 22 , 2008
• Organization Chart
• Proposed FY 08-09 Budget
• Budget Overview
• Significant Future Issues
• Summary of Unfunded Needs
PRESENTATION OUTLINE
• Organization Chart
• Proposed FY 08-09 Budget
• Budget Overview
• Significant Future Issues
• Summary of Unfunded Needs
PRESENTATION OUTLINE
ORGANIZATION CHART
Department DirectorLarry Jones
Office on AgingMimi Reggentin
EMS Medical DirectorGeorge Ralls MD
Human ResourcesMarya Labrador
Mental Health & HomelessnessDonna Wyche
Deputy DirectorElla J. Gilmore
Deputy DirectorPete Clarke
Community Action Karl Anderson
Cooperative ExtensionGlinder Stephens
Head StartCathleen Armstead
Mosquito ControlTom Breaud
History CenterSara Van Arsdel
Citizens’ CommissionTyra Witsell
Medical ExaminerJan Garavaglia MD
Corrections MedicalDonna Loyko
Youth & Family ServicesSyd McCallister
Medical Clinic/PCANMargaret Brennan
ADA CoordinatorSamme Ripley
FiscalYolanda Brown
• Organization Chart
• Proposed FY 08-09 Budget
• Budget Overview
• Significant Future Issues
• Summary of Unfunded Needs
PRESENTATION OUTLINE
PROPOSED FY 08-09 BUDGET
CurrentFY 08 $ Change
ProposedFY 09
Total Budget $136.9M ($18.4M) $118.5M
General Fund Budget $85.4M ($3.2M)
$82.2M
Staffing 828 (14) 814
PROPOSED FY 08-09 BUDGET(General Fund)
CurrentFY 08 $ Change
ProposedFY 09
Personal Services $24.8M ($0.4M) $24.4M
Operating Budget $60.6M ($2.8M) $57.8M
Budget Change -3.7%
Staffing 433 (15) 418
CurrentFY 08 $ Change
ProposedFY 09
Capital Improvement Projects
$18.5M ($18.4M) $0.1M
Budget Change -99.5%
PROPOSED FY 08-09 BUDGET
• Organization Chart
• Proposed FY 08-09 Budget
• Budget Overview
• Significant Future Issues
• Summary of Unfunded Needs
PRESENTATION OUTLINE
Mandated Costs Mandated Costs are $22.1M
27% of General Fund Budget
BUDGET OVERVIEW
Mandated Costs
• Child Protection Exams-$176,000 Exams for suspected child abuse
• Medicaid Match-$9.3M inpatient and nursing home costs
• Health Care Responsibility Act- $225,000 Payment to out of county hospitals for emergency care of Orange County indigents
• Burial Program- $204,000 indigent burials
BUDGET OVERVIEW
Mandated Costs
Medical Examiner - $3.62M
•Required by Florida Statutes Chapter 406
• Increasing workload
•Osceola County share 18%
BUDGET OVERVIEW
Mandated Costs
DJJ Cost Shift- $8.6M
•Counties are charged a per-diem rate for each pre-disposition day a juvenile is in secure detention
•County has no control over rates or expenditures
BUDGET OVERVIEW
BUDGET OVERVIEW
Mandated Budget
-
5,000,000
10,000,000
15,000,000
20,000,000
25,000,000
2004 20092004 2009
BUDGET OVERVIEW
Budget minus Mandated
40,000,000
47,500,000
55,000,000
62,500,000
70,000,000
2004 20092004 2009
BUDGET OVERVIEW
Budget by Funding Source
Federal Grants $28.7M 25%
State Grants $4.9M 4%
General Fund $82.3M 71%
Federal Grants
State Grants
General Fund
Medical Clinic/PCAN
$28.5 Million
Head Start
$14.6 Million Mental Health and Homeless Issues
$4.3 Million
Youth &Family Services
(includes Ryan White)
$37.2 Million
EMS & Medical Examiner
$5.2 Million
Community Action, Cooperative Extension,
HFS Dept Off ice (includes ADA and
Commission on Aging), Fiscal & Human Resources,
Mosquito Control, Public Health, History Center
$14 Million
Citizens' Commission for Children
$12.1 Million
General Fund and Grants
Total $115.9M
BUDGET OVERVIEW
BUDGET OVERVIEW
Medical Clinic/PCAN
$28.5 Million
Head Start
$14.6 Million Mental Health and Homeless Issues
$4.3 Million
Youth &Family Services
(includes Ryan White)
$37.2 Million
EMS & Medical Examiner
$5.2 Million
Community Action, Cooperative Extension,
HFS Dept Office (includes ADA and
Commission on Aging), Fiscal & Human Resources,
Mosquito Control, Public Health, History Center
$14 Million
Citizens' Commission for Children
$12.1 Million
BUDGET OVERVIEW
Citizens' Commission for Children
10.4%
- Neighborhood
Centers for Families
-After School Zone
-Contract Oversight
$12.1M
Citizens’ Commission for Children
• Established in 1989 as an alternative to Juvenile Welfare Board
• 10-member board
• Mission was to fund and monitor services for children, youth and families
BUDGET OVERVIEW
Citizens’ Commission for Children
• Funds 13 Neighborhood Centers for Families
• Funds 26 middle schools for the After School Zone
• Manages the Citizen’s Review Panel
BUDGET OVERVIEW
Citizens’ Commission for Children
After School Zone
• Started in 1999 to respond to increase in juvenile crime and violence
• Funded by Orange County
• Managed through contracts with YMCA and Boy’s and Girl’s Club
• County Funding since inception - $28.6 M
BUDGET OVERVIEW
BUDGET OVERVIEW
Citizens’ Commission for Children
After School Zone
Effect of School Board Time Change
• Doubles program hours
• Maintaining current model requires an additional $1.6M (2 additional hours)
• No prior discussions with the County
BUDGET OVERVIEW
BUDGET OVERVIEW
Citizens’ Commission for Children
After School Zone (cont’d)
Options for cost reductions:
• Cap enrollment
• Reduce transportation services
• Eliminate field trips
• End the program at 5:30pm instead of 6:00pm
• Reduce two weeks for the “Summer Zone”
Discussions ongoing with OCPS
BUDGET OVERVIEW
Youth & Family Services
-GOV
-Shelter
-Crisis/FRP
-Veterans
-DJJ
-Ryan White
$32.7M
32.1%
Youth and Family Services
“A Safety Net for Children and Families”
• Crisis and Long Term Family Assistance
• Residential Services
• Counseling and Case Management
• Home Based Services
• Ryan White
• Veterans Services
BUDGET OVERVIEW
Youth and Family Services
Crisis and Long Term Family Assistance (Welfare Revolving Fund)
• Crisis Assistance Program -Short term assistance providing one time rental/mortgage payment, utilities to prevent homelessness
• Family Resource Program -Case Management and temporary financial support for long term self-sufficiency
BUDGET OVERVIEW
BUDGET OVERVIEWBUDGET OVERVIEW
Youth and Family Services
Welfare Revolving Fund
FY 06-07• 45,000 calls• 80% eligible based on
prescreening• 5% assisted (2,622 families)• Call volume up 20% in FY 07-08
Costs per client increasing Funding history
• $2M FY 96-97• $1M FY 08-09
BUDGET OVERVIEWBUDGET OVERVIEW
Youth and Family Services
Residential Services
• GOV• Youth Shelter• Family Preservation• Family Counseling• Delinquency Supervision
BUDGET OVERVIEW
Youth and Family Services Current issues
• Children requiring more complex and cost intensive services
• State funds for child welfare continues to be reduced limiting options for children
• Working to match County resources with community needs
• Seeking appropriate grant increases
• Continuing strong public/private partnerships
BUDGET OVERVIEW
BUDGET OVERVIEW
Medical Clinic/ PCAN
-PCAN
-Pharmacy
-Specialty Care
-Medicaid Match
-Internal Medicine
-Volunteers
-Case Management
$28.5M
24.6%
Primary Care Access Primary Care Access NetworkNetwork
Primary Care Access Primary Care Access NetworkNetwork
BUDGET OVERVIEW
PCAN Growth 2000-2007
5,00017,610
27,611 32,35946,246
65,29979,000
100,000
020,00040,00060,00080,000
100,000120,000
Fiscal Year
Un
du
plic
ate
d P
ati
en
ts
En
rolle
d
Program Growth
BUDGET OVERVIEW
Primary Care• Hypertension• Diabetes• Asthma• Heart Disease• Acute Care
Secondary Care• Cancer• Cardiology• Orthopedics• Diabetes• Gastroenterology
Primary Care Access Network
BUDGET OVERVIEW
Top 5 Diagnosis
Primary Care Access Network (PCAN)
• Number of uninsured continue to grow
• Partners are financially pressured due to reduced Medicaid reimbursement rates
• Funding has remained static for many years
• May be able to use IGT if cap room exists
BUDGET OVERVIEW
• More uninsured
• More health care plans being rolled back
• Cost of services increasing
• PCAN funding flat until last year’s $1M dollar reduction
• PCAN at a critical juncture
• Patients facing health care decisions vs. living expenses
BUDGET OVERVIEW
Primary Access Care Network (PCAN)
Impact on PCAN services
• Cap patient enrollment
• Limit specialty services
• Consolidate clinics/services
• Limit dollar value of services
• Curtail diagnostics/labs
BUDGET OVERVIEW
Primary Care Access Network (PCAN)
BUDGET OVERVIEW
Head Start
-Class Rooms
-Transportation
-Social Services
-Nutrition Services
-Special Needs
$14.6M
12.6%
Comprehensive services provided for 1,536 children
• Educational Curriculum
• Transportation
• Health Services
• Special Needs Services (10% required)
BUDGET OVERVIEW
Head Start
BUDGET OVERVIEW
HEAD START CENTERS
• Maintains High Quality Services
• Earned and maintains National Accreditation
• Increase Recruitment of Volunteers
Head Start Center
BUDGET OVERVIEW
Challenges
Federal Reauthorization Act
• Priority on homeless children
• Enhanced teacher credentials
• Increased transportation, food and other operational costs
• Children served have more severe needs
Head Start
BUDGET OVERVIEW
Responses to Challenges
• Re-assignment and Cross Training of Staff
• Increase Internal Monitoring
• Reduction of Transportation Routes
• Continue to Maximize Efficiencies
BUDGET OVERVIEW
Head Start
• Organization Chart
• Proposed FY 08-09 Budget
• Budget Overview
• Significant Future Issues
• Summary of Unfunded Needs
PRESENTATION OUTLINE
SIGNIFICANT FUTURE ISSUES
• Economy continues to weaken
• Increasing stress on individuals and families
– Financial– Emotional– Physical
• Demands on social services will continue to increase
SIGNIFICANT FUTURE ISSUES
• PCAN • Housing Assistance
• Citizens’ Commission for Children • Central Receiving Center – Phase 2• Welfare Revolving Fund
$518,327
$688,624
$317,220
$206,000
$1,211,450$2,941,621
FY 07-08 - Funding for Homeless
SIGNIFICANT FUTURE ISSUES
Strategies for Addressing Increased Service Demands
• Review contract compliance• Prioritize Services• Consolidate Services• Consider privatization• Seek More Funding!
• Organization Chart
• Proposed FY 08-09 Budget
• Budget Overview
• Significant Future Issues
• Summary of Unfunded Needs
PRESENTATION OUTLINE
After School Zone - $1.6M
• To totally fund additional two hours a day
• Will bring back to the BCC in August or September
• Several options are available
SUMMARY OF UNFUNDED NEEDS
Crisis Assistance - $1.2M
• Increasing demand in worsening economic conditions
• Currently meeting 5% of need
• In place, well functioning system to help residents avoid homelessness
SUMMARY OF UNFUNDED NEEDS
PCAN - $2.8M
• Community based system of care for our increasing number of uninsured
• Clinic partners are feeling financial strain
• Funding needs may cause enrollment caps and/or reductions in specialty/diagnostic care
SUMMARY OF UNFUNDED NEEDS
• After School Zone $1.6M
• Crisis Assistance $1.2M
• PCAN $2.8M
SUMMARY OF UNFUNDED NEEDS
Total $5.6M
HEALTH AND FAMILY SERVICES DEPARTMENT
FY 2008-09Budget Worksession
July 22, 2008