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HEALTH AND FAMILY SERVICES DEPARTMENT

HEALTH AND FAMILY SERVICES DEPARTMENT. FY 2008-09 Budget Worksession July 22 , 2008. PRESENTATION OUTLINE. 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

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HEALTH AND FAMILY SERVICES DEPARTMENT

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  1. HEALTH AND FAMILY SERVICES DEPARTMENT FY 2008-09 Budget Worksession July 22 , 2008

  2. PRESENTATION OUTLINE • Organization Chart • Proposed FY 08-09 Budget • Budget Overview • Significant Future Issues • Summary of Unfunded Needs

  3. PRESENTATION OUTLINE • Organization Chart • Proposed FY 08-09 Budget • Budget Overview • Significant Future Issues • Summary of Unfunded Needs

  4. ORGANIZATION CHART

  5. PRESENTATION OUTLINE • Organization Chart • Proposed FY 08-09 Budget • Budget Overview • Significant Future Issues • Summary of Unfunded Needs

  6. PROPOSED FY 08-09 BUDGET

  7. PROPOSED FY 08-09 BUDGET(General Fund)

  8. PROPOSED FY 08-09 BUDGET

  9. PRESENTATION OUTLINE • Organization Chart • Proposed FY 08-09 Budget • Budget Overview • Significant Future Issues • Summary of Unfunded Needs

  10. BUDGET OVERVIEW Mandated Costs Mandated Costs are $22.1M 27% of General Fund Budget

  11. 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

  12. BUDGET OVERVIEW Mandated Costs Medical Examiner - $3.62M • Required by Florida Statutes Chapter 406 • Increasing workload • Osceola County share 18%

  13. 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

  14. BUDGET OVERVIEW 2004 2009

  15. BUDGET OVERVIEW 2004 2009

  16. BUDGET OVERVIEW

  17. BUDGET OVERVIEW General Fund and Grants Total $115.9M

  18. BUDGET OVERVIEW

  19. BUDGET OVERVIEW - Neighborhood Centers for Families -After School Zone -Contract Oversight $12.1M 10.4%

  20. BUDGET OVERVIEW 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

  21. 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

  22. 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

  23. BUDGET OVERVIEW

  24. 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

  25. 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

  26. BUDGET OVERVIEW -GOV -Shelter -Crisis/FRP -Veterans -DJJ -Ryan White $32.7M 32.1%

  27. BUDGET OVERVIEW 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

  28. 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

  29. BUDGET OVERVIEW

  30. BUDGET 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

  31. BUDGET OVERVIEW Youth and Family Services Residential Services • GOV • Youth Shelter • Family Preservation • Family Counseling • Delinquency Supervision

  32. 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

  33. BUDGET OVERVIEW -PCAN -Pharmacy -Specialty Care -Medicaid Match -Internal Medicine -Volunteers -Case Management $28.5M 24.6%

  34. BUDGET OVERVIEW

  35. BUDGET OVERVIEW Program Growth

  36. Primary Care Hypertension Diabetes Asthma Heart Disease Acute Care Secondary Care Cancer Cardiology Orthopedics Diabetes Gastroenterology BUDGET OVERVIEW Primary Care Access Network Top 5 Diagnosis

  37. BUDGET OVERVIEW 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

  38. BUDGET OVERVIEW Primary Access Care Network (PCAN) • 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

  39. BUDGET OVERVIEW Primary Care Access Network (PCAN) Impact on PCAN services • Cap patient enrollment • Limit specialty services • Consolidate clinics/services • Limit dollar value of services • Curtail diagnostics/labs

  40. BUDGET OVERVIEW -Class Rooms -Transportation -Social Services -Nutrition Services -Special Needs $14.6M 12.6%

  41. BUDGET OVERVIEW Head Start Comprehensive services provided for 1,536 children • Educational Curriculum • Transportation • Health Services • Special Needs Services (10% required)

  42. BUDGET OVERVIEW HEAD START CENTERS

  43. BUDGET OVERVIEW Head Start Center • Maintains High Quality Services • Earned and maintains National Accreditation • Increase Recruitment of Volunteers

  44. BUDGET OVERVIEW Head Start Challenges • Federal Reauthorization Act • Priority on homeless children • Enhanced teacher credentials • Increased transportation, food and other operational costs • Children served have more severe needs

  45. BUDGET OVERVIEW Head Start Responses to Challenges • Re-assignment and Cross Training of Staff • Increase Internal Monitoring • Reduction of Transportation Routes • Continue to Maximize Efficiencies

  46. PRESENTATION OUTLINE • Organization Chart • Proposed FY 08-09 Budget • Budget Overview • Significant Future Issues • Summary of Unfunded Needs

  47. Economy continues to weaken Increasing stress on individuals and families Financial Emotional Physical Demands on social services will continue to increase SIGNIFICANT FUTURE ISSUES

  48. PCAN Housing Assistance Citizens’ Commission for Children Central Receiving Center – Phase 2 WelfareRevolving Fund $518,327 $688,624 $317,220 $206,000 $1,211,450 $2,941,621 SIGNIFICANT FUTURE ISSUES FY 07-08 - Funding for Homeless

  49. Strategies for Addressing Increased Service Demands Review contract compliance Prioritize Services Consolidate Services Consider privatization Seek More Funding! SIGNIFICANT FUTURE ISSUES

  50. PRESENTATION OUTLINE • Organization Chart • Proposed FY 08-09 Budget • Budget Overview • Significant Future Issues • Summary of Unfunded Needs

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