NACCHO Annual 2010 Memphis, TN Matthew J. Dillon

1. Viewing Public Health Financial Information from a Different Perspective: Financial Ratio Analysis in Florida County Health Departments July 14, 2010 NACCHO Annual 2010 Memphis, TN Matthew J. Dillon

2. Lets Continue Our Journey Walking Man – source unknown….

3. Quick Perspective….. • Administration sets policy • Program staff deliver the services • Administrative staff are there to support the programs • Finance & Accountings role is that of the scorekeeper

5. Florida Department of Health • 67 County Health Departments • $834 M CHDs Statewide • $208 B Department Wide • Co-managed under the State and Local Board of County Commissioners • All State Employees • Single Accounting System • Unified chart of accounts

6. Challenges on what to collect: • We collect lots of information, just depends on how and what you want to retrieve • Issues with trying to collect information from the various operations, especially clinical • i.e. What is primary care, what is core public health?

7. Florida Accounting and Information Resource System (FLAIR) • Very cumbersome but effective system • Approximately 2 M accounting transactions/year • Multiple Reports • Okay for Finance and Accounting Staff • Difficult for Department Managers to read • i.e. one report shows only revenues while another expenditures but not both with a Total

9. Financial Information Reporting System • Developed a reporting system called FIRS • Easy reports to read in similar formats • Accessible via the DOH network • All you need is an email address • Access the reports for your CHD or all CHDs within the state.

10. FIRS • Good for comparing similar operations, staffing, workload, population, budget, FTEs, etc. • Can provide revenues and expenditures per program or • Secondly can develop reports for a division (example, you can have separate budgets for the personnel department, finance and accounting, IT, etc. and you can also have a group report for all the offices).

13. Gathering Information • Used FIRS • This was the main foundation for our financial data gathering

14. Florida Advantages: • We use a similar codes, chart of accounts, accounting structure, format, etc. • Most all financial data was in one data base • We had access to the data • If we pulled the data we would have control on how it was sorted • Consistently right or consistently wrong • Workload was put on limited staff • Instructions were clear among those involved

15. Florida Disadvantages: • 2 M Transactions/ year • (6M+ transactions) to manage causing difficulty in sharing and reviewing the information collected in files via spreadsheets/email

16. Multiple DOH/State of Florida Systems FLAIR FIRS CONMAN extracts from Department of Management Systems External Links Sources of Data

17. http://www.floridacharts.com/charts/chart.aspx http://edr.state.fl.us/ http://quickfacts.census.gov/qfd/states/12000.html Most of the demographics came from one of the 3 sites below:

18. Results: • Data pull for 45 of the 61 criteria • CHDs gathered for the remaining 16 items

19. Key Players in Data Gathering • Greg Ballard • Jennie Bishop • Penny Dyer • Matthew Dillon • Lil Perry • Ernesto Rubio

20. Scope of CHD Clinical Services • 1 million clients served annually. • Over 250 clinic sites throughout state.

21. Financial and Other Related Indicators Revenues Expenditures

22. Financial – Revenues

23. Annual Comparisons • Captured 3 FY’s • Actual Amounts and • Added Budget for each year Revenues

24. Financial – Expenditures

25. Annual Comparisons Additional Expenditure Breakdowns

26. Special Revenue and Expenditures

27. Additional Revenue Breakdowns

28. Additional Expenditure Breakdowns

29. Additional Breakdowns

30. Other Financial, Demographic, Workforce, and Mission Critical

31. Demographic

32. Workforce

33. Mission Critical

34. Ratios

36. Revenues per Capita $16,228,647 Total Revenues / Population = Revenues / Capita $64.48 Capita 251,703

41. Florida Finance Ratio Analysis Initiative 2006-2008: • Population size: • 1 = <25,000; • 2 = 25,000-49,999; • 3 = 50,000-99,999; • 4 = 100,000-499,999; • 5 = 500,000-999,999; • 6 = >1,000,000

47. Florida Local Health Agency Revenue Per Capita 2008

48. Florida Local Health Agency Expense Per Capita 2008