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HomeMy WebLinkAboutHealth ServicesHealth Services Janice Garceau, HS Director Holly Harris, BH Director Heather Kaisner, PH Director Cheryl Smallman, Business Officer ▪FY 24-25 Proposed Budget Presentation May 22, 2024 Health Services Overview To promote and protect the health and safety of our community. Mission: FY 2025 Proposed: 419.30 FTE +1.0 FTE PHE I extended for Immunizations +1.0 FTE BHS II anticipated for Deflection Behavioral Health 276.45 FTE Admin Services 50.10 FTE Public Health 90.75 FTE Director’s Office 2 FTE 2 FY 24-25 Department Fiscal Issues •Public Health funding •Crisis Program – After-hours Stabilization Center services •Space in Downtown Area •Client acuity and team-based service model impact on billable hours •Increasing personnel costs •Increasing indirect expenses •Expiring funds •COVID-19 •Crisis Program - CJC IMPACTS, HB 5204, DCSO funding uncertain, COHC •ARPA •BH Workforce Short-term Fiscal Issues Long-term Fiscal Issues 3 FY25 Challenges •Grants expand services to community and allow DCHS to innovate; however… •Grant funding restricted on administrative costs Limited Resources to Cover Overhead CMHP & LPHA Stretched Thin •Increasing pressure to address unmet basic needs that exceed scope of Health Services capacity, mandates, and resources 4 Administrative Staffing Constrained •Increasing costs, ISFs and indirect cost allocation limitations constrain adequate administrative staffing FY25 Initiatives •Maximize on Behavioral Health, Public Health & Primary Care co-location and integration to improve client outcomes •Expansion of Non-law enforcement response Integration Refocus Efforts on Core Services •Evaluate and focus on mandated and core services 5 Administrative •Explore federally negotiated indirect cost rate to capture full cost of program •Reduce administrative burden for clinicians Behavioral Health Outlook Health Services Fund Structure 274 270 276 7 Director’s Office (org 2743150) Admin Services (org 2743151) Behavioral Health (org 2743152) Public Health (org 2743153) OHP Mental Health Reserve Acute Services (to be closed in FY25) Access and Integrated Services Comp. Care for Youth & Families Crisis Services I/DD … Department Level Financials Program Level Financials 7 FY 24-25 BH Five-Year Forecast $- $5,000,000 $10,000,000 $15,000,000 $20,000,000 $25,000,000 $30,000,000 FY 2024 FY 2025 FY 2026 FY 2027 FY 2028 FY 2029 Five-Year Forecast Ending Working Capital Minimum Working Capital Policy 8 FY 24-25 BH Five-Year Forecast – Cont. $- $5,000,000 $10,000,000 $15,000,000 $20,000,000 $25,000,000 $30,000,000 FY 2024 FY 2025 FY 2026 FY 2027 FY 2028 FY 2029 Five-Year Forecast Ending Working Capital Minimum Working Capital Policy 25% Minimum Operating Reserve 9 OHP Mental Health Reserve 10 - 5 10 15 20 25 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029($) MillionsReserve level 25% Operational Budget Special Request – I/DD Admin Support KEY FACTS: •Average supervision ratio is 1:10. •I/DD leadership without direct admin support leading to inefficiencies. •Adding a dedicated support would increase supervisor efficiency while maintaining supervision ratios. ASK: Add 1.0 FTE to regular COST: $109,618 FUNDING: $33,000 in CGF; in Proposed. 11 Public Health Outlook FY 24-25 PH Five-Year Forecast $(2,000,000) $(1,000,000) $- $1,000,000 $2,000,000 $3,000,000 $4,000,000 $5,000,000 FY 2024 FY 2025 FY 2026 FY 2027 FY 2028 FY 2029 Five-Year Forecast Ending Working Capital Minimum Working Capital Policy 13 FY 24-25 PH Five-Year Forecast – Cont.14 $- $1,000,000 $2,000,000 $3,000,000 $4,000,000 $5,000,000 FY 2024 FY 2025 FY 2026 FY 2027 FY 2028 FY 2029 Five-Year Forecast Ending Working Capital Minimum Working Capital Policy FY 24-25 PH Opportunities & Unknowns •Revenue generating services •Public Health Modernization •Community partner collaboration •Longterm Prevention funding 15 Changes from Proposed Budget Updates from the Proposed Budget •Immunization Funding (+222,328; extends 1.0 FTE limited) •Women Infants and Children (WIC) (+69,336) •IMPACTS Funding (+200,143) •City of Bend MCAT (+120,000; existing 1.0 FTE) •Reduction of Aid and Assist Funding (-79,000) •Deflection Program (+$378,336; +1.0 FTE BHS II) 17 Thank you