Health Services. Spending and Staffing. Summary to Budget

Transcription

1 Health Services Summary This section includes the Health Services budget in the General Fund which supports the County s contribution to the Tacoma-Pierce County Health Department. It also includes the entire budget for the Tacoma-Pierce County Health Department as required by intergovernmental agreement as the County is the fiduciary agent for this entity. The $36.7 million budget represents 3.6% of the total County budget for Funding Source 2018 Percent of Total Intergovernmental Revenue 15,506, % Charges for Services Revenue 10,251, % License & Permit Revenue 5,457, % Miscellaneous Revenue 1,490, % ed Use of Fund Balance 4,021, % Total 36,727, % 2015 to 2017 Health Services functions are 2.2%, or $723,600, above the 2015 level. General Fund support for the Health Services Fund has remained consistent with prior years The 2018 budget for Health Services functions is 0.4%, or $149,000, below the prior year. 40 Spending and Staffing Health Services Page 515 Health Services 2,537, Tacoma-Pierce County Health Dept 34,189, Total 36,727, Millions Pierce County

2 Health Services 512 Pierce County 2018

3 Health Services MAJOR ACCOMPLISHMENTS IN 2017 The Tacoma Pierce County Health Department responded to more than 4,000 cases of communicable diseases such as tuberculosis, HIV and E-coli and implemented control and prevention measures to stop disease outbreaks. We supported Multicare and Franciscan mobile nurses in providing over 16,000 immunizations. In addition, we provided 3,378 flu vaccines at 60 schools to make sure Pierce County children are protected against diseases such as measles and whooping cough. With funding from a $400,000 grant, we have focused on community, and healthy systems strategies to decrease diabetes, and hypertension management in Pierce County. We are developing policies to prevent youth initiation of e-cigarettes and increase the availability of tobacco-free housing. In 2016, 185 properties comprising 3,132 units have adopted smoke-free policies. Each month, we provided 24,500 outpatient opiate substitution service to 1,300 unduplicated adults (18+). In addition, we continue in our role as the local lead organization for the Washington Health Benefit Exchange, helping uninsured residents to access free or affordable health insurance. By inspecting more than 5,400 septic systems and monitoring 1,401 water systems, we made sure our residents had clean water. Over 1,500 water quality tests were taken to ensure safe shellfish harvesting, and safe swimming beaches. We also worked with residents to clean up garbage, illegal dumping activities, and non-compliant septic systems in 944 separate cases. We conducted 4,500 evidence-based home visits, and connected 26,000 families to needed services. Working with our partners, schoolchildren received 7,400 dental sealants, 7,300 fluoride varnish treatments, and 16,700 screenings and exams. Pierce County

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5 HEALTH SERVICES General Fund Summary: Pierce County s contribution to the Tacoma-Pierce County Health Department is provided through this General Fund Health Services budget. Highlights: The County s General Fund budget allocation supports various priority health services and programs (Health Pool), a specific contribution for METH Lab health related expenses, and the Domestic Violence Hotline. The County s 2018 budget allocation is equal to prior years. The 2018 budget includes additional resources for the Planning and Public Works Department, in conjunction with the Health Department, to evaluate the consolidation of permitting services. The budget also includes resources for the Human Services and Health Department to evaluate areas of the County with poor health conditions and to identify strategies for improvement. The Health Department s total budget and proposed services for next year are shown in the following section. FUNDING SOURCES Absolute Percent ed General Fund Support 2,537,670 2,537,670 % Total 2,537,670 2,537,670 % EXPENDITURES Absolute Percent Intergovernmental Services 2,437,800 2,437,800 2,437,800 2,437,800 % Transfers Out 99,870 99,870 99,870 99,870 % Total 2,537,670 2,537,670 2,537,670 2,537,670 % Pierce County

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7 TACOMA-PIERCE COUNTY HEALTH DEPARTMENT The mission of the Tacoma-Pierce County Health Department is to protect and improve the health of all people and places in Pierce County. Summary: The Tacoma-Pierce County Health Department is responsible for the protection of public health and the safety of the citizens of the City of Tacoma, unincorporated Pierce County, and other cities and towns within the County. The policy for the Health Department is set by the Board of Health, whose membership includes the Mayor and a Councilmember of the City of Tacoma, the County Executive and three County Councilmembers, an elected official representing the other cities and towns, and one Member-At-Large selected by the Board. Funding for the Health Department is a combination of federal, state, and local monies, grants, fees for service, and private contributions. Health Pool funds are received from the City of Tacoma and Pierce County. Highlights: The proposed year 2018 Health Department budget totals $34,189,959; a decrease of $149,003 from the 2017 beginning budget of $34,338,962 (Board of Health Resolution , July 19, 2017). The anticipated revenue for 2018 represents a.4% decrease from Health Pool from the City of Tacoma remains the same as 2017 at $555,790. Estimated City of Tacoma Restricted dollars shows an increase of $11,500 from 2017 for a total of $707,500. Anticipated Health Pool funding from Pierce County remains stable at $2,424,790. Estimated Pierce County Restricted dollars shows an increase of $40,990 from 2017 for a total of $778,050. Major factors contributing to the net decrease of $149,003 are due to decreases in Federal and State Categorical funding $1,326,247, and increases in Treatment Services anticipated fee revenue. Pierce County Health Pool, City of Tacoma Health Pool, State General (Public Health), State and Local Capacity Development Fund, and Medicaid Administrative Match dollars are distributed proportionally to programs. Estimated use of Fund Balance in 2018 is budgeted at a total amount of $1,483,981, a 28.0% increase from the estimated use of Fund Balance for This amount is primarily from fee supported programs. Cumulative reserves of $24,272 and Title XIX Medicaid Administrative Claiming fund balance will support programs throughout the Department. Salaries and Benefits show an increase of $261,234 over Salary and Benefit budgets were calculated using a system that provides detailed projected amounts per Pierce County

8 Tacoma-Pierce County Health Department employee. Built into the 2018 budget are a 2.5% Cost of Living Allowance (COLA) increase, and an estimated 8.0% health insurance premium increase. Supplies, Professional Services, Other Services and Charges, and Intergovernmental Services show a combined decrease of $132,340. The major causes for this increase are an increase in salaries of $261,234, and a decrease in other services and charges of $100,377. Beginning in 2017, rent allocation is separated from the indirect cost allocation to better fund necessary improvements to the Health Department s current facility or to accommodate expenses associated with leasing other space up to $1.5 million. The applied indirect cost rate for 2018 remains the same as 2017 at 20.0%. The indirect rate supports; Department Administration; Communication; and Finance; Human Resources; Information Technology; and Assessment, Planning and Improvement. Beginning in 2017, facility and operational costs are allocated as a separate direct cost proportional to the square footage used. Prior to 2017, facility and operations costs, included rent, were included in the indirect cost allocation. Capital Outlay is budgeted at $125,000. This is a decrease of $169,000 from the 2017 budget. Capital expenses in 2018 are budgeted for facility and information technology upgrades. Other Financing Uses (Operational Transfers) is budgeted at $756,090, a decrease of $100,048 from Transfers from fee programs totaling $492,522 will support food service establishment inspections and treatment services, among other programs. Title XIX Medicaid Administrative Claiming fund balance are allocated among the programs that earn the revenue. A transfer of $24,272 from cumulative reserves will support programs throughout the Department. While the Health Department is not currently facing dramatic budget impacts as it has in recent years, we continue to shrink, and innovation is becoming a more critical part of how we think about and fund our important public health work. We have added resources to better support our upcoming Website implementation and records management as well as making investments in our strategic plan priorities of behavioral health and injury prevention. The Department continues to invest in health equity efforts that help guide how we evaluate, design and deliver services to Pierce County communities. Enhancing our support of these areas helps us to strengthen our position as the innovative and reliable source of local public health information, data, service and policy. 518 Pierce County 2018

9 Tacoma-Pierce County Health Department FUNDING SOURCES Absolute Percent License & Permit Revenue 5,071,003 5,494,342 5,354,860 5,457, , % Intergovernmental Revenue 15,934,991 18,495,068 16,980,085 15,506,079 (1,474,006) (8.7) % Charges for Services Revenue 8,585,832 9,434,500 9,344,644 10,251, , % Miscellaneous Revenue 1,469,768 1,241,409 1,505,189 1,490,224 (14,965) (1.0) % ed Use of Fund Balance 1,154,184 1,483, , % Total 31,061,594 34,665,319 34,338,962 34,189,959 (149,003) (0.4) % EXPENDITURES Absolute Percent Salaries 16,756,560 17,919,499 18,827,740 19,088, , % Benefits 5,809,302 6,120,782 6,939,458 6,930,609 (8,849) (0.1) % Supplies 811, , , ,240 25, % Other Services and Charges 6,290,907 7,222,313 7,522,594 7,265,136 (257,458) (3.4) % Capital Outlays 60,012 98, , ,000 (169,000) (57.5) % Total 29,728,635 32,166,528 34,338,962 34,189,959 (149,003) (0.4) % Pierce County

10 Tacoma-Pierce County Health Department 2013 STAFFING SUMMARY 2014 General Fund Office of the Director Business Support Services Human Resources Information Technology Assessment, Planning & Improve Vital Records Total General Fund Special Revenue Funds Cross Collaborative Initiatives Environmental Health Administration Public Health Emergencies On-Site Sewage/Surface Water Waste Mgmt & Code Enforcement Water Resources/Hazardous Waste Food & Comm Safety Phys Activity, Nutr, Tobacco Prev Community Transformation Community Environmental Health Substance Abuse Services Family Support Partnerships Maternal & Child Outreach Communicable Disease Admin Communicable Disease Network Communicable Disease Epidemiology Stregthening Families Admin Oral Health STD/HIV Disease Control Youth Prevention Initiatives Total Special Revenue Funds Total Health Department Pierce County 2018

11 Tacoma-Pierce County Health Department Fund Balance Federal State FUNDING SOURCES Pierce County Health Pool City of Tacoma Health Pool Pierce County Special City of Tacoma Special Lic/Permits Fee's/Misc Contribution Other Financing Sources Total 2018 Funding Sources General Fund Office of the Director 239, ,003 32, ,314 Information Technology 58,583 34,286 7,859 24, ,000 Office of Asmnt Planning & Improv 219, ,904 88,316 20, , ,091 Other Administrative Accounts 24,272 24,272 Vital Records 760, ,000 Non-Departmental 239, ,296 Cross Collaborative Initiatives 211, ,531 28,315 60, ,920 Total General Fund 263, , , ,136 88,507 1,171,499 24,272 2,812,893 Special Revenue Funds Communicable Disease Network 196, , ,322 38,581 10,000 31, ,202 STD/HIV Disease Control 418, ,815 92,763 21, ,072 2,000 17,194 1,132,765 CD Epidemiology 603, , ,264 91,288 79,937 73,821 1,927,619 Public Health Emergencies 733, ,752 Community Environmental Health 197, ,582 26, ,567 CD Food and Community Safety 391,555 70,000 4,147, ,720 4,945,079 Onsite Sewage/Surface Water 368,166 3,231,000 3,599,166 Waste Mgmt/Code Enforcement 187,000 53, ,000 42,500 32,500 1,013,600 2,303,600 Water Resources/Hazardous Waste 116, , , ,014 33, ,110 29, ,000 1,574,487 Community Transformation 324, ,734 PAN & Tobacco Prevention 81, , , ,213 75,500 60,000 1,150 9,088 1,747,196 Family Support Partnership 355, , ,165 56, ,940 65, ,000 45,443 1,793,924 Strengthening Families Admin 102, ,377 97,957 22,453 18, ,378 Oral Health 57,861 75,762 27,002 6,189 63,083 5, ,902 Youth Prevention Initiatives 405,482 56,608 12, , ,867 Maternal & Child Outreach 1,243, , ,504 48, ,750 70,551 39,389 2,752,304 Substance Abuse Services 156,802 5,769,222 5,926,024 Total Special Revenue Funds 1,220,413 4,399,972 5,725,466 2,038, , , ,500 15,038, ,818 31,107,566 Internal Service Funds Internal Services 269, ,500 Total Internal Service Funds 269, ,500 Total Health Department 1,483,981 4,619,101 6,385,248 2,424, , , ,500 16,479, ,090 34,189,959 Pierce County

12 Tacoma-Pierce County Health Department 2018 Salary Benefits EXPENDITURES Total Salary & Benefits Operations & Maintenance Other Financing Uses Capital Outlay Division Management Support Services Total 2018 Expenditures General Fund Office of the Director , ,248 1,168, ,707 (939,971) 411,314 Business Support Services ,140, ,583 1,570, ,302 (1,672,155) Human Resources , , , ,671 (745,537) Insurance Premiums 243,186 (243,186) Information Technology , , , , ,000 (1,405,739) 125,000 Office of Asmnt Planning & Improv , ,064 1,179, ,543 (545,710) 830,091 Other Administrative Accounts 24,272 24,272 Vital Records , , , , , ,000 Non-Departmental 239, ,296 Cross Collaborative Initiatives ,060 74, ,866 23,567 70, ,920 Total General Fund ,643,646 1,548,954 6,192,600 1,586, , ,000 (5,355,144) 2,812,893 Special Revenue Funds Communicable Disease Admin , , ,993 32,021 (508,014) Communicable Disease Network , , , ,223 40, , ,202 STD/HIV Disease Control , , , ,163 62, ,794 1,132,765 CD Epidemiology , ,733 1,103, , , ,269 1,927,619 Public Health Emergencies , , ,519 60,139 40, , ,752 Environmental Health Admin , , ,192 81,245 (659,437) Community Environmental Health ,197 44, ,481 24,979 22,729 56, ,567 Food & Community Safety ,106, ,553 2,896, , , , ,227 4,945,079 Onsite Sewage/Surface Water ,728, ,844 2,395, , , ,861 3,599,166 Waste Mgmt/Code Enforcement ,010, ,755 1,423, , , ,089 2,303,600 Water Resources/Hazardous Waste , , , , , ,425 1,574,487 Community Transformation Grant ,292 31, , ,639 21,819 54, ,734 PAN & Tabacco Prevention , ,559 1,063, , , ,200 1,747,196 Family Support Partnership , , , ,938 95, ,986 1,793,924 Strengthening Families Admin , , , ,269 (592,551) 68, ,378 Oral Health ,323 38, ,884 26,605 11,261 39, ,902 Maternal & Child Outreach ,283, ,721 1,725, , , ,718 2,752,304 Substance Abuse Services ,512, ,526 3,508, , , , ,537 5,926,024 Youth Prevention Initiatives ,379 93, , ,034 33, , ,867 Total Special Revenue Funds ,445,328 5,381,655 19,826,983 5,689, ,522 5,098,459 31,107,566 Internal Service Funds Internal Services 224,574 44, ,500 Total Internal Service Funds 224,574 44, ,500 Total Health Department ,088,974 6,930,609 26,019,583 7,501, , ,000 (211,759) 34,189, Pierce County 2018