Barbie Robinson, Health Services Director Rod Stroud, Health Services Interim Assistant Director Terri Wright, CAO Analyst

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1 Barbie Robinson, Health Services Director Rod Stroud, Health Services Interim Assistant Director Terri Wright, CAO Analyst

2 Department of Health Services Budget Page 115, Binder Tab Budget is $245.2 Million $5 Million or 2.0% Decrease Permanent Positions FTE Increase Supplemental Changes: $9.4 Million, including 2 FTE for cannabis

3 Allocated Position History Affordable Care Act Crisis Stabilization Unit

4 General Fund vs Non General Fund Actuals History $300,000,000 $250,000,000 Actual 2011 Realignment, IGT, & increased Medi-Cal due to ACA Budget $200,000,000 $150,000,000 $100,000,000 $50,000,000 $ General Fund Other Expenditures General Fund Average

5 FY Expenditure Areas Behavioral Health 95,685,500 39% Administration 2,451,716 1% Public Health 45,082,505 18% First 5 5,867,596 2% Health, Planning, Policy & Eval 8,977,563 4% Transfers/Reimb 87,190,746 36%

6 FY Revenue Sources Reimburs/Transfers 101,154,598 41% Fund Balance 2,768,019 1% General Fund 9,072,722 4% Realignment 37,731,799 15% Grants, Contracts, Misc. 4,355,434 2% License-Fees 14,035,695 6% MHSA 20,258,524 8% Federal 17,526,643 7% State 38,352,191 16%

7 Significant Budget Changes Gross Salary and Benefit increases of $7.5 million due to negotiated increases and addition of positions added to support foster care reform, cannabis, CalOHSA safety standards, and the Medical Therapy Unit. Services and Supplies are increasing by $4.7 million due to increases to county cost plan charges, ISD charges, departmental admin charges, and behavioral health contracts. Expenditure increases managed by maintaining approximately 40 unfunded vacancies that are being kept due to upcoming revenue opportunities: Drug Medi-Cal, Whole Person Care

8 Declining Revenues Fiscal Challenges o Intergovernmental Transfer Revenue o State Grants o Other Department Reimbursements Increasing Costs o Salary & Benefits o A-87 o ISD Delayed Payments o State Plan Amendment o Interim Payments

9 Fiscal Strategies Improved Budget Policies o Flat Realignment o Admin Allocation o Fund Balance Organizational Structure o HPPE Transition Programmatic Assessment o Program Inventory o Strategic Reductions OneDHS Culture o Improved Intra-Departmental Collaboration

10 Department Overview

11 Public Health Disease Control and Public Health Lab - Responded to 24 infectious disease outbreaks and over 120 calls for Zika virus testing Women Infants & Children (WIC) Received 3-year grant to mentor other WIC agencies

12 Behavioral Health Investment in Mental Health Wellness Act Grant - Opened Harstad House in December 2016 Drug Medi-Cal Organized Delivery System Expansion Implementation Plan Received Approval in February 2017

13 Administration Strategic Plan - Initiated Department's 5- year Strategic Planning Process Workforce Development Plan - Developed Workforce Development Plan

14 Health Policy, Planning & Evaluation California Accountable Communities of Health Initiative Received $250,000 grant award Cavity-Free Sonoma Received $3.5 million grant award focused on creating a comprehensive system of dental care to serve 12,000 Medi-Cal children

15 First 5 Sonoma County READY Kindergarten Readiness Assessment - Expanded to 35 schools assessing 1/3 of Sonoma County s kinder students Universal Development Screening - Piloted at FQHC pediatric well-check appointments

16 Department By the Numbers Behavioral Health 515 CAPE - Clients 570 MST Clients 1520 MST Encounters 4,000+ CAPE - Individuals Trained 5,000+ Specialty Mental Health Services 15,000+ Outreach Services HPPE 361 Kinder Dental Assessments 3,113 School Sealant Program Participants 525 Responsible Beverage Program Individuals Trained Public Health 8,119 Environ. Health Inspections 7,816 Nurse Home Visits 8,000 WIC Individuals Served 13,452 Public Health Lab Tests 1,139 Animals Returned to Owners 1,104 Animals Adopted First 5 Sonoma County 500+ Triple P Providers Trained 20,000 Parent Resource Guides/ New Parent Kits Issued 825 Preschool Scholarships Provided

17 FY Objectives Develop and implement Securing Our Safety Net priorities Implement County Drug Medi-Cal Organized Delivery System Develop and implement strategies related to relocation of Department facilities

18 Questions/Discussion