Denver Health & Hospital Authority 2017 Budget Overview

Transcription

1 Denver Health & Hospital Authority Budget Overview 1

2 Denver Health Strategic Overview Mission of the Denver Health and Hospital Authority (CRS ) 1. Provides access to quality preventive, acute and chronic health care for all of the citizens of Denver regardless of ability to pay. 2. Provides high quality emergency medical services to the citizens of Denver and the Rocky Mountain region. 3. Fulfills public health functions as dictated by the Denver charter and the needs of the citizens of Denver. 4. Provides health education for patients and participates in the education of the next generation of health care professionals. 5. Engages in research which enhances its ability to meet the health care needs of patients of the Denver Health system. 2

3 Denver Health Strategic Overview 3

4 Denver Health Strategic Overview STRATEGIC IMPERATIVE #3: Provide the right healthcare, at the right time, and in the right place GOAL I access primary care services on a schedule convenient to me GOAL I can be seen in a specialty care clinic in less than 10 business days if I so choose 2016 GOAL I work at a hospital where there are no Boarders in the ED GOAL I can schedule elective surgery in less than 30 days if I so choose 4

5 Denver Health Strategic Overview STRATEGIC IMPERATIVE #3: Provide the right healthcare, at the right time, and in the right place. METRIC: Summation of expanded access hours available 2016 Establish baseline 10% increase over 2016 baseline % increase over 2016 baseline GOAL I access primary care services on a schedule convenient to me GOAL I work at a hospital where there are no Boarders in the ED GOAL I can be seen in a specialty care clinic in less than 10 business days if I so choose GOAL I can schedule elective surgery in less than 30 days if I so choose HIGH LEVEL TACTICS 2016 Eliminate the wait list (0 patients on waitlist) Increase same day, after hour, weekend, and alternative service hours to 125% of YE 2016 hours 5

6 Metrics (Projected) (Projected) Uninsured Patients at DH 57,123 60,000 61,800 Medicaid Patients treated at DH 152, , ,800 Managed Care Plan Enrollment City &County of Denver DHMP Enrollment 11,901 12,133 12,497 1,052 1,103 2,000 6

7 Metrics (Projected) (Projected) Labor Productivity 108% 102% 100% Employee Engagement Patients with Positive Overall Hospital Rating Patients with Positive Overall Outpatient Rating % 93.2% 93.5% 91.6% 92.4% 93.0% 7

8 Metrics (Projected) (Projected) Mortality Observed/Expected DH Primary Care Adult Tobacco Users 23.8% 22.1% 21.1% Teen Birth Rates (age 15 19) 24.0 per 1,000 females 21.4 per 1,000 females 19.0 per 1,000 females 8

9 Key Expansion Proposals 9

10 Denver Sheriff Department Changes $190,000 impact 2.0 FTE Health Information Management (HIM) Clerks - $90,000 Electronic Medical Record System - $100,000 The HIMs clerks are will help in keeping up with the current volume of Health Record filing while DH works with the Sheriff s Department on options for a new Electronic Medical Record system. Metric Annualized Projection Projection Total Visits 419, , ,410 Total Health Record Sections Completed Per Week 2,808 2,808 5,200 10

11 Outpatient Behavioral Health Services 1.0 FTE Licensed Professional Counselor $75,000 impact Outpatient Behavioral Health Services (OBHS) is requesting funding for substance use disorder treatment personnel to continue providing medication assisted therapy and counseling. Our substance use disorder programs have been an integral part of the community continuum of care for several decades. Our multidisciplinary clinical teams include physicians, nursing, clinical psychologists, social workers, case managers and professional counselors. The grant funding for this program will decrease in. As a result of Affordable Care Act (ACA), more substance use treatment services are being funded through Medicaid, thus federal pass through funding is being reduced. Unfortunately, these federal funding reductions come at a time when each day, 44 people in the United States die of prescription opioid overdose; a rate now outpacing annual traffic fatalities (HHS). Metric 2015 Total Therapy Visits per Year (12 visits for 75 patients) 2016 Annualized Projection Projection

12 Denver CARES Emergency Patrol Van (ESP) $309,905 impact 3.5 FTEs EMT Basic New ESP Van Expand the amount of ESP Van coverage to full three units Sunday-Thursday and four units Friday and Saturday. This will enable better response to the DIA area as well as lessoning the negative impact of long wait times or instances where the ESP units are unavailable for public safety agencies. Additional ESP van coverage will decrease wait times for all three public safety agencies (DPD, DFD, EMS). There were 4,285 calls in 2015 where a ESP van was not available. DPD had to transport the patient to CARES. This increased capacity will lessen the burden on the DPD to have to transport these patients or find alternative solutions. It will also provide more capability for ESP vans to respond to District 5 and DIA. ESP Transports and Requests for Transport 2015 Total 2016 Annualized Projection Projection ESP Completed Transports DPD forced to transport or there was no van available Total Calls Percentage of Total Calls where DPD was forced to transport or there was no van available 51% 33% 30% 12

13 Director of Epidemiology and Informatics $186,505 impact 1.0 FTE Denver Public Health is responsible for planning and developing interoperate information systems. These require stewardship, governance relationships, agreements, and strategic investments. They need defined leadership in informatics and epidemiology to create and navigate a technology road map. This request will provide the City & County of Denver with a resource that makes electronic health record information available on a quarterly basis. Information will be accessible through the internet. Data will be shared between Denver Public Health and Denver Environmental Health. City Council and the Mayor s Office will have ongoing access to automated processes for sharing data. The position is currently grant funded. Name of Change Request Proposal Impacted Measure Name Data Source / How Calculated 2015 Actuals 2016 Forecasted Projected Director Epidemiology and Informatics Number of reports generated from Colorado Health Observation Regional Data Service (CHORDS) Summary data - CHORDS audit log (reports per year) Same Number of reports generated from epidemiology and informatics groups SharePoint log, PowerPivot report (reports submitted per quarter)

14 Denver Health All Funds Expenditures-Appendices A & B $64,000,000 Appendix A and B Budget by Fund $62,000,000 $60,000,000 $58,000,000 $56,000,000 $54,000,000 $52,000,000 $50,000, Contract Budget 2016 Contract Budget Contract Budget Workers' Compensation $295,000 $295,000 $295,000 Special Revenue Funds (Head Start) $405,000 $405,000 $500,000 CIP $700,000 $2,432,967 $2,432,967 Human Services Fund $468,000 $974,568 $815,170 DIA $2,585,500 $3,231,848 $3,576, Trust Fund $88,100 $97,900 $97,489 General Fund $54,877,500 $54,356,125 $54,422,899 14

15 Denver Health All Funds Revenues and Appendix C -9% Chan $3,000,000 $2,500,000 $743,970 $2,000,000 $631,892 $281,256 $1,500,000 $1,000,000 $1,605,551 $1,654,759 $1,804,956 $500,000 $ Estimated 2016 Estimated Estimated General Fund 911 Trust Fund 15

16 Contract Personnel Overview FTE (Bars) Contract Personnel Budget and FTE Contract Base FTE 274 CSA FTE at DHHA Actual 2016 Revised Projected Approved Nurse Home Visit Program FTE AIM Program FTE Department of Safety FTE Family Crisis Center FTE Child Welfare FTE Denver Sheriffs FTE Denver Cares FTE Public Health FTE Denver Fire & Training FTE Total FTE Total FTE Budget $20,816,058 $21,952,300 $21,952,300 $22,275,

17 Thanks to the City and County of Denver for your ongoing support! 17