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

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

Department of Health Services Budget Page 115, Binder Tab 16 2017-18 Budget is $245.2 Million $5 Million or 2.0% Decrease 651.7 Permanent Positions 14.25 FTE Increase Supplemental Changes: $9.4 Million, including 2 FTE for cannabis

Allocated Position History 700 600 Affordable Care Act Crisis Stabilization Unit 500 400 300 200 100 0 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15 2015-16 2016-17 2017-18

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 $- 2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15 2015-16 2016-17 2017-18 General Fund Other Expenditures General Fund Average

FY 17-18 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%

FY 17-18 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%

Significant Budget Changes Gross Salary and Benefit increases of $7.5 million due to negotiated increases and addition of 14.25 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

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

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

Department Overview

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

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

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

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

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

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

FY 2017-18 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

Questions/Discussion