Health System FY 2010-11 Budget Presentation June 22, 2010 Jean S. Fraser, Chief
Our Work is Driven by a Shared Vision San Mateo County Shared Vision 2025 HEALTHY COMMUNI TY : Our neighborhoods are safe and provide residents with access to quality health care and seamless services
Mission Statement To build a healthy community and increase San Mateo County residents’ longevity and quality of life by: Preventing health issues before they occur Protecting the public from environmental and disease hazards Providing services to vulnerable populations Partnering with others to accomplish our mission 3
Divisions � Administration � Aging and Adult Services � Behavioral Health and Recovery Services � Community Health � Correctional Health Services � Family Health Services � Health Policy and Planning � San Mateo Medical Center 4
FY 09-10 Accomplishments � Successful accreditations at SMMC hospital, Burlingame LTC, Correctional Health � Implemented electronic health records in Behavioral Health and SMMC � Opened Urgent Care Clinic at SMMC � Full Service Partnerships for mentally ill decreased adult incarceration 53% ; adult arrests 82% ; youth suspensions 63%
FY 09-10 Accomplishments � Responded to H1N1 outbreak & managed vaccine distribution � Launched BHRS prevention and early intervention strategic plan � Implemented take-back programs for fluorescent tubes and compact fluorescent lights � Initiated grant-funded re-entry plan
FY 09-10 Accomplishments � Published Building Health Into San Mateo County Cities � Completed 5-year plan for preventing childhood obesity update � Diverted 140,000 gallons of hazardous waste from landfill
FY 09-10 Provided services to many people � 1,300 Adult Protective � 40,000 birth and death Cases (APS) opened records � 2,300 mentally ill � 47,000 9-1-1 EMS calls inmate intakes � 60,500 pediatric visits � 3,250 Alcohol and Other Drug clients � 236,000 outpatient visits � 10,270 Mental Health monthly caseload � 350,000 H1N1 vaccines � 19,000 WIC clients � 800,000 H1N1 Code � 22,000 ACE clients Red Calls
FY 09-10 County STARS Awards � Family Health Services Prenatal to 3 Program = Program Performance Award � SMMC's Pain Management Care Clinic = Customer Service Award
FY 09-10 County Initiatives � Green Team: Increased use of video conferencing; local food system development; advocated for active and public transportation � Succession Planning: Received 2-year state funded training position for Public Health Lab Director; mentored professional and college age interns � Cultural Competence: Improved collection of race, ethnicity, language and gender data; increased staff training
FY 09-10 Increased Demand � 48% increase in ACE enrollment � 9% increase in open Mental Health cases � 13% increase in Emergency Room visits � 7% increase in IHSS clients � 4,997 patients on wait list for primary care appointment
FY 09-10 Mid-Year Staffing Reductions � Staffing � 78 positions reduced � 11 Filled � 67 Vacant
FY 09-10 Mid-Year Service Reductions � Eliminated HOME Team � Severely reduced admissions of new BLTC patients, reducing patients by 30 � Eliminated early intervention services for non Medi-Cal families and children � Eliminated Court-related substance use treatment through Prop 36 � Reduced SMART Team from 24/ 7 to 12 hrs/ day
Health System in the context of the County’s Vision 2025 FY 2010-11 $ Change FY 2010-11 % Change Health System ( 1 0 ,2 1 0 ,0 5 0 ) -9 % All other Healthy 26,585,213 + 16% Community departments Total operating 17,168,198 + 5% departments
FY 10-11: Budget Gap $28.2 million budget gap 45% Realignment and other state funding lost 40% Net County Cost lost 15% staff cost increases not covered by NCC 1 5
FY 2010-11 Staffing Reductions � 49 Positions � 12 Filled � 37 Vacant � 28 community-based organization positions
FY 10-11 Funding loss by division San Mateo Medical Center $10.7 million Behavioral Health and Recovery $10.2 million Services Community Health $2.6 million Aging and Adult Services $1.6 million Health Policy and Planning $1.4 million Family Health Services $1.1 million Correctional Health Services $650,000
FY 2010-11 Reductions � Reducing outreach and enrollment capacity for insurance coverage programs � Reducing programs on parenting, pregnancy prevention for incarcerated youth and adults � Reducing community engagement on bioterrorism, airport security, farm food safety � Reducing youth development initiative support
FY 2010-11 Reductions � Creating waiting lists at Medical Therapy Unit for severely disabled children � Reducing case management programs for adults under the age of 65 � Reducing AIDS Case Management Program resulting in larger caseloads
FY 2010-11 Reductions � Reducing the nursing hours for our long- term care patients to State minimum � Reducing on-site medical care for juvenile probation and adults jails � Eliminating Hepatitis A/ B vaccination program in jail
FY 2010-11 Reductions We are turning away people we have never turned away before: � At SMMC clinics, we will not take on new adult patients for those above 200% of the Federal Poverty Level -- $3,100 a month for a family of three
FY 2010-11 Reductions 980 people will no longer get alcohol or substance abuse treatment We are turning away people we have never turned away before: � Adults who need live-in treatment � Adults who need outpatient alcohol and other drug services � Adults being released from prison needing services
FY 10-11 Reductions 2,000 fewer people will be provided with mental health services We are turning away people we have never turned away before: � Women with post-partum depression � Workers who lost employment-based insurance and can’t get psychiatric medications � Young adults with depression
Further challenges ahead � Right role for County in providing nursing care as our population ages? � Sustaining safety net health services until coverage is expanded through health reform in 2014?
Questions?
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