Virginia Department of Health Presentation to West Virginia October - PowerPoint PPT Presentation

Virginia Department of Health Presentation to West Virginia October 28, 2015 1

Outline • VDH Structure • VDH Communication Methods • VDH Overview & Budget Highlights 2

The mission of VDH is to protect and promote the health of ALL people in Virginia 3

Vision: Virginia Will Become The Healthiest State In The Nation 4 4

§ 32.1-2. Finding and purpose. The General Assembly finds that the protection, improvement and preservation of the public health and of the environment are essential to the general welfare of the citizens of the Commonwealth . For this reason, the State Board of Health and the State Health Commissioner , assisted by the State Department of Health, shall administer and provide a comprehensive program of preventive, curative, restorative and environmental health services, educate the citizenry in health and environmental matters, develop and implement health resource plans, collect and preserve vital records and health statistics, assist in research, and abate hazards and nuisances to the health and to the environment, both emergency and otherwise, thereby improving the quality of life in the Commonwealth.

VIRGINIA DEPARTMENT OF HEALTH Office of the Commissioner November 10, 2015 State Health Commissioner Marissa Levine, MD, MPH Director of Governmental Office Manager and Regulatory Affairs Nancy Glasheen Joseph Hilbert Adjudication Officer Director of Internal Audit Douglas Harris Alvie Edwards Director of Strategic Planning Office of Information and Evaluation Management vacant Debbie Condrey, CIO Chief Deputy Deputy Commissioner Deputy Commissioner for Deputy Commissioner Commissioner for Administration CHS for Population Health David Trump, MD, MPH, Richard Corrigan Robert Hicks Lilian Peake, MD, MPH MPA Office of Risk Operations Director for Operations Communication and Operations Director CHS Office of Operations Director for Education for Population Jennifer Mayton Financial Director for Public Health & Suzi Silverstein Health Management Administration Operations Director for Preparedness Office of Emergency Chris Gordon Elizabeth Franklin Mike McMahon CHS Kim Allan Preparedness Chris Gordon Bob Mauskaupf Business Office of Human Director of the Operations Office of Emergency Manager Resources Office of Family Director for Process and Director for Medical Services Steve Murman Rebecca Bynum Health Services Evaluation Oversight Public Health & Gary Brown vacant CHS Health Equity Office of Licensure and Director of Office of Bill Edmunds Chris Gordon Certification Process Director of the Purchasing and Erik Bodin Office of Environmental Improvement General Services Office of Minority Office of the Chief vacant Health Services Steve VonCanon Health and Medical Examiner Allen Knapp Health Equity William Gormley, MD Adrienne McFadden, Office of Epidemiology Director for Public MD, JD Laurie Forlano, DO, Health Nursing MPH Joanne Wakeham Office of Radiological Health 35 Health Districts Steve Harrison Office of Drinking Water John Aulbach 6

Management of Health Districts • Deputy Commissioner directly supervises 33 of 35 district directors and serves as reviewer for 300 district managers • Each district is led by a physician director and managed by team that includes nursing, environmental, and business managers • District directors also supervise clinicians, pharmacists, dentists, and laboratorians where those services still exist 7

Role of District Directors • Medical and public health resource for private sector, local government officials, and public utility operators. • Manage operations for local health departments within their district. • Carry out authority delegated by the Commissioner and Deputy Commissioner • 75% of directors have MPH and 66% are board certified in preventive medicine 8

Communication Event Notifications:  Release Information  Situation and/or Problem  Immediate Impact or Required Action  Background  Discussion  Recommendation or Action Taken  Conclusion 9

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Community Health Services Network of Health Districts & Local Health Departments 11

Community Health Services • 134 cities and counties are organized into 35 Health Districts • District boundaries usually follow planning districts and include as few as 1 and up to 10 cities and/or counties • There is at least one service delivery site in every city and county • Services vary among localities within a district and between districts based on local needs, funding, and private sector capacity 12

Alternatives for LHD Operation • Locality may enter into a contract with VDH to operate (130 of 134 localities) • Administer their LHD under contact to VDH (4 of 134 localities) • Operate an independent LHD with no state funding (no locality has chosen this option) 13

Philosophy Behind Local Health Districts (LHDs) in VA • LHDs are a partnership between state and local governments • LHDs work closely with private sector health care providers and systems • Array of LHD services varies based on local need • Preserve flexibility for LHDs on “how” to improve community health while assuring compliance with policy, regulation, and law • Partnership is the key 14

Strengths of Virginia’s Public Health System • Local health districts in every city and county that provides basic public health services • Joint state and local funding of local health districts • Interdisciplinary management of districts • Flexibility to adapt to local needs • Public-private partnerships to improve health 15

Local Health District Services • Services provided in every LHD include communicable disease control, family planning, inspection of public establishments that serve food, permitting of onsite sewage disposal and well construction, emergency preparedness and response. • Limited number of districts provide pharmacy, lab, and general medical services 16

Service Delivery Models • Most districts have more than one of the following models depending on service and community capacity:  LHD staff provide services directly to clients  LHD provides services with individual provider contracts or through agreements with non-profits  LHD provides initial service then hand-off to private sector  LHD collaborates with private sector to assure service 17

Evolution of Modern Public Health System • Prior to the creation of the existing system, all parts of Virginia did not have access to basic public health services throughout the state, including control of communicable diseases and immunizations • Cities tended to have more established, better funded public health services • Rural areas had a limited tax base and could not afford to establish more comprehensive public health services 18

88% Percent of VDH Budget Spent in Local Communities State-Level Support 12% Expenditures in the Local Community 88% 19

VDH Funding & Staffing – FY 2008 to FY 2016 FY2016 FY2008 Total $638,605,455 Total $535,427,433 Federal General Federal 312,721,600 $221,735,469 $169,123,124 General 49% 32% 41% 152,085,583 24% Dedicated Special Special Dedicated $15,844,925 $128,723,905 Special Special 3% 24% 28,839,230 144,959,042 23% 4% FTEs FTEs GF: 1,664 GF: 1,481 NGF: 2,107 NGF: 2,191 Total : 3,771 Total: 3,672 20

Virginia Department of Health Appropriation by Fund 2008 - 2016 $350 Millions $313M $312M $313M $300 $304M $250M $251M $247M $250 $251M $222M $200 $174M $169M $169M $170M $167M $166M $164M $161M $161M $150 $156M $160M $161M $153M $152M $154M $151M $147M $145M $100 2008 2009 2010 2011 2012 2013 2014 2015 2016 General Fund Special Fund Federal Fund 21

Virginia Department of Health General Fund 2008 - 2016 $175 Millions $170 $165 $160 $155 $150 $145 $140 $135 2008 2009 2010 2011 2012 2013 2014 2015 2016 22

LHD Funding Streams • State Funds Appropriated by General Assembly • Local matching funds appropriated by local government based on ability to pay formula developed by JLARC • 100% Local funds above the match requirement • Revenue earned from services delivered • Federal grant funds that are primarily categorical in nature 23

Cooperative Budget Percentage of Shared Cost Between State and Locality Funding, Excluding Self Generated Revenue Locality State General Local Government Self Generated Fund Share % Share % Revenue % Clarke County 60.386% 39.614% 11.8% Frederick County 55.744% 44.256% 19.9% Page County 61.073% 38.927% 13.8% Shenandoah County 58.031% 41.969% 19.9% Warren County 57.234% 42.766% 16.3% Winchester City 56.958% 43.042% 18.3% District Average % 58.237% 41.763% 24

Cooperative District Budget Totaling $5,021,704 Breakdown $1,229,500 25% $2,173,440 43% State Funds $1,618,764 Local Funds 32% Revenue 25

Total Funding Of The District Budget Breakdown Including Federal Funds $6,249,319 $1,229,500 State Funds $2,173,440 20% 35% $1,227,615 Local Funds 19% $1,618,764 Grants 26% Revenue 26

Questions?? 27