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FY 2010-11 Budget Challenges
February 16th, 2010
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Revenue OutlookDepartment ExpensesBudget ChallengesSummary
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Revenue OutlookDepartment ExpensesBudget ChallengesSummary
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General Fund 99% Grants 1% $ 45.1 Million
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44625396
326751
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General FundGrants
East44,625,396.00326,751.00
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99
1
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General Fund99
Grants1
3rd Qtr1.4
4th Qtr1.2
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Health Services DivisionsCorrections Health ServicesPCAN/Orange
County Medical ClinicMosquito ControlMedical ExaminerEmergency
Medical Services
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Revenue OutlookDepartment ExpensesBudget ChallengesSummary
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43%44%13%
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43%Medicaid (15M)HCRA (500K)Medical Examiner (2.7M)
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44%PCAN (14.2M)OCMC (4.5M)Pharmacy (1M)
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13%Mosquito Control (1.7M)EMS Office (1.4M)HSD Office
(700K)Public Health Unit (1.8M)
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Revenue OutlookDepartment ExpensesBudget ChallengesSummary
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$ 44.6 Million7% Reduction = $ 3.1 Million
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326751
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General FundGrants
East44,625,396.00326,751.00
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General Fund99
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3rd Qtr1.4
4th Qtr1.2
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$ 44.6 MillionBudget Challenges
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Budget Amendment of $ 6M
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AHCA proposal: Increase Medicaid nursing home cost to
counties
$ 3 Million
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MedicaidRefugee Medical Assistance
Children & pregnant womenAdults or couples without
children
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$ 20 MillionMedicaid
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37% IncreasePCAN Patients in Thousands
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85
92
111
116
PCAN patients in thousands
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2007200820092010
PCAN patients in thousands8592111116
0.3647058824
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Primary Care$ 6M$ 6M
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UninsuredOther62%11%27%PCAN Primary Care
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62
27
5
6
Medicaid
Sales
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Sales
Uninsured62
Medicaid27
Medicare5
Other6
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Uninsured62%County Dollars support the uninsured16% of total
PCAN primary care fundingPCAN Primary Care
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62
27
5
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Sales
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Uninsured62
Medicaid27
Medicare5
Other6
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Closing of Alafaya clinic
Eliminate almost 10,000 appointment slots
Close some pharmacies
Eliminate physician/ARNP positions
Community Health Centers, Inc.7% Budget reduction =
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Secondary CareExpanded exclusion list implemented in July 2008
due to projected budget shortfall
Fewer patients receiving specialist referrals, diagnostic tests,
specialty procedures
PCAN Secondary Care (6M)
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Mosquito Control
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Mosquito Control Budget1% reduction = 5.5% reduction in
Pesticides
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First outbreak of Dengue in Florida in 50 years
Disease can range from mild to life threatening
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Revenue OutlookDepartment ExpensesBudget ChallengesSummary
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43% of HSD budget covers mandated expenses
Mandated expenses likely to increase
7% reduction to overall budget equals 53% if Mandated and PCAN
removed
Mosquito Control budget reductions not recommended
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Reducing HSD budget by 7% will require significant reductions in
PCAN:
Closure of one or more clinic sites
Loss of approximately 10,000 appointment slots
Limiting coverage to fewer conditions
Reducing provider reimbursement
Enrollment cap
**Should be 26% other and 35% Mandated
PCAN is not the entire Medical Clinic budget. It is just the
funds used toward PCAN.*Should be 26% other and 35% Mandated
PCAN is not the entire Medical Clinic budget. It is just the
funds used toward PCAN.*Should be 26% other and 35% Mandated
PCAN is not the entire Medical Clinic budget. It is just the
funds used toward PCAN.*Should be 26% other and 35% Mandated
PCAN is not the entire Medical Clinic budget. It is just the
funds used toward PCAN.*10/2009: ACHACounty participation in
Medicaid cost of nursing home and intermediate care has not kept
pace with increases experienced by the Medicaid program for these
servicesHas not changed since inception of the Florida Medicaid
program
*In addition to the possibilities of expanded eligibility under
Health Care reform, the Haiti catastrophe has a potential impact on
Medicaid expenditure
Humanitarian ParoleeHaitian Entrants are eligible to apply
for:Supplemental Security Income (SSI)*Food
Stamps*Medicaid*Temporary Assistance for Needy Families
(TANF)*Refugee Cash Assistance (RCA)* (RCA is essentially the same
as TANF but for single adults or couples without minor children who
are eligible for refugee services, including parolees)Refugee
Medical Assistance (RMA)* (RMA is essentially the same as Medicaid
but for single adults or couples without minor children who are
eligible for refugee services, including parolees)
**Discuss future issues and how this may impact the county.*This
is the overall HSD budget. How would this look if we only included
the budget for PCAN? **110K total; $6M10K active in secondary
services; $6MCost per patient for secondary services 8-10 times
higher15% decrease in # of patients served in Secondary CareMaking
19% fewer referrals into Secondary Care
*$1.7M budget$1.2M salaries and benefits$390K discretionary
Dengue returns to FL after 50 years
*
