HEALTH SERVICES DEPARTMENT FY Budget Worksession July 11, 2011

Organization Chart Proposed FY Budget Accomplishments Budget Challenges Summary Presentation Outline

Organization Chart Proposed FY Budget Accomplishments Budget Challenges Summary Presentation Outline

Organization Chart George Ralls M.D. Office of the Medical Director, EMS Medical Clinic/PCAN Margaret Brennan Medical Clinic/PCAN Margaret Brennan Mosquito Control Tom Breaud, Ph.D. Mosquito Control Tom Breaud, Ph.D. Corrections Medical Edwin Pont, M.D. Corrections Medical Edwin Pont, M.D. Medical Examiner Jan Garavaglia, M.D. Medical Examiner Jan Garavaglia, M.D.

Organization Chart Proposed FY Budget Accomplishments Budget Challenges Summary Presentation Outline

Proposed FY Budget Current FY 11$ Change Proposed FY 12 Personal Services$8.6M($0.2M)$8.4M Operating Budget36.2M(1.1M)35.1M Budget Change(2.9%) Staffing

Organization Chart Proposed FY Budget Accomplishments Budget Challenges Summary Presentation Outline

Accomplishments Expanded healthcare access: –22,500 new patients –113,000 patient visits in 2010 New partnership with Florida Hospital –Outlook Clinic for depression and anxiety disorders Developed “PCAN Toolkit” to help others replicate PCAN Volunteers provided $5.9M in uncompensated care to the uninsured PCAN/OCMC

Mosquito Control –Conducted complaint investigations within 2 days 99.7% of the time –Completed spray missions for adult mosquitoes within 5 days 99.8% of the time Medical Examiner –Developed an enhanced case management system EMS –Organized the implementation of 12 lead ECG transmission system wide Accomplishments

Organization Chart Proposed FY Budget Accomplishments Budget Challenges Summary Presentation Outline

Other Budget Challenges Total Budget $43.5M 13% 39%48% MandatedPCAN/OCMC

Other Budget Challenges Total Budget $43.5M Mosquito Control 4% Public Health 4% EMS Office 3% Health Services Administration 2% 13%

Primary CareSecondary Care PCAN Funding Budget Challenges

Medicaid  Economy  Healthcare Reform  Enrollment  County Costs Budget Challenges

Orange County Medicaid Enrollees (in thousands) Apr08Apr09Apr10 Budget Challenges Feb11 46% Increase in 3 Years

69% increase in 3 Years Medicaid Billed/Paid FY07-10 Orange County Budget Challenges

Organization Chart Proposed FY Budget Accomplishments Budget Challenges Summary Presentation Outline

Health Services Department proposed budget $43.5M –2.9% reduction Budget Challenges –PCAN funding –Medicaid costs rising –Anticipating added costs due to Healthcare reform –AHCA billing process may change Pictures Summary

FY Budget Worksession July 11, 2011 HEALTH SERVICES DEPARTMENT

Florida Medicaid Million Enrollees107,000 Providers $20.2 Billion

Pictures Medicaid Expansion Accountable Care Organizations Insurance Reform s Individual Mandate Temporary Health Insurance Exchange Permanent Health Insurance Exchange PPACA (Healthcare Reform Act)