2. 2018 budget presentation – Health
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2018 budget presentation – Health
Jennifer DeCubellis, Deputy County Administrator
2018 Health Line budget presentation – October 5, 2017

3. Health and Human Service- Strategic Planning
Transform how we deliver services
Improve outcomes for our residents by changing the experience
Create a vibrant organizational culture
2018 Health Line budget presentation – October 5, 2017

4. Health Line of Business Overview
Health Administration and Support
Hennepin County Medical Center •
Public Health
Medical Examiner
Hennepin Health
NorthPoint Health and Wellness
2018 Health Line budget presentation – October 5, 2017

5. 2017 Collaboration Highlights
Hennepin County Medical Center Collaboration
Epic Electronic Health Record Improvements
HCMC Medicaid Strategy
Research and Evaluation on Social Determinants of Health
Medicaid Early Childhood Innovation Lab
Aligned Advocacy on Federal Health Care Changes
2018 Health Line budget presentation – October 5, 2017

6. Operating budget 2017 adjusted 2018 proposed Percent change
Health Administration
$893,328
$1,041,228
16.56%
NorthPoint
40,758,894
41,239,282
1.18%
Medical Examiner
6,307,589
6,560,259
4.01%
Hennepin Health
262,991,856
253,549,339
(3.59)%
Uncompensated Care
22,500,000
0.00%
SARS
950,000
970,000
2.11%
Public Health
61,663,858
62,333,124
1.10%
Total
$396,065,525
$388,193,232
(1.99%)
Presented by Dave Lawless for each business line.
2018 Health Line budget presentation – October 5, 2017

7. Property tax 2017 adjusted 2018 proposed Percent change
Health Administration
$893,328
$1,041,228
16.56%
NorthPoint
6,202,974
6,327,033
2.00%
Medical Examiner
3,969,781
4,231,474
6.59%
Hennepin Health
0.00%
Uncompensated Care
22,500,000
SARS
950,000
970,000
2.11%
Public Health
23,485,508
23,954,827
Total
$58,001,591
$59,024,562
1.76%
Presented by Dave Lawless for each business line.
2018 Health Line budget presentation – October 5, 2017

8. Full-time equivalents (FTEs)
2017 adjusted
2018
proposed
Percent
change
Health Administration
12.0
15.0
25.00%
North Point
247.2
245.6
(0.65)%
Medical Examiner
37.0
38.0
2.70%
Hennepin Health
114.5
0.00%
Uncompensated Care
0.0
SARS
Public Health
416.9
425.6
2.10%
Total
410.7
413.1
1.34%
Presented by Dave Lawless for each business line.
2018 Health Line budget presentation – October 5, 2017

9. Budget drivers: NorthPoint
Given the 2018 start of construction NorthPoint anticipates that budgeted patient volumes will remain at approximately the same level as 2017
State and Federal changes in health care are being closely monitored for any impacts on reimbursements and grants
NorthPoint continues to work closely with Hennepin Health partners to effect changes in healthcare delivery, quality, cost and innovation
NorthPoint’s innovation provides for piloting and funding of new models in trauma informed care, opioid treatment and integrated care
Continued achievements in patient quality and access supports county-wide disparity reduction goals and new funding opportunities
2018 Health Line budget presentation – October 5, 2017

10. Budget drivers: NorthPoint
NorthPoint continues to experience strong growth in demand for clinic services.
NorthPoint is committed to quality of care such as early intervention in prenatal care.
2018 Health Line budget presentation – October 5, 2017

11. Budget drivers: Medical Examiner
Employee Engagement
Workforce Development
Personal Services and Workload:
Replaced supervisor position with investigator to reduce employee turnover
Created a formalized training program for investigators
Support a transport model to continue reduction of lifting injuries
National Association of Medical Examiner Accreditation (NAME):
A Medical Examiner (ME) position is required to maintain NAME accreditation status
Added 6 months of a ME’s salary with intent to hire July 2018
Goal to recruit, hire, and train a ME prior to pending retirement
Continuous Improvement
Core Values
Customer Service
Partnerships and Relationships:
Finalized a 30 year Cooperative Services Agreement with Dakota and Scott Counties effective January 1, 2017
Terms include operational and capital budget allocation
$2.68 million in State Bonding received for the New Medical Examiner’s Facility
Operational Impact of a New Regional Medical Examiner Facility:
Align personal services and facility operating expense
Focus on workforce development and develop pathways for employment
Create relationships with local universities that provide forensic education
Diversity and Inclusion
2018 Health Line budget presentation – October 5, 2017

12. Budget drivers: Medical Examiner
Employee Engagement
Workforce Development
Personal Services and Workload:
National Association of Medical Examiner Accreditation (NAME):
Projected autopsies for 2017 ~ 1300
Continuous Improvement
Customer Service
Partnerships and Relationships:
From
Total cases increased by 3.8% (2051 to 2133)
Autopsies increased by 8.7% (1176 to 1288)
Scene visits increased by 0.4% (1392 to 1397)
Operational Impact of a New Regional Medical Examiner Facility:
Diversity and Inclusion
2018 Health Line budget presentation – October 5, 2017

13. Budget drivers – Hennepin Health
Hennepin Health's membership increased by ~21,000 members (average ~30,000)
Population mix has changed (lower claims cost)
Per member per month rates have changed
Total expenditures are expected to decrease $9.4 million or 3.6%
Driven by:
healthcare costs from a change in the mix of enrollees and
lower than expected prescription drug costs
Offset by:
Cost increases in personal services to address additional membership
Added 25 FTE's and 10 Limited Duration employees in the 2017 budget year.
This slide replaces last year’s “trends, issues and budget changes.”
What are the approximately top 5 areas creating significant changes in new budget needs, increase in last year’s budget needs or reduction/elimination of budget needs. What are the big things looking forward to 2018 at that the board needs to know about.
Topics include:
- Metrics related the issue (in charts that can be displayed)
- What led you to believe this was an issue or an opportunity that we need to go after at this time
- What conclusion did you reach (direction you are taking)
What the budget impact is of this initiative;  include if there is any non-property tax revenue being used
Weave into this discussion how the 2018 work in your business line is reducing disparities. Reducing disparities is woven into David’s general presentation to be given Sept. 12.
Think about this list as the topics that could become your business line’s board briefings in 2018.
2018 Health Line budget presentation – October 5, 2017

14. Budget drivers – Hennepin Health
Hennepin Health Enrollment Growth
Enrollment Mix
This slide replaces last year’s “trends, issues and budget changes.”
What are the approximately top 5 areas creating significant changes in new budget needs, increase in last year’s budget needs or reduction/elimination of budget needs. What are the big things looking forward to 2018 at that the board needs to know about.
Topics include:
- Metrics related the issue (in charts that can be displayed)
- What led you to believe this was an issue or an opportunity that we need to go after at this time
- What conclusion did you reach (direction you are taking)
What the budget impact is of this initiative;  include if there is any non-property tax revenue being used
Weave into this discussion how the 2018 work in your business line is reducing disparities. Reducing disparities is woven into David’s general presentation to be given Sept. 12.
Think about this list as the topics that could become your business line’s board briefings in 2018.
2018 Health Line budget presentation – October 5, 2017

15. Budget Drivers: Public Health
Crisis Calls 2015: 19,257
2016: 29,768
2017: 36,000
Cities Readiness Initiative Public Health Emergency Preparedness funds 2015: $443,300
2016: $419,100
2017: $414,300
Better Together Hennepin:
$1.5 million annually
Public Health Protection and Promotion:
$ ? annually
2017 MEASLES:
$400,000
TB: $50,000
Elimination of evidence-based Teen Pregnancy Prevention funding is counter- productive
ACA repeal/replace actions putting Public Health Prevention funds at risk
Emergency Responses remain unfunded, though they regularly occur
Demand for Crisis Services continues to grow beyond funded capacity
Declining Emergency Prep grants erode our ability to prevent and control disease outbreaks
2018 Health Line budget presentation – October 5, 2017

16. Emergencies Are Frequent
2018 Health Line budget presentation – October 5, 2017

17. 2018 Areas of Focus Disparity reduction efforts
Health in All Policies (HiAP)
Social determinants of health
Employment pathways
On-going improvement of health care programs
Behavioral health continuum
Building community supports (housing, health coaching, new interventions)
Formal structure for deeper alignment with HCMC
Medicaid strategy
Integration of health and human services,
Child and family well-being, early intervention
Enhanced interventions to support individuals with disabilities
Opioid strategy- county wide response
2018 Health Line budget presentation – October 5, 2017

18. Discussion
2018 Health Line budget presentation – October 5, 2017