1. NACCHO Annual 2010 Memphis, TN Matthew J. Dillon
Viewing Public Health Financial Information from a Different Perspective: Financial Ratio Analysis in Florida County Health Departments
July 14, 2010
NACCHO Annual 2010
Memphis, TN
Matthew J. Dillon

2. Lets Continue Our Journey
Ross
Walking Man – source unknown….

3. Quick Perspective….. Administration sets policy
Program staff deliver the services
Administrative staff are there to support the programs
Finance & Accountings role is that of the scorekeeper
Ross

5. Florida Department of Health
67 County Health Departments
$834 M CHDs Statewide
$208 B Department Wide
Co-managed under the State and Local Board of County Commissioners
All State Employees
Single Accounting System
Unified chart of accounts

6. Challenges on what to collect:
We collect lots of information, just depends on how and what you want to retrieve
Issues with trying to collect information from the various operations, especially clinical
i.e. What is primary care, what is core public health?

7. Florida Accounting and Information Resource System (FLAIR)
Very cumbersome but effective system
Approximately 2 M accounting transactions/year
Multiple Reports
Okay for Finance and Accounting Staff
Difficult for Department Managers to read
i.e. one report shows only revenues while another expenditures but not both with a Total

9. Financial Information Reporting System
Developed a reporting system called FIRS
Easy reports to read in similar formats
Accessible via the DOH network
All you need is an address
Access the reports for your CHD or all CHDs within the state.

10. FIRS
Good for comparing similar operations, staffing, workload, population, budget, FTEs, etc.
Can provide revenues and expenditures per program or
Secondly can develop reports for a division (example, you can have separate budgets for the personnel department, finance and accounting, IT, etc. and you can also have a group report for all the offices).

13. Gathering Information
Used FIRS
This was the main foundation for our financial data gathering

14. Florida Advantages:
We use a similar codes, chart of accounts, accounting structure, format, etc.
Most all financial data was in one data base
We had access to the data
If we pulled the data we would have control on how it was sorted
Consistently right or consistently wrong
Workload was put on limited staff
Instructions were clear among those involved

15. Florida Disadvantages:
2 M Transactions/ year
(6M+ transactions) to manage causing difficulty in sharing and reviewing the information collected in files via spreadsheets/

16. Sources of Data Multiple DOH/State of Florida Systems External Links
FLAIR
FIRS
CONMAN
extracts from Department of Management Systems
External Links

17. Most of the demographics came from one of the 3 sites below:

18. Results: Data pull for 45 of the 61 criteria
CHDs gathered for the remaining 16 items

19. Key Players in Data Gathering
Greg Ballard
Jennie Bishop
Penny Dyer
Matthew Dillon
Lil Perry
Ernesto Rubio

20. Scope of CHD Clinical Services
1 million clients served annually.
Over 250 clinic sites throughout state.

21. Financial and Other Related Indicators
Revenues
Expenditures

22. Financial – Revenues

23. Annual Comparisons Captured 3 FY’s Actual Amounts and
Added Budget for each year
Revenues

24. Financial – Expenditures

25. Annual Comparisons
Additional Expenditure Breakdowns

26. Special Revenue and Expenditures

27. Additional Revenue Breakdowns

28. Additional Expenditure Breakdowns

29. Additional Breakdowns

30. Other Financial, Demographic, Workforce, and Mission Critical

31. Demographic

32. Workforce

33. Mission Critical

34. Ratios

36. Revenues per Capita
Total Revenues / Population = Revenues / Capita
$16,228,647
$64.48
Capita
251,703

41. Florida Finance Ratio Analysis Initiative 2006-2008:
Population size:
1 = <25,000;
2 = 25,000-49,999;
3 = 50,000-99,999;
4 = 100, ,999;
5 = 500, ,999;
6 = >1,000,000

47. Florida Local Health Agency Revenue Per Capita 2008

48. Florida Local Health Agency Expense Per Capita 2008

51. Florida Local Health Agency Days of Revenue in Accounts Receivable 2008

52. Florida Local Health Agency Accounts Receivables Written Off as a % of Total Collected 2008

54. Florida Local Health Agency Total Margin 2008

55. Florida’s Current Measures
Revenue per Capita
Expenditure per Capita
Margin of revenue to expenditures

56. SUMMARIZE FINDINGS #1 – Showed immediate coding errors
Provided 3 FY’s to trend on a single page:
Actual Data vs. Budgeted Data
Baseline data for DOH & individual county CHD
Management Decisions – Data/Evidence-based

57. Next Steps………. Decide what to capture up front to reduce workload
Prioritize Key Data Elements
Review Coding Activities
Standardize
Technology
Become more efficient with technology to reduce staff workload

58. GOALS / ACTION………. DONE DONE Obtain “buy-in” from Leadership
State Level
Local Level
Action Taken
Peggy Honore visited Tallahassee – Statewide webinar
Leadership and key peer support
Established a workgroup
Intent
Identify ratios
Implement seamlessly with new business plan beginning of Fiscal Year
Monitor and Analyze data
DONE
DONE

59. “The project is to develop and assess the viability of using a series of ratios to compare public health financial and administrative infrastructure information and then be able to compare the results to other CHDs/states.  We all think this analysis will provide yet another resource for moving forward with making sound business decisions relative to public health.  This may also play a role in a future credentialing process for local and county health departments”. 
Michael Sentman
Assistant Deputy State Health Officer
Florida Department of Health

60. Thank you for your time……. Questions??