1. Health Services Department May 25 th, 2010

2. Mandated PCAN Other Department Expenses 43% 44% 13%

3. Mandated Department Expenses 43% Medicaid (15M) HCRA (500K) Medical Examiner (2.7M)

4. Other Department Expenses 13% Mosquito Control (1.7M) EMS Office (1.4M) HSD Office (700K) Public Health Unit (1.8M)

5. PCAN Department Expenses 44% PCAN (14.3M) OCMC (4.5M) Pharmacy (1M)

6. $ 43.4 Million FY 09-10 Adopted Budget 7% Reduction = $ 3 Million

7. Decreases in Operating and Personal Services Expenses Revenue from ME fees $2.4 M decrease in PCAN funding FY 10-11 Proposed Budget 7% Reduction = $ 3 Million $ 41 Million

8. Budget Challenges Primary Care Access Network $ 14.3 M $ 11.9 M (17%)

9. Primary Care –Closure of a clinic site –Loss of appointment slots –Close some pharmacies –Eliminate positions Secondary Care –Fewer patients receiving specialist referrals, diagnostic tests, specialty procedures Budget Challenges Potential Impacts

10. Primary CareSecondary Care Budget Challenges