1. Health Services Department FY 2014-15 Budget Worksession July 14, 2014

2. Organization Chart Proposed FY 2014-15 Budget Accomplishments Budget Challenges Summary Presentation Outline

3. Organization Chart Proposed FY 2014-15 Budget Accomplishments Budget Challenges Summary Presentation Outline

4. Organization Chart Office of the Medical Director, EMS Margaret Brennan (Medical Clinic/PCAN) Tom Breaud, Ph.D. (Mosquito Control) Robert Buck, D.O. (Corrections Medical) Jan Garavaglia, M.D. (Medical Examiner) Christopher Hunter M.D., PhD. (Acting Director) Dil Luther (Animal Services) Carol Burkett (Office for Drug Free Community) Donna Wyche (Mental Health & Homelessness)

5. Organization Chart Proposed FY 2014-15 Budget Accomplishments Budget Challenges Summary Presentation Outline

6. Proposed FY 2014-15 Budget Current FY 2014$ Change Proposed FY 2015 Personal Services$15.9M$0.1M$16.0M Operating Budget70.8M(10.6M)60.2M Budget Change(12.1%) Staffing2401241

7. Current FY 2014$ Change Proposed FY 2015 Capital Improvement Projects $0.1M$0.5M$0.6M Budget Change385% Proposed FY 2014-15 Budget

8. Organization Chart Proposed FY 2014-15 Budget Accomplishments Budget Challenges Summary Presentation Outline

9. Accomplishments Animal Services Error reduction procedures in place Increased veterinarian coverage Extended hours of operation to include Sunday Medical Examiner’s Office Partnered with Orlando Health and FSU College of Medicine to provide medical training in forensic pathology EMS Office of the Medical Director Completed update of all EMS treatment protocols and created a web-based mobile application

10. Accomplishments Prescription Drug Take Back Day Office for Drug Free Community PCAN/OCMC 2013 Emerging Leaders in Healthcare Transformation Award from CJA Over 100,000 uninsured patients served Mosquito Control Inspected over 10,000 sites and sprayed over 90,000 acres Mental Health & Homelessness 350 Families served through WrapAround Orange Orange County Youth Mental Health Commission

11. Organization Chart Proposed FY 2014-15 Budget Accomplishments Budget Challenges Summary Presentation Outline

12. Primary CareSecondary Care PCAN Funding Budget Challenges

13. Youth Mental Health Commission Recommendations Budget Challenges Expanded WrapAround Orange Community Action Team CAT Mobile crisis team Database/Navigation

14. Predicted active season Emerging concerns about Dengue Fever and Chikungunya Emergency control measures are costly –Some species require door-to-door methods Budget Challenges Mosquito Control

15. Organization Chart Proposed FY 2014-15 Budget Accomplishments Budget Challenges Summary Presentation Outline

16. Health Services Department proposed budget $76.7M –($10.1M) in Operating Budget Budget Challenges –PCAN –Youth Mental Health –Mosquito Control Pictures Summary

17. FY 2014-15 Budget Worksession July 14, 2014 Health Services Department

18. Corrections Health Services FY 2014-15 Budget Worksession July 14, 2014

19. Organization Chart Proposed FY 2014-15 Budget Accomplishments Budget Challenges Summary Presentation Outline

20. Organization Chart Proposed FY 2014-15 Budget Accomplishments Budget Challenges Summary Presentation Outline

21. Organization Chart Health Services Administrator Jane Jenkins, B.S.N. Health Services Administrator Jane Jenkins, B.S.N. Mental Health Services Leonard Branch, Ph.D. Mental Health Services Leonard Branch, Ph.D. Pharmacy Services Shari Hopwood, Pharm.D. Pharmacy Services Shari Hopwood, Pharm.D. Physicians and Mid-level Providers Medical Director Robert Buck, D.O. Medical Director Robert Buck, D.O.

22. Organization Chart Proposed FY 2014-15 Budget Accomplishments Budget Challenges Summary Presentation Outline

23. Proposed FY 14-15 BUDGET Current FY 14$ Change Proposed FY 15 Personal Services$12.5M$0.4M$12.9M Operating Budget9.3M(0.4M)8.9M Budget Change(0.2%) Staffing169

24. Offsite Medical Other Medications Lakeside 16% 14% 53% Operating Budget $8.9M Proposed FY 14-15 Budget

25. Organization Chart Proposed FY 2014-15 Budget Accomplishments Budget Challenges Summary Presentation Outline

26. Accomplishments Hospitalization Length of Stay –Consistently lower than the community average Increased use of generic medications to reduce pharmacy cost Opened an additional medical and dental clinic Achieved full accreditation from the NCCHC

27. Organization Chart Proposed FY 2014-15 Budget Accomplishments Budget Challenges Summary Presentation Outline

28. Budget Challenges Cost of Healthcare –Hospitalization –Specialist referrals –Pharmaceuticals Older, sicker inmate population 30% of inmates require mental health intervention

29. Organization Chart Proposed FY 2014-15 Budget Accomplishments Budget Challenges Summary Presentation Outline

30. Corrections Health Services proposed budget $21.7M Budget Challenges –Cost of healthcare –Older, sicker population –High percentage of mental health patients Pictures Summary

31. FY 2014-15 Budget Worksession July 14, 2014 Corrections Health Services

32. Offsite Medical 53% Operating Budget $ 8.9M Hospitalization ($ 4.6M) Specialist referrals Inpatient days Offsite diagnostics Consultant fees Proposed FY 14-15 Budget

33. 16% Operating Budget $ 8.9M Over half of inmates are on medications Mental health meds Meds for various chronic conditions About 6000 pills daily Medications Proposed FY 14-15 Budget

34. Lakeside14% Operating Budget $ 8.9M 9 Beds at Lakeside –Acute mental health treatment –Forced medication –Therapeutic environment Proposed FY 14-15 Budget

35. Other Operating Budget $ 8.9M Dialysis Medical supplies X-rays & ultrasounds Ambulance transport Laboratory tests Proposed FY 12-13 Budget