1. HEALTH SERVICES DEPARTMENT FY 2011-12 Budget Worksession July 11, 2011

2. Organization Chart Proposed FY 2011-12 Budget Accomplishments Budget Challenges Summary Presentation Outline

3. Organization Chart Proposed FY 2011-12 Budget Accomplishments Budget Challenges Summary Presentation Outline

4. 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.

5. Organization Chart Proposed FY 2011-12 Budget Accomplishments Budget Challenges Summary Presentation Outline

6. Proposed FY 2011-12 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%) Staffing1311130

7. Organization Chart Proposed FY 2011-12 Budget Accomplishments Budget Challenges Summary Presentation Outline

8. 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

9. 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

10. Organization Chart Proposed FY 2011-12 Budget Accomplishments Budget Challenges Summary Presentation Outline

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

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

13. Primary CareSecondary Care PCAN Funding Budget Challenges

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

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

16. 69% increase in 3 Years Medicaid Billed/Paid FY07-10 Orange County Budget Challenges

17. Organization Chart Proposed FY 2011-12 Budget Accomplishments Budget Challenges Summary Presentation Outline

18. 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

19. FY 2011-12 Budget Worksession July 11, 2011 HEALTH SERVICES DEPARTMENT

20. Florida Medicaid 2010 3 Million Enrollees107,000 Providers $20.2 Billion

21. Pictures 2010201120122013201420152016201720182019 Medicaid Expansion Accountable Care Organizations Insurance Reform s Individual Mandate Temporary Health Insurance Exchange Permanent Health Insurance Exchange PPACA (Healthcare Reform Act)