1. HHSCC Funding Study An Analysis of Health and Human Services Funding in Pinellas County FY 2005-06 March 2008

2. Purpose Study was designed to answer the following:  What are the sources of public funding directed to health and human services in the county?  For a designated financial period, what is the amount of public funding in total and broken out by population and program types?  How are funds from the various sources leveraged, linked, or dependent upon one another?

3. Methods March 2008

4. Levels of Analysis 1. Federal – Florida in general and Pinellas specifically 2. State – Federal conduit, general revenue and trust funds 3. Local – Funding patterns and creative organizational structures Study examined funding sources, mechanisms, and patterns from three perspectives:

5. Scope

6.  Hospitals (n = 5), funders (n = 8), and governmental designees/lead agencies (n = 5) were surveyed; all responded with the exception of one hospital system  Initial lists of provider agencies resulted from a query of 2-1-1 Tampa Bay Cares’ ServicePoint database (n = 127); list refined through iterative process (n = 103)  Data were received from 91 provider agencies - effective response rate = 88.3% Survey Participants

7. Federal Funding Summary  Total federal dollars to Florida and to Pinellas County have increased over the last ten years  Majority of funds came as direct payments to individuals through programs (e.g., Medicare)  Florida ranked 45 th in per capita ranking for percentage of federal funds spent on health and human services  Pinellas County receiving less than 3% of federal grants to the state

8. State Funding Summary   Florida State Constitution mandates balanced budget  (e.g., Medicaid)  State acknowledges impact of long-term care spending (e.g., Medicaid)  State left with three options 1.Increase its revenues 2.Reduce its expenditures 3.Assign some of its work to counties or other subsidiary governments

9. Total Revenue Health and Human Services 1. Does not include the four HCA for-profit hospitals operating in Pinellas.

10. Total Revenue by Age Group

11. Source of Revenue by Age group

12. Total Revenue by Service Category

13. Educational

14. Individual and Family Life

15. Individual and Family Life Detailed View of Program Revenue

16. Behavioral Health

17. Behavioral Health Service Specific

18. Basic Needs

19. Other Sources of Revenue  In-Kind Services $4,789,879  Foundations$7,665,484  Fund-Raising$11,690,328  Matching $ and Pass-Through  71 programs = $18,650,163

20. Conclusions and Recommendations March 2008

21. Recommendation Leadership Networks to conduct risk assessments  vulnerability to future budget cuts  strategies to mitigate risk  assure that all existing sources of revenue are maximized  create contingency plans in event of future revenue loss Conclusion Funding for Health and Human Services is at both short- and long-term risk

22. Recommendation Analyze Fiscal And Clinical Effectiveness of New Models Analyze Fiscal And Clinical Effectiveness of New Models Conclusion Complicated Funding Mechanisms Serve To Hinder Coordinated And Integrated Service Delivery

23. Recommendation  Implement selected strategies identified by the court.  Formulate strategy to reduce number of mentally ill individuals in correctional system. Conclusion Correctional system functions as “de-facto mental institutions” (Supreme Court for the State of Florida, 2007)

24. Recommendation Develop a process for collecting financial information across systems for accurate and current information Conclusion No single system for collecting “real time” information on the funding

25. OPPORTUNITIESRISKS

26. Thank You! The HHSCC gratefully acknowledges the members of the HHSCC Administrative Forum, the Pinellas County charitable health and human services agencies, funders and hospitals for their data contributions to this study. To learn more about the HHSCC and/or download a complete copy of the report go to: www.hhscc-pinellas.org