Title
Adopt a Resolution to:
a. Authorize the Auditor-Controller to amend the FY 2016-17 Health Department Public Health's Adopted Budget 001-4000-HEA003-8124 to increase appropriations and estimated revenues by $434,907, funded by 1991 Health Realignment (4/5ths vote required); and
b. Authorize the Auditor-Controller to amend the FY 2016-17 Health Department Administration’s Adopted Budget 001-4000-HEA014-8438 to decrease appropriations and estimated revenues by $434,907 (4/5ths vote required); and
c. Authorize an operating transfer in the amount of $434,907 from the Department of Health, Public Health Realignment (025-4000-HEA013-8424-7614) to the Department of Health, Public Health (001-4000-HEA003-8124-5940) (4/5ths vote required)
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors support the request to:
a. Authorize the Auditor-Controller to amend the FY 2016-17 Health Department Public Health's Adopted Budget 001-4000-HEA003-8124 to increase appropriations and estimated revenues by $434,907, funded by 1991 Health Realignment (4/5ths vote required); and
b. Authorize the Auditor-Controller to amend the FY 2016-17 Health Department Administration’s Adopted Budget 001-4000-HEA014-8438 to decrease appropriations and estimated revenues by $434,907 (4/5ths vote required); and
c. Authorize an operating transfer in the amount of $434,907 from the Department of Health, Public Health Realignment (025-4000-HEA013-8424-7614) to the Department of Health, Public Health (001-4000-HEA003-8124-5940) (4/5ths vote required).
SUMMARY/DISCUSSION:
The Health Department’s Public Health Bureau (Public Health) monitors injury, disease, and death in Monterey County; investigates potential outbreaks and public health threats; and employs control strategies and policy recommendations to prevent future occurrences. Public Health includes Communicable Disease Prevention and Control, Public Health Laboratory, Public Health Preparedness, Regional Health Teams, Health Promotion and Chronic Disease Prevention Services, Supplemental Nutrition Program for Women, Infants, and Children (WIC), Nutrition Services, Vital Records, Nurse Family Partnership, Whole Person Care, Tobacco Control, and Employee Wellness.
Public Health experienced greater demand for budgetary resources than were originally included in its FY 2016-17 Adopted Budget (001-4000-HEA003-8124). To address this higher demand for budgetary resources, the Health Department requests approval to transfer $434,907 in appropriations and 1991 Health Realignment revenues from the Department’s Administration Bureau to the Public Health Bureau to fund these services. Examples of increased demand for budgetary resources include:
• The Public Health Laboratory maintained a lower than budgeted vacancy rate to ensure successful certification by laboratory accrediting and regulatory agencies.
• Health filled vacant Communicable Disease Prevention and Control positions to meet infectious disease case management and prevention needs, such as the tuberculous outbreak in February, 2017. On February 14, 2017, Health requested Board of Supervisors approval for three new positions to implement the Nurse Family Partnership (NFP) program in FY 2016-17. Appropriations for NFP were not included in the Adopted Budget for Public Health.
• The Health Department needs to allocate appropriations for a disease database migration. Health’s documentation of prior tuberculous (TB) treatment is maintained in a legacy database that is no longer supported. The original developer has agreed to extract the data so that the County may continue communicable disease case management and properly monitor outcomes. The consequences of not accessing the data include individuals being re-treated unnecessarily and being treated with the wrong medication. This increases their risk of liver injury and other serious side effects, the spread of TB disease, and development of drug resistant TB strains. The vendor has agreed to complete the extraction for $78,000.
Health’s total requested increase in appropriations is $434,907. This is the sum of $356,907 for personnel costs and $78,000 for the TB database migration.
The State of California allocates 1991 Health Realignment (HR) monies to counties for health and public health services. Monterey County utilizes HR to fund Health Department Bureaus, including Public Health and Administration. Administration forecasts to underspend its FY 2016-17 HR allocation by $434,907. These HR amounts may be used for the unanticipated FY 2016-17 service expenditures in the Public Health Bureau.
This work supports the Monterey County Health Department 2011-2015 Strategic Plan Initiative 2) Enhance community health and safety by emphasizing prevention and it supports one or more of the ten essential public health services: 6) Enforce laws and regulations that protect health and ensure safety; and 7) Link people to needed personal health services and assure the provision of health care when otherwise unavailable.
OTHER AGENCY INVOLVEMENT:
None
FINANCING:
Health requests utilizing available 1991 Health Realignment monies from the Administration bureau for unanticipated services in the Public Health bureau. This request will have no impact to budgeted Health Realignment fund balance.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
Check the related Board of Supervisors Strategic Initiatives:
☐Economic Development:
• Through collaboration, strengthen economic development to ensure a diversified and healthy economy.
☒Administration:
• Promote an organization that practices efficient and effective resource management and is recognized for responsiveness, strong customer orientation, accountability and transparency.
☒Health & Human Services:
• Improve health and quality of life through County supported policies, programs, and services; promoting access to equitable opportunities for healthy choices and healthy environments in collaboration with communities.
☐Infrastructure:
• Plan and develop a sustainable, physical infrastructure that improves the quality of life for County residents and supports economic development results.
☒Public Safety:
• Create a safe environment for people to achieve their potential, leading businesses and communities to thrive and grow by reducing violent crimes as well as crimes in general.
Prepared by: Joe Ripley, Finance Manager II, x1250
Approved by: Ezequiel Vega, Assistant Director of Health, x4622