0

Virginia Department of Health Overview and Introduced

Budget

Presentation to Senate Finance Committee, Health and Human

Resources SubcommitteeMaureen Dempsey, MD, FAAP

Acting State Health CommissionerJanuary 7, 2013

1

VDH – Who We AreA Statewide Network of Central Office Programs & Local Health

Departments

2

VDH - Who We AreMission: To protect and promote the health of all

Virginians

Communicable Disease Prevention and Control• Treatment and Control of TB, STD and other communicable

diseases• VDH conducts over 300 disease outbreak investigations

annually• TDAP – Administered 77,634 doses in local health

departments.• Adolescent and adult booster vaccine • Boosts immunity to diphtheria, tetanus and pertussis diseases;

especially important for pertussis since immunity resulting from either DTaP vaccine or infection wanes after 5-10 years

3

VDH - Who We Are

Environmental Health Hazards Protection• Restaurant Inspections• Well and Septic Tank Permits and Inspections• Rabies• Shellfish• Bedding and Upholstery• Radiological Health

Vital Records and Health Statistics

Medical Examiners and Anatomical Services

4

VDH - Who We Are

Preventive Health Services• Family Planning• Prenatal Care• Immunizations• Obesity• Chronic Disease• Health Assessment, Promotion and Education• WIC • Child and Adult Feeding Programs

5

VDH - Who We AreDrinking Water• Implements the federal Safe Drinking Water Act, Virginia’s Public

Water Supply Law, Virginia’s Waterworks Regulations to protect public health.

Licensure & Certification• Administers the Virginia medical facilities and services licensure

laws and regulations in order to assure the quality of care and to protect public health.

Emergency Preparedness & Response• Assist and facilitate all hazards planning that guides communities to

prepare for, withstand, and recover from public health incidents.

6

VDH Serves the Public Across The Life Span of Virginians(Data for 2011)

Oversight of Healthcare

Facilities = 5,764 Vital Records Issued = 327,337

Deaths Investigated =

5,811

Screened For Infectious Disease

= 150,000

Served Through WIC =155,018

Over 26,000Restaurant Inspections

Newborns Screened = 100,000

Served By Summer Food Service =

57,000

Screened for Lead Poisoning

= 98,000

Elderly Screened for Nursing Home

Admission = 8,000

Vaccines Administered =

395,083

Home Visits Conducted =

29,963

Served By Family Planning Services

= 83,000

7

VDH - Who We AreEmergency Medical Services• Office of EMS is responsible for developing an efficient and

effective statewide EMS system.

Health Research Planning & Coordination• The Office of Minority Health & Health Equity serves several

different functions including:• Identifying various health inequities and their root causes• Serves as State Office of Rural Health coordinating and

disseminating information, providing technical assistance and helping coordinate rural health interests statewide

• Manages the scholarship and loan programs to improve access to care by increasing the number of practitioners in underserved areas of the state.

8

Acting State Health CommissionerMaureen Dempsey, MD, FAAP

Internal Audit Adjudication Officer

Office Manager Director of Governmental and Regulatory Affairs

Policy Analyst Performance Improvement Manager

Acting Chief Deputy for Public Health

Marissa Levine, MD, MPH

Deputy for AdministrationJoan Martin

Deputy for Community Health Services

Bob Hicks

Deputy for Public Health and Preparedness

Marissa Levine, MD, MPH

Office of Epidemiology

Office of Family Health Services

Office of Environmental Health Services

Office of Drinking Water

Office of Minority Health and Health Equity

Office of Financial Management

Office of Purchasing and General Services

Risk Management & Internal Control

Office of Human Resources

Office of Information Management

35 Health Districts

Director of Public Health Nursing

Healthcare Reimbursement

Office of Risk Communications and

EducationOffice of Emergency

Medical Services

Office of Licensure And Certification

Office of the Chief Medical Examiner

Virginia Department of Health Office of the Commissioner

January 2013

9

VDH Funding & Staffing – FY 2008 to FY 2013

FTEsGF – 1,554NGF – 2,215Total –3,759

FTEsGF – 1,664NGF – 2,107Total –3,771

General $169,123,124

32%

Special $128,723,905

24%

Dedicated Special

$15,844,925 3%

Federal $221,735,469

41%

FY2008Total $535,427,433

General $156,492,622

25%

Special $136,646,382

22%

Dedicated Special

$21,977,864 4%

Federal $303,986,060

49%

FY2013Total $621,084,928

10

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

50.0%

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Virginia Department of HealthAppropriation by Fund 2001 - 2013

(As A Percent of Total Appropriation)

General Fund Special Fund Federal Fund

The Increase in federal appropriation in FY2008 is attributable to funding for the WIC program.The increase in federal appropriation in FY2013 is attributable to funding for the Child and Adult Special Feeding Programs.The federal appropriations illustrated above do no include ARRA or H1N1 funding. Because these funds were for a limited time period, they were not included in the Appropriation Act.

11

Expenditures in the Local Community

88%

State-Level Support

12%

88 % Percent of VDH BudgetSpent in Local Communities

12

Introduced Budget

FY2013 FY2014

GF NGF GF NGFBase Appropriation $156,492,622 $464,592,306 $152,362,687 $471,381,793

Proposed Reductions $0 $0 ($986,816) $0

Proposed New Funding $350,000 $0 $332,402 $555,900

Total Proposed Budget by Fund $156,842,622 $464,592,306 $151,708,273 $471,937,693

Total Proposed Budget by FY $621,434,928 $623,645,966

13

Proposed General Fund Resources

Provide resources to continue Harmful Algal Bloom Monitoring

• Replaces the loss of federal CDC funding to address and respond to existing and emerging health issues associated with harmful algal blooms occurring in Virginia's Chesapeake Bay and Bay tributaries. FY 2014 $150,000 GF

Rent Increases at local health departments • Provides additional funding to address increases for the

Hopewell, Galax, King George, Wythe and Suffolk health departments

• FY 2014 $97,565 GFFY 2014 $56,034 NGF

14

Proposed General Fund Resources (Revised*)

Fund local share of 3% bonus in local health departments • Provides additional GF support for the onetime 3% bonus for state

employees in local health departments. The remaining $488K of the 3% bonus is to be paid from the state share of district revenues. Language directs VDH to pay the entire local share of the state bonus (total cost $838K).

FY2013 $350,000 GFFY 2013 $488,000 NGF *

Replace telephone system in Madison Building• Provides GF support to replace the Madison Building's telephone

system.

FY2014 $84,837 GF

15

Proposed Savings Community Health Services

•Supplant GF appropriations for the Resource Mothers Program in the second year.

FY 2014 ($499,866) GF FY 2014 $499,866 NGF

•Transfer the cost for school health services to the City of Norfolk.

FY 2014 ($423,344) GF

16

Proposed Savings Eliminates GF support for the Hemophilia Advisory Board. • This amendment implements reorganizations approved by the

General Assembly through Chapters 803 and 835 of the 1012 Acts of Assembly.

FY2014 ($714) GF

Adjust funding for changes in methodology for Oracle charges• Reduces the GF share of planned changes in VITA charges related

to Oracle specific costs effective July 1, 2013. Oracle costs will be charged to the specific agencies with Oracle licenses rather than share the costs among the many agencies using the same servers where the Oracle software resides.

FY2014 ($62,892) GF

17

Emerging Issues Influencing the Future of Public Health in Virginia

Public Health Informatics

Continued Ability of Local

Governments to Provide Matching

Funds

Impact of Patient Protection and Affordable Care

Act (PPACA)

Uncertainty Of Future Funding For State Public

Health

Disease Investigation

Capacity

Environmental Health

Monitoring

National Accreditation

18

Questions??