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HomeMy WebLinkAboutGallatin City County Health Department Fiscal Year 2010 BudgetC:\DOCUME~1\sulmen\LOCALS~1\Temp\1 City Commission Memo FY 2010.doc Commission Memorandum REPORT TO: Honorable Mayor and City Commission FROM: Stephanie Nelson, Health Officer Gallatin City-County Health Department SUBJECT: Gallatin City County Health Department FY 2010 Budget MEETING DATE: August 24, 2009 AGENDA ITEM TYPE: Special Presentation RECOMMENDATION: None BACKGROUND: The County Commission has approved the FY 2010 Preliminary Budget for Gallatin City County Health Department. The budget will be considered for final approval by the County Commission on September 29, 2010. Prior to the final approval the City Commission has historically approved the Preliminary Budget as well. This year Commissioner Bryson requested that I do a brief presentation on the budget as part of the City’s budget presentation. The Health Department’s final budget would be placed on the City Commission’s agenda as a consent item on September 28th. FISCAL EFFECTS: The preliminary FY 2010 budget is attached. ALTERNATIVES: Attachments: Report compiled on: 118 PUBLIC HEALTH CITY / COUNTY HEALTH FUND _______________________________________________________________ Fund Overview The City / County Health Fund was created by an Inter-local Agreement between Gallatin County and the City of Bozeman. The agreement sets forth the criteria for operation of the Fund, including authorization to levy taxes inside the City of Bozeman. The Fund in FY 06 had a mill levy of 5.01. The Budget for FY 2010 calls for a levy of 5.01mills. This millage does increase the taxes for the Fund. The increased tax is been placed in a capital reserve for future needs. The Fund is separated into three activities: 1) Administration, 2) Human Services and 3) Environmental Health. These divisions are under the authority of the City/County Health Board and the City / County Health Officer is responsible for the day - to - day activity of the divisions. Risks to public health are assessed and monitored; appropriate policies, rules and regulations promulgated and enforced; and community based public health strategies created. The City / County Health Officer supervises the activities of the Human Services and Environmental Health divisions, along with all grants used by the Department. The Health Officer is charged with the responsibility to assure that the department complies with the requirements for each grant as set forth in individual contracts. ******************************************************** Fund Goals • Prevent epidemics and the spread of disease. • Protect against environmental hazards. • Prevent injuries. • Promote and encourage healthy behaviors. • Respond to disasters and assist communities in recovery. • Assure the quality and accessibility of health services. • Support efforts to reduce risk of acute and chronic disease. ***************************************************** Recent Accomplishments • Leading Health Indicators completed and put onto web • Program evaluations completed • Unified Health Command Three-Year Plan Completed • Office moved • Board of Health Work Plan completed for the Air and Water Committees and the Prevention Alliance ADMINISTRATION 19% HUMANSERVICES 36% ENVIRONMENTAL 51% FY 2010 CITY/COUNTY HEALTH FUND ACTIVITES F-6 119 PUBLIC HEALTH CITY / COUNTY HEALTH FUND _______________________________________________________________ Fund Budget Object of Expenditure Actual Final Actual Start-Up Request Preliminary FY 2008 FY 2009 FY 2009 FY 2010 FY 2010 FY 2010 Personnel 1,252,279$ 1,233,471$ 1,201,431$ 1,201,431$ 1,221,499$ 1,219,717$ Operations 221,649 226,510 192,355 192,355 196,635 197,667 Debt Service - - - - - - Capital Outlay - 53,284 53,284 53,284 66,117 66,867 Transfers Out - - - - - - Total 1,473,928$ 1,513,265$ 1,447,070$ 1,447,070$ 1,484,251$ 1,484,251$ Budget by Fund Group General Fund -$ -$ -$ -$ -$ -$ Special Revenue Funds 1,473,928 1,513,265 1,447,070 1,447,070 1,484,251 1,484,251 Debt Service Funds - - - - - - Capital Project Funds - - - - - - Enterprise Funds - - - - - - Internal Service Funds - - - - - - Trust & Agency Funds - - - - - - Total 1,473,928$ 1,513,265$ 1,447,070$ 1,447,070$ 1,484,251$ 1,484,251$ Funding Sources Tax Revenues 975,940$ 1,051,339$ 1,051,339$ 985,798$ 1,051,339$ 1,051,339$ Non-Tax Revenues 344,381 326,622 326,622 316,012 292,886 342,030 Cash Reappropriated 153,607 135,304 69,109 145,260 140,026 90,882 F-7 120 PUBLIC HEALTH CITY / COUNTY HEALTH FUND _______________________________________________________________ Fund Personnel No. of   Positions FT/PT Title FTE  1 Full-Time Health Officer (SN) 1.00  2 Full‐Time Directors (SM, TR) 2.00  3 Full‐Time EH Program Lead (TM,DM,SH) 3.00  5 Full‐Time EH Specialists (CC,FC,TJ,DS,EZ) 5.00  1 Full‐Time Program Asst – EHS (NR) 1.00  1 Full‐Time Program Technical Asst‐EHS (TS) 1.00  4 Full‐Time Public Health Nurse (AA,LH,SB,MP) 4.00  2 Part‐Time Public Health Nurse (KC,TW) 1.11  3 Part‐Time PHN Program Mgr (SS,BK,TC) 2.40  1 Full‐Time Lead Data Mgmt Tech (CN) 1.00  1 Full‐Time Executive Admin Asst (TL) 1.00  1 Full‐Time Accounting Tech (LW) 1.00  2 Full‐Time Administrative Asst. (NM,DS) 2.00  1 Part‐Time Health Program Coordinator (AF) 0.75  1 Full‐Time Program Admin Asst (MS) 1.00  1 Full‐Time WIC‐Program Mgr (DH) 1.00  2 Full‐Time WIC‐Nutrition tech (LM, AL) 2.00  1 Part‐Time Lead Social Worker (SC) 0.80   Part‐Time Temp Nurses‐set aside for  emergency outbreak/flu $19,207           Total Program 31.06  F-8 121 PUBLIC HEALTH HEALTH ADMINISTRATION _______________________________________________________________ Department Overview The Health Administration office oversees the fiscal, contractual and mandate regulation responsibility of the Health Department. This office administers the Public Health Emergency Preparedness (PHEP) grant and Public Health Promotion activities. The overriding administrative goal is to support the Board of Health and the staff of the Gallatin City/County Health Department in meeting the Department’s mission. Through the department’s administrative support, risks to public health are assessed and monitored; appropriate policies, rules and regulations promulgated and enforced; and community-based public health strategies created. It is recognized that this goal is dependent on dedicated staff, an engaged public and stable funding. The Health Officer is the Department Head and supervises the activities of the Directors of Human Services and Environmental Health. The Health Office is responsible to assure that the department complies with the requirements for each grant as set forth in individual contracts. ***************************************************** Department Goals • Prevent epidemics and the spread of disease. • Protect against environmental hazards. • Prevent injuries. • Promote and encourage healthy behaviors. • Respond to disasters and assist communities in recovery. • Assure the quality and accessibility of health services. • Support efforts to reduce risk of acute and chronic disease. ****************************************************** Recent Accomplishments • BOH 2008-2009 Strategic Activities determined • Public Health Emergency Plans have been updated and exercised. • Multiple public health promotion campaigns have taken place. • Legislative changes related to licensed establishments. F-9 122 PUBLIC HEALTH HEALTH ADMINISTRATION _______________________________________________________________ Activity Budget Object of Expenditure Actual Final Actual Start-Up Request Preliminary FY 2008 FY 2009 FY 2009 FY 2010 FY 2010 FY 2010 Personnel 153,546$ 221,732$ 199,703$ 227,590$ 215,280$ 214,530$ Operations 97,533 27,298 - 27,318 27,812 27,812 Debt Service - - - - - - Capital Outlay 1,762 20,278 - 20,278 32,095 32,845 Transfers Out - - - - - - Total 252,841$ 269,308$ 199,703$ 275,186$ 275,187$ 275,187$ Budget by Fund Group - General Fund -$ -$ -$ -$ -$ -$ Special Revenue Funds 252,841 269,308$ 199,703$ 275,186 275,187 275,187$ Debt Service Funds - - - - - - Capital Project Funds - - - - - - Enterprise Funds - - - - - - Internal Service Funds - - - - - - Trust & Agency Funds - - - - - - Total 252,841$ 269,308$ 199,703$ 275,186$ 275,187$ 275,187$ Funding Sources Tax Revenues 275,183$ 212,018$ 201,417$ 212,018$ 212,018$ 212,018$ Non-Tax Revenues 21,924 37,454 37,454 21,268 21,268 37,112 Cash Reappropriated (44,266) 19,836 (39,168) 41,900 41,901 26,057 Total 252,841$ 269,308$ 199,703$ 275,186$ 275,187$ 275,187$ Department Personnel No. of   Positions FT/PT Title FTE  1 Full‐Time Health Officer 1.00  1 Full‐Time Executive Admin Asst 1.00  1 Full‐Time Accounting Tech 1.00  3  Total Program 3.00  F-10 123 PUBLIC HEALTH HEALTH ADMINISTRATION _______________________________________________________________ 2010 Budget Highlights Personnel • No change – Plan for Retirement of Health Officer within two years. Operations • No change Capital • Continue to accumulate sufficient capital reserves County Commission Goals/Division Response The County Commission established a set of overarching goals for the county government. Listed below are the County Commission’s goals, followed by the methods by which the Health Administration is striving to fulfill those goals. Exceptional Customer Service • Customer satisfaction and input will be considered in the program evaluation process • Support web based access to public records and services Be Model for Excellence in Government • Comply with City, County and Federal Standards • Enhance program efficiency and management by use of electronic records • Plans for responding to public health emergencies will be drilled and adjusted for improvement • Facilitate the Unified Health Command Improve Communications • Increased public knowledge of department – receive positive impression from public • Public access to website To be the Employer of Choice • Provide an employee-friendly work environment • Implement performance based appraisals Adhere to the long term plan • Continue to increase efficency by implementing the informatic plans Equate community need with the budgetary decisions • Leading Health Indicators updated • Priorities set with Prevention Alliance F-11 124 PUBLIC HEALTH HEALTH ADMINISTRATION _______________________________________________________________ F-12 Workload Indicators Actual Actual Actual Estimated Indicator FY 2007 FY 2008 FY 2009 FY 2010 1 . Number of programs evaluated 7 9 9 10 2 . Number of contracts reconciled 9 9 9 10 3 . Number of Health Promotion campaigns/activities 8 8 8 10 Performance Measures YTD Projected Measure FY 2009 FY 2010 1 .QA/QI - Customer Satisfaction Surveys Completed EHS 100% 100% HS 50% 100% - % of Job Description Reviewed & Updated 100% - - - - % of Programs Evaluated - LEAN Process Implemented 25% 50% 2 .Improve Efficiency - Electronic Medical Record Implemented 75% 100% - Administrative changes made due to LEAN process - - - 100% 3 .Communication - Annual Report Created & on Web done - - - - Leading Health Indicators Updated done - - - - Web Updated on-going 4.Emergency Preparedness - UHC Strategic Plan Updated done - - - - Multi-patient Care Plan Completed - - - 100% Comments WORKLOAD INDICATORS/PERFORMANCE MEASURES 125 PUBLIC HEALTH HEALTH HUMAN SERVICES (NURSING) _______________________________________________________________ Department Overview Human Services (HS) provides a variety of programs in every community (Belgrade, Bozeman, Manhattan, Three Forks and West Yellowstone) of the County. Public Health Nurses (PHN) are assigned a geographic area of the County to provide services. Their presence allows for better understanding of the individual community needs and desires. The PHN sit on community or school advisory groups or councils. This interface between the Health Department and the community is fundamental in providing adequate, insightful and timely services in each community. The HS office is responsible for Communicable Disease (CD) surveillance and investigation as required by law. Both adult and child immunization clinics are offered as a preventive measure. In addition, HS contracts with the State to provide services to HIV/AIDS and TB patients. PHN are involved in daycare inspections to assure compliance with regulations associated with communicable disease and immunizations. A variety of Federal preventive health grant programs are administered through HS. These programs include: Women, Infant and Children (WIC) Nutrition Program; Breast and Cervical Health program; Lead Prevention Grant; and a number of Maternal Child Health (MCH) Block Grant services. The MCH Block Grant supports school nursing services (in addition to school contracts), home visitation programs that target high-risk pregnant women and children up to the age of 5 years, breastfeeding support, and prenatal and parenting classes. The HS staff works collaboratively with many organizations to create successful community-based programs such as, the Child Car Seat Clinics and the Partnership to Strengthen Families program, which provides child abuse and neglect prevention services. The demographics of Gallatin County show the need for services to women, child and families. Seventy four percent (74%) of the county’s population is under 39 years of age. Seventeen percent of the population has an income at or below the Federal Poverty Level ($12,675 for a family of 4), and 39% percent live at 200% of poverty level. A recent community survey revealed that affordable health care is the number one concern of community members, educators and health care providers. Through the MCH programs, the Health Department provides information, education, support and advocacy to help meet the needs of these families. Another factor that drives MCH programs, in addition to family need, is the availability of funding sources. The programs are supported, in whole or in part, by grants or contracts. Without the infusion of these dollars into the budget, the Health Department would not be able to provide the present level of services. ****************************************************** Department Goals • Develop standards, outcomes and data for each Human Services program. • Develop and complete Consumer Satisfaction Survey. • Provide infrastructure support to programs serving our most vulnerable MCH populations. • Increase the number of women screened through the Breast & Cervical Health Program. • Expand adolescent immunization clinics to include additional rural schools. • Increase immunization rates of 2 year olds. • Enhance communicable disease surveillance, data collection and timeliness of reports. ******************************************************** Recent Accomplishments Program evaluations have been created for all services delivered by the Human Services office. Results of these annual evaluations will be used for quality improvement. F-13 126 PUBLIC HEALTH HEALTH HUMAN SERVICES (NURSING) _______________________________________________________________ Division Budget - HHS Object of Expenditure Actual Final Actual Start-Up Request Preliminary FY 2008 FY 2009 FY 2009 FY 2010 FY 2010 FY 2010 Personnel 401,899$ 353,047$ 349,206$ 355,849$ 350,166$ 349,151$ Operations 93,338 93,875 92,962 72,771 77,438 78,453 Debt Service - - - - - - Capital Outlay - 15,706 - 15,706 16,722 16,722 Transfers Out - - - - - - Total 495,237$ 462,628$ 442,168$ 444,326$ 444,326$ 444,326$ Budget by Fund Group General Fund -$ -$ -$ -$ -$ -$ Special Revenue Funds 495,237 462,628 442,168 444,326 444,326 444,326 Debt Service Funds - - - - - - Capital Project Funds - - - - - - Enterprise Funds - - - - - - Internal Service Funds - - - - - - Trust & Agency Funds - - - - - - Total 495,237$ 462,628$ 442,168$ 444,326$ 444,326$ 444,326$ Funding Sources Tax Revenues 339,633$ 334,635$ 317,903$ 334,635$ 334,635$ 334,635$ Non-Tax Revenues 3,831 34,538 52,588 34,538 34,538 50,338 Cash Reappropriated 151,773 93,455 71,677 75,153 75,153 59,353 Total 495,237$ 462,628$ 442,168$ 444,326$ 444,326$ 444,326$ Division Personnel No. of   Positions FT/PT Title FTE  1 Full‐Time Human Service Director 1.00  1 Full‐Time Lead Data Mgmt Tech 1.00  2 Full‐Time Administrative Assistant 1.80  1 Part‐Time PHN Program Mgr .80  1 Part‐Time Public Health Nurse  .51  2 Full‐Time Public Health Nurse  1.26    Total Program 6.37  F-14 127 PUBLIC HEALTH HEALTH HUMAN SERVICES (NURSING) _______________________________________________________________ Division Budget – Maternal Child Health/School Nursing Object of Expenditure Actual Final Actual Start-Up Request Preliminary FY 2008` FY 2009 FY 2009 FY 2010 FY 2010 FY 2010 Personnel 183,890$ 167,084$ 153,576$ 167,557$ 148,182$ 152,488$ Operations 70,743 71,384 63,786 - 51,994 51,994 Debt Service - - - - - - Capital Outlay 3,524 12,111 6,714 - 10,229 5,923 Transfers Out - - - - - - Total 258,157$ 250,579$ 224,076$ 167,557$ 210,405$ 210,405$ Budget by Fund Group General Fund -$ -$ -$ -$ -$ Special Revenue Funds 258,157 250,579 275,448 167,557 210,405 210,405 Debt Service Funds - - - - - - Capital Project Funds - - - - - - Enterprise Funds - - - - - - Internal Service Funds - - - - - - Trust & Agency Funds - - - - - - Total 258,157$ 250,579$ 275,448$ 167,557$ 210,405$ 210,405$ Funding Sources Tax Revenues 1$ -$ -$ -$ -$ -$ Non-Tax Revenues 178,218 200,757 208,871 - 184,663 184,663 Cash Reappropriated 79,939 49,822 66,577 - 25,742 25,742 Total 258,158$ 250,579$ 275,448$ -$ 210,405$ 210,405$ Operating Reserve: $25,631 (10%) Division Personnel No. of   Positions FT/PT Title FTE  1 Part‐Time Public Health Nurse  .60  1 Part‐Time Lead Social Worker    .80  3 Full‐Time Public Health Nurse 1.19         Total Program 2.59  F-15 128 PUBLIC HEALTH HEALTH HUMAN SERVICES (NURSING) _______________________________________________________________ Division Budget – Communicable Disease Object of Expenditure Actual Final Actual Start-Up Request Preliminary FY 2008 FY 2009 FY 2009 FY 2010 FY 2010 FY 2010 Personnel 99,429$ 163,631$ 98,680$ 158,917$ 163,259$ 162,814$ Operations 283,066 245,005 233,783 - 266,292 266,737 Debt Service - - - - - - Capital Outlay 5,285 84,039 - - 97,992 97,992 Transfers Out - - - - - - Total 387,780$ 492,675$ 332,463$ 158,917$ 527,543$ 527,543$ Budget by Fund Group General Fund -$ -$ -$ -$ -$ Special Revenue Funds 387,780 492,675 587,416 158,917 527,543 527,543 Debt Service Funds - - - - - - Capital Project Funds - - - - - - Enterprise Funds - - - - - - Internal Service Funds - - - - - - Trust & Agency Funds - - - - - - Total 387,780$ 492,675$ 587,416$ 158,917$ 527,543$ 527,543$ Funding Sources Tax Revenues 1$ -$ -$ -$ -$ -$ Non-Tax Revenues 157,257 262,255 326,734 - 334,270 334,270 Cash Reappropriated 230,523 230,420 260,682 - 202,125 193,273 Total 387,781$ 492,675$ 587,416$ -$ 536,395$ 527,543$ Operating Reserve: $61,566 (10%) Division Personnel No. of   Positions FT/PT Title FTE  1 Part‐Time PHN Program Mgr  .80  3 Full‐Time Public Health Nurse  1.55   Temporary Public  Health Nurse –Set  aside for emergency outbreak  only $19,207    1 Full‐Time Program Admin Asst  .15    Total Program 2.5  F-16 129 PUBLIC HEALTH HEALTH HUMAN SERVICES (NURSING) _______________________________________________________________ Division Budget – Women, Infants & Children Object of Expenditure Actual Final Actual Start-Up Request Preliminary FY 2008 FY 2009 FY 2009 FY 2010 FY 2010 FY 2010 Personnel 156,523$ 130,248$ 130,867$ 128,733$ 148,830$ 128,197$ Operations 31,188 55,903 48,757 - 57,782 59,337 Debt Service - - - - - - Capital Outlay - - - - - - Transfers Out - - - - - - Total 187,711$ 186,151$ 179,624$ 128,733$ 206,612$ 187,534$ Budget by Fund Group General Fund -$ -$ -$ -$ -$ -$ Special Revenue Funds 187,711 186,151 179,624 128,733 206,612 187,534 Debt Service Funds - - - - - - Capital Project Funds - - - - - - Enterprise Funds - - - - - - Internal Service Funds - - - - - - Trust & Agency Funds - - - - - - Total 187,711$ 186,151$ 179,624$ 128,733$ 206,612$ 187,534$ Funding Sources Tax Revenues -$ -$ -$ -$ -$ -$ Non-Tax Revenues 187,711 185,296 185,296 - 186,343 181,678 Cash Reappropriated - 855 (5,672) - 20,269 5,856 Total 187,711$ 186,151$ 179,624$ -$ 206,612$ 187,534$ Division Personnel No. of   Positions FT/PT Title FTE  1 Full‐Time WIC Program Manager 1.00  2 Full‐Time Nutrition Technician 2.00         Total Program 3.00  F-17 130 PUBLIC HEALTH HEALTH HUMAN SERVICES (NURSING) _______________________________________________________________ Division Budget – Cancer Prevention Fund Object of Expenditure Actual Final Actual Start-Up Request Preliminary FY 2008 FY 2009 FY 2009 FY 2010 FY 2010 FY 2010 Personnel 44,782$ 89,976$ 90,775$ 67,148$ 77,692$ 77,430$ Operations 49,015 48,201 16,483 - 100,140 105,402 Debt Service - - - - - - Capital Outlay - 25,311 1,981 - 19,730 14,730 Transfers Out - - - - - - Total 93,797$ 163,488$ 109,239$ 67,148$ 197,562$ 197,562$ Budget by Fund Group General Fund -$ -$ -$ -$ -$ Special Revenue Funds 93,797 163,488 159,281 67,148 197,562 197,562 Debt Service Funds - - - - - - Capital Project Funds - - - - - - Enterprise Funds - - - - - - Internal Service Funds - - - - - - Trust & Agency Funds - - - - - - Total 93,797$ 163,488$ 159,281$ 67,148$ 197,562$ 197,562$ Funding Sources Tax Revenues -$ -$ -$ -$ -$ -$ Non-Tax Revenues 60,300 127,458 127,458 127,458 123,800 123,800 Cash Reappropriated 33,497 36,030 31,823 (60,310) 73,762 73,762 Total 93,797$ 163,488$ 159,281$ 67,148$ 197,562$ 197,562$ Operating Reserve: $21,208 (10%) Division Personnel No. of   Positions FT/PT Title FTE  1 Part‐Time Health Program Manager .75   Part‐Time PHN Program Mgr   1 Full‐Time Administrative Assistant .20  1 Full‐Time Program Admin Asst .85  3  Total Program 1.80  F-18 131 PUBLIC HEALTH HEALTH HUMAN SERVICES (NURSING) _______________________________________________________________ Division Budget – (PHEP) Health Preparedness & NACCHO Grant Object of Expenditure Actual Final Actual Start-Up Request Preliminary FY 2008 FY 2009 FY 2009 FY 2010 FY 2010 FY 2010 Personnel 81,337$ 94,866$ 71,882$ 105,666$ 65,415$ 65,239$ Operations 21,584 28,597 24,914 - 81,041 81,217 Debt Service - - - - - - Capital Outlay 1,762 63,972 - - 105,250 105,250 Transfers Out - - - - - - Total 104,683$ 187,435$ 96,796$ 105,666$ 251,706$ 251,706$ Budget by Fund Group General Fund -$ -$ -$ -$ -$ Special Revenue Funds 104,683 187,435 195,890 105,666 251,706 251,706 Debt Service Funds - - - - - - Capital Project Funds - - - - - - Enterprise Funds - - - - - - Internal Service Funds - - - - - - Trust & Agency Funds - - - - - - Total 104,683$ 187,435$ 195,890$ 105,666$ 251,706$ 251,706$ Funding Sources Tax Revenues -$ -$ -$ -$ -$ -$ Non-Tax Revenues 114,646 124,308 124,308 124,308 127,595 132,645 Cash Reappropriated (9,963) 63,127 71,582 (18,642) 124,111 119,061 Total 104,683$ 187,435$ 195,890$ 105,666$ 251,706$ 251,706$ Operating Reserve: $3,451 Division Personnel No. of   Positions FT/PT Title FTE  1 Part‐Time PHN Program Mgr .80         Total Program .80    F-19 132 PUBLIC HEALTH HEALTH HUMAN SERVICES (NURSING) _______________________________________________________________ Division Budget – Grant Summary Object of Expenditure Actual Final Actual Start-Up Request Preliminary FY 2008 FY 2009 FY 2009 FY 2010 FY 2010 FY 2010,,, Personnel 565,961$ 645,805$ 545,780$ -$ 603,378$ 586,168$ Operations 455,596 449,090 387,723 - 557,249 564,687 Debt Service - - - - - - Capital Outlay 10,571 185,433 8,695 - 233,201 223,895 Transfers Out - - - - - - Total 1,032,128$ 1,280,328$ 942,198$ -$ 1,393,828$ 1,374,750$ Budget by Fund Group General Fund -$ -$ -$ -$ -$ -$ Special Revenue Funds 1,032,128 1,280,328 942,198 - 1,393,828 1,374,750 Debt Service Funds - - - - - - Capital Project Funds - - - - - - Enterprise Funds - - - - - - Internal Service Funds - - - - - - Trust & Agency Funds - - - - - - Total 1,032,128$ 1,280,328$ 942,198$ -$ 1,393,828$ 1,374,750$ Funding Sources Tax Revenues 2$ -$ -$ -$ -$ -$ Non-Tax Revenues 698,132 900,074 972,667 - 956,671 957,056 Cash Reappropriated 333,996 380,254 424,992 - 446,009 417,694 Total 1,032,130$ 1,280,328$ 1,397,659$ -$ 1,402,680$ 1,374,750$ Division Personnel No. of   Positions FT/PT Title FTE  1 Part‐Time Public Health Nurse (TW) .60  2 Part‐Time PHN Program Mgr (BK, TC) 1.60  1 Part‐Time Lead Social Worker .80  1 Full‐Time WIC Program Manager (DH) 1.00  2 Full‐Time Nutrition Tech (LM, AL) 2.00  1 Part‐Time Health Program Coordinator (AF).75  1 Full‐Time Administrative Assistant (NM) .20  1 Ful‐Time Program Admin Asst (MS) 1.00  4 Full‐Time Public Health Nurses (SB,MP, AA, LH) 2.74       13  Total Program 10.69  F-20 133 PUBLIC HEALTH HEALTH HUMAN SERVICES (NURSING) _______________________________________________________________ 2010 Budget Highlights Personnel • No change Operations • No change. Capital • Continue to build capital reserve County Commission Goals/Department Response The County Commission established a set of overarching goals for the county government. Listed below are the County Commission’s goals, followed by the methods by which the Health Human Services (Nursing) is striving to fulfill those goals. Exceptional Customer Service • Prevent and contain epidemics • Assess the community’s health • Provide community based health prevention services Model for Excellence in Government • Promote healthy behavior • Assure access to quality health care • Comply with State and Federal grant requirements Improve Communications • Provide health prevention messages to reduce risk of acute and chronic disease • Public access to website To be the Employer of Choice • Performance based employee appraisals F-21 134 PUBLIC HEALTH HEALTH HUMAN SERVICES (NURSING) F-22 Workload Indicators Actual Actual Actual Projected Indicator FY 2007 FY 2008 FY 2009 FY 2010 1. Maternal Child Health - Caseload * Women of child-bearing age 896 637 * Pregnant women 97 123 * Infants (under age 1) 1,204 1,085 * Children (1-22 years) 2,231 2,304 * Children with special health needs 293 337 2. School Nursing * Number of schools served 13 13 13 13 3. Communicable Disease (CD)/Immunizations * Total reportable communicable diseases 1,090 1,155 * Number of persons seen in the clinic 6,174 5,548 * Number of child vaccinations given 7,292 6,517 * Number of adult vaccinations given 3.623 3,226 4. Women Infant and Children * Total number of women seen 281 290 * Total number of children seen 780 803 5. Breast and Cervical Health * Number of women served 444 364 * Number of breast pre-cancerous diagnosed 1 1 * Number of cervical pre-cancerous diagnosed 11 13 * Number of invasive breast cancer 3 6 * Number of invasive cervical cancer 1 0 Performance Measures Actual Actual Actual Projected Measure FY 2007 FY 2008 FY 2009 FY 2010 1. Maternal child Health * % low birth weight (A) 5.6% * % Prenatal Care-1st trimester (B) 89.0% * % Teen births (C) 4.0% * Infant Mortality Rate (D) 6.1% 2. Communicable Disease (CD)/Immunizations) * Cases followed-up within 24 hrs of report 100% 100% 100% 100% 3. Women Infant and Children * Increase the number of participants by 5% 1061-5% (E) 1093-3% 1148-5% 4. Breast and Cervical Health * Increase participation by 1% 444-16% 364-21% (E) 135 PUBLIC HEALTH HEALTH HUMAN SERVICES (NURSING) F-23 Comments A. Percent of all live births B. Percent of live births by month pre-natal care began C. Percent of live births to women 15-19 years D. Five year rates per 1,000 live births E. Decrease 136 PUBLIC HEALTH ENVIRONMENTAL HEALTH SERVICES _______________________________________________________________ Division Overview Environmental Health Services (EHS) is a function of the Gallatin County City / County Health Department. EHS is responsible for enforcement of state laws and regulations, and County rules and Regulations on environmental health statutes involving food, water, wastewater and air. These statutes require EHS to inspect and enforce regulations for food establishments, public accommodations, day care centers and trailer courts. EHS issues permits and inspects septic systems within the County and assists other governmental agencies in the investigation and remediation of environmental health problems or issues. EHS performs site evaluations of proposed subdivisions to ensure compliance with the Sanitation in Subdivision Act and local septic regulations. In addition to these mandatory programs, EHS manages the local radon program and is under a contract with the State to inspect public water systems. ****************************************************** Division Goals: • Complete the septic permit scanning project • Start scanning the subdivision database • Continue cross-training EHS staff • Update the Health Code ****************************************************** Recent Accomplishments • Implemented electronic record management system for Food Establishment Program • Streamlined the variance procedure for the BOH F-24 137 PUBLIC HEALTH ENVIRONMENTAL HEALTH SERVICES _______________________________________________________________ Division Budget Object of Expenditure Actual Final Actual Start-Up Request Preliminary FY 2008 FY 2009 FY 2009 FY 2010 FY 2010 FY 2010 Personnel 646,175$ 658,692$ 661,057$ 617,992$ 656,053$ 656,036$ Operations 76,455 105,337 79,337 92,266 91,385 91,402 Debt Service - - - - - - Capital Outlay 5,315 17,300 5,315 17,300 17,300 17,300 Transfers Out - - - - - - Total 727,945$ 781,329$ 745,709$ 727,558$ 764,738$ 764,738$ Budget by Fund Group General Fund -$ -$ -$ -$ -$ -$ Special Revenue Funds 727,945 781,329 745,709 727,558 764,738 764,738 Debt Service Funds - - - - - - Capital Project Funds - - - - - - Enterprise Funds - - - - - - Internal Service Funds - - - - - - Trust & Agency Funds - - - - - - Total 727,945$ 781,329$ 745,709$ 727,558$ 764,738$ 764,738$ Funding Sources Tax Revenues 285,951$ 504,686$ 479,452$ 504,686$ 504,686$ 504,686$ Non-Tax Revenues 284,620 254,630 209,505 167,900 237,080 254,580 Cash Reappropriated 157,374 22,013 56,752 54,972 22,972 5,472 Total 727,945$ 781,329$ 745,709$ 727,558$ 764,738$ 764,738$ Division Personnel No. of   Positions FT/PT Title FTE  1 Full‐Time EH Director 1.0  3 Full‐Time EH Program Lead 3.0  5 Full‐Time EH Specialist 5.0  1 Full‐Time Program Technical Asst 1.0  1 Full‐Time Program Assistant 1.0         Total Program 11.0  F-25 138 PUBLIC HEALTH ENVIRONMENTAL HEALTH SERVICES _______________________________________________________________ F-26 2010 Budget Highlights Personnel • ½ FTE moved to Human Services Grant funding. Operations • No change Capital • Computer table top (3) - $5,400 • Capital Reserve – GIS/GPS/Tablets - $3,195 County Commission Goals/Department Response The County Commission established a set of overarching goals for the county government. Listed below are the County Commission’s goals, followed by the methods by which the Environmental Health Services is striving to fulfill those goals. Exceptional Customer Service • Implement electronic filing and food service inspections. • Streamline and increase coordination of the permitting process with Planning. • Create programs to document location of public wastewater treatment systems. Be Model for Excellence in Government • Participate in the regional public health emergency responses plan. • Review and modify EHS programs. Improve Communications • Design, develop, and implement a mechanism to receive client feedback. • Improve public access to the Department’s website. • Perform a minimum of six outreach or educational talks. To be the Employer of Choice • Continue advanced training. • Performance based employee appraisals. 139 PUBLIC HEALTH ENVIRONMENTAL HEALTH SERVICES _______________________________________________________________ WORKLOAD INDICATORS / PERFORMANCE MEASURES Workload Indicators Actual Actual Actual Projected Indicator FY 2007 FY 2008 FY 2009 FY 2010 1. Number of septic applications processed 315 265 250 2. Number of sub applications processed (lots) 118(657) 80(240) 70(200) 3. Number of food establishment inspections 977 1100 1100 4. Number of temporary food events inspected 205 265 265 5. Number of ServSafe class participants 108 80 100 6. Number of complaints investigated 234 200 200 7. Number of public accommodations inspected 58 58 55 8. Number of trailer courts inspected 69 64 64 9. Number of pools/spas inspected 122 135 130 10. Number of septic inspections (# seen) 286(147) 250(40) 220(40) 11. Number of site evaluations (# seen) 191(97) 160(25) 140(40) 12. Number of public water inspections 34 18 15 13. Number of Plan reviews 78 65 60 14. Number of initial Sub reviews for Planning 136 100 80 Performance Measures Actual Actual Actual Projected Measure FY 2007 FY 2008 FY 2009 FY 2010 1. Percent of septic permits scanned 59% 75% 90% 2. Percent of site evaluations seen 62% 25% 25% 3. Number of Health Code chapters updated N/A 2 4 4. Percent of clients satisfied with service 95% 98% 90% Comments • The County has begun discussing the role of EHS in the permitting, review and oversight of public wastewater treatment systems in the county. The performance measures and workload estimates may be affected by the decision. • The Montana Department of Public Health and Human Services have initiatives involving the inspection of tourist homes which may affect workload estimates. Additionally, new regulations regarding the review of non-public water and wastewater systems may be implemented and affect EHS’s workload. F-27 140