Virginia Department of Health Presentation to West Virginia October - - PowerPoint PPT Presentation

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Virginia Department of Health

Presentation to West Virginia

October 28, 2015

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Outline

• VDH Structure
• VDH Communication Methods
• VDH Overview & Budget Highlights

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The mission of VDH is to protect and promote the health of ALL people in Virginia

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Vision: Virginia Will Become The Healthiest State In The Nation

§ 32.1-2. Finding and purpose.

The General Assembly finds that the protection, improvement and preservation of the public health and

• f the environment are essential to the general welfare
• f the citizens of the Commonwealth. For this reason, the

State Board of Health and the State Health Commissioner, assisted by the State Department of Health, shall administer and provide a comprehensive program of preventive, curative, restorative and environmental health services, educate the citizenry in health and environmental matters, develop and implement health resource plans, collect and preserve vital records and health statistics, assist in research, and abate hazards and nuisances to the health and to the environment, both emergency and otherwise, thereby improving the quality of life in the Commonwealth.

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VIRGINIA DEPARTMENT OF HEALTH

Office of the Commissioner November 10, 2015

State Health Commissioner

Marissa Levine, MD, MPH

Office Manager Nancy Glasheen Adjudication Officer Douglas Harris

Director of Process Improvement

vacant

Director of Strategic Planning and Evaluation vacant Director of Governmental and Regulatory Affairs Joseph Hilbert Director of Internal Audit Alvie Edwards Office of Information Management Debbie Condrey, CIO

Chief Deputy Commissioner

David Trump, MD, MPH, MPA

Deputy Commissioner for Administration Richard Corrigan Deputy Commissioner for CHS Robert Hicks Operations Director for Public Health & Preparedness Kim Allan Operations Director for Public Health & Health Equity Chris Gordon

Office of Risk Communication and Education Suzi Silverstein Office of Emergency Preparedness Bob Mauskaupf Office of Emergency Medical Services Gary Brown Office of Licensure and Certification Erik Bodin Office of the Chief Medical Examiner William Gormley, MD Office of Epidemiology Laurie Forlano, DO, MPH Office of Radiological Health Steve Harrison Office of Drinking Water John Aulbach

Operations Director for Administration Mike McMahon Office of Financial Management Elizabeth Franklin Office of Human Resources Rebecca Bynum Office of Purchasing and General Services Steve VonCanon Operations Director for CHS Jennifer Mayton Director for Process and Evaluation Oversight CHS Bill Edmunds 35 Health Districts Director of the Office of Family Health Services vacant Director of the Office of Minority Health and Health Equity Adrienne McFadden, MD, JD Office of Environmental Health Services Allen Knapp Operations Director for CHS Chris Gordon Business Manager Steve Murman Deputy Commissioner for Population Health Lilian Peake, MD, MPH Director for Public Health Nursing Joanne Wakeham Operations Director for Population Health Chris Gordon

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Management of Health Districts

• Deputy Commissioner directly supervises 33 of

35 district directors and serves as reviewer for 300 district managers

• Each district is led by a physician director and

managed by team that includes nursing, environmental, and business managers

• District directors also supervise clinicians,

pharmacists, dentists, and laboratorians where those services still exist

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Role of District Directors

• Medical and public health resource for private

sector, local government officials, and public utility operators.

• Manage operations for local health departments

within their district.

• Carry out authority delegated by the

Commissioner and Deputy Commissioner

• 75% of directors have MPH and 66% are board

certified in preventive medicine

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Communication

Event Notifications:

• Release Information
• Situation and/or Problem
• Immediate Impact or Required Action
• Background
• Discussion
• Recommendation or Action Taken
• Conclusion

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Community Health Services

Network of Health Districts & Local Health Departments

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Community Health Services

• 134 cities and counties are organized into 35

Health Districts

• District boundaries usually follow planning

districts and include as few as 1 and up to 10 cities and/or counties

• There is at least one service delivery site in

every city and county

• Services vary among localities within a district

and between districts based on local needs, funding, and private sector capacity

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Alternatives for LHD Operation

• Locality may enter into a contract with VDH to
• perate (130 of 134 localities)
• Administer their LHD under contact to VDH (4 of

134 localities)

• Operate an independent LHD with no state

funding (no locality has chosen this option)

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Philosophy Behind Local Health Districts (LHDs) in VA

• LHDs are a partnership between state and local

governments

• LHDs work closely with private sector health

care providers and systems

• Array of LHD services varies based on local

need

• Preserve flexibility for LHDs on “how” to improve

community health while assuring compliance with policy, regulation, and law

• Partnership is the key

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Strengths of Virginia’s Public Health System

• Local health districts in every city and county that

provides basic public health services

• Joint state and local funding of local health districts
• Interdisciplinary management of districts
• Flexibility to adapt to local needs
• Public-private partnerships to improve health

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Local Health District Services

• Services provided in every LHD include

communicable disease control, family planning, inspection of public establishments that serve food, permitting of onsite sewage disposal and well construction, emergency preparedness and response.

• Limited number of districts provide

pharmacy, lab, and general medical services

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Service Delivery Models

• Most districts have more than one of the

following models depending on service and community capacity:

• LHD staff provide services directly to clients
• LHD provides services with individual provider

contracts or through agreements with non-profits

• LHD provides initial service then hand-off to private

sector

• LHD collaborates with private sector to assure service

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Evolution of Modern Public Health System

• Prior to the creation of the existing system, all parts of

Virginia did not have access to basic public health services throughout the state, including control of communicable diseases and immunizations

• Cities tended to have more established, better funded

public health services

• Rural areas had a limited tax base and could not afford

to establish more comprehensive public health services

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Expenditures

in the Local Community 88%

State-Level Support 12%

88% Percent of VDH Budget Spent in Local Communities

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VDH Funding & Staffing – FY 2008 to FY 2016

FTEs GF: 1,664 NGF: 2,107 Total : 3,771

General $169,123,124 32% Special $128,723,905 24% Dedicated Special $15,844,925 3% Federal $221,735,469 41%

FY2008 Total $535,427,433

FTEs GF: 1,481 NGF: 2,191 Total: 3,672

General 152,085,583 24% Special 144,959,042 23% Dedicated Special 28,839,230 4% Federal 312,721,600 49%

FY2016 Total $638,605,455

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Virginia Department of Health Appropriation by Fund 2008 - 2016

$169M $169M $153M $151M $147M $156M $154M $160M $152M $145M $161M $164M $170M $166M $161M $161M $167M $174M $222M $251M $250M $247M $251M $304M $312M $313M $313M $100 $150 $200 $250 $300 $350 2008 2009 2010 2011 2012 2013 2014 2015 2016 Millions General Fund Special Fund Federal Fund

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Virginia Department of Health General Fund 2008 - 2016

$135 $140 $145 $150 $155 $160 $165 $170 $175 2008 2009 2010 2011 2012 2013 2014 2015 2016 Millions

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LHD Funding Streams

• State Funds Appropriated by General

Assembly

• Local matching funds appropriated by local

government based on ability to pay formula developed by JLARC

• 100% Local funds above the match

requirement

• Revenue earned from services delivered
• Federal grant funds that are primarily

categorical in nature

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Locality State General Fund Share % Local Government Share % Self Generated Revenue % Clarke County 60.386% 39.614% 11.8% Frederick County 55.744% 44.256% 19.9% Page County 61.073% 38.927% 13.8% Shenandoah County 58.031% 41.969% 19.9% Warren County 57.234% 42.766% 16.3% Winchester City 56.958% 43.042% 18.3% District Average % 58.237% 41.763% Cooperative Budget Percentage of Shared Cost Between State and Locality Funding, Excluding Self Generated Revenue

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Cooperative District Budget Totaling $5,021,704 Breakdown

$2,173,440 43% $1,618,764 32% $1,229,500 25%

State Funds Local Funds Revenue

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$2,173,440 35% $1,618,764 26% $1,227,615 19% $1,229,500 20%

State Funds Local Funds Grants Revenue

Total Funding Of The District Budget Breakdown Including Federal Funds $6,249,319

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Questions??