No. 1-00

Approving the Department of Public Health's Proposed Budget For Fy 2000-01, Approving the Reallocation of Funds To Develop New Programs To Reduce the Need For Acute and Emergency Care, and Approving Cost Reductions Necessary To Absorb Cost Increases

WHEREAS, the Department of Public Health has developed a budget for FY 2000-01 which implements several high-priority initiatives consistent with recommendations made during the Strategic Planning process that have been endorsed by the Health Commission; and,

WHEREAS, for the FY 2000-01 budget, the Department was instructed to fund cost of living increases to its civil service employees, to fund other cost increases, to fund costs of volume increases, and to absorb revenue losses within existing resources, for a total gap of $40 million; and,

WHEREAS, the Department was informed that no additional General Funds will be allocated at the current time to fund increased costs or lost revenues for fiscal year 2000-01; and,

WHEREAS, the costs to provide and maintain acute and emergency services at the current level are increasing beyond the amount of funding available to the Department; and,

WHEREAS, there is a significant number of patients in acute care that could be served in sub-acute and community based treatment; and,

WHEREAS, the Department's goal for next fiscal year is to reduce admissions and lengths of stay and to accelerate the discharge of patients who do not require acute care; and,

WHEREAS, the Department has re-prioritized its services to fund increases to prevention, community-based and sub-acute services to provide more appropriate level of care to patients; and,

WHEREAS, the Department recognizes that funding its infrastructure is critical to the continuation of its services, and has requested increases to its capital project and equipment budgets in order to begin to address long-standing underfunding of equipment and maintenance and repair of its facilities; and,

WHEREAS, the Department has also reallocated its resources to backfill reductions to HUD/McKinney housing grants, to maintain costs of supported housing services, and by funding unavoidable cost increases; and,

WHEREAS, the Department has proposed to reconfigure services to meet budget constraints and to provide more effective delivery of primary care based services; and,

WHEREAS, the Department has proposed changes in Community Health Network outpatient pharmacy services, primary care services, billing services, and materials management services in order to reduce costs and enhance productivity; and,

WHEREAS, the Department will grant cost of living adjustments to contractors, including the University of California, by reallocating and reducing costs within contracted programs and in other operating expenses; and,

WHEREAS, the Department has proposed to enhance trauma services, to increase children's mental health services, mental health pharmacy services, and public health services, all of which are funded through increased State and Federal revenues; and,

WHEREAS, the Department's budget still requires an additional General Fund allocation of approximately $19.6 million in order to balance to its expenditures; and,

WHEREAS, decreases in acute care beds and services will occur as community based and skilled nursing alternatives are achieved; and,

WHEREAS, an additional $6 million would be needed to fully realize the savings from the reduction of the decertified beds at San Francisco General Hospital; and,

WHEREAS, the Department cannot make further reductions without seriously eroding quality of services; now, therefore, be it

RESOLVED, that the Health Commission approves the submittal of the Department of Public Health's FY 2000-01 plan and budget, and, be it

FURTHER RESOLVED, that the Health Commission directs the Department of Public Health to request additional General Funds in the amount of $25.6 million to avoid service reductions, and, be it

FURTHER RESOLVED, that the Health Commission directs the Department of Public Health to begin reconfiguring services and implementing new programs that are consistent with the Department's expenditure budget as appropriated by the Mayor and Board of Supervisors in order achieve cost savings in the current year.

I hereby certify that the foregoing resolution was adopted by the San Francisco Health Commission on February 15, 2000, and amended on March 7, 2000.

Sandy Ouye Mori, Executive Secretary to the Health Commission