Sonoma County Department of Health Services Fiscal Year 2019-2020 Adopted Budget
The Sonoma County Department of Health Services (DHS) budget supports the actions and vital programs that reinforce the county’s commitment to promote, protect, and ensure access to services to support the health, recovery, and well-being of all in Sonoma County. For Fiscal Year (FY) 2019-20, DHS’s overall budget, one of the largest Departmental budgets within the County, includes a yearly operating budget of approximately $243 million dollars.
In preparing its FY 2019-20 Recommended Budget, DHS was facing a revenue gap of $11 million, including $8 million in its Behavioral Health Division and $3 million in its Public Health Division. Like FY 2018-19, the $11 million revenue gap was primarily the result of a continued decline in revenue and increasing costs. FY 2019-20 will be the fourth year the Health Department will experience flat growth in a major funding stream – 1991 Health and Mental Health Realignment funds as the result of the In Home Support Services (IHSS) redirect.
The lack of 1991 Realignment growth in concert with increasing costs, including an increase in the Health Department’s labor and institutional costs, are a major contributor to the Health Department’s FY 2019-20 fiscal challenges.
As a result, of the budget challenges in the Behavioral Health Division, the Department has made progress on several initiatives aimed at improving the efficiency and effectiveness of operations in order to maximize revenues and reduce costs.
Specifically:
- Implementation of the Avatar electronic health record;
- Improved claiming for Medicare reimbursement;
- Improved documentation to maximize Medi-Cal reimbursements; and
- Created a revenue cycle management unit designed to improve forecasting, reporting, and monitoring.
The reductions in the Public Health Division programs requires the Department to work more effectively with partners and leverage funding across systems and programs in order to ensure access to the highest quality and cost-effective programs. Strategies have been identified to address any potential gaps in service that may occur in our public health programs as a result of reductions. Specifically, existing resources within PHD have been identified to support the affected programs and thus reductions were chosen in programming that could be mitigated in this fashion. Additionally, data on these programs is being gathered to analyze how PHD can more efficiently use its resources to continue providing these services.
Additionally, during budget hearings, the Board of Supervisors recognized safety net programs as a priority and approved additional funding of $5.96 million to restore critical and vital public health and behavioral health services. We are grateful for the Board’s intervention and the restoration funding that will allow us to continue the following programs:
- Residential Care Facilities – $2.65 million
- Adult Outpatient Services – $1.3 million
- Peer and Family Support Services – $1.16 million
- Disease control function – $487k
- Emergency Preparedness – $100k
- Public Health Support – $264k
However, unfortunately, the Board was unable to restore funding for all proposed reductions within the Department and those community partners who are impacted have been directly notified.
Department leadership and management are continually working to identify strategies to mitigate these challenges and will continue to provide updates here as they become available.