Chesterfield Health District Budget Analysis

1
Chesterfield Health District Budget Analysis

• Ayesha Allen
• Stephen Harkins
• Xia Li
• Brooke Rossheim
• Epid 602
• October 12, 2005

2
The Framework of Budget Development
The CHD Budget
3
Definitions

• Cooperative Budget Includes state general funds,
  local general funds, and generated revenue.
• Programs include
• Dental Health (7)
• Environmental Health (18)
• Family Planning (11)
• General Medical (20)
• Health Support (5)
• Administration (13)
• MCH (16)

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Definitions - II

• Non cooperative Budget Non state funds,
  including federal funds, grants, and private
  funds for targeted programs.
• Programs include
• Family Planning (16)
• Breast Cervical Cancer Screening (4)
• Abstinence (8)
• Child Health (6)
• WIC Administration FFY 05 (30)
• WIC Breastfeeding (2)
• WIC Nutrition (8)
• Planning Focus Area A-1 (7)
• EPI-Focus Area B (7)
• IAP (5)
• Injury Death Reductions (0)
• Address Asthma (2)
• Infant Health (2)
• TB Outreach Services (3)

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Chesterfield Health District (CHD)

• Includes
• Chesterfield County
• City of Colonial Heights
• Powhatan County

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Overview of CHDs Population and Budget
POPULATION (Census 2003)
/capita
PH BUDGET FY 2006
CH City of Colonial Heights CC Chesterfield
County PC Powhatan County
7
Overview of the CHD Cooperative Budget

• The total budget is 5,842,785
• Total Personnel Budget 4,785,427 (82)
• Total Non-Personnel Budget 1,057,358 (18)
• The states share of this budget is 56.491,
  which translates into 2,434,663
• The local match is 43.509, which is 1,875,192

8
Overview of the CHD Cooperative Budget - II

• Estimated Earned Revenue is 939,800
• Net Budget (State Local) is 4,309,855
• 100 Locally Funded Expenses (3 program areas,
  Environmental, Administration, and MCH) are
  593,130

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Overview of the CHD Cooperative Budget - III

• Additional funding allocated by Chesterfield
  County that is not represented in the COOP
  budget.
• 1,000,000 for approximately 25 public health
  school nurses who are promoting education, family
  health, and other public health activities.
• Funds are managed by CHD

10
Overview of the CHD Non-Cooperative Budget

• Total budget 904,347
• Total Personnel Budget 772,584 (85.4)
• Total Non-Personnel Budget 131,763 (14.6)

11
CHD Budget Analysis

• It is noteworthy that approximately 82 of the
  total budget represents personnel services, while
  18 represents non-personnel services.

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CHD Coop Budget Analysis Personnel Services

• Total Cost 4,785,427
• Largest costs
• Salaries 3,395,870
• Health insurance 503,425
• Retirement 302,568
• FICA 255,249
• Wages 197,651

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Budget Analysis for CHD Coop Budget
Non-personnel Services

• Represents contractual services(36), supplies
  materials(28), continuous charges(15),
  equipment (21), transfer payments(0), property
  and improvements(0), and plant
  improvements(0)
• Total cost 1,057,358
• Money distributed to major resources such as
  equipment (computers, printers), x-rays lab
  services, office supplies, rent, infrastructure
  and maintenance are small when compared to
  personnel services.

14
Major Sources of CHD Revenue

• Septic System Fees 94,000
• Well Permit Fees 42,000
• Restaurant Permits 32,700
• Vital Statistic Fees 124,300
• Child Health Services 56,000
• General Medical Clinic Fees 316,000
• Family Planning Services 67,000
• Medicaid Dental 100,000
• Maternal Child Health 52,500

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Strengths of the CHD Coop Budget

• CHD appears to be well managed fiscally and have
  a strong auditing system (line items are easily
  tracked via CARS system, day to day checks of the
  budget, year end settlement (YES)).
• Money budgeted seems to be strategically
  allocated to support CHD goals which are
  consistent with county health goals per Dr.
  Nelsons lecture.
• The generated revenue can allow for diversion of
  some of the funds for other pressing needs.
• Controlling costs to save money, for example
  video conference to avoid travel costs, training
  (in house).
• Possibly, an upcoming large capital improvement
  project to improve infrastructure.

16
Weaknesses of CHD Coop Budget

• Unable to carry over monies from one fiscal year
  to the next.
• Also, unable to encumber funds. Cut off date is
  June 30.
• While not unique to CHD, concern about declining
  state appropriation for public health in the face
  of increasing costs of doing business. (Examples,
  increasing employee health insurance premiums,
  rising fuel costs, etc.)

17
Weaknesses of CHD Coop Budget - II

• Apparent high personnel costs would seem to limit
  available funds to implement programs. (Example
  MCH category in the coop budget)

18
Suggestions For Improvement

• Increased funding of Public Health from all 3
  levels of government seems imperative,
  particularly given recent events - Hurricane
  Isabel here in 2003, recent devastating
  hurricanes affecting New Orleans and Gulf Coast,
  in addition to recent acts and constant threat of
  terrorism (recent bombings in London and Spain
  NYC subway alerts)
• Strategies to reduce costs such as buying
  equipment in bulk to save money as well as
  overhead costs with the possibility of new
  infrastructure.