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DPH proposes $1.9 billion two-year budget with investments in clinics, IT and behavioral health
Summary
DPH budget staff presented a FY2014—16 proposal with a projected $1.9 billion department budget, modest baseline revenue growth, targeted investments in call-center operations, IT security/clinical-informatics and HR, and identified outstanding balancing needs and potential state funding reductions.
Department leaders briefed the Health Commission on the Department of Public Health—s proposed FY2014—16 budget, outlining projected revenues, planned investments, and known risks tied to state and federal policy changes.
Greg Wagner, the department's chief financial officer, said the department is entering the budget cycle with a projected budget of about $1,900,000,000 and that prior mayoral investments corrected a structural salary imbalance (about $50,000,000) that helped stabilize planning. He noted the mayor's office had absorbed the state's "realignment" recoupment (about $33—135 million in staff remarks), which eased immediate balancing pressures.
Budget Director Jenny Louie walked commissioners through initiatives: a projected baseline revenue growth at San Francisco General of approximately $17,000,000 over the next two fiscal years; a set of revenue-neutral behavioral health investments supported by 2011 realignment funding (to support KDA settlement compliance and clinic director restorations); and proposed new initiatives including an SF Health Network call center (phased over two years with a goal of answering calls within three minutes), expanded IT security and clinical-informatics support, telehealth upgrades, and HR investments (3 new HR positions in year one and 5 in year two).
Louie also identified several balancing items and risks: a community-programs reduction of $8,800,000 in 2014—15 (annualizing to $17,700,000), a potential HIV funding reduction up to $3,000,000 (still preliminary), and the earlier-noted state realignment reduction. She said the current package addresses roughly $14,000,000 of a $21,000,000 mayor's office target, leaving approximately $7,000,000 still to be identified, and that staff were working with the mayor's office on the gap.
Commissioners and public nurses pressed for clarity on whether stated salary savings were compatible with hiring goals for San Francisco General and the emergency department. Budget staff explained some salary savings reflect attrition assumptions rather than position deletions and that planned hiring associated with the new San Francisco General Hospital would add roughly 100 FTEs at the time of the hospital reopening in 2015—16. Staff committed to provide commissioners with an itemized FTE table showing which positions are new, restored, or true-ups for the next meeting.
Louie also described other proposed investments such as a Market Street clinic lease (E9) as a potentially revenue-offsetting expansion of primary-care and pharmacy capacity, pharmacist-led anticoagulation clinic staffing, and fiscal intermediary conversions to bring some services in-house while preserving service levels.
