Subcommittee trims Department of Public Health appropriation request after budget analyst review

The Budget and Finance Subcommittee forwarded to the full Board an amended ordinance to appropriate $23,711,912 to cover cost overruns in the Department of Public Health for fiscal year 2009–2010, after the budget analyst recommended a $2,904,303 reduction.

A hospital official (identified in the transcript as Mr. Sasse) said San Francisco General typically sees revenue variances tied to appeals, court decisions and reimbursement processes, and that the proposed ordinance primarily reallocates surplus hospital revenues rather than drawing on the general fund. "A large portion of it is associated with prior period adjustments...and a portion of it is associated with additional revenues that we were unable to really nail down at the time we put our budget together," the presenter said.

Harvey Rose, the budget analyst, reported that the department subsequently recalculated its need and recommends reducing the appropriation to $20,807,609. He also emphasized that no general fund revenues are required for this request because it uses surplus San Francisco General revenue, prior settlements, and other non‑general fund sources.

Committee members asked for clarification of revenue sources. The presenter identified Medicare/Medicaid billing and a $7.5 million safety net care pool tied to Medi‑Cal waiver calculations maintained by the California Association of Public Hospitals as key components of the revenue adjustments.

Public comment yielded none and the committee approved moving the amended ordinance to the full Board without objection.