Denver Health & Hospital Authority2017 Budget Overview

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Denver Health Strategic Overview2017

Mission of the Denver Health and Hospital Authority (CRS 25-29-101)1. Provides access to quality

preventive, acute and chronic health care for all of the citizens of Denver regardless of ability to pay.

2. Provides high quality emergency medical services to the citizens of Denver and the Rocky Mountain region.

3. Fulfills public health functions as dictated by the Denver charter and the needs of the citizens of Denver.

4. Provides health education for patients and participates in the education of the next generation of health care professionals.

5. Engages in research which enhances its ability to meet the health care needs of patients of the Denver Health system.

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Denver Health Strategic Overview2017

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Denver Health Strategic Overview2017

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STRATEGIC IMPERATIVE #3: Provide the right healthcare, at the right time, and in the right place.

GOALI can be seen in a

specialty care clinic in less than 10 business

days if I so choose

2016

2017

2021GOAL

I access primary care services on a

schedule convenient to me

GOALI work at a hospital where there are no Boarders in the ED

GOALI can schedule

elective surgery in less than 30 days if I

so choose

Denver Health Strategic Overview2017

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STRATEGIC IMPERATIVE #3: Provide the right healthcare, at the right time, and in the right place.

2016

2017

2021METRIC: Summation of expanded access hours available

10% increase

over 2016 baseline

HIGH LEVEL TACTICS2016 2017

Eliminate the wait list (0 patients on waitlist) Increase same day, after hour, weekend, and alternative service hours to 125% of YE 2016 hours

50% increase

over 2016 baseline

GOALI can be seen in a

specialty care clinic in less than 10 business

days if I so choose

GOALI access primary care

services on a schedule convenient

to me

GOALI work at a hospital where there are no Boarders in the ED

Establish baseline

GOALI can schedule

elective surgery in less than 30 days if I

so choose

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Metrics 2015 2016(Projected)

2017(Projected)

Uninsured Patients at DH 57,123 60,000 61,800

Medicaid Patients treated at DH 152,051 160,000 164,800

Managed Care Plan Enrollment 11,901 12,133 12,497

City &County of Denver DHMP

Enrollment1,052 1,103 2,000

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Metrics 2015 2016(Projected)

2017(Projected)

Labor Productivity 108% 102% 100%

Employee Engagement 4.05 3.99 4.05

Patients with Positive Overall Hospital

Rating92.4% 93.2% 93.5%

Patients with Positive Overall Outpatient

Rating91.6% 92.4% 93.0%

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Metrics 2015 2016(Projected)

2017(Projected)

Mortality Observed/Expected 0.68 0.65 0.63

DH Primary Care Adult Tobacco Users 23.8% 22.1% 21.1%

Teen Birth Rates(age 15 – 19)

24.0 per 1,000 females

21.4 per 1,000 females

19.0 per 1,000 females

Key Expansion Proposals

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Denver Sheriff Department Changes

$190,000 impact

• 2.0 FTE Health Information Management (HIM) Clerks - $90,000• Electronic Medical Record System - $100,000

The HIMs clerks are will help in keeping up with the current volume of Health Record filing while DH works with the Sheriff’s Department on options for a new Electronic Medical Record system.

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Metric 2015 2016 Annualized Projection 2017 Projection

Total Visits 419,532 460,390 483,410

Total Health Record Sections Completed Per Week 2,808 2,808 5,200

Outpatient Behavioral Health Services

$75,000 impact• 1.0 FTE Licensed Professional Counselor

Outpatient Behavioral Health Services (OBHS) is requesting funding for substance use disorder treatment personnel to continue providing medication assisted therapy and counseling. Our substance use disorder programs have been an integral part of the community continuum of care for several decades. Our multi-disciplinary clinical teams include physicians, nursing, clinical psychologists, social workers, case managers and professional counselors. The grant funding for this program will decrease in 2017.

As a result of Affordable Care Act (ACA), more substance use treatment services are being funded through Medicaid, thus federal pass through funding is being reduced. Unfortunately, these federal funding reductions come at a time when each day, 44 people in the United States die of prescription opioid overdose; a rate now outpacing annual traffic fatalities (HHS).

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Metric 2015 2016 Annualized Projection 2017 Projection

Total Therapy Visits per Year (12 visits for 75 patients) 900 900 900

$309,905 impact

3.5 FTEs EMT BasicNew ESP Van

Expand the amount of ESP Van coverage to full three units Sunday-Thursday and four units Friday and Saturday. This will enable better response to the DIA area as well as lessoning the negative impact of long wait times or instances where the ESP units are unavailable for public safety agencies.

Additional ESP van coverage will decrease wait times for all three public safety agencies (DPD, DFD, EMS). There were 4,285 calls in 2015 where a ESP van was not available. DPD had to transport the patient to CARES. This increased capacity will lessen the burden on the DPD to have to transport these patients or find alternative solutions. It will also provide more capability for ESP vans to respond to District 5 and DIA.

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Denver CARES Emergency Patrol Van (ESP)

ESP Transports and Requests for Transport 2015 Total 2016 Annualized Projection 2017 Projection

ESP Completed Transports 4139 7841 9000

DPD forced to transport or there was no van available 4285 3949 4000

Total Calls 8424 11790 13000

Percentage of Total Calls where DPD was forced to transport or there was no van available 51% 33% 30%

Director of Epidemiology and Informatics

$186,505 impact

• 1.0 FTE

Denver Public Health is responsible for planning and developing interoperate information systems. These require stewardship, governance relationships, agreements, and strategic investments. They need defined leadership in informatics and epidemiology to create and navigate a technology road map.

This request will provide the City & County of Denver with a resource that makes electronic health record information available on a quarterly basis. Information will be accessible through the internet. Data will be shared between Denver Public Health and Denver Environmental Health. City Council and the Mayor’s Office will have ongoing access to automated processes for sharing data. The position is currently grant funded.

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Name of Change Request Proposal Impacted Measure Name Data Source / How Calculated 2015 Actuals 2016 Forecasted 2017 Projected

Director Epidemiology and InformaticsNumber of reports generated from

Colorado Health Observation Regional Data Service (CHORDS)

Summary data - CHORDS audit log (reports per year) 2 3 5

Same Number of reports generated from epidemiology and informatics groups

SharePoint log, PowerPivot report (reports submitted per quarter) 350 350 350

Denver Health All FundsExpenditures-Appendices A & B

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2015 Contract Budget 2016 Contract Budget 2017 Contract BudgetWorkers' Compensation $295,000 $295,000 $295,000Special Revenue Funds (Head Start) $405,000 $405,000 $500,000CIP $700,000 $2,432,967 $2,432,967Human Services Fund $468,000 $974,568 $815,170DIA $2,585,500 $3,231,848 $3,576,336911 Trust Fund $88,100 $97,900 $97,489General Fund $54,877,500 $54,356,125 $54,422,899

$50,000,000

$52,000,000

$54,000,000

$56,000,000

$58,000,000

$60,000,000

$62,000,000

$64,000,000

Appendix A and B Budget by Fund

-9% Chan

Denver Health All FundsRevenues and Appendix C

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$1,605,551 $1,654,759 $1,804,956

$281,256

$631,892

$743,970

$-

$500,000

$1,000,000

$1,500,000

$2,000,000

$2,500,000

$3,000,000

2015 Estimated 2016 Estimated 2017 Estimated

General Fund 911 Trust Fund

Contract 2017 Base

FTE

274

CSA FTE at DHHA

132

Contract Personnel Overview

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2015 Actual 2016 Revised 2017 Projected 2017 ApprovedNurse Home Visit Program FTE 0.00 2.05 2.05 2.05AIM Program FTE 0.00 3.00 3.00 3.00Department of Safety FTE 0.00 0.40 0.40 0.40Family Crisis Center FTE 6.78 8.03 0.00 0.00Child Welfare FTE 0.00 0.00 7.62 7.62Denver Sheriffs FTE 111.30 116.98 116.98 118.98Denver Cares FTE 85.81 85.66 85.66 89.16Public Health FTE 45.30 46.30 46.30 47.30Denver Fire & Training FTE 5.00 5.00 5.00 5.00Total FTE 254.19 267.42 267.01 273.51Total FTE Budget $20,816,058 $21,952,300 $21,952,300 $22,275,674

0.00

50.00

100.00

150.00

200.00

250.00

FTE

(Bar

s)Contract Personnel Budget and FTE

Thanks to the City and County of Denver for your ongoing support!

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