In implementing the budget, the department will be organized into five major divisions with the following functions:



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Phyllis Murdock, Director Public Health Department Summary Mission Statement The mission of the Public Health Department is to protect the public through promoting individual, community, and environmental health. Department Description and Key Issues The Department of Public Health provides a wide range of services in more than 50 programs that are designed to promote and protect the health of all County residents and visitors. The department strives to address the core public health functions as mandated by the State of California. These essential functions consist of providing adult indigent care; promoting and protecting community health through attention to women and children s health issues and communicable and sexually-transmitted diseases; planning for and responding to disasters; and protecting our County s valuable natural resources while improving the environment. In implementing the budget, the department will be organized into five major divisions with the following functions: Nursing Services Provides a wide array of services to promote health and wellness, including: home nursing services, health assessments, nursing case management and occupational/physical therapy services for children with physically disabling health care needs under the California Children s Services program, nursing services for foster children, family planning clinic services, immunizations, substance abuse treatment, pregnancy care resources through the Maternal Child and Adolescent Health program, well child exams under the Child Health and Disability Program, childhood lead poisoning prevention, dental health, injury prevention and low cost child car seats program. Communicable Disease and Emergency Response Provides diagnosis, education, surveillance, epidemiological follow-up and monitoring of treatment for communicable diseases, such as sexually transmitted diseases, enteric diseases, hepatitis A, B and C, salmonella, meningitis and tuberculosis. This division also provides emergency response and preparedness through collaborations with local hospitals and health care providers, fire departments, Office of Emergency Management, law enforcement and other partners to protect the public from negative health outcomes in times of emergencies and disasters. The Public Health Laboratory provides advanced testing capabilities to detect agents of infectious disease and other threats to the public s health including plans for bioterrorism and disaster preparedness. Environmental Health Provides services as required by State law and County ordinances to meet environmental health and sanitary needs within the County. The Environmental Health Division includes the following programs: inspection of food establishments, public swimming pool inspections, small water systems inspections and monitoring, hazardous waste management, solid waste, liquid waste, water well permitting and inspections, underground and aboveground storage tanks, land use regulations and permitting of water wells and wastewater systems, and inspection of correctional/detention facilities. Community Health Provides data collection and analysis, systematic program review, health education, community outreach and promotion. A key focus of the division is to lead the department through the process of accreditation aimed at advancing the quality and performance of the Public Health Department. The division also includes the Women, Infants and Children s Program which provides nutrition education and food vouchers to pregnant and breastfeeding women and to children up to age five. 227

Phyllis Murdock, Director Public Health Department Summary General Administration Provides overall fiscal, contractual and operational management of the department, including information systems, personnel management, purchasing services, and interdepartmental relations. The division also provides a full range of animal control services within the unincorporated portions of the County. These services include rabies control, animal licensure, investigation of bites and animal quarantine, containment of stray dogs, sheltering, investigation of animal nuisances and cruelty, and dead animal pickup on County roadways. Another key program in this division is vital statistics where all births and deaths in the County are registered and certificates issued, including burial permits, in accordance with State law. This division also includes an allocation necessary to meet the County s obligation under Section 17000 of the Welfare and Institutions Code to fund the anticipated medical expenses for indigents under the County Medical Services Program. Department Budget PUBLIC HEALTH 2010-11 2011-12 2012-13 2012-13 Actuals Adopted Requested Recommended Licenses and Permits 109,088 100,000 118,200 118,200 Fines, Forfeits, Penalties 352,543 350,000 360,000 360,000 Use of Money and Property 146,193 215,000 192,400 192,400 State Revenues 12,895,188 14,861,503 14,869,011 13,673,050 Federal Revenues 3,707,236 3,292,262 3,944,551 3,944,551 Charges For Services 2,871,873 2,948,366 3,035,562 3,035,562 Miscellaneous Revenues 24,175 12,066 15,950 15,950 Other Financing Sources - - - - Total Revenues $ 20,106,296 $ 21,779,197 $ 22,535,674 $ 21,339,713 Salaries and Employee Benefits 11,239,372 12,631,638 12,901,036 12,901,036 Services and Supplies 9,576,375 9,967,489 10,746,951 10,746,951 Other Charges 1,624,048 2,020,034 1,371,436 1,133,736 Capital Assets 197,875 96,343 92,000 92,000 Total Direct Expenditures $ 22,637,670 $ 24,715,504 $ 25,111,423 $ 24,873,723 Other Financing Uses 31,388 - - 986,902 Total Expenditures $ 22,669,058 $ 24,715,504 $ 25,111,423 $ 25,860,625 Net Costs/Use of Fund Balance $ 2,562,762 $ 2,936,307 $ 2,575,749 $ 4,520,912 2012/13 Recommended Use of GPR $ 724,304 2012/13 Recommended Use of Restricted Fund Balance $ 3,796,608 228

Phyllis Murdock, Director Source of Funds (Revenues) State and federal revenues are the largest revenue sources for the department. Charge for services are fees collected for services such as the public health laboratory, clinic, and environmental health inspection. The restricted fund balance is the use of the Public Health Realignment Restricted Cash Account to fund the department operations. The use of General Purpose Revenues (GPR) is the required transfer from the General Fund to the Public Health Fund as required by State law. Fines, Forfeits, Penalties 1% Public Health Department Summary Recommended Source of Funds (Revenues) $25,860,625 State Revenues 53% Use of Money and Property 1% Licenses and Permits <1% Federal Revenues 15% Rest. Fund Balance 15% Charges For Services 12% Miscellaneous Revenues <1% GPR 3% Use of Funds (Expenditures) Salary and benefits is the largest expenditure category for the department. Services and supplies include various contract services such as animal shelter/care and environmental consulting. They also include medical/dental supplies, leases, utilities, and training. Other charges include costs for support services, which include Administration, Auditor, County Counsel, General Services, Human Resources, Information Systems, and Treasurer. Summary of Budget Request and Recommendation Salaries & Employee Benefits Requested The department budget request includes the net increase of 0.2 positions. This includes the addition of two Administrative Assistants, one Program Development Manager, one Salaries and Employee Benefits 50% Recommended Use of Funds (Expenditures) $25,860,625 Services and Supplies 42% Other Charges 4% Other Financing Uses 4% Capital Assets <1% Full Time Equivalent (FTE) Positions 2008-09 Adopted Position Allocation 176.35 2009-10 Adopted Position Allocation 157.05 2010-11 Adopted Position Allocation 158.10 2011-12 Adopted Position Allocation 158.25 2011-12 Current Position Allocation* 160.25 2012-13 Recommended Position Allocation 160.45 *As of 4/10/12 229

Phyllis Murdock, Director Public Health Department Summary Administrative Coordinator, 0.2 Public Health Nurse (existing position going from 0.8 FTE to full time), and one Community Services Program Manager (new position for which a job description needs to be created). These changes are necessary to create the Community Health Division which will be focused on leading the department through a successful accreditation process. Recommended The recommendation includes funding for requested staffing levels. Services & Supplies Requested The department budget request includes funding to maintain current service levels. Recommended The recommendation includes funding for requested services and supplies. Capital Assets Requested The department budget request includes funding for accreditation software and two replacement vehicles. The department budget request includes a transfer to the Capital Projects Fund to remodel the Public Health Laboratory. Recommended The recommendation includes requested capital assets. The recommendation includes a transfer of $724,304 from the General Fund to the Public Health Fund for the Maintenance of Effort as required by State law. The recommendation includes a transfer of 10%, estimated to be $1,195,962, of realignment revenues from the Public Health Fund to the Welfare Fund. The recommended transfer reduces the General Fund contribution to the Department of Employment and Social Services. 230

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