Transcript Document

INTRO TO PUBLIC HEALTH ADMIN,
GRANTS & REPORTS
Presentation to the AMSSA Conference
June 24, 2014
Dave Greeman, Budget Director
MDH Mission
• To protect, maintain and improve the health of all
Minnesotans
• Health Protection
• Health Improvement
• Health Care Reform
Departmental Program Structure
Health Improvement Bureau
Health Protection Bureau
• Community and Family Health
• Environmental Health
• Health Promotion and Chronic
• Infectious Disease Epid.,
Disease
• Center for Health Equity
• Office of Statewide Health
Improvement
Prevention and Control
• Public Health Laboratory
• Office of Emergency
Preparedness
Policy, Quality and
Compliance Bureau
Administrative Services
• Compliance Monitoring
• Human Resources
• Health Policy
• Internal Audits
• Finance and Facilities Mgmt
• Information Technology
MDH Budget by Funding Source
FY 2014 Budget
$595 million
General
14%
Health Care Access
6%
State Government
Special Revenue
8%
Federal
44%
Temporary Assistance
for Needy Families
2%
Medical Education 13%
Other
1%
Special Revenue
12%
How Sources of Funding Have Changed
Source
FY 2002-03
FY 2006-07
FY 2010-11
FY 2014-15
GF
16%
16%
14%
14%
SGSR
7%
8%
9%
8%
HCAF
3%
2%
7%
6%
Spec. Rev.
10%
9%
9%
12%
Federal
40%
44%
42%
46%
MERC
24%
21%
19%
13%
Largest Sources of Federal Funding
2014-15
Federal Agency
Amount
US Department of Agriculture
$235 million
Centers for Disease Control (CDC)
$101 million
Health Resources and Services Administration
(HRSA)
$77 million
Administration for Children and Families (ACF)
$25 million
Environmental Protection Agency (EPA)
$20 million
MDH Sections Most Reliant on
Federal Funds
Section
% of Funding
from Federal
Sources
Office of Emergency Preparedness
97%
Infectious Disease Epidemiology Prevention
and Control
Community and Family Health
79%
Health Promotion and Chronic Disease
63%
76%
How Funds Are Spent
Total FY 2014 Budget of $595 billion
• Grants: $393 million (66%)
• Payroll: $113 million (19%)
• Non-payroll Operating: $89 million (15%)
Staffing
Base FY 2014-15 MDH Staffing Levels
• Total FTEs: 1,264
• General Fund FTEs: 135 (10.7%)
Health Improvement
Community and Family Health
• Manages and oversees
FY 2014 $208 million
General
Fund
19%
TANF
5%
Federal
76%
programs to support families and
young children, including WIC
and family home visiting
• Provides grants and technical
assistance for pre-pregnancy
family planning
• Works with providers and local
agencies to improve health and
development screenings and
follow-up services for children
Health Improvement
Health Promotion and Chronic Disease
• Works to improve prevention and
FY 2014
$25 million
General
Fund
23%
Special
Revenue
12%
Federal
63%
Environm
ental
2%
treatment of conditions such
stroke, diabetes, asthma, arthritis,
etc.
• Operates breast and cervical
cancer screening programs for
low-income women
• Provides grants for services that
improve and protect health
including dental sealants, poison
control and asthma treatment
• Operates a statewide cancer
registry
Health Improvement
Center for Health Equity
• Collects racial, ethnic, and language
FY 2014
$6 million
data to inform policy makers about
the health of populations of color and
develops appropriate indicators to
measure progress.
• Administers the Eliminating Health
Disparities Initiative (EHDI) grant
program
• Connects populations of color with
MDH and local public health experts
to identify and address actions
essential to eliminating heath
disparities.
TANF
35%
General
Fund
65%
Health Improvement
Statewide Health Improvement
FY 2014
$35 million
• Supports all Minnesotans in
General
Fund
9%
Federal
34%
Health
Care
Access
56%
Other
1%
leading healthier lives, raising
healthier families and building
healthier communities by
preventing disease well before it
starts.
• Operates programs that address
the leading causes of chronic
disease, including tobacco use,
poor nutrition and lack of physical
activity
• Operates tobacco cessation
programs throughout the state
Policy, Quality and Compliance
Compliance Monitoring
FY 2014
$36 million
Federal
24%
• Regulates approximately 870
General
Fund
8%
SGSR
28%
Special
Revenue
40%
health and long-term care
facilities in the state, including
hospitals and nursing homes
• Regulates health-related
professionals.
• Investigates reports of
maltreatment under the
Vulnerable Adults Act
• Regulates HMOs and countybased purchasing plans in the
state
Policy, Quality and Compliance
Health Policy
• Performs research to monitor
FY 2014
$123 million
GF
5%
SGSR
4%
HCAF
12%
and understand health care
access and quality, market
conditions, and care spending.
• Develops and leads health reform
efforts
• Sets standards for primary care
clinics and certifies health care
homes
• Oversees a secure, web-based
Federal
11%
MERC
65%
Special
Revenue
3%
system for registering all
Minnesota births and deaths and
issuing certified birth/death records
• Supports rural and primary
healthcare facilities and providers
through technical assistance,
grants and workforce support
Health Protection
Environmental Health
FY 2014
$47 million
Clean
Water
12%
• Monitors the quality of drinking
General
Fund
6%
Federal
20%
Other
2%
Special
Revenue
11%
SGSR
49%
water and prevents contamination
• Protects indoor air quality from
risks associated with lead,
asbestos, radon and tobacco
smoke
• Protects the safety of food served
in commercial establishments
• Identifies and responds to
emerging environmental health
risks
Health Protection
Infectious Disease Epid., Prev. and Control
FY 2014
$34 million
• Detects, investigates and
General
Fund
11%
Special
Revenue
9%
Other
1%
Federal
79%
mitigates infectious disease
threats and outbreaks using 24/7
response capability
• Promotes vaccination to prevent
disease and provides vaccines
for low-income children
• Prevents the spread of disease
through HIV prevention grants,
providing medications for TB and
coordinating health screenings
• Prevents and investigates
foodborne disease outbreaks
Health Protection
Public Health Lab
FY 2014
$23 million
Federal
25%
• Screens newborns for over 50
Other
1%
General
Fund
10%
Special
Revenue
27%
SGSR
37%
serious congenital conditions
• Analyzes a wide variety of
environmental samples to identify
contaminants of emerging concern
• Performs tests on patient
specimens to determine the
presence or absence of diseasecausing agents
• Trains a network of microbiology
laboratories in rapid identification,
notification and referral of potential
agents of bioterrorism
Health Protection
Office of Emergency Preparedness
• Coordinates state response to
FY 2014
$15 million
Special
2%
Federal
97%
Other
1%
public health emergencies
caused by infectious disease
outbreaks, natural disasters and
criminal activities
• Maintains communication
systems to provide timely
information to providers, local
governments and the public
• Plans and oversees the
inventory and distribution
systems to disseminate
medications and medical
supplies in a public health
emergency
Administrative Services
• Manages the MDH budget to
FY 2014
$42 million
Federal
2%
General
Fund
23%
•
•
•
Special
Revenue
75%
•
ensure that resources are properly
tracked, budgets are well-planned,
and financial activities meet
standards set by federal, state and
private funders
Manages facilities space in five
metro and eight Greater Minnesota
locations
Collects and analyzes data to
measure performance of MDH in
meeting statewide goals
Operates an internal audit section
Provides legal and internal audit
services to the department
State Public Health System
Under Minnesota’s Local Public Health Act,
“a community health board [CHB] has the
general responsibility for development and
maintenance of a system of community
health services under local administration
and within a system of state guidelines and
standards.” Minn. Stat. §145A.04, subdivision 1
State Public Health System
• A CHB is the governing body for local
public health in Minnesota. A CHB may be
comprised of a single county, multiple
contiguous counties, or in a limited number
of cases, a single city.
• The powers and duties of a CHB can be
assigned to human services board.
State Public Health System
CHBS are responsible for addressing areas of
public health responsibility, which include:
(1) assuring an adequate local public health
infrastructure;
(2) promoting healthy communities and healthy
behaviors;
(3) preventing the spread of communicable
disease;
(4) protecting against environmental health
hazards; and
(5) preparing for and responding to emergencies.
Public Health Grants
• MDH operates approximately 100 grant programs
to address public health needs in the state.
• Funding for the programs comes from state and
federal sources.
• Requirements for the programs are set by the
Legislature, Congress, and state and federal
rules related to budgeting and accounting
• Grants are awarded to CHBs, local government
units and non-profits depending on the
requirements
Types of Public Health Grants
Grants are awarded either competitively or through
a formula.
• Examples of competitive grants include
• Family Planning Special Project
• Tobacco Use Prevention
• Examples of Formula Grants
• Maternal and Child Health Block Grants
• Local Public Health Grants
• Examples of Grants that combined aspects of
both a formula and competition
• Statewide Health Improvement Program
• Medical Education and Research
Timing of Grants and Grant Cycles
• Timing of federal grants and reporting cycles are
generally driven by:
• The budgeting period established by the funding agency
• The timing of obtaining legislative approval to spend federal funds.
• Many federal grants do not coincide with fiscal or
calendar year periods.
• MDH must award grants on the cycles dictated by
funders in order to ensure that the funds are
expended within the grant cycle.
Public Health Grant Payments
• The Office of Grants Management has established a
grants management policy for all state executive branch
agencies.
• The most recent update of the policy finds that cost
reimbursement is the preferred method for making grant
payments.
• Since January 1, 2013, a number of public health grants,
including the Local Public Health Act grant and the
Maternal and Child Health Block grant have been
distributed through a cost reimbursement system.
Public Health Grant Payments
• Advance payments may be allowed if an agency
believes that a grantee will account for the grant
funds and abide by the terms of the agreement.
• In order to make advance payments, agencies
must prepare a written justification.
Public Health Grant Monitoring
• State agencies must conduct one monitoring visit
per grant period for each grant over $50,000 and
once per year for grants over $250,000.
• State agencies must also conduct financial
reconciliation of grantees’ expenditures at least
once during the grant period on grants over
$50,000.
Reporting and Claiming
Administrative Costs
• Generally local government grantees that do not
have a federally approved indirect cost rate may
use an indirect cost rate equal to 10% of modified
total direct costs
• Local grantees may account for staffing costs as
direct expenditures if those costs can be directly
attributed to the program.
Local Public Health Grant
• CHBs that comply with the LPHA are eligible for
funding through the LPHA Grant
• LPHA grant funds awarded in CY 2014 totaled
$32.9 million
• LPHA grants include state General Funds,
Federal TANF funds and Federal Title V funds
• Each CHBs allocation is based on 2003
allocations for a number of categorical grants.
Local Public Health Grant
• CHBs must provide a 75% match for state funds
received through the LPHA grant.
• Funds eligible for the local match include property
taxes, reimbursements from third parties, fees,
other local funds, and donations or non-federal
grants used to address public health activities.
• CHBs may use LPHA grants to address areas of
public health responsibility and local priorities
developed through a community health
assessment and community health improvement
planning process.
Contact Information
Dave Greeman
Budget Director
Minnesota Department of Health
Phone: 651 201-5235
E-mail: [email protected]