BOARD OF SUPERVISORS

Gloria Molina

First District

Yvonne Brathwaite Burke

Second District

Zev YaroslavskyThird District

Don KnabeFourth District

FRED LEAFChief Operating officer Michael 0. Antonovich

Fifth DistrictCOUNTY OF LOS fl-JGELESDEPARTMENT DF HEALTH SERVICES313 N. Figueroa, Los Angeles, CA 90012

(213) 240-8101

September16,2004

The HonorableBoardof SupervisorsCountyofLos Angeles383 KennethHahnHall ofAdministration500 WestTempleStreetLos Angeles,California90012

Dear Supervisors:

FISCAL YEAR 2003-04YEAR-END APPROPRIATIONADJUSTMENT

(All Districts) (4 Votes)

IT IS RECOMMENDEDTHAT YOUR BOARD:

1 ApprovetheattachedFiscal Year (FY) 2003-04Year-EndAppropriationAdjustment(AA)(AttachmentI) for theDepartmentof HealthServices(DHS) to increasethedesignationbalance,asofJune30, 2004, to $568.7million, comprisedof a $215.6million Fiscal Year 2003-04actualoperatingsurplus,andan existing $353.1million designationbalancefrom prior fiscal years;andto reallocatecertainappropriationsandrevenueswithin theDepartmentto align themwith FY2003-04final experience.This AA establisheda$126.9million reservedaccountfor long-termreceivablesfrom thedesignationfor estimatedCost BasedRevenueClinics (CBRC) collections.

2. Approve the attachedFY 2003-04AA (AttachmentJI) to reallocateandadjustthe appropriationandrevenuerelatedto the PersonalAssistanceServicesCouncil-ServiceEmployeesInternationalUnion (PASC-SEIU),In-HomeSupportiveServices(IHSS)HealthCarePlan in accordancewithFY 2003-04final experienceand to reducethe transferof funding to theDepartmentof PublicSocial Services(DPSS)by $1.5 million.

3. ApprovetheattachedFY 2003-04AA (Attachment1.11) to realigntheavailablefunding for the

MeasureB SpecialRevenuefund in accordancewith FY 2003-04final experience.

PURPOSE/JUSTIFICATIONOF RECOMMENDEDACTIONS:

The Board’sapprovaloftheseAA’s (AttachmentsI - III) for FY 2003-04will:

1. Increasetotal DHS funds, asofJune30, 2004, to $568.7 million in thedesignation,comprisedofa $215.6million FY 2003-04actualoperatingsurplus(AttachmentIV) andtheexisting $353.1million designationbalancefrom prior fiscal years. This is $36.1 million morethanthe forecastin our June10, 2004 ‘Fiscal Outlook’. This varianceis principally due increasedVehicleLicenseFeeestimatesof $12.1 million; increasedone-timerevenuerelatedto mentalhealthservicesof$11.6million for third party liability cancellations,audit settlements,andoverrealizedrevenue;reduceddebtservicecostsfor the LAC +USC Medical Centerreplacementfacility of

THOMAS L. GARThWAJTE, M.D.Director and Chief Medical Officer

The HonorableBoardof SupervisorsSeptember16, 2004Page2

$5.2 million; increasedprior yearStaterevenuefor Children’s Medical Servicesof $4.0 million;increasedSB 1732 revenueof $1.1 million; and variousotherchangesof $2.1 million overestimatespreviouslyreportedin the above-mentioned‘Fiscal Outlook’.

2. Reallocatecertainappropriationsandrevenueswithin DHS to align them with the Department’sFY 2003-04final experience.

3. Transfer$126.9million to a reservedaccountfor long-termreceivableswithin the designationforestimatedCBRC collections. Of the $568.7million designationbalanceat the end of FY 03-04,the Auditor-Controller(A-C) hasplaced$126.9million in a reserveaccountfor long-termreceivablesrelatingto CBRC revenuepayments,for CBRC servicesprovidedthroughJune30,2004,that will likely not be receivedby June30, 2005. The expecteddelay in receivingthesepaymentsfrom the Stateis due to the time beingtakento completetheir annualauditsof CBRCcostreports. Sincethe State is payingus for CBRC servicesbasedon highly conservativeinterim rates,pendingcompletionof its CBRC costreportaudits, the interim paymentsareexpectedto be muchlessthan the final reimbursementmadeafter auditcompletion. Theconsequenceof placinga portionof the designationbalancein the reserveaccountis that suchfundsare not availablefor use in the following fiscalyear.

4. Align DHS appropriationsand revenuesrelatedto the PASC-SEIUIHSS Health CarePlan withFY 2003-04final experience,andreducethe transferof funding to DPSSby $1.5 millionresultingfrom lower thanexpectedoperatingactivity.

5. Align AppropriationsMeasureB SpecialRevenuefund in accordancewith FY 2003-04final

experience.

FISCAL IMPACT/FINANCING:

The recommendedactionsadjustthe variousDepartmentalbudgetsto reflect DHS’ actual financialexperiencefor FY 2003-04. It alsoincreasesthe designationbalanceto $568.7million, as of June30,2004,of which $126.9was placedin a reservedaccountfor long-termreceivablesfrom thedesignationfor estimatedCBRC collections.

On December2, 2003 your BoardapprovedAuditor-Controllerrecommendedguidelinesformonitoringthe LAC +USC Medical CenterAccumulativeCapitalOutlay(ACO) Fund establishedinFY 1998-99for the purposeof purchasingnew equipmentfor the LAC+USC Medical CenterReplacementProject. In accordancewith thoseguidelines,we are reportingthat $105.0million wastransferredinto the ProvisionalFinancingUsesof the ACO fund during FY 2003-04. No expenditureshavebeenmadeto datefrom the ACO fund, andno encumbranceshavebeenestablished.However,$1.2 million in interesthasbeenearnedon the balancein FY 2003-04,bringing the total endingbalanceto $106.2million.

FACTS AND PROVISIONS/LEGALREOUIREMENTS:

Not applicable.

CONTRACTING PROCESS:

Not applicable.

IMPACT ON CURRENTSERVICES(OR PROJECTS):

This Year-EndAA hasno impacton currentservices.

The HonorableBoardofSupervisorSeptember16, 2004Page3

When approved,this Departmentrequiresthreesignedcopiesof the Board’saction.

R spectfull submitted,

Thomas G waite, M.D.

DirectoranffChiefMedical Officer

TLG:mm

Attachments(4)

c: ChiefAdministrative OfficerCountyCounselExecutiveOfficer, Board ofSupervisorsAuditor-Controller

YRENDBAO4.doc

flA._Lfl%._i .U~iLa’~J_ ~• .jr:-;~~ ~

nfl 55ZM Ill8~

COUNTY OF Los ANGELES

REQUEST FOR APPROPRIATION ADJUSTMENT _____________

DEPARTMENT OF Health Services September 7 k92004

AUDITOR-CONTROLLER.THE FOLLOWING APPROPRIATION ADJUSTMENT IS DEEMED NECESSARY BY THIS DEPARTMENT. WILL YOU PLEASE REPORT AS TO

ACCOUNTING AND AVAILABLE BALANCES AND FORWARD TO THE CHIEF ADMINISTRATIVE OFFICER FOR HIS RECOMMENDATION ORACTION. ADJUSTMENT REQUESTED AND REASONS THEREFOR

BIlEG~7TADJIJ4IENT

FISCAL YEAR 2003—04

4-VOTE

See attached for details

Justification:This budget adjustment is necessary to properly reflect total DM5 surplus funds in theHospital Enterprise Funds, increase to $568.7 million the DM5 Hospital Enterprise FundDesignation for future use, and reallocate closing appropriation and revenues within DM5.This budget adjustment does not affect Cperating Subsidy.

F)4:rn9/7/04

~4f~ain Mun07, Chief

CHIEF ADMINISTRATIVE OFFIcERS REPORT —~ DHS—Contro]jer’ s Division

REFERRED TO THE CHIEF ACTION APPROVED AS REQUESTEDADMINISTRATIVE OFFICER FOR— ~,_t RECOMMENDATION *51ht#cAict /

/1 APPROVED (AS REVISED):_____________________ 19AUDITOR-CONTROLLER BY LtTh~-tV /1,p..-’ BOARD OF SUPERJISORS

NO 34! A SEP7 g~ __________

DWUTY COUNTY CLEaR

Srno e COPI ES TO ThE AUDITOR-CONTROLLER

AUACHMENT I-BPage 1 of 6

DEPARTMENT OF HEALTH SERVICES

YEAR-END BUDGET ADJUSTMENTFISCAl YEAR 2003

4- VOTE

SOSE& usa

LAC÷uscHealthcare Network LAC+ USC Healthcare NetworkMN4-HG-60010-3306 MN4-HG-60010-6100Approp, For Cont-Canc lA/P& Commit) $ 3,933,000 Other Financing Uses $ 16,484,000

MN4-HO-60010-1000 MN4-HG-60010-991 ISalaries & Employee Benefits 33,630,000 Operating Transfer In 14,313,000

MN4-HG-6001O-2000 MN4-HG-60010-9912Services and Supplies 21,512,000 Operating Subsidy 91,948,000

MN4-HG-60010-5500Other Charges 11,502,000

MN4-HG-60010-R21 2Medi-Cal HMO 6,189,000

MN4-HG’6001 0-9435Medicare 6,068,000

MN 4-HG-600 10’9 9 10Operating Transfers In’ Measure B 18,602,000

MN4’HG-6001 0-9433Medi-Cal 21,309,000

Total Northeast Area $ 122,745,000 $ 122,745,000

Ooastal Area (H/UCLA Medical Center) coastal AreaMN1-HH-60020-3306 MN1-HH-60020-6100Approp. For Cont-Canc lA/P& Commit) $ 760.000 Other Financing Uses $ 8,104,000

MN1-HH-60020-1000 MN1 -HH-60020-9910Salaries & Employee Benefits 15,026,000 Operating Transfers In - Measure B 2,023,000

MN1-HH-60020-2000 MN1-HH-60020-991 1Services and Supplies 10,150,000 Operating Transfer In 4,597,000

MN1-HH-60020-5500 MN1-HH-60020-991 2Other Charges 4,939,000 Operating Subsidy 27,678,000

MN1-HH-60020-R21 2Medi-Cal HMO 6.062,000

MN1-HH-60020-9435Medicare 817.000

MN 1 -HH-60020-9423Self-Pay 4,648,000

Total Coastal Area $ 42,402.000 $ 42,402,000

wsat~ 5:55 PM

t?’~T1 34/ 1

ATTACHMENT I-BPage 2 of 6

OFPA RTMENT OF HEAL TH SER VICESYEAR-EN~BtiD~ETADJUSTMENT

FISCAL YEAR 2003,04

4-VOTE

usa

Southwest Area (MLK/D Medical Center) Southwest AreaMNS-HK-60030-33O6 MNS-HK-60030-6100Approp. For Cont-Canc IA/P& Commitl $ 586,000 Other Financing Uses $ 8,950,000

MN5-HK-60030-1 000 MNS-HK-60030-991 0Salaries & Employee Benefits 5,798,000 Operating Transfers In - Measure B 3,01 9,000

MNS-HK-60030-2000 MN5-HK-60030-991 1Services and Supplies 3,653,000 Operating Trans In 5,249,000

MNS-HK-60030-5500 MNS-HK-60030-991 2Other Charges 3,812,000 Operating Subsidy 1,129,000

MNS-HK-60030-821 2Medi-Cal HMO 3,907,000

MNS-HK-6003O-9820Mental Health - Patienf Care/Non FFP 591,000

Total Southwest Area $ 18,347,000 $ 18,347,000

Rancho Los Amigos Medical Center Sancho Los Amigos Medical CenterMN7-HR-60040-3306Approp, For Cont-Canc IA/P& Commitl $ 229,000 MN7-HR-60040-6100

Other Financing Uses $ 3,752,000MN7-HR-60040-1 000Salaries & Employee Benefits 11,925,000 MN7-HR-60040-991 1

Operating Transfer In 3,200,000MN7-HB-60040-2000Services & Supplies 13,057,000 MN7-HR-60040-991 2

Operating Subsidy 27,197,000MN7-HR-60040-5500Other Charges 2,102,000

MN7-HR-60040-9435Medicare 6,836,000

Total Rancho Los Amigos $ 34,149,000 $ 34,149,000

San Fernando Valley Area (OV/UCLA Medical Center) San Fernando Valley AreaMN3-HO-60050-33O6 MN3-HO-60050-5500Approp. For Cont-Canc IAIP& Commitl $ 278,000 Other Charges $ 1,022,000

MN3-HO-6005O-1 000 MN3-HO-6005O-61 00Salaries & Employee Benefits 5,076.000 Other Financing Uses 6,005,000

MN3-HO-60050-2000 MN3-HO-60050-9910Services and Supplies 2,724,000 Operating Transfers In - Measure B 13,560,000

MN3-HO-60050-R21 2 MN3-H0-60050-991 1Medi-Cal HMO 3,867,000 Operating Transfer In 2,730,000

MN3-HO-60050-9435Medicare 5,973,000

MN3-HO-60050-991 2Operating Subsidy 5,399,000

Total San Fernando Valley Area $ 23,317,000 $ 23,317,000

5” ~ •~-P,,.- ,5_~PQ5S555PS0P559

aA555~SAC A5A5&255A 555PM

J?~’~341 ci ~ j,cc4

ATTACHMENT I-B

Page 3 of 6DEPA STM E N T OF HEA LTH SFR VICES

YEAR-END BUDGET ADJUSTMENTFISCALYEAR2003-04

4-VOTE

501 lACES’ usa

Antelope Valley Area (High Desert Hospital) Antelope Valley AreaMN6-HD-60060-1 000 MN6-H0-60060-991 1Salaries & Employee Benefits $ 1,113,000 Operating Transfer In $ 1,719,000

MN6-HD-60060-2000 MN6-H0-60060-991 2Services and Supplies 4,376000 Operating Subsidy 3,770,000

Tote] Antelope Valley Area $ 5,489,000 S 5,489,000

SB 855 Enterprise Fund SB 855 Enterprise FundMN2-HS-6007O-991 2 MN2-HS-60070-3085Operating Subsidy $ 183,874,000 Designation for OHS $ 88,755,000

MN2-HS-6007O-61 00 MN2-HS-6007O-3026Other Financing Uses 31,808,000 Reserve for OHS Long Term Receivables $ 126,927,000

Tota] SB 855 Enterprise Fund $ 215,682,000 $ 215,682,000

Total Enterprise Fund $ 462,131,000 $ 462,131,000

AIDS AIDSAOl -HS-25770-3306 AOl -HS-25770-9001Approp. For Cont-Canc IAIP& Commitl $ 241,000 Federal-Other Revenue $ 4,555,000

AOl -HS-25770-1000Salaries & Employee Benefits 375,000

AOl-H S-257 70-2000Services and Supplies 4,269,000

Alcohol & Drug Alcohol & DrugAOl -HS-20400-33O6 A0l-HS-2O400-9031Approp. For Cont-Canc ]A/P& Commit] $ 1,276,000 Federal Grants S 1,305,000

Children’s Medical Services Children’s Medical ServicesAO1-HS-25740-3306 AO1-HS-25740-8831Approp. For Cont-Canc ]AIP& Commiti $ 86,000 State - Other Revenue $ 5,414,000

AOl -HS-25740-1000Salaries & Employee Benefits 6,474,000

AO1-HS-2574O-2000Services and Supplies 2,175,000

AO1-HS-2574O-5500Other Charges 1 ,009MOO

iCA,55’A,I•~C5,~5p1ss,s5.’SP5CA—,osAC5o44.c)As} SS~2O5, 555PM

y~ 3*1 A- ‘7- ~-JcO4

ATTACHMENT I-BPage 4 of 6

DEPARTMENT OF HEALTH SERVICESYEAR-END BUDGET ADJUSTMENT

FISCAIYEAR200S-04

4-VOTE

son usa

Public Health Services Public Health ServicesAOl -HS-23450-33O6 AO1-HS-2345O-883lApprop. For Cont-Canc ]A/P& Commit] $ 2,195,000 State - Other Revenue $ 10,290,000

AOl -HS-2345O-l 000 AO1-HS-23450-9001Salaries & Employee Benefits 10,772,000 Federal - Other Revenue 10,719,000

AO1-HS-2345O-2000 -

Services and Supplies 16,284,000

A01-HS-23450-5500Other Charges 1,043,000

AOl -HS-23450-6030Equipment 466,000

Health Services Administration Health Services AdministrationAOl -HS-20000-3306 AOl -HS-20000-9426Approp. For Cont-Canc ]AIP& Commit] $ 8,39L000 Community Health Plan $ 26,076,000

AOl -HS-20000-l000 AOl-HS-20000-9825Salaries & Employee Benefits 4,735,000 Other General Fund Dept 30,005,000

AO1-HS-20000-2000Services and Supplies 31,276,000

AOl-HS-20000-5500Other Charges 1,107,000

AOl -HS-20000-6O3OEquipment 2,001,000

Office of Managed Care Office of Managed CareA0l-HP-l 9975-3306 AOl-HP-i 9975-9426Approp. For Cont-Canc ]A/P& Commit] $ 1,594,000 CHP - Medi-Cal $ 15,795,000

AOl-HP-i 9975-2000 AOl-HP-i 9975-R206Services and Supplies 23,850,000 CHP - Healthy Families 1,856,000

AO1-HP-l9975-942AIn-Home Supportive Services 6,705,000

Juvenile Court Health Services

AOl -HS-20600-33O6Approp. For Cont-Canc ]A/P& Commit] $ 5,000

AO1-HS-20600-1000Salaries and Employee Benefits $ 1,913,000

Aol -HS-20600-2000Service & Supplies 1,688,000

AOl -HS-2O600-5500Other Charges 111,000

AOl -HS-20600-9307CBRC 659,000

AO1-HS-2O600-B771Other State Aid - Health 316,000

CA5Co~555PM

13”iff 341

ATTACHMENT P-BPage 5 of 6

OFPA RTM FNT OF HFALTH SERVICESYEAR-END BUDGET ADJUSTMENT

4-VOTE

usa

General Fund - Health General Fund - HealthAOl -HS-l 9998-9299 A0l-HS-l 9998-5500Other Financing Sources Genera] Fund Heelthcare $ 43,181.000 Other Charges $ 43,181,000

Realignment (Sales Tax)AOl-HS-i 9999-8899Sales Tax $ 96,000

Non-Departmental Revenue IVLF)AOl-ND-I0001-8716State Vehicle License Fee - AB 1288 $ 23,213,000

H/UCLA Surgery Emergency RoomAOl -HS-771 76-6014Fixed Assets - Building & lmprov. 927,000

El Monte CHC Seismic RetroAOl -HS-865O5-6014Fixed Assets - Building & lmprov, 230,000

Central HC Seismic RetroAO1-HS-86509-601 4Fixed Assets - Building & Improv. 429,000

Hudson CHC Seismic RetroAO1-HS-86514-60l4Fixed Assets - Building & lmprov. 726,000

H/UCLA Refurb Parlow LibraryA0i-H5-86516-60l4Fixed Assets - Building & lmprov. 125,000

Central HC X-Ray SpaceAOl -HS-865 71-6014Fixed Assets - Building & lmprov. 214,000

c,ssspes 55-SA SACS555 AP~2XA 5:55PM

/3A*134; .~i

ATTACHMENT I-BPage 6 of 6

OFPAATM E NT OF HF ALTH SERVICESYEAR-END BIIDG FT ADJU STMENT

FISC4LYFAR200,~-04

4-VOTE

usa

General Fund Subsidy - ILAC + USC Hlthcare Network)AO1-AC-2l 224-6100Operating Transfers Out $ 91,948,000

General Fund Subsidy - (Coastal Area)AOi-AC-21 226-6100Operating Transfers Out $ 27,678,000

General Fund Subsidy (Southwest Area)AO1-AC-2l228-6100Operating Transfers Out S 1,129,000

General Fund Subsidy - (RLA)A01-AC-21 230-6100Operating Transfers Out $ 27,197,000

General Fund Subsidy - (San Fernando Valley Area)AO 1 -AC-2 1232-6100Operating Transfers Out $ 5,399,000

General Fund Subsidy - (Antelope Valley Area)AOl -AC-2 1234-6100Operating Transfers Out $ 3,770,000

General Fund Subsidy - (SB 855 Enterprise Fund)Aol -AC-2 1236-6100Operating Transfers Out $ 183,874,000

Total General Fund $ 345,174,000 $ 345,174.000

Total Department S 807,305.000 $ 807,305,000

Noted & Approved:

in Munoz, Chief: Contoller’s Divisionepartment of Health Services Final

,‘,,,C~s,s,S•APA’d55PA5,55A5 CAS’SAA CS-CA SACS ,CS ~S525CA555:9:

~C14~34I ~ 9-j- ~cC~

. .A, SIN 352M 111*3 . -

COUNTY OF LOS ANGELES

REQUEST FOR APPROPRIATION ADJUSTMENT ft~’DEPARTMENT OF HEALTH SERVICES AUGUST 13,~ 2004

AUDITOR-CONTROLLER,THE FOLLOWING APPROPRIATION ADJUSTMENT IS DEEMED NECESSARY BY THIS DEPARTMENT, WILL YOU PLEASE REPORT As TO

ACCOUNTING AND AVAILABLE BALANCES AND FORWARD TO THE CHIEF ADMINISTRATIVE OFFICER FOR HIS RECOMMENDATION ORACTION, ADJUSTMENT REQUESTED AND REASONS THEREFOR

BUDGET ADJUSTMENTFISCAL YEAR 2003—04

4-VOTE

See attached for details

Justification:This budget adjustment is necessary to reallocate and adjust appropriationand revenue within the Department of Health Services (DHS) specificallyrelated to the Personal Assistance Services Council—Services EmployeesInternational Union (PASC—SEIU), In—Home Support Services (IHSS) HealthCare Plan, and to recover $l.543 million of unused funding from theDepartment of Public Social Services (DPSS).

EM: fl8/13/04

E$~�Munoz, ChiefCHIEF ADMINISTRATIVE OFFICER’S REPORT ~~S—Controller ‘s Division

REFERRED TO THE CHIEF ACTIONADMINISTRATIVE OFFICER FOR—

RECOMMENDATION

APPROVED (AS REVISED)t 19AUDITOR-CONTROLLER BY BOARD OF SUPER JISORS

No. 332 I,~ BY

DEPUTY COUNTY Cl-IRK

SEND S COPIEs TO ThE AUDITOR-CONTROLLER

SOURCES:

DEPARTMENT OF HEALTH SERVICESIHSS HEALTH BENEFITS PROGRAM

FISCAL YEAR 2003-04

4-VOTE

USES:

LAC÷USCHealthcare Network

MN4-HG-6001O-991 2

Operating Subsidy $ 713,000

LAC+USC Healthcare Network

MN4-HG-60010-942A

CHP Medi-CaI (IHSS) Revenue $ 713,000

Total Northeast Area

Coastal Area (HIUCLA Medical Center)MN1-HH-60020-9912

Operating Subsidy

Total Coastal Area

Southwest Area (MLK/D Medical Center)

MNS-HK-60030-991 2

Operating Subsidy

Total Southwest Area

Operating Subsidy

Total San Fernando Valley Area

Antelope Valley Area (High Desert Hospital)

MN6-l-ID-60060-991 2

Operating Subsidy

Total Antelope Valley Area

Total Enterprise Fund

~~33 ~

S 713,000

5 263,000

5 263,000

5 211,000

S 211,000

5 286,000

Coastal AreaMN1-HH-60020-942A

CHP Medi-Cal (lHSS) Revenue

Southwest Area

MN5-HK-60030-942A

CHP Medi-Cal (Il-ISS) Revenue

San Fernando Valley AreaMN3-HO-60050-942ACHP Medi-CaI (IHSS) Revenue

Antelope Valley AreaMN6-HD-60060-942A

S 70,000 CHP Medi-CaI (IHSS) Revenue

S 70.000

S 1,543,000

San Fernando Valley Area {OV/UcLA Medical Center)MN3-HO-60050-991 2

$ 286,000

S 713,000

5 263,000

5 263,000

5 211,000

S 211,000

5 286,000

S 286,000

5 70,000

5 70,000

S 1,543,000

SOURCES:

DEPARTMENT OF HEALTH SERVICESIHSS HEALTH BENEFITS PROGRAM

FISCAL YEAR 2003-04

4-VOTE

USES:

General Fund Subsidy - (LAC+USC HealthCare Network)AO1-AC-21 224-6100Operating Transfers Out S

General Fund Subsidy - (Coastal Area)

AO1-AC-21226-6100Operating Transfers OUt

General Fund Subsidy - (Southwest Area)AO1-AC-21 228-6100Operating Transfers Out

General Fund Subsidy - (San Fernando Valley Area)

AO1-AC-21232-6100

Operating Transfers OUt

General Fund Subsidy -(Antelope Valley Area)AOl -AC-21234-6100Operating Transfers Out

713,000

263,000

211,000

286,000

70,000

~-~$ 1,543.000

S 3,086,000

Noted & Approved:

Ef~JiasrI6tChief, Contoller’s Division

Department of Health Services

m:\exceRfl\omc\omcO3O4\[ihss closing ba-0304.xls]dhs

Total General Fund

Total Department

$

S 1,543,000

L3M~33S g~i~-2004

,,,..UOIU,S’SUU4 ,LD:s4 faa £1.4 044 ~0~0 £DLIAA1IA rsa%,,as. Vttd’

DEPARTMENT OF PUBLIC SOCIAL SERVICESIHSS HEALTH BENEFITS PROGRAM

A FISCAL YEAR 2003-04

4-VOTE

SOURCES: USES:

AOl -SS-2641 0-2000IHSS-Services and Supplies $1,543,000

Total Department Si,1543.000 .1: 0

Noted & Approved:

tandy ‘~l~1r~4a,Director, FiscalOperationsDepartmen~tfPublic Social Services

(74 ~ C~-f3-~co4

DEPARTMENT OF PUBLIC SOCIAL SERVICESIHSS HEALTH BENEFITS PROGRAM

FISCAL YEAR 2003-04

4-VOTE

SOURCES: USES:

AOl -SS-26410-2000IHSS-Services and Supplies $1,543,000

Total Department ________

Noted & Approved:

Uandy Yo~in~g/Director, Fiscal Operations

Depadme~(tof-’Public Social Services

~ 33~’I ~ -.2cO 4-

76R 352M I~/ø2

. .COUNTY OF LOS ANGELES

REQUEST FOR APPROPRIATION ADJUSTMENT

DEPARTMENT_OF _________________

AUDITOR-CONTROLLER.THE FOLLOWING APPROPRIATION ADJUSTMENT IS DEEMED NECESSARY BY THIS DEPARTMENT. WILL YOU PLEASE REPORT As TO

ACCOUNTING AND AVAILABLE BALANCES AND FORWARD TO THE CHIEF ADMINISTRATIVE OFFICER FOR HIS RECOMMENDATION ORACTION

See attached for details

Justification:

ADJUSTMENT REQUESTED AND REASONS THEREFOR

BUDGET ADJUSTMENT

FISCAL YEAR 2003—04

4-VOTE

This budget adjustment is necessary to realign the available funding for oçerating transfersout to various DHS hospitals for the MeasureB Special Revenue fund in Fl 2003—04.

EM:m9/7/04

,Ifr~C~unoz, ChiefCHIEF ADMINISTRATIVE OFFICER’S REPORT ~a~S_ControllerIs Division

REFERRED TO THE CHIEFADMINISTRATIVE OFFICER FOR—

ACTI ON

‘/‘ RECOMMENDATION

(I~r~~APPROVED (AS REVISED):BOARD OF SUPERIISORS

DEPUTY COUNTY CLERK

Health Services

DEPT’S.No

Septetter7,y42004

AUDITOR-CONTROLLER BY

NO.34! a

VAPPROVED AS REQUESTED

9~ih4V!S~7~L pgBY

19

SEND S COPIES TO mE AuDITOR-CON’rnoLLER

A1TACHMENT IIIABPage 1 of 1

DEPARTMENT OF HEALTh SERVICESMEASURE B BUDGET ADJUSTMENT

FISCAL VFAR 2003

4-VOTE

Measure B - Harbor/UcLA Medical Center Measure B - LAC+USC Medical CenterBW9~HS-41012-6100 BW9AHS.4101 4-6100Operating Transfers Out $ 2,023,000 Operating Transfers Out $ 18,602,000

Measure B - King/Drew Medical Center8W9-HS-41 015-6100Operating Transfers Out $ 3,01 9.000

Measure B A Olive View Medical CenterBW9~HS-41013-6100Operating Transfers Out $ 13,560,000

Total S 18,602,000 S 18,602,000

Noted & Approved:

Efr ‘ noz, Chief, Contoller’s Divisionrtment of Health Services Final

5~ S~i2tO~ ACtA~&

S&P7~7ioc4

ATrACHMENT IVPage 1 of 1

DEPARTMENT OF HEALTH SERVICESSUMMARY EXPLANATION OF BUDGETARY VARIANCES

FISCAL YEAR 2003-04($ In Millions)

Sources FY 2003-04

Surplus from Operations:

- current Fiscal Year $ 19.1

- Prior Fiscal Years 14.2Subtotal $ 33.3

Extraordinary Expenditure Variances:- Hiring Delays/Freezes $ 25.3- Employee Benefits 10.1- Clinical Resources Management 20.6 8)

- Other Charges 26.3 (C)

- Fixed Asset Surplus 3.5- Commitment/Payables cancellations 21.0- Capital Projects 2.7

Subtotal $ 109.5

Extraordinary Funding Variances:- Medi-Cal $ (25.3) (0)

-AB915 23.2 IE)

- CBRC (35.0) (F)

- SB 855 20.9 (6)- 1115 Waiver Administrative Cost Reimbursement 2.0- Tobacco Tax (CHIP) 1.5- Mental Health Services 11.6- Reimbursement Settlements 20.8- Sales Tax 0.1- Vehicle License Fees 23.2- CHP Equity Distribution 29.8

Subtotal $ 72.8

Total Fiscal Year 2002-03 $ 215.6

Other:- Designation Balance $ 353.1

June 30, 2004 Designation Balance $ 568.7

Notes:(A) Reflects the inability to fill the AB 394 Nursing Staffing Ratio items.(B) Surplus primarily due to program implementation delays based on the

unavailability of necessary technology solutions.(C) Surplus primarily due to reduced medical malpractice ($16.8M), reduceddebt

service for the LAC+USC replacement facility ($5.2M), reducedinterest expense($2.OM), and various other surplus ($2.3M).

(0) Deficit due to increased TAR denial rates.(C) This revenue was not budgeted in FY 03-04 due to uncertainty over CMS

approval, however, CMS finally approved in September 2003.(F) Deficit primarily due to latest audit results and revised outpatient visits.

(°) Surplus primarily due to DSH cliff relief in the Medicare Prescription Drug Bill andOBRA ‘93 DSH cap relief.

(H) Surplus due to third party liability cancellations, audit settlements, overrealizednon-patient care revenue and overrealized FFP revenue.

(I) Per final estimates provided by CAO.I”) Surplus due to liquidation of the CHP Equity Trust Fund per A-C requirements.

(m:kexcel\acc,ual\schedo4\closingba\budvarexP.xIS) 9/16/2004 12:13 PM