Health Services Agency
Overview
Mission Statement
To promote and ensure a healthy community and environment by providing education, outreach, and comprehensive health services in an inclusive and accessible manner.
Department Overview
The Health Services Agency exists to enhance, protect and improve the health of the people in Santa Cruz County. To accomplish this, the Department provides a wide variety of health-related services in the areas of public health, environmental health, behavioral health and health center services.
Budget Summary
Department Budget Overview
Budget Summary of Changes
The Health Services Agency (HSA) budget makes important investments in ensuring a healthy community and environment by implementing strategies to support the local rollout of CalAIM (California’s transformation of the Medi-Cal system), increasing the number of local beds available to serve children in mental health crisis, expanding the mobile crisis response to a 24/7/365 model, expanding substance use treatment programs and residential treatment capacity, and advancing environmental, public, and health care services for our communities most vulnerable. The budget includes scheduled and negotiated salary and benefit increases. Facilities improvements in the budget include an HVAC system in the Homeless Persons Health Project Health Center space, a new Children’s Crisis Center (encompassing a crisis stabilization programming and residential facility), and the development of a new 34-bed Low-Barrier Navigation Center for behavioral health clients.
The budget recommends staffing of 725.25 full-time equivalent (FTE) positions, which includes unfunding 18.60 FTE positions, deleting 36.5 FTE, of which, 28.0 FTE limited term positions are set to expire on June 30, 2024, as a result of sunsetting COVID-19 related funds, and adding 12.75 FTE positions, for a net reduction of 42.35 FTE positions. The changes by division include: unfunding of 1.0 FTE Chief of Psychiatry, 1.0 FTE move into Behavioral Health, add of 8.0 FTE, and delete of 5.5 FTE, for a net addition of 2.50 FTE positions in Behavioral Health to increase administrative support to clinical staff, resulting in greater efficiency for client facing positions; unfunding 7.8 FTE positions in Health Centers and an addition of 0.75 FTE Clinic Nurse II positions to increase service provision and enable broader access to care for a net decrease of 7.05 FTE; unfunding 1.0 FTE position in Environmental Health; no changes in Health Benefits; unfunding 8.8 FTE, deleting 31.0 FTE, Deleting 3.0 unfunded FTE, addition of 4.0 FTE, and 1.0 FTE move out of Public Health for a net reduction of 36.8 FTE positions in Public Health due sunsetting of pandemic-related funding, with additional investments to implement the Future of Public Health grant; and no position changes recommended in Administration.
Supplemental Budget Summary of Changes
The Supplemental Budget deletes 1.0 FTE Administrative Aide in Administration and 1.0 FTE Medical Assistant and 1.0 FTE Office Assistant II in Health Centers. The budget also adds 1.0 FTE Administrative Aide in Health Centers, funded through Ryan White grant funds, and 1.0 FTE limited-term Mental Health Client Specialist I in Public Health, funded through the California Overdose Prevention and Harm Reduction Initiative (COPHRI).
Additionally, the Supplemental Budget funds the following existing unfunded positions: 1.0 FTE Public Health Nurse II, 1.0 FTE Physician Assistant/Nurse Practitioner, and 1.0 FTE Medial Assistant in Health Centers, funded through increased outpatient clinics revenue, and 1.0 FTE limited-term Senior Health Educator in Behavioral Health funded through Opioid Settlement Agreement funds.
The Proposed and Supplemental Budgets funded staffing includes the net deletion of 37.55 FTE positions for a total of 730.05 FTE funded positions.
Last Day Budget Summary of Changes
The Last Day Budget adds $244,512 in expenditures and $200,000 in revenues for HSA’s CARE Act implementation. This requires an increase of $44,512 in General Fund contribution funded by a reduction in General Fund Contingency.
Adopted Budget Summary of Changes
The Adopted Budget adds $23,380,126 in expenditures and $23,355,970 in revenues. The changes are from $23,861,285 in 2023-24 revenue agreements and $23,215,296 in related appropriations that continue into 2024-25. They also include $24,156 in 2023-24 unspent contract expenditures that continue into 2024-25, and $505,315 in reduced expenditures and $140,674 in added revenues from 2024-25 concluding budget actions.
District Sales Tax Contribution
The General Fund Contingencies budget includes a new District Sales Tax contribution of $400,000 for behavioral health room and board expenses in licensed residential facilities in unincorporated areas. This contribution will be transferred to Behavioral Health in 2024-25.
Open the Services Overview or Operational Plan Objectives below for more details.
Department Services and Objectives
Footnotes
1 – Indicates change from FY 2021-22 Allowed Budget
2 – General Fund Contribution is the share of General County Revenues (primarily property tax and other local taxes) allocated to each department. Other funds that contribute to this budget are shown on the Budget Details page.
3 – Indicates change from FY 2021-22 Adjusted Funded Positions (including Board-approved mid-year changes as of April 1, 2022).
Budget Details
The charts below show department expenditures and revenues by division and service. Click on the pie charts to drill down for more detail. Complete detail can be found on the County's Transparency Portal.
Expenses by Service
Expenses and Revenues over time
Personnel Details
The chart below provides the department personnel detail by division, service, and classification.