COUNTY OF SAN MATEO

County Manager’s Office

DATE:

February 23, 2009

BOARD MEETING DATE:

March 3, 2009

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

David S. Boesch, County Manager

SUBJECT:

FY 2008-09 Mid-Year County Performance Report

RECOMMENDATION:

Accept the FY 2008-09 Mid-Year Report on the Performance of County Programs.

BACKGROUND

Countywide implementation of Outcome-Based Management (OBM) began in 1999 during the Shared Vision 2010 community process. OBM is the management system that was implemented to track the performance of all County programs toward achieving the long-term commitments and goals identified through the Shared Vision process. OBM will continue to be used to align programs and services toward the five community outcomes of Shared Vision 2025:

• Healthy Community

• Prosperous Community

• Livable Community

• Environmentally Conscious Community

• Collaborative Community

Performance reports are prepared to communicate mid-year and year-end progress of programs toward achieving performance targets established during budget development. Each program has Headline Measures selected from measures of Quality (how well we do it) and Outcomes (is anyone better off?). These Headline Measures are the most important indicators of program success, and serve to provide the reader with a quick assessment of progress toward performance targets and goals. This mid-year report contains two years of historical data and year-end estimates for the current year for each Headline Measure, along with a ü indicating whether performance targets will be met. A brief discussion is also included on trends and factors affecting performance.

DISCUSSION

County programs are expected to meet current year performance targets for 83% of Quality and Outcomes measures, exceeding the Countywide target of 75%. It is estimated that 18 of 22 departments/budget units will meet or exceed the 75% target by the end of the fiscal year. A summary of agency/department performance as well as a discussion of Headline Measures for each program is included in the attached report.

Four departments expect to come in under the 75% Countywide target, primarily due to the state of the economy, which has resulted in increased caseloads and reductions in funding

The Treasurer-Tax Collector’s Office expects to meet current year performance targets for 63% of its Quality and Outcomes measures. The current state of the economy and existing market conditions have adversely affected the level of earnings for the County Investment Pool, which is managed by the Treasurer, and collection and cost recovery efforts performed by Revenue Services.

The Human Services Agency expects to meet current year performance targets for 69% of its Quality and Outcomes measures. Of the 8 measures that are not expected to meet targets, 4 are expected to come in just under target, 3 measures will undergo methodology refinements during the next budget development cycle, and 1 is expected to come in significantly under target. This performance measure is about direct client service delivery contracts receiving on-time approval, which is estimated at 70% with a target of 95%. On-time approval results for FY 2008-09 reflect an extraordinary one-time review of all child welfare based contracts. HSA is using contract dashboards and efforts such as training and process improvements to ensure timely execution of all community based contracts.

The Department of Housing expects to meet current year performance targets for 60% of Quality and Outcomes measures. Performance has been affected by the economic situation and reductions in state and federal funding, resulting in fewer resources to the community.

The San Mateo Medical Center (SMMC) expects to meet current year performance targets for 68% of its Quality and Outcomes measures, which is a significant improvement from the prior year. The current economic environment has caused an increase in the indigent patient base in the face of resource shortfalls, staff shortages, and particularly high physician turnover rates. While a few controllable measures such as the percentage of success in achieving treatment goals have shown great improvement, other measures, such as the number of falls and the percent of inpatient days by Medicare and medical payor source, have declined because of external or uncontrollable factors. SMMC will continue performance improvement projects and committee workgroups such as the Patient Experience Initiative, Comfort Rounds, Core Measures Alert Initiative, the Endoscopy Scheduling Improvement Project, Provider at Triage Initiative, and the Outpatient Medication Safety Committee.

QUALITY AND OUTCOMES MEASURES EXPECTED TO MEET TARGETS

by Department/Agency

2006

Actual

2007

Actual

2008

Actual

2009

Estimate

Will Achieve

75% Target

Assessor- Clerk-Recorder (Page 7)

84%

76%

56%

83%

YES

Controller's Office (Page 9)

88%

65%

85%

96%

YES

County Counsel (Page 12)

80%

100%

100%

100%

YES

County Manager/Clerk of the Board (Page 12)

75%

57%

72%

87%

YES

Employee and Public Services

75%

N/A

N/A

N/A

N/A

Human Resources Department (Page 15)

N/A

100%

92%

92%

YES

Information Services Department (Page 16)

89%

100%

94%

100%

YES

Treasurer-Tax Collector (Page 17)

75%

75%

69%

63%

NO

Administration and Fiscal

81%

78%

76%

88%

YES

Child Support Services (Page 51)

80%

50%

40%

100%

YES

Human Services Agency (Page 51)

86%

67%

70%

69%

NO

Children, Youth and Family Services

83%

63%

64%

75%

YES

Department of Housing (Page 38)

67%

70%

56%

60%

NO

Department of Public Works (Page 33)

63%

79%

74%

80%

YES

Fire Protection Services (Page 28)

N/A

89%

50%

82%

YES

Parks Department (Page 31)

N/A

50%

77%

100%

YES

Planning and Building (Page 30)

N/A

75%

50%

88%

YES

Public Safety Communications (Page 27)

N/A

80%

80%

75%

YES

Real Property Services (Page 27)

N/A

80%

50%

100%

YES

Community Services

N/A

76%

69%

80%

YES

Coroner's Office (Page 19)

100%

83%

83%

83%

YES

District Attorney/Public Administrator (Page 19)

64%

67%

100%

100%

YES

Probation Department (Page 24)

68%

50%

73%

76%

YES

Sheriff's Office (Page 20)

80%

65%

77%

77%

YES

Criminal Justice

78%

61%

77%

78%

YES

Health Department (Page 40)

73%

72%

81%

96%

YES

San Mateo Medical Center (Page 48)

62%

80%

42%

68%

NO

Health System

71%

71%

72%

90%

YES

Total County

74%

72%

73%

83%

YES

FISCAL IMPACT

There is no fiscal impact related to accepting this report.