DPH reports $129M FY21–22 revenue surplus; controller adjustments and one‑time funds drive balance
November 01, 2022 | San Francisco City, San Francisco County, California
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Jenny Luigi, financial officer for the San Francisco Department of Public Health, presented the FY21–22 fourth‑quarter financial report and said the department is projecting a $129 million revenue surplus and approximately $142 million in ending fund balance before reserve deposits. Luigi said much of the increase reflects one‑time or temporary sources and formula/rate changes that commissioners should treat with caution when projecting ongoing revenue.
Key items noted included an $18.7 million controller’s office adjustment to repay prior‑year withdrawals of MRA funds; approximately $4.9 million in provider relief funds recognized as a final disbursement; a $38.5 million one‑time threshold payment under a global payment program; and a $3.27 million FMAP extension matching amount. Luigi said the department will apply positive balances to offset city general‑fund deficits and make additional deposits to the management reserve (bringing that reserve to a fully funded level of about $123 million).
Division‑level details included net patient revenue gains at Zuckerberg San Francisco General (ZSFG) partly offset by operating-cost variances driven by COVID‑related pressures; Laguna Honda Hospital saw higher per‑diem revenues but will incur recertification and contract expenses in the next fiscal year; behavioral health benefited from prior‑year settlement closeouts; primary care projected revenue shortfalls of about $4.3 million; and the health network faced shortfalls tied to MA administrative billing and Healthy San Francisco fees.
On COVID‑response funds, Luigi reported revised budget adjustments, actual spending and encumbrances that will roll into the next fiscal year; she estimated $154 million projected COVID spending with $15.7 million remaining in the COVID fund at year end. Luigi also flagged continuing‑fund accounting entries and said one line in the packet was an unreconciled carry‑forward artifact that staff will correct.
Commissioners asked clarifying questions about continuing funds, Medicaid redetermination impacts on capitation and Healthy San Francisco, and the timing of potential general‑fund reduction targets from the Mayor and Controller. Luigi said the department would monitor Medicaid redetermination and include potential impacts in future budget submissions.
No formal policy action was taken; the report will inform upcoming budget discussions.
Key items noted included an $18.7 million controller’s office adjustment to repay prior‑year withdrawals of MRA funds; approximately $4.9 million in provider relief funds recognized as a final disbursement; a $38.5 million one‑time threshold payment under a global payment program; and a $3.27 million FMAP extension matching amount. Luigi said the department will apply positive balances to offset city general‑fund deficits and make additional deposits to the management reserve (bringing that reserve to a fully funded level of about $123 million).
Division‑level details included net patient revenue gains at Zuckerberg San Francisco General (ZSFG) partly offset by operating-cost variances driven by COVID‑related pressures; Laguna Honda Hospital saw higher per‑diem revenues but will incur recertification and contract expenses in the next fiscal year; behavioral health benefited from prior‑year settlement closeouts; primary care projected revenue shortfalls of about $4.3 million; and the health network faced shortfalls tied to MA administrative billing and Healthy San Francisco fees.
On COVID‑response funds, Luigi reported revised budget adjustments, actual spending and encumbrances that will roll into the next fiscal year; she estimated $154 million projected COVID spending with $15.7 million remaining in the COVID fund at year end. Luigi also flagged continuing‑fund accounting entries and said one line in the packet was an unreconciled carry‑forward artifact that staff will correct.
Commissioners asked clarifying questions about continuing funds, Medicaid redetermination impacts on capitation and Healthy San Francisco, and the timing of potential general‑fund reduction targets from the Mayor and Controller. Luigi said the department would monitor Medicaid redetermination and include potential impacts in future budget submissions.
No formal policy action was taken; the report will inform upcoming budget discussions.
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