ADMINISTRATION OF MEDIAL SERVICES OF PUERTO RICO

PUERTO RICO MEDICAL SERVICES ADMINISTRATION

LEGAL BASIS: Law No. 66 of June 22, 1978, as amended.

MISSION: Guarantee the centralized rendering of medical assistance, maintenance, supply, and others services, to medical-hospital institutions located at the Medical Center of Puerto Rico, in order for medical services to be rendered efficiently.

ORGANIZATIONAL STRUCTURE:

The Puerto Rico Medical Services Administration is attached to the Department of Health and serves the following counseling and assistant service unit offices:

Legal Counseling and Industrial Relations

Operational Audit

Communications and Community Relations

Executive Director

Budget and Management

Fiscal Resources

Human Resources

Information Systems

GEOGRAPHICAL STRUCTURE:

The offices of the Medical Services Administration are located at the Medical Center in Río Piedras.

PROGRAM STRUCTURE:

The Medical Services Administration has the following programs:

General Management and Administration

Direct Medical Services for Patients

Operating Services

Summary of Available Agency Resources

Consolidated Budget

(In thousands of dollars)

Programs	1998	1999	2000	2001
Operating Expenditures	Expended	Expended	Current	Recommended
General Management and Administration	3,260	3,359	3,260	3,567
Direct Medical Services for Patients	70,143	177,955	70,143	70,812
Operating Services	52,956	56,798	52,956	61,753
Total, Operating Expenditures	126,359	238,112	126,359	136,132

Revenues by Source
Operating Expenditures
Joint Resolution General Budget	0	3,954	0	0
Appropriations	0	14,555	0	0
State Funds	0	6,000	0	0
Federal Funds	0	30,511	0	0
Revenues from Internal Sources	126,359	183,092	126,359	136,132
Total, Consolidated Budget	126,359	238,112	126,359	136,132

Operating Budget by Concept
Payroll and Related Costs	67,271	126,153	67,271	76,667
Facilities and Public Service Payments	7,859	30,058	7,859	9,433
Subcontracted Services	6,370	15,324	6,370	4,599
Donations, Subsidies and Distributions	42,714	58,446	42,714	41,521
Information Systems	0	1,771	0	1,771
Transportation Costs	2,140	6,358	2,140	2,140
Other Expenditures	5	2	5	1
Total, Operating Expenditures	126,359	238,112	126,359	136,132

Filled and Proposed Positions
Total Amount of Positions	2,043	1,998	*1,343	*1,343
Average Cost per Position	33	63	50	57

* Remarkably it lowers human resources which are a must to the implementation of the early retirement program of the Medical Services Administration.

ADDITIONAL STATISTICAL DATA (In dollars)

Concept	1998	1999	2000	2001
Publicity Expenses	18,862	23,578	23,578	23,578
Training Expenses	154,532	154,532	154,532	154,532

PROGRAMS

PROGRAM: General Management and Administration

Description of the Program: It provides the necessary means for the management, supervision, planning, and administration of the agency, as well as support services for the rest of the programs.

Purpose: It facilitates the work of Direct Medical Services for Patients and Operational Services by furnishing the necessary administrative support services. It conducts the managerial operation of the agency pursuant to the adopted public policy on health services for the People.

Goal:

Maintain complete effective coordination between programs and administrative management in order to facilitate and expedite efficient work between both components. These efforts are translated into conducting activities, meetings, and conferences with employees at the managerial as well as operational level.

The indicators and activities information submitted by the Agency did not comply with the Management for Results.

AVAILABLE and Proposed PROGRAM RESOURCES

Human Resources

Positions Filled	12/92	03/94	09/94	09/95	09/96	09/97	09/98	09/99	9/2000
Administrators	24	24	26	22	16	16	16	16	16
Secretaries	24	24	24	22	15	15	15	15	15
Clerical Personnel	140	140	137	137	12	20	20	20	20
Attorneys	3	3	3	3	3	3	3	3	3
Others	1	1	1	1	1	1	1	1	1
Total, Positions Filled	192	192	191	185	47	55	55	55	55

Program Budget

(In thousands of dollars)

Program	1998	1999	2000	2001
Operating Expenditures	Expended	Expended	Current	Recommended
General Management and Administration	3,260	3,359	3,260	3,567
Total Budget	3,260	3,359	3,260	3,567

Revenues by Source
Operating Expenditures
Revenues from Internal Resources	3,260	3,359	3,260	3,567
Total, Revenues	3,260	3,359	3,260	3,567

Operating Budget by Concept
Payroll and Related Costs	2,398	2,502	3,398	2,709
Facilities and Public Services Payments	119	118	119	119
Subcontracted Services	547	547	547	547
Transportation Costs	191	191	191	191
Other Expenditures	5	1	5	1
Total, Operating Expenditures	3,260	3,359	3,260	3,567

Approved Budget for 2001: The recommended budget reflects a slight increase, which is due to an increase in payroll negotiated by way of collective bargaining.

PROGRAM: Direct Medical Services for Patients

Description of the Program: It facilitates direct medical services for patients such as: Health Homes, Outpatient Clinics, Emergency Rooms, Surgery Rooms, Trauma Centers, and Support Services; Pharmacy, Laboratory, Medical Records, Escort, Pathology, Laundry, Preparation and Distribution of Meals, Radiology, Respiratory Care, Biomedicine, and Transfusion Services. These medical services classified as tertiary and supratertiary are offered 24 hours a day, 365 days a year. Moreover, it is in charge of implementing the agency medical rules; planning, organizing, and managing activities with respect to the quality of the services, as well as medical research and education.

Purpose: Furnish health services to patients of the highest quality at reasonable prices at medical service institutions that comprise the Medical Center complex.

Goal:

Maintain all medical-hospital services in: the Health Home, using 8,000 days for patients of the facilities; Outpatient Clinics, serving 122,232 patients per their medical specialty; the Emergency Room, furnishing services to 73,896 patients; the Operating Room, performing 10,000 medical-surgical interventions per specialty; the Trauma Center, offering attention to 8,000 politraumatized patients, and the Support Services needed to facilitate the medical attention of its clients.

The indicators and activities information submitted by the Agency did not comply with the Management for Results

AVAILABLE and Proposed PROGRAM RESOURCES

Human Resources
Positions Filled	12/92	03/94	09/94	09/95	09/96	09/97	09/98	09/99	9/2000
Administrators	14	14	15	130	141	141	141	141	141
Secretaries	69	69	70	38	47	47	47	47	47
Nurses	320	320	325	320	313	313	313	313	313
Hospital Personnel	496	496	630	541	461	523	478	78	78
Clerical Personnel	82	82	85	96	111	111	111	111	111
Maintenance Employees	43	80	41	34	34	34	34	34	34
Others	20	44	48	50	12	12	12	12	12
Total, Positions Filled	1,044	1,105	1,214	1,209	1,119	1,181	1,136	736	736

Program Budget

(In thousands of dollars)

Program	1998	1999	2000	2001
Operating Expenditures	Expended	Expended	Current	Recommended
Direct Medical Services for Patients	70,143	177,955	70,143	70,812
Total Budget	70,143	177,955	70,143	70,812

Revenues by Source
Operating Expenditures
Joint Resolution General Budget	0	3,954	0	0
Appropriations	0	14,555	0	0
State Funds	0	6,000	0	0
Federal Funds	0	30,511	0	0
Revenue from Internal Sources	70,143	122,935	70,143	70,812
Total, Operating Expenditures	70,143	177,955	70,143	70,812

Operating Budget by Concept
Payroll and Related Costs	39,104	97,214	39,104	39,773
Facilities and Public Services Payments	2,802	23,128	2,802	2,802
Subcontracted Services	2,869	13,594	2,869	2,869
Transportation Costs	800	5,018	800	800
Donations, Subsidies and Distributions	24,568	39,000	24,568	24,568
Other Expenses	0	1	0	0
Total, Operating Expenditures	70,143	177,955	70,143	70,812

Recommended Budget for 2001: The recommended budget reflects a slight increase this must to the increase in list negotiated by means of Collective Agreement.

PROGRAM: Operating Services

Description of the Program: All Assistant, General, and Physical Plant Services activities are comprised in this program. Assistant services are comprised of the rendering of centralized services for food and clothing, cleaning, and the contracting for billing and collection of services.

Purpose: General services are accountable for providing of material supplies, medical-surgical equipment and materials. The physical plant performs all activities with respect to the engineering, maintenance, and the preservation of the physical plants, as well as the transportation, sanitation, and ornamentation of the grounds. This array of services is furnished to facilities of institutions that are members of the Medical Center so that they may operate as one entity.

Goal:

Attend to all requested services with respect to: the contracting of services; billing and collection for the medical services provided, and the development of the physical facilities, through the granting of twenty-six contracts, the billing of $1.4 million for services offered, and the maintenance and preservation of hospital facilities.

The indicators and activities information submitted by the Agency did not comply with the Management for Results

AVAILABLE and Proposed PROGRAM RESOURCES

Human Resources

Positions Filled	12/92	03/94	09/94	09/95	09/96	09/97	09/98	09/99	9/2000
Administrators	14	14	15	23	33	33	33	33	33
Secretaries	47	47	39	25	45	45	45	45	45
Security Guards	60	60	60	48	48	48	48	48	48
Hospital Personnel	134	134	0	0	39	39	39	39	39
Maintenance Employees	196	233	272	266	279	279	279	179	179
Pharmacists	18	18	18	20	16	16	16	16	16
Clerical Personnel	30	30	30	32	168	168	168	113	113
Engineers	3	3	3	3	3	3	3	3	3
Dietitians	17	17	17	7	7	7	7	7	7
Others	313	111	117	122	129	169	169	69	69
Total, Positions Filled	832	667	571	546	767	807	807	552	552

Program Budget

(In thousands of dollars)

Program	1998	1999	2000	2001
Operating Expenditures	Expended	Expended	Current	Recommended
Operating Services	52,956	56,798	52,956	61,753
Total Budget	52,956	56,798	52,956	61,753

Revenues by Source
Operating Expenditures
Revenues from Internal Resources	52,956	56,798	52,956	61,753
Total, Revenues	52,956	56,798	52,956	61,753
Operating Budget by Concept
Payroll and Related Costs	25,769	26,437	25,769	34,185
Facilities and Public Services Payments	4,938	6,812	4,938	6,512
Subcontracted Services	2,954	1,183	2,954	1,183
Donations, Subsidies and Distributions	18,146	19,446	18,146	16,953
Transportation Costs	1,149	1,149	1,149	1,149
Information Systems	0	1,771	0	1,771
Total, Operating Expenditures	52,956	56,798	52,956	61,753

Recommended Budget for 2001: The budget will allow the Administration (ASEM) to maintain its services to the participating entities.