Committee on Appropriations A/V — 2016

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Lynne Valenti, Secretary of the Department of Social Services00:02:54
Department of Social Services FY16 Budget Compared to FY1700:04:30
FY17 request totals $1,509,503,336 and 1717.3 FTE (55 FTE for Medicaid expansion)00:05:20
FY17 request is an increase of $410,215,215 ($10,816,090 in general funds) and 61 FTE00:05:46
Major Expansions and Reductions00:06:03
Major General Fund Impacts00:06:17
Federal Medical Assistance Percentage (FMAP)00:06:22
Title XIX History of FMAP00:07:02
FY17 Title XIX FMAP Blended Rates results in a $15,442,178 reduction in general funds00:07:11
Title XXI CHIP History of FMAP00:07:15
FY17 Title XXI (CHIP) Enhanced FMAP Blended Rates results in a $2,052,708 decrease in general funds00:07:25
Major General Fund Impacts continued00:07:37
Total reduction to the general fund for FMAP in FY17 amounts to $17,486,54500:07:47
Provider Inflation totals $14,917,509 in general funds00:07:52
Changes in Medicaid Eligibles, Cost, and Utilization totals $6,795,023 in general funds00:08:05
Behavioral Health Expansion totals $4,183,950 in general funds00:08:08
Provider Reimbursement Rate Adjustment - $1,298,981 in general funds00:08:27
Other Reductions/Increases - $1,107,172 in general funds00:08:54
Victims of Crime Assistance Grant - $3,974,702 in federal funds00:09:08
Co-Occurring State Incentive Grant - reduction of $701,000 in federal funds00:09:22
Federal Fund Authority Reductions ($16,000,000)00:09:34
Medicaid Expansion - $373,644,565 in federal funds and 55 FTE00:09:39
Senator Heineman question - removal of federal fund authority 00:09:58
Senator Tidemann question - reduction of $16,000,00000:10:25
Representative Hunhoff question - Co-Occuring Grant00:11:18
Office of the Secretary00:12:19
Representative Hunhoff question - department vacancies 00:13:07
Senator Van Gerpen question - fraud recovery of $9.4 million00:14:02
Senator Heineman question - are recovery funds forecasted in the budget00:14:45
Brenda Tidball-Zeltinger responded regarding the Recovery funds00:15:00
Office of the Secretary FY16 Budget Compared to FY1700:15:30
Senator Heineman question - MMIS reductions00:16:13
Brenda Tidball-Zeltinger responded regarding MMIS 00:16:38
Division of Economic Assistance00:18:50
Who we serve and Services Provided:00:19:00
SNAP - FY15 average monthly households served was 43,562 00:19:27
TANF - FY15 average monthly caseload was 3,02900:19:37
CHIP - 68% of the people on Medicaid are children00:20:25
Division of Economic Assistance - FY16 Budget compared to FY17 Request00:21:22
$606,018 increase in general funds for inflation00:21:35
A reduction of $1,000,000 in federal fund authority for Weatherization00:21:50
Senator Parsley question - weatherization reduction00:22:14
Representative Hunhoff question - funding for Auxiliary Placement00:22:58
Senator Heineman question - information on SNAP Employment & Training00:23:50
Representative Anderson question - long-term data on SNAP Employment00:25:38
Senator Heineman question - how many actually become employed00:26:30
Medical Services and Adult Services and Aging00:27:49
Division of Medical Services - South Dakota Medicaid00:28:12
Medicaid is not Medicare. It is an entitlement program, all people eligible must be served.00:28:55
Currently Who We Serve00:30:00
Approximately 68% of those served are children00:30:07
Health Care Services00:30:52
FY16 Operating Budget00:31:12
Service Delivery00:31:19
The Big 4: Physician Services, Inpatient Hospital, Outpatient Hospital, Prescription Drugs00:31:40
Senator Heineman question - is mental health part of the services provided00:32:27
Representative Hunhoff question - utilization breakdown of services by youth/adults00:33:25
Senator Buhl-O'Donnell question - is partial hospitilization included00:34:20
Senator Tidemann question - where do ER services fit in00:34:54
Annual Avg. Title XIX Cost Per Eligible00:35:28
FY15 Actuals: Eligibles totaled 117,346; 610 more than appropriated00:35:50
Cost Per Eligible: $4,520; 3.6% lower than appropriated00:36:18
Representative Ring question - why was the actual cost lower than expected00:37:05
Senator Van Gerpen question - SNAP 00:38:20
Senator Parsley question - are all 1,700 eligible for employment00:42:00
Representative Hunhoff question - SNAP requirements00:43:00
Representative Partridge question - cost of drug testing for TANF and SNAP00:44:05
Key factors that impact budget and expenditures:00:45:50
FMAP, Changes in the number of eligibles, Changes in utilization and Changes in cost00:46:00
Historical data on eligibles00:46:41
Avg Monthly Eligibles by Fiscal Year: FY13 through FY1700:48:00
Proposing a revision to FY16 budget to increase eligibles by 1,02000:48:32
Proposing an increase in eligibles for FY17 of 1,26800:48:48
Ten year history of eligibles00:49:47
Medicaid Average Monthly Eligible Totals (Chip, XIX Children, XIX Adults)00:50:47
Average Utilization Rates for the Big 400:51:18
FY16 Revised: increase in eligibles but lower cost per eligible00:52:09
Average Cost for the Big 400:52:35
Annual Avg. Title XIX Cost Per Eligible:00:53:12
Representative Hunhoff question - report on Health Home Program00:54:18
Representative Ring question - average cost of the Big 4 for last 10 years00:55:23
Senator Heineman question - how are revised annual costs determined00:56:13
Medical Services Budget00:57:58
Medical Services Budget - FY16 Appropriated to FY17 Recommended00:58:56
Physician Services: Increase of $3,428,529 00:59:48
Inpatient Hospital: 01:01:40
FY17 recommended budget increase of $7,181,25301:01:41
Graduate Medical Education Program: 3 GME Payments totaling $2,845,83201:01:54
Disproportionate Share Hospital Payments totaling $1,588,081 to 23 hospitals01:02:16
FY17 recommended budget rate adjustment for Inpatient Psychiatric of $684.0001:03:37
Representative Hunhoff question - what is paid to HSC for psychiatric services01:03:43
Representative Ring question - history of disproportionment payments01:04:07
Representative Hunhoff question - funding source for disproportionment payments01:04:45
Outpatient Hospital01:05:03
FY17 recommended budget increase of $6,360,31701:05:04
Breast & Cervical Cancer Testing and Preventative Treatment01:05:17
FY Recommended Budget for Breast & Cervical Cancer Testing & Preventative Treament is $644,09101:06:19
Representative Hunhoff question - is there a screening program for low income individuals currently01:07:14
Senator Heineman question - what determines which women receive the testing01:08:44
Representative Anderson question - where in the budget is the savings as a result of this testing01:09:47
Prescription Drugs - FY17 recommended budget increase of $3,861,57101:10:45
Representative Hunhoff question - rebates on prescription drugs01:11:11
Rate Adjustments:01:12:16
Proposed rate adjustment for emergency transportation providers totals $636,60101:12:24
Emergency Transportation Rate Adjustment impacts over 200 providers01:12:52
Proposed rate adjustment for In-Home Services totals $697,67201:13:29
Senator Parsley question - rate adjustment for fixed wing and helicopters01:13:48
Representative Hunhoff question - cost savings as a result of prescription rebates01:15:01
Applied Behavior Analysis01:18:38
FY17 recommended budget is an increase of $299,37001:20:48
Representative Hunhoff question - how many children will receive services01:21:01
Health Care Services - All Others01:22:26
FY16 General BIll Amendment for Part B totals $1,972,15401:23:33
FY17 recommended budget is an increase of $11,820,93901:24:00
Representative Hunhoff question - how many dual eligibles01:24:10
Annual Avg. Title XIX Cost Per Eligible: $5,01401:26:01
Total FY17 Medical Services Budget w/Medicaid Expansion $980,796,24901:26:46
Total FY17 Medical Services Budget $607,151,68401:26:47
Medical Services FY16 Budget Compared to FY1701:26:58
Division of Adult Services and Aging01:28:54
FY17 recommended budget (In-Home Services) rate adjustment: $511,55701:29:29
FY17 recommended budget (Assisted Living) rate adjustment: $145,40901:30:14
Victims' Services: FY17 recommended budget totals $3,974,70201:30:50
Representative Hunhoff question - addition to current program, need for additional FTE01:33:09
FY16 Budget compared to FY17 for Adult Services & Aging01:33:46
Children's Services:01:34:15
Division of Child Support serves over 60,000 families01:34:23
Senator Buhl-O'Donnell question - establishment of paternity01:35:55
FY16 Operating Budget01:36:29
FY16 Budget compared to FY17 Budget01:36:31
FY17 budget request includes an increase for inflation totaling $59,58601:36:38
Division of Child Protection Services01:37:05
Virgena Wieseler, Child Protection Services Director01:37:12
Subsidized Guardianship and Subsidized Adoption:01:38:30
FY17 request is for 25 additional guardianship subsidies01:39:01
FY17 request is for an increase of 40 additional adoption subsidies01:39:20
FY16 Budget Compared to FY1701:40:35
Representative Anderson question - adoption process/financial responsibility01:40:40
Representative Hunhoff question - how long will the family receive subsidies01:41:38
Senator Parsley question - are the subsidies on a sliding scale or fixed01:42:10
Senator Heineman question - subsidized guardianships01:42:50
Representative Romkema question - average subsidy for the adopting family01:44:59
Division of Child Care Services01:46:07
Services provided and delivery of services01:46:10
FY16 Budget Compared to FY17 - an increase of $901,65501:46:48
Amy Iversen-Pollreisz, Behavioral Health Division01:47:41
Human Services Center (HSC) - Who We Serve and Services Provided01:47:51
HSC Admissions: 1,960 in SFY15 of which 89% were involuntary admissions01:48:17
HSC has 301 beds to provide adult and adolescent inpatient services01:48:27
HSC FY16 Operating Budget01:48:46
HSC Staffing: 566 FTE, 85% full time, 15% part time01:48:55
Turnover for diret care staff in FY15 was 26.0%, Overall Turnover was 20%01:49:06
FY17 request of $455,332 to reclassify approximately 238 employees01:49:30
Representative Hunhoff question - what percent of turnover are long time employees01:50:35
Senator Buhl-O'Donnell question - difference between mental health aide and mental health technician01:51:22
Senator Parsely question - educational requirements for staff01:52:05
FY16 General Bill Amendment: decrease of $225,561 in general funds for utility rates01:52:42
Senator Van Gerpen question - what percent of positions are vacant and in what areas01:53:24
Senator Van Gerpen question - how many psychiatrist positions and are they filled01:54:08
Senator Buhl-O'Donnell question - do vacancies affect bed availability01:55:20
Senator Van Gerpen question - what happens to the personal services funds for vacant positions01:56:24
Senator Parsley question - challenges in finding psychiatric services01:57:15
Representative Hunhoff question - does the FY17 budget have additional funding to keep up with the market competitiveness01:58:17
Senator Tidemann question - overtime for HSC employees01:59:00
Senator Buhl-O'Donnell question - average number of hours worked per employee02:00:00
Senator Van Gerpen question - is overtime time and a half02:00:20
HSC FY16 Budget compared to FY1702:00:39
HSC FY17 Funding Sources02:01:45
Division of Behaviorial Health02:01:54
Community Behavioral Health - Who We Serve and Services Provided02:02:01
Community Behavioral Health FY16 Operating Budget02:02:21
Juvenile Justice Reinvestment Initiative02:02:27
FY17 recommended budget includes an increase of 4.0 FTE and $3,203,509 in general funds02:02:30
Community Behavioral Health FY16 Budget compared to FY1702:04:20
Community Behavioral Health FY17 Funding Sources02:04:51
Senator Heineman question - expansions in mental health02:05:06
Ms. Iversen-Pollreisz referred to Docment No. 3 - Program Outcomes02:06:00
Senator Heineman question - CARE vs Impact Services02:08:30
Senator Tidemann question - total dollars and FTE for the Juvenile Justice Reinvestment Initiative02:10:32
Representative Hunhoff question - information on the 4 FTE in the Juvenile Justice Reinvestment Initiative02:11:15
Representative Hunhoff question - where will the 4 FTE be located and what are the education qualifications02:12:25
Representative Anderson question - budget for Juvenile Justice Reinvestment Initiative02:13:12
Correctional Behavioral Health - serving inmates with behavioral health needs02:14:07
Correctional Behavioral Health FY16 Operating Budget02:15:00
FY17 recommended budget request includes an increase of 2 FTE and $133,047 in other funds02:15:10
Senator Heineman question - where will you find qualified staff02:16:05
Senator White question - salary range for the 2 FTE in Correctional Behaviorial Health02:17:15
Representative Hunhoff question - are there like positions at other correction facilities02:18:20
Representative Anderson question - is Corrections providing funding02:19:15
Correctional Behavioral Health FY16 Budget Compared to FY1702:19:35
Correctional Behavioral Health FY17 Funding Sources02:19:45
Boards - Informational02:19:50
Boards - FY16 Budget Compared to FY1702:20:00
Representative Hunhoff requested information on the Program Outcomes02:20:49
Program Outcomes - Division of Economic Assistance02:21:40
SNAP - 92% were still employed, $10.22 average wage02:21:45
TANF: 806 entered employment, average wage of $9.7102:22:04
Representative Hunhoff question - does Department of Labor work with these individuals02:23:10
Senator Buhl-O'Donnell question - comparing outcome data for SNAP vs. TNAF02:24:11
Division of Medical Services - Program Management - Health Home02:25:25
111 Health Homes serving 121 locations in SFY1502:26:35
Recipients are placed into1 of 4 tiers depending on need02:27:45
Tier 1: 98 enrolled02:27:52
Tier 2-4: 5,743 enrolled02:28:30
Health Home Clinical Outcomes02:31:00
Health Home Clinical Outcomes by disease02:31:35
Representative Hunhoff question - is there follow-up as part of the screening activities02:35:45
Senator Heineman question - what is the budget for Health Homes02:37:27
Division of Adult Services & Aging - Community Based Services In-Home Services02:39:57
In FY15 6,251 individuals were served in their home02:40:35
Senator Tidemann question - are the 6,251 distributed across the state02:40:55
Representative Hunhoff question - is the number of people served staying stable02:42:50
Senator Tidemann question - does the staff help individuals make the transition to long-term care02:43:48
Division of Child Care Services02:45:50
Child Care Survey: 97% have been able to maintain employment02:46:02
Child Care Survey: 91% would not be able to work without assistance02:46:10
Child Care Survey results: 34% are in school or training02:46:16
Human Services Center - Geriatric Services02:47:02
41 reviews conducted, 35 (85%) remained in their community02:47:20
Criminal Justice Initiative - Substance Abuse02:47:55
In FY15 901 individuals received treatment for substance abuse02:48:00
In FY15 332 individuals received treatment for criminal thinking02:48:09
In FY15 20 individuals were served through the Rural pilot program02:48:17
Substance Abuse Outcomes02:48:59
Senator Heineman question - MMIS02:50:10
Representative Hunhoff question - foster care work group02:53:28
Sheila Weber, SD Association of Youth Care Providers02:54:43
Justin Smith, SD Association of Youth Care Providers02:54:43
Senator Tidemann question - source of funds for the agencies03:01:47
Senator Tidemann question - do the agencies receive donations03:02:26
Senator Tidemann question - do the agencies receive county or municipality funding03:03:13
Representative Romkema question - how many were served by Volunteers of America, budget information03:03:51
Representative Partridge question - is the request for one-time money03:05:45
Senator Van Gerpen question - what year was the data/cost reports collected03:07:58
Senator Heineman question - what is the impact of the Juvenile Justice Reinvestment Initiative03:08:40
Representative Romkema question - how many children are served03:11:05
Representative Romkema question - where would the children be if not for Community Providers03:11:12
Representative Romkema question - cost difference between state and community provider facilities03:11:17
Representative Romkema question - average daily cost of care03:14:10
Adjourn: Partridge/Buhl-O'Donnell03:15:25

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