Committee on Appropriations A/V — 2017

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Senator Tidemann announced the Revenue Projections Subcommittee Members:00:01:41
Senators Wiik, Chair, Cronin, Nesiba, Partridge00:01:50
Representatives Hunhoff, Vice-Chair, Bartels, Ahlers, Anderson00:02:04
Lynne Valenti, Secretary of the Department of Social Services00:02:25
Department Vision and Mission00:06:28
2016 Calendar Year Federal Poverty Guidelines00:06:50
The 2017 numbers just became available and will be provided to the Committee00:07:07
FY17 Budget compared to the FY18 Recommended Budget00:07:22
FY18 budget totals $1,177,000,956 with 1,653.3 FTE00:07:30
The FY18 budget is an increase of $8,336,173 in general funds and an overall increase of $32,726,91500:07:44
FTE Utilization00:08:20
LRC's budget summary00:08:53
Major General Fund Impacts to DSS Budget: Federal Medical Assistance Percentage (FMAP)00:09:10
Senator Partridge question regarding the FMAP share for various states 00:10:15
FY18 FMAP Blended Rate for Title XIX is 44.76% (45.89% in FY17)00:10:57
FY18 FMAP Blended Rate for CHIP is 8.33% (9.12% in FY17)00:11:15
Title XIX History of FMAP by federal fiscal year00:11:27
Title XXI CHIP History of FMAP by federal fiscal year00:12:03
Summary of the Major General Fund Impacts for FY1800:12:37
Representative Hunhoff question regarding temporary increase in CHIP FMAP00:13:12
Senator Peters question on $7,678,573 general fund decrease in FMAP00:14:25
Continuation of Major General Fund Impacts for FY1800:15:00
Provider Rate Reimbursement: requesting funding for remainder of Year 2 of a 3 year plan00:16:11
Representative Hunhoff question on which base year was used for cost report00:17:20
Senator Tidemann question on cost reports from providers00:18:20
Senator Nesiba question on how providers deal with discrepancy in expenditures00:18:42
Representative Ahlers question on why nursing homes are not included00:19:44
Senator Peters requested information on nursing home methology00:22:35
Senator Peters question on disparity of the 2015 and 2016 cost reports00:23:00
Brenda Tidball-Zeltinger, Deputy Secretary responded to 2016 cost reports00:23:50
Representative Hunhoff requested information on average case mix rate for nursing homes00:25:20
Senator Peters requested 2016 average case mix rate00:27:05
Office of the Secretary FY18 Recommended Budget totals $26,119,045,182.7 FTE and includes $9,207,463 in general funds00:27:55
Laurie Mikkonen, Director of Finance00:28:30
Division of Economic Assistance - Who is Served and Services Provided00:28:45
Division of Economic Assistance FY18 Recommended Budget totals $87,059,820, 320.5 FTE and a decrease of $116,098 in general funds00:30:00
The decrease in the Auxiliary Placement Program includes adjustments to the FY17 General Bill amendment00:31:10
Senator Nesiba question on TANF adjustments 00:31:22
Representative Hunhoff question on decline in auxiliary placement00:32:38
Ms. Mikkonen responded regarding declining numbers in the Auxilliary Placement Program00:32:45
Senator Peters question on what community programs are serving youth00:34:03
Representative Hunhoff question on education funding in the auxiliary placement program00:36:45
Medical Services and Adult Services and Aging00:37:30
Brenda Tidball-Zeltinger, Division of Medical Services00:37:50
South Dakota Medicaid Plan00:38:00
Division of Medical Services: Who is Served00:40:05
68% of the participants are children00:40:20
Senator Sutton question on 52% of federal proverty ($10,560/year for a family of 3)00:41:45
Senator Sutton question on number of individuals above the FPL that do not qualify for Medicaid00:42:12
Health Care Services00:45:45
Service Delivery: Over 15,000 enrolled providers00:46:40
Health Care Services - The Big 4 represent over 56% of the total budget00:47:20
The "Big 4" include Physician Services, Inpatient Hospital, Outpatient Hospital and Prescription drugs00:47:20
Program Administration, Medical Cost Management, Pharmacy Management00:48:10
80% participate in the Primary Care Case Management00:50:24
Division of Medical Services: Annual Avg. Cost per Eligible for FY1600:52:30
FY16 ended with 60 more eligibles than budgeted00:52:55
Costs for both Title XIX and CHIP were lower than budgeted00:53:20
Senator Peters requested a breakout of the 60 extra eligibles00:53:50
Key factors that impact budget and expenditures00:54:54
Annual Avg. Cost per Eligible for FY17 Revised00:55:41
FY17 revised numbers show an increase of 465 eligibles from that budgeted00:55:42
Average cost per Title XIX eligible went from $5,015 to $5,06300:56:03
Average Cost per CHIP Eligible went from $1,920 to $1,78300:56:13
FY17 revised numbers show 1,994 less eligibles in Title XIX but 2,459 more eligibles in Title XXI00:57:00
Representative Hunhoff question on how hospitals and physicians are reimbursed00:58:00
Eligibles01:00:31
FY17 revised number of eligibles is 120,347 with122,020 estimated for FY1801:02:15
DSS Medical Services - Avg. Monthly Eligibles by FY01:02:35
Medicaid Avg. Monthly Eligible Totals show a 1.4% growth01:03:05
Representative Anderson question on location of the population being served01:03:35
Senator Nesiba question on turnover of individuals being served01:06:30
Representative Karr question on how the number of eligibles in South Dakota compares to other states01:07:42
Representative Hunhoff question on eligibles: are they new or has eligibility changed01:09:00
Medical Services Budget - change in Title XIX and CHIP amounts to 2.02%01:10:45
Inpatient Hospital: FY18 recommended budget is an increase of $4,574,986 with $2,047,767 in general funds01:11:45
Representative Hunhoff question on monitoring prior authorization of services01:13:27
Outpatient Hospital: FY18 recommended budget is an increase of $4,722,641 including $2,113,852 in general funds01:14:15
Representative Hunhoff question on critical access percentage01:16:55
Physician Services: FY18 recommended budget is an increase of $455,887 including $204,055 in general funds01:18:20
Representative Hunhoff question on enrolled physicians01:19:15
Senator White question on the new administration reviewing reimbursement for Prescription Drugs01:20:05
Prescription Drugs: FY18 recommended budget is an increase of $1,035,225 with $463,365 in general funds01:22:30
Health Care Services - All Others: FY18 recommended budget is an increase of $17,948,142 with $7,625,024 in general funds01:22:44
Provider Rate Adjustments - getting providers to 90%01:24:22
FY18 recommended budget rate adjustments for Emergency Transportation and In-Home Services01:24:35
Representative Hunhoff questions on private duty nursing01:26:00
Senator Peters question on air ambulance rates01:27:27
Annual Avg. Cost Per Eligible for FY18: $1,795, an increase of 0.7% for CHIP, and $5,289 or 4.5% for Title XIX01:28:08
Medical Services Budget: Total FY18 Budget $637,400,14401:28:50
FY18 Budget totals $637,400,144, an increase of $28,736,881 with $7,441,407 being general funds01:29:03
Senator Peters question on Outpatient Hospital Reimbursement Methodology01:29:45
Division of Adult Services and Aging01:32:30
Who is served and Services Provided01:32:36
Key Opportunities for Long Term Services and Support Improvements01:33:30
Long Term Services and Supports Reorganization01:36:25
Representative Hunhoff question on the public awareness program01:37:18
Senator White question on serving veterans in nursing homes01:39:55
Senator Tidemann question on how veterans services are covered in the nursing home01:41:01
Senator White requested a list of nursing homes that accept veterans01:41:40
Senator Peters question on nursing homes accepting veterans under the federal requirements01:42:02
Senator Peters question on public awareness campaign and the success of social media01:42:30
Senator Peters question on expanding access to home and community-based services01:44:20
Senator Tidemann comments on measurable goals and timeframe for expanding access to the program01:45:07
Division of Adult Services & Aging: FY18 FTE Recommended: 1 FTE for a Nurse and 1 FTE for a Program Specialist01:47:45
Representative Howard question on the requested Program Specialist01:49:12
Senator Peters questions on request for additional nurses01:49:59
Senator Tidemann requested total number of FTE in the referenced areas01:56:25
Representative Hunhoff question on the services/assessments that are already being provided01:56:38
Provider Rate Adjustments for In-Home Services and Assisted Living01:58:40
Senator Cronin question on In-Home Services rate adjustment01:59:35
Representative Bartels question on the provider rate adjustments02:02:45
Division of Adult Services & Aging FY18 Recommended Budget totals $205,017,901, 101.0 FTE and a reduction of $402,151 in general funds02:05:39
Division of Child Support 02:05:58
Services are provided for over 60,000 families02:06:03
Division of Child Support collected and distributed $115.3 million in FY1602:06:16
Division of Child Support FY18 Recommended Budget totals $8,935,791, 83.0 FTE and an increase in general funds of $9,810 for inflation02:07:03
Senator Cronin question on enforcement of child support payments02:07:10
Senator Cronin requested information on the recovery rate of collecting child support payments02:09:28
Representative Bartels comments on child support payments02:11:13
Senator Haverly question on obligation recovery center02:12:12
Senator Peters comments on obligation recovery center02:13:30
Representative Anderson question on federal funding for this program02:13:55
The program is a match, 66% federal funds, 34% state funds02:14:10
Division of Child Protection Services - Virgena Wieseler, Director02:14:48
Services Provided - Division received 17,806 requests for services in FY1602:15:15
Representative Hunhoff question on timeliness of adoption of children02:17:40
Senator Cronin question on adoptions02:19:10
Senator Peters question on income guidelines for adopting families02:19:40
Senator Cronin question on how to improve the adoption process02:20:41
Large turnover rate in Child Protection Services02:22:08
Child Protection Services: request for additional staff due to increase in caseload and referrals02:22:50
Representative Hunhoff requested information on number of referrals and number of children in foster care02:24:18
Senator Tidemann question on exit interviews02:24:35
Senator Haverly question on difficulty hiring staff02:25:49
Division of Child Protection Services is requesting 6 FTE(Social Service Aide) at a cost of $253,314 with $215,317 in general funds02:26:00
Division of Child Protection Services FY18 recommended budget totals $67,276,128, 251.8 FTE, including $36,036,408 in general funds02:27:20
Senator Peters requested information on turnover and additional FTEs02:29:40
Representative Howard question on requested Social Service Aides and hours worked by the Family Service Specialists02:31:28
Senator Haverly question on areas covered by Social Services Aides02:32:12
Representative Peterson question on experience with the Safe Families for Children Program02:33:32
Services provided and service delivery02:34:03
Division of Child Care Services - Services Provided02:35:20
The Division of Child Care Services served an average of 2,132 families monthly in SFY1602:35:44
Senator Peters question on changes in FY18 to incentivize employment02:36:42
Division of Child Care Services FY18 Recommended Budget totals $22,371,599, 25 FTE and involves a decrease of $669,994 in general funds02:40:42
Representative Hunhoff question on the decline in child care subsidies02:41:38
Troy Jones, Administrator of the Human Services Center in Yankton02:43:25
Behavioral Health - Human Services Center02:43:33
In FY16 the Human Services Center had 1,742 admissions of which 87.94% were involuntary02:43:50
HSC Staffing & Turnover Rates02:44:20
Human Services Center has 566 FTE, 85% full time, 15% part time02:44:23
HSC Percent of Total Turnover in FY16: 19.0% and Percent of Direct Care Staff Turnover in FY16 was 24.0%02:44:50
Representative Hunhoff question on unfilled positions for direct care02:45:01
Mr. Jones reported a total of 36.5 vacancies:11 nurses, 8.5 aides, 7 counselors, with the remaining non-clinical02:45:12
Representative Hunhoff question on the amount of overtime paid due to open positions02:45:58
Representative Hunhoff question on issues on weekends due to lack of staff02:46:28
The Human Services Centers FY18 Budget totals $49,672,795, 556.0 FTE and involves an increase in general funds of $827,63002:47:13
Senator Peters question on the closure of the adolescent chemical dependency unit02:49:00
Amy Iversen-Pollreisz, Deputy Secretary02:49:40
Senator Peters question on average daily cost for the service02:50:40
Senator Cronin question on the number of children and facilities available to help these adolescents02:51:03
Senator Tidemann question on the capacity of other facilities02:51:50
Senator Peters question what services are available at the Human Services Center for adolescents02:51:57
FY17 General Bill Amendments02:52:30
Senator Cronin question on utility costs and plant operations utilities02:53:13
Representative Hunhoff question pay differential for weekend hours02:54:45
Senator Cronin question on rapid hire program02:56:48
Division of Behavioral Health - Community Behavioral Health02:58:30
Who is served and services provided02:58:45
In FY16 19,825 consumers were served in Community Mental Health Centers02:58:55
In FY16 12,297 consumers were served in Substance Abuse Treatment Centers02:59:02
Mental Health Initiative: requesting funding for 6 months for Pennington County Mental Health Court02:59:20
Representative Hunhoff question on process for developing training modules03:00:39
Representative Anderson question on the 6 month funding request03:01:30
Senator Peters question on budget for Community Mental Health Centers and Substance Abuse Treatment Centers03:02:45
Senator Cronin question on funding for Pennington County Mental Health Court03:05:05
Representative Howard question on Pennington County Mental Health Court03:06:20
Representative Hunhoff questions on IMPACT03:07:25
Senator Cronin question re:breakdown of funding between county and state for Mental Health Court03:09:05
Special One-Time Funding for Methamphetamine Treatment involving $603,740 in general funds03:11:15
Representative Hunhoff question on methamphetamine treatment03:12:45
Senator Tidemann question on the target area for the treatment03:14:25
FY18 Budget totals $4,206,681 with $2,746,364 in general funds03:14:34
Community Behavioral Health FY18 Budget totals $68,498,738 with an increase in general funds of $929,94903:14:50
Representative Hunhoff question on the increase for community health care providers03:15:33
Correctional Behavioral Health - Services Provided to Inmates in State Prison03:15:57
Boards - Informational Information03:16:52
Correctional Behavioral Health FY18 Budget totals $4,206,681 with a decrease in General Funds of $389,23303:16:55
Representative Hunhoff question on cost comparison between HSC and state prison for mental health03:17:28
Senator Cronin question on the $515 increase for Psychiatric Consultants03:18:15
Representative Hunhoff comments on mental health issues and closed programs03:20:20
Senator Peters comments on information needed by the Committee03:21:55
Representative Hunhoff question re:recent Rapid City Journal story re:hospitals not accepting alzheimers patients03:25:00
Senator Tidemann question on the effect of block grants in South Dakota03:26:25
Representative Bartels question on Behaviorial Health increase for Juvenile Justice Initiative03:28:00