delaware health and social services department of health and social services joint finance committee...
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Delaware Health and Social Services
Department of Health and Social Services
Joint Finance CommitteeFiscal Year 2012 Budget Hearing
Rita LandgrafCabinet SecretaryFebruary 28, 2011
Delaware Health and Social Services
OFFICE OF THE OFFICE OF THE SECRETARYSECRETARY
State Service State Service CentersCenters
Social Social ServicesServices
Aging and Adults Aging and Adults with Physical with Physical DisabilitiesDisabilities
Substance Abuse Substance Abuse and Mental Healthand Mental Health
Long Term Long Term Care Care
Residents Residents ProtectionProtection
Developmental Developmental DisabilitiesDisabilities
Public HealthPublic Health
Medical ExaminerMedical Examiner
Child Support Child Support EnforcementEnforcement
Medicaid and Medicaid and Medical Medical
AssistanceAssistance
Management Management ServicesServices
Visually Impaired Visually Impaired
Delaware Health and Social Services
Our Services• DHSS provides services that Delawareans consume every day across the life
spectrum – Birth to Earth
• Medicaid; TANF; SNAP; CHIP, LIHEAP, Americorp
• Subsidized child care and cash assistance; death and forensic testing; marriage and birth records; restaurant inspections; water safety testing; immunizations, monitors and control disease, cancer screening and treatment, provide substance abuse and mental health treatment, child support enforcement
• Services for: the aging, adults with developmental and physical disabilities, visually impaired, and other vulnerable populations
• Manages four long term care facilities and the state's only psychiatric hospital, the
Delaware Psychiatric Center.
Delaware Health and Social Services
Our ServicesMust facilitate and empower individuals and communities to gain healthy outcomes, both inphysical wellness and emotional well being; to gaineconomic self sufficiency, which will eliminate orlimit long term reliance on government, and toprotect and support those citizens most vulnerabledue to advanced age, disabilities, and producepositive outcomes for the individuals we serve
Delaware Health and Social Services
OUR CURRENT AND PROJECTED ENVIRONMENT
CHALLENGES
Delaware Health and Social Services
Medicaid Eligible'sMEDICAID ELIGIBLES: JULY 2008 - JANUARY 2011
0
25,000
50,000
75,000
100,000
125,000
150,000
175,000
200,000
225,000
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FY 2009 Monthly Average160,018 Eligibles
FY 2010 Monthly Average173,769 Eligibles ( + 8.6%)
FY 2011 Monthly Average YTD 190,393 Eligibles (+9.6%)
Delaware Health and Social Services
FOOD SUPPLEMENT PROGRAMRECIPIENTS: JULY 2008 - DECEMBER 2010
0
10,000
20,000
30,000
40,000
50,000
60,000
70,000
80,000
90,000
100,000
110,000
120,000
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SFY 2010 Monthly Average107,036 Total Recipients (+25.4%)
SFY 2011 Monthly Average YTD125,627 Total Recipients
(+17.4%)
Delaware Health and Social Services
DIVISION OF SOCIAL SERVICES Application Activity
Delaware Health and Social Services
The Solutions:
• Smarter Budgeting – Core Service identification; triage; and partnerships
• Efficient Sizing– Through strategic reviews, rightsizing and implementing non-traditional practices
to support workforce and advance the Department to better meet the needs of our citizens
• Smarter Spending– Rewarding performance, not just good intentions. Advancing evidence based
practices leading to better outcomes for Delaware’s citizens
• Smarter Management– Using flexibility, supporting each other across the Department and across the
administration. Ensuring resources are expended where needed and avoiding unintended consequences
Delaware Health and Social Services
Our Prioritization Rationale
Delaware Health and Social Services
Top Priorities• Improving the health of Delawareans and show through statistical
analysis - Health Care Reform opportunities• Streamline service delivery to meet demand of increasing
population - To effectively collaborate within DHSS so that customers receive the maximum possible service as seamlessly as possible
• Preserving services to our most vulnerable populations• Community living for everyone• Provide high quality customer service – both in interpersonal
interactions and in addressing the concern presented• Strive to offer programs that empower or assist clients in self-
improvement and to rely less on entitlements
Delaware Health and Social Services
Top Priorities
• Consolidate financial services management in all divisions under one umbrella/ DHSS unit
• Use technology and human resources to maximize efficiency, productivity and service delivery
• Create employment opportunities, enhance education and promote a more efficient government
• Maximize federal and state funding to help Delaware residents achieve maximum independence
Delaware Health and Social Services
DHSS State Budget Overview
$813.5 $891.6$975.2
0200400600800
10001200
FY 10 FY 11 FY 12 Rec
General Fund Budgets($ in millions)
Delaware Health and Social Services
Budget • FY11 GF Budget $891,599.4
• Net DHSS/OMB Adjustments and New Dollars = $83,634.9 Million
• FY 12 GRB = $975,234.3 (9.4% Increase over FY11)
Delaware Health and Social Services
FY 12 Budget Request – (cont’d)Base Reductions ($18,847.1) & (29.0) FTE’s
Overtime Casual ($4,758.10)Vacant FTE’s (29.0) FTE’s ($1,489.4)
Salary Savings ($2,581.7)General Assistance ($4,547.5)LTC Savings ($1,200.0)Other Reductions ($4,271.3)
Federal Funds Reallocation $4,909.8DSAMH $49.0DSS $4,913.8
Structural Changes ($100.0) & (3.0) FTE’s Weatherization to DNREC (3.0) FTE’s ($100.0)
LTC TransitionIRM/Fiscal ConsolidationNewark Clinic
Delaware Health and Social Services
GRB Gains to Support Services within Community
Funding support for 25 individuals transitioning back to community from DPC
DDDS funding to support 140 Special School Graduates and 75 new residential placements
Off-setting the loss of federal funds in TANF and Child Care with General funds
Transition funding for General Assistance
Delaware Health and Social Services
Additional Focus Areas
• Health Care Reform
• Re-Entry Update
Delaware Health and Social Services
Health Care Reform- A Challenge and an Opportunity
Challenge/ Opportunity for Delaware:
Maximize benefits for Delaware citizens to support the goals of widespread access to health insurance & health care, supporting people in community-based settings, and promoting healthy lifestyles
Delaware Health and Social Services
Grants to Date• Health Benefit Exchange Planning Grant - $1 million• Premium Review Grant - $1 million• Aging and Disability Resource Center - $400,000• Maternal, Infant and Child Visitation Program - $1.280 Million• Personal Responsibility Education - $250,000• Public Health Infrastructure Grant - #1 - $100,000• Supplemental Funding – Behavioral Risk Factor Survey - $37,860• Strengthen Epidemiology, Lab and health information system
capacity - $429,055• Healthy Communities – Tobacco Cessation - $54,554• HIV Surveillance Enhanced Lab Reporting - $51,218
Delaware Health and Social Services
Grants Continued• Health Insurance Consumer Information - $141,930• Medicare Prescription Drug Program - $84,240• Background Checks on Direct Care (LTC) $3,000,000• Primary Workforce Traineeship $156,671• New Access for Fed. Funded Health Ctrs. $1,299,330• Increase Demand for Health Centers $ 937,211• Capital Improvement $2,089,754• HIT for Health Ctrs. $1,231,799
• Total $13, 544,505
Delaware Health and Social Services
Re- Entry Update
• One area where the State must work smarter has to do with those who are incarcerated. Far too many of them, upon release, re-offend, thus costing the citizens of Delaware more expenses for re-arrest, re-adjudication, re-incarceration. In response to this issue, the Governor charged me with leading an initiative for a smarter approach to working with the incarcerated population. This initiative has been logically labeled as the Prison Re-Entry Initiative.
Delaware Health and Social Services
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