fy2022 budget recommendation presented to joint

FY2022 BUDGET RECOMMENDATIONPresented to Joint Appropriations Committee

February 3rd, 2021

VISIONEvery South Dakotan Healthy and Strong

MISSIONWorking together to promote, protect, and improve health

GUIDING PRINCIPLES Serve with integrity, respect, and compassionFocus on evidence-based prevention and outcomesSupport data-driven innovationAchieve health equity in all communitiesDemonstrate proactive leadership and strengthen partnershipsExhibit transparency and accountability

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For further information, please visit https://doh.sd.gov/strategicplan/

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https://doh.sd.gov/strategicplan/

Office Locations

77 locations statewide

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FY21 Budget

FTE General Federal Other Total

Administration 34.0 $1,053,427 $ 2,593,268 $ 1,706,500 $ 5,353,195

Health Systems Development & Regulation 70.0 4,176,454 11,356,391 1,234,597 16,767,442

Family and Community Health 192.5 4,471,186 28,292,764 6,723,626 39,487,576

SD Public Health Lab 31.0 - 4,144,697 3,840,450 7,985,147

Correctional Health 110.9 - - 24,753,208 24,753,208

Tobacco Prevention & Reduction 3.0 - 1,585,331 4,500,232 6,085,563

Licensing Boards 24.4 - 478,422 5,378,646 5,857,068

Total 465.8 $9,701,067 $ 48,450,873 $ 48,137,259 $ 106,289,199

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LRC budget briefing - pg. 2-4

Division of Administration• Administrative Services

• Public Information• Division of Finance• Health Information Technology

• Data, Statistics, and Vital Records• Maintain the state’s vital records including the

registration and issuance of approximately 50,000 records:

• Birth: 25,814• Death: 12,260• Marriage: 6,985 • Divorce records: 1,878• Amendments and other requested changes: 2,568

• Provide analysis and publication of health statistics

• https://doh.sd.gov/statistics/FY21 Budget

FTE 34.0 General $ 1,053,427 Federal 2,593,268 Other 1,706,500 Total $ 5,353,195

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https://doh.sd.gov/statistics/

Division of AdministrationPublic Health Laboratory

FY21 Budget

FTE 31.0 General $ -Federal 4,144,697 Other 3,840,450 Total $ 7,985,147

FY2020 Test Volume• Environmental Health

• 53,379 tests• Forensic chemistry

• 23,313 tests• Medical microbiology

• 54,781 tests

The PHL is in good standing with all federal regulations including Clinical Laboratory Improvement Amendments (CLIA) and the Environmental Protection Agency (EPA).

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Department of Health Correctional Health

110.9 FTE

Pierre17.5 FTE

RC WC5.5 FTE

Springfield23.7 FTE

Sioux Falls58.6 FTE

Yankton WC2.8 FTE

Administration2.8 FTE

Division of AdministrationCorrectional Health

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• Locations:• SDSP Hill• Jameson Annex• MDSP Springfield• Yankton Work Center• Rapid City Work Center• Pierre Women’s Prison

• Types of staff:• Physicians• Physician Assistants• Registered Nurses• Licensed Practical Nurses• Dentists• Dental Hygienists• Optometrists

The Correctional Health program is Other Funds in DOH and General Funds in DOC.

FY21 Budget

FTE 110.9 General $ -Federal -Other 24,753,208 Total $ 24,753,208

Division of AdministrationCorrectional Health

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Correctional HealthPharmacy Budget

• FY15 – Implementation of electronic pharmacy system and purchase of pharmaceuticals through the Minnesota Multistate Contracting Alliance for Pharmacy (MMCAP)

• FY20 – Implementation of 340b Drug Pricing Program

- The federal 340B Drug Pricing Program requires drug manufacturers to provide drugs at significantly reduced prices to safety net providers- Eligible safety net providers provide care to all regardless of ability to pay

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Health Systems Development & Regulation

FY21 Budget

FTE 70.0 General $ 4,176,454 Federal 11,356,391 Other 1,234,597 Total $16,767,442

• Licensure & Certification

• Rural Health

• Health Protection

• Public Health Preparedness & Response

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• DOH ensures state and federal health and safety standards pertaining to health care facilities are met through:

• Licensure/certification• Inspection• Regulation of health care facilities• X-ray equipment• Laboratories

• Licenses/certifies and regulates approximately 1,500 health care facilities

• Inspects health care facilities for compliance with state and federal regulations

• Registers controlled substance practitioners

Health Systems Development & RegulationLicensure & Certification

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• DOH supports access to quality health care in rural and medically underserved communities through:

• Health care professional recruitment and retention• Health care workforce initiatives• Technical assistance to rural health care facilities

• Ensures statewide access to Emergency Medical Services (EMS) through:

• Certification of Emergency Medical Providers (EMTs and EMRs)• Coordination and development of ambulance services and emergency

medical system• Second generation AED distribution and education to EMS and first-

responders

• Administers the statewide Trauma System

Health Systems Development & RegulationRural Health

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Health Systems Development & RegulationHealth Protection

• DOH ensures state health and safety standards:• Food service• Lodging• Campgrounds

• Annual licensure of over 5,000 food service, lodging, and campground establishments

• Inspections are conducted through a contract with Department of Public Safety

• Plan review and approval for new construction and renovations• Food safety training and technical assistance by DOH staff

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Health Systems Development & RegulationPublic Health Preparedness & Response

• Responsible for developing and maintaining planning and infrastructure to effectively respond to:

• Bioterrorism events• Infectious disease outbreaks• Other public health threats/emergencies

• Statewide hospital preparedness planning• Surge planning

• Public health and medical stockpiles of critical supplies, materials, and pharmaceuticals

• Procurement and distribution of PPE and supplies

• Coordination of public health and medical response to disasters

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Family & Community Health

FY21 Budget

FTE 192.5 General $ 4,471,186 Federal 28,292,764 Other 6,723,626 Total $ 39,487,576

• Disease Prevention Services

• Child & Family Services

• Chronic Disease Prevention & Health Promotion

20LRC budget briefing - pg. 15-21

• 32.4 FTE• Staff located in Pierre, Sioux Falls, Rapid City, Aberdeen, and

Watertown• Services:

• Healthcare-Associated Infection• Communicable Diseases• Tuberculosis Control• HIV Surveillance and Prevention• Ryan White Part B

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Family & Community HealthDisease Prevention Services


• 173% increase in diseases reported from 2015-2019

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Number of Diseases Reported

2015 12,9522016 16,7722017 19,6172018 29,4392019 35,355

0

5000

10000

15000

20000

25000

30000

35000

40000

2015 2016 2017 2018 2019

Number of Diseases Reported 2015-2019


Rapid City Metro Statistical Area (Meade & Pennington Counties)

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Cases of Disease from 2015 through 20192015 2016 2017 2018 2019

HIV 16 14 74 75 101Hepatitis C 106 118 99 106 127TB, active and latent 17 15 6 5 6All Diseases 1874 1948 2547 2687 3485

0

1000

2000

3000

4000

2015 2016 2017 2018 2019

All Disease Cases

+86% Increase


Sioux Falls Metro Statistical Area (Lincoln, McCook, Minnehaha, & Turner Counties)

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0100020003000400050006000700080009000

2015 2016 2017 2018 2019

All Disease Cases

+140% Increase


Mobridge Area (Campbell, Corson, Dewey, & Walworth Counties)

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0

500

1000

2015 2016 2017 2018 2019

All Disease Cases

+28% Increase

• 137.1 FTE• 77 office locations statewide• Women, Infants, & Children (WIC) – Nutrition education and

supplemental food program. • Serves pregnant women, breastfeeding women, postpartum

women, infants and children to age 5 who meet eligibility requirements (income and nutrition risk factors)

• Poverty level – 185% of the Federal Poverty Level• 14,250 participants per month• Provides prescribed food package monthly

• Pregnant Women Services • Assessment/Perinatal Education – 715 contacts/month• Home Visiting Program Services – 390 families per month

• Infant Mortality - Safe Sleep • Immunizations (childhood and flu immunizations)

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Family & Community HealthOffice of Child and Family Services (OCFS)

• 19.1 FTE• Staff located in Pierre, Sioux Falls, and Aberdeen• Focus areas:

• Cancer Programs• Suicide Prevention• Opioid Abuse• Injury Prevention• Diabetes• Heart Disease• Nutrition and Physical Activity• Tobacco Prevention and Reduction

• Services• SD QuitLine has served 102,451 since 2002 with a 40% quit rate• Cancer screening (breast and cervical) – implement in clinics statewide

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Family & Community HealthChronic Disease Prevention and Health Promotion

Department of HealthFY22 Funding Sources

Federal$48,469,945

45.92%

General$10,252,602

9.71%Other

$46,831,85844.37%

Total Funds$105,554,405

28LRC budget briefing - pg. 1

FY22 Governor’s Budget Recommendation

FTE General Federal Other Total FY2021 Budget Base 465.8 $ 9,701,067 $ 48,450,873 $ 48,137,259 $ 106,289,199 Expansion/Reduction

Increase/(Decrease)Health Systems Development & Regulation

Rural Residency 7,618 19,072 26,690 Health Protection Inspections 18,263 18,263

Family and Community HealthDisease Intervention Specialists 3.0 227,873 227,873 Public Health Assistants - Contact Tracers 5.0 297,781 297,781

EpidemiologistSurveillance 3.0 -Informatics 2.0 -

Correctional HealthDecrease in estimated patient count (1,363,621) (1,363,621)Provider Inflation 25,266 25,266

Informational Boards 32,954 32,954

Inflation/Expansion Total 13.0 551,535 19,072 (1,305,401) (734,794)

Total FY2022 Governor Recommended Budget 478.8 $ 10,252,602 $ 48,469,945 $ 46,831,858 $ 105,554,405

29LRC budget briefing - pg. 1-4

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Inflationary Increases:

• Rural Residency Program• Increase of $7,618 general funds• Increase of $19,072 federal fund expenditure authority

• Health Protection Inspections• Increase of $18,263 general funds due to the increased rate

from DPS

Health Systems Development & Regulation



• Budget Request:• 8.0 FTE Total• 3.0 Disease Intervention Specialists (DIS) • 5.0 Public Health Assistants (PHA)

• General funds• Personal Services: $ 438,954• Operating Expenses: 86,699• Total: $ 525,654

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• 3.0 FTE – Disease Intervention Specialists (DIS)• $227,873 general funds• Duties of the DIS include:

• conduct initial investigation of reported diseases to determine if it meets criteria to be considered a case

• locate and interview patients/positive case to determine appropriate next steps (isolate, identify close contacts, etc.)

• specimen collection• follow-up with healthcare providers• administer medications/directly observed med therapy• conduct patient education and provider training• provide training, education, and technical assistance for providers around

infectious disease control, anti-microbial stewardship, vaccine management, etc.• vaccinations for preventable diseases

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• 5.0 FTE – Public Health Assistant (PHA) is a new, more cost-effective model of supporting service delivery by allowing the DIS to focus solely on case investigations.

• $297,781 general funds• Duties of the PHA will include:

• contact tracing as required (call, text, home visit, etc.)• reinforce patient education• support wraparound services such as finding housing for patient who needs

to be isolated, assuring the individual has food and meds to support isolation, assist with transportation, getting to appointments, etc.

• refer patient to resources specific to their needs and assist with application process

• assist with clinic audits for Vaccines for Children (VFC) program


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• Locations for proposed FTE:

DIS PHASioux Falls 1 2Rapid City 1 1Mobridge 1 0Pierre 0 1Aberdeen 0 1Total 3 5


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• 3.0 FTE Epidemiologist • $0 increase - requesting FTE only. Funded through Federal

cooperative agreements• Coordinate infectious disease surveillance for E. coli, pertussis,

West Nile Virus, and other pathogens; participate in multi-state response with CDC

• Provide case specific and outbreak data to DIS to investigate• Conduct disease surveillance to inform Public Health

Preparedness & Response• Increase in diseases reported drives need for increased

epidemiology staff• Qualifications: Master’s degree in public health, knowledge of

infectious disease processes and epidemiologic/biostatistic principles, and statistical software

EpidemiologySurveillance


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• 2.0 FTE Informatics • $0 increase - requesting FTE only. Funded through Federal

cooperative agreements• Responsible for reporting requirements for infectious diseases to

CDC and HHS• Conducts syndromic surveillance from hospital case reports• Integrates electronic reporting from hospitals, laboratories, and

federal partners• Implements and maintains data dashboards for public use• Qualifications: Master’s degree in public health informatics,

knowledge of health information technology, and data coding languages

EpidemiologyInformatics


Correctional HealthFY2022 Governor’s Recommended Budget Summary

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FY21 Base Budget $24,753,208

Decrease due to decrease in estimated ADC for FY21 $ (2,087,067)

Increase due to inflation and increased patient count FY22 $ 748,712

Total Recommended Other Fund Decrease $ (1,338,355)

FY22 Budget Recommendation $ 23,414,853


2021 DOH Legislation

HB 1021 - An Act to make an appropriation to reimburse certain health care professionals who have complied with the requirements for certain health care recruitment assistance programs and to declare an emergency.

• Appropriates $521,967 to the DOH to reimburse three physicians and two nurse practitioners who have complied with the requirements of the Recruitment Assistance Program and $270,000 to the DOH to reimburse eligible health care professionals who have complied with the terms of the Rural Health Care Facility Recruitment Assistance Program.

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General Bill Amendments

FY 2021 General Bill Amendments

Family and Community Health• 6 months of 13.0 new FTE

• 6.5 increase in FY21 FTE • $262,827 increase in General Funds • $0 change in Federal fund authority

Correctional Health• Estimated patient count decrease for FY21

• Decrease Other Funds authority ($2,087,067)

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• Identified over 100,000 cases of COVID-19 and notified over 121,000 close contacts• Performed over 775,000 COVID-19 tests statewide (over 376,000 unique persons)• COVID-19 hotline has responded to over 59,000 calls and the DOH call center has

received over 18,000 calls• The COVID.sd.gov website has received almost 13.4 million visits since it was

launched on January 27, 2020• Distributed over 530,000 N-95 respirators and over 1.4 million surgical masks from the

state stockpile to healthcare providers statewide• Hosted over 140 webinars for healthcare professionals, long-term care facilities, and

laboratories.• Recordings and slides on COVID.sd.gov

• Assisted all 9 tribes with over 260,000 items of PPE distributed to tribes, over 190 scheduled calls, and more than 10,000 tests run by SDPHL through mass testing events.

• Provided technical assistance to small businesses statewide with over 370 calls/emails from businesses and employees regarding COVID-19 and more than 50 consultations

• Conducted over 380 infection control surveys in nursing homes and assisted living centers

• Hosted over 130 media briefings

Summary of DOH COVID-19 Response (as of 01-04-2021)

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Summary of DOH COVID-19 Funding (as of 01-04-2021)

Title Amount

Awarded through

date

Immunization 639,124$ Jul-2021

Ryan White Part B 50,000$ Mar-2021

Title 18/Medicare Survey & Cert 107,861$ Sep-2021

Rape Prevention & Education 9,273$ Jan-2021Public Health Emergency Response (PHER) Public Health Emergency Preparedness (PHEP) program 4,567,500$ Mar-2021

Small Rural Hospital Improvement Plan (SHIP) 3,456,997$ Sep-2021

Hospital Preparedness Program (HPP) COVID Supplemental I 350,752$ Jun-2021

Hospital Preparedness Program (HPP) COVID Supplemental II 1,202,283$ Jun-2021Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (ELC) CARES 2020 5,075,000$ Apr-2022Paycheck Protection Program, and Healthcare Enhancement Act (PPPHEA) - Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (ELC) - tagged 'Project E' 57,932,604$ Nov-2022Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (ELC) Project Firstline 'Project F' 892,363$ May-2022Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases (ELC) Surveillance 'Project O' 50,000$ Jul-2021

Total COVID-19 Funding 74,333,757$

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Current COVID-19 Funding $ 74,333,757

Additional Funding Announced; not yet budgetedAMD Technologies 131,000 Public Health Laboratory Preparedness 515,000 Travelers Health 200,000 ELC Enhanced Detection Expansion 50,919,542 Vaccination 7,993,649

Total COVID-19 Funding $ 134,092,948

Laboratory Testing, $31,475,006

Contact Tracing, $10,510,988

Vaccination, $2,860,822

IT Infrastructure, $13,926,654

Infection Control, $1,631,679

Epidemiology/Data, $3,234,918

Public Health, $4,567,500

Healthcare (SHIP/HPP), $5,010,032

Other, $1,116,158

DOH COVID-19 Funding (as of 01-04-2021)

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DOH COVID-19 Awarded and Expended (as of 01-04-2021)

“Awarded” and “Expended” include amounts allowed from Coronavirus Relief Fund, as well as DOH COVID funding

$50

$13

$3

$15

$2 $4 $5 $6

$2 $2

$8

$27

$5 $ $1 $0 $2 $1 $3 $2 $2

$9

$-

$5

$10

$15

$20

$25

$30

$35

$40

$45

$50

$55

Mill

ions

AWARDED

EXPENDED

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DOH Contacts

Secretary of HealthKim Malsam-Rysdon ([email protected])

Division DirectorsHealth Systems Development & Regulation – Lynne Valenti, Deputy Secretary

([email protected])Administration – Joan Adam ([email protected])

Family & Community Health – Beth Dokken ([email protected])Finance – Darcy McGuigan ([email protected])

Communications Director – Daniel Bucheli ([email protected])

State Epidemiologist – Joshua Clayton ([email protected])

South Dakota Department of Health600 East Capitol AvenuePierre, SD 57501-2536

605-773-3361http://doh.sd.gov/

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http://doh.sd.gov/

fy2022 budget recommendation presented to joint

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