delaware health and social services fiscal year 2014 budget hearing office of management and budget...

Delaware Health and Social Services

Fiscal Year 2014 Budget HearingOffice of Management and Budget

Legislative HallSenate Chambers

Tuesday, November 13, 2012Rita Landgraf

Cabinet Secretary

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

Improve the quality of life for Delaware’s residents by promoting health and well-being, fostering self sufficiency and protecting vulnerable

populations

Delaware Health and Social Services

DHSS AccomplishmentsThe First Four Years

• Public Health Transformation– Combating Infant Mortality– Enhanced Efforts in Reducing Prescription Drug

Abuse– Healthy Lifestyles Groundwork

Delaware Health and Social Services

DHSS AccomplishmentsThe First Four Years (cont’d)

• State of Delaware and US DOJ Settlement

Reforming Delaware’s Mental Health System

Delaware Health and Social Services

DHSS AccomplishmentsThe First Four Years (cont’d)

• Community Based

• Peer Support

• Enhanced Crisis Service

• HB 311 and HJR 17

Delaware Health and Social Services

DHSS Accomplishments The First Four Years (cont’d)

• Moving LTC clients to community settings

Integration of LTC facilities into DSAAPD

• Care Transitions Program

Delaware Health and Social Services

State LTC Picture

Delaware Health and Social Services

DHSS Accomplishments The First Four Years (cont’d)

• Managed LTC Medicaid – Diamond State Health Plan Plus

• Electronic Health Records (EHR)• Program of All-Inclusive Care for the Elderly (PACE)• Health Benefit Exchange (HBE)• Disproportionate Share Hospital (DSH) Program• Telehealth

Delaware Health and Social Services

DHSS Accomplishments The First Four Years (cont’d)

• Providing Eligible Delawareans with Food Benefits – Focus on Children and Elders

• USDA Bonus Award Recognition

• Improving Efficiency and Access via On-Line Application Upgrade

• Financial Empowerment

Delaware Health and Social Services

DHSS Accomplishments The First Four Years (cont’d)

• Enhancing Lives for Individuals with Disabilities– Focus on Employment for Individuals with Visual Impairments

– Continued Efforts in residential placements for Individuals with Developmental Disabilities

– Continued Efforts in Supporting Families

– Employment First Legislation

Delaware Health and Social Services

Budget Process

Delaware Health and Social Services

THE NEXT FOUR YEARS

MOVING FORWARD:

Delaware Health and Social Services

Moving Forward

• Quality AssuranceProcess Quality unit

• Information Technology (IT) ImprovementsStandard Functional Applications within DHSS

Data Collection Improvements

Analytical Capabilities improvements

Infrastructure Improvements

Delaware Health and Social Services

Medicaid Growth

Delaware Health and Social Services

Food Supplement Program Growth

Delaware Health and Social Services

Delaware Health and Social Services

Budget Process• FY13 GF Budget $1,047,299.5

• FY14 Door Openers Resources needed for increased volume, annualizationIncrease of 6% needed

• Requested New Dollars $ 75,801.3• FY14 Total GF Request $1,123,100.8

7% Increase over FY13

Delaware Health and Social Services

FY 14 GF Budget Request - $1,123,100.8

Door Openers - $65,870.7

DMMA – Medicaid Base $39,007.9 Medicaid One-Time $11,200.0 Total $50,207.9

Delaware Health and Social Services

FY 14 GF Budget Request - $1,123,100.8

Door Openers (Cont’d)DOJ/DPC Settlement $4,327.0 • Housing Vouchers• Targeted Case Management• Supported Employment• Assertive Community Treatment• Peer Supports

Delaware Health and Social Services

FY 14 GF Budget Request - $1,123,100.8

Door Openers (Cont’d)

DDDS - FY 13 Placements Full Year Funds $2,992.9

DDDS - New Community Placements/ $3,819.0 Special School Grads

DHSS - FY 13 Salary Policy Contingency $4,523.9

Delaware Health and Social Services

FY 14 GF Budget Request - $1,123,100.8Enhancements

Supply enhancement to meet testing demand (OCME) $ 100.0

Birth to Three contract nurses and educators (DMS) $ 393.0

PC 5 Year Replacement Schedule (DMS) $ 815.0

Enhanced Family Supports (DDDS) $ 715.5

Reduce Personal Attendant Waiting List (DSAAPD) $ 461.7

Increase Home Delivered Meals (DSAAPD) $ 700.0

Delaware Community Cooperative Agreement (DPH) $ 333.5

Increase Personal Needs Allowance (DMMA) $ 56.7

Emergency Shelter Placements for APS (DSAAPD) $ 200.0

Other $ 910.7

Delaware Health and Social Services

FY 14 GF Budget Request - $1,123,100.8Inflation/Volume

Network and Licensing for computer applications (DMS) $257.3

Contractual Services increase to meet demand (DLTCRP) $ 65.7

Lease Escalators (DMS) $147.1

Common Area Maintenance (DMS) $194.3

Foster Grandparents (DSSC) $ 84.5

Assisted Technology-Assessment and Training (DVI) $ 25.0

Delaware Care (DSSC) $ 47.2

Emergency Shelters (DSSC) $ 39.9

Delaware Health and Social Services

FY 14 GF Budget Request - $1,123,100.8

One-Time

Programming Video Lottery Intercept (DCSE) $ 35.0

Information Technology (IT) Infrastructure Improvements (DMS) $4,372.5

Electronic Medical Records Expansion (DPH) $ 195.0

Electronic Medical Records LTC (DSAAPD) $ 234.3

Information Technology (IT) Planning (DSAAPD) $ 300.0

Scanning of Back Files into Client Information System (DCSE) $ 54.0

Delaware Health and Social Services

FY 14 GF Budget Request – $1,123,100.8

Other ItemsBase reductionsDPC Personnel (DPC) ($128.7)

Cash Assistance (DSS) ($136.2)

Contractual Services-Sickle Cell contract to G-I-A (Admin-OSEC) ($49.5)

Structural Changes

Move funding and positions from Institutional Care to Community Services

DSAMH- & DDDS 11 FTEs and $602.3

Realignment of Resources

DSS positions to Office of the Secretary for Quality Assurance unit

Cash Assistance to Child Care, to cover loss of federal funds, and to Fair Hearings

DHSS positions and funding to DTI to manage Computer Application Enhancement Projects (16.0) FTEs ($492.9)

Delaware Health and Social Services

FY 14 Capital Budget Request Project Name

• Maintenance & Restoration $ 3,750,000

• Minor Capital Improvements $ 7,250,000

• Roof Repair/Replacement $ 9,000,000

• IT Projects $17,601,400

Delaware Health and Social Services

FY 14 Capital Budget Request (cont’d)

Project Name•DPC Deferred Maintenance $2,070,500

•DHSS Carvel $ 541,800

•Drinking Water $1,840,000

•Water Management Account $ 100,000

•Sussex Building-DPC $ 685,000

•EMS Renovations $ 981,500

Delaware Health and Social Services

Important Partnerships

CROSS CABINET INITIATIVES

• Delaware State Housing Authority – SRAP

• Early Childhood Education

• I-ADAPT - Individual Assessment and Discharge Planning Teams

COMMUNITY PARTNERS

Delaware Health and Social Services