fiscal year 2013 budget hearing office of management and budget legislative hall senate chambers
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Fiscal Year 2013 Budget Hearing Office of Management and Budget Legislative Hall Senate Chambers Wednesday, November 2, 2011 Rita Landgraf Cabinet Secretary. OFFICE OF THE SECRETARY. Management Services. State Service Centers. Social Services. Public Health. Medical Examiner. - PowerPoint PPT PresentationTRANSCRIPT
Delaware Health and Social Services
Fiscal Year 2013 Budget HearingOffice of Management and Budget
Legislative HallSenate Chambers
Wednesday, November 2, 2011Rita 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
Delaware Health and Social Services
Focus and Accomplishments • Workforce Resource Alignment and Focus on
Succession Planning • Quality Control/PERM• Growing Together Portfolio
Delaware Health and Social Services
Focus and Accomplishments • Health Care Reform• Program Integrity• Diamond State Health Plan Plus• Electronic Health Records• Tobacco Cessation • Emergency Diabetes Medical Care • Community Blood Screenings • Combining the CHAP and SFL Programs
Delaware Health and Social Services
Focus and Accomplishments
• Mobile Crisis Service Partnership• Peers/Consumer Affairs• DOJ Settlement• Eliminating the drug felony bar• DACSES Replacement Project,
Delaware Health and Social Services
Focus and Accomplishments
• New Certification Standards
• Established an internal Protection and Advocacy Team• ADRC• Care Transitions• Diamond State Health Plan Plus-
Managing In This Economy
Balancing the Demand with Supply While Advancing the
Mission
Delaware Health and Social Services
Financial Challenges Intractable?
A “perfect storm” – the convergence of:
Inexorable cost drivers: Double digit annual increases in health care
costs.
Pension (and Social Security) obligations as population ages.
Rising debt and debt service.
Delaware Health and Social Services
Federal Fiscal Picture
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 – re-alignment of human resources within priorities of service
• 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
Delaware Health and Social Services
Cost Avoidance/Cost Savings
• Right Care, Right Time, Right Place – Building Access to Community
• Managed LTC
Delaware Health and Social Services
State LTC Picture
Delaware Health and Social Services
Cost Avoidance/Cost Savings
Continuum of Care Contracting in Mental Health
Promotion of Self Sufficiency through Financial Empowerment
Delaware Health and Social Services
Cost Avoidance/Cost Savings
• Contract Management
• Training
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 the demands 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 focus – re-alignment and re-allocation
– access for those who are at DPC clinically ready for discharge – state operated LTC and diversion supports
• 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 – engage peer specialists
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
Top Priorities
Community-Based Enhancements
• Systemic practice in discharge/transitional planning
• Flexible budgeting between facilities and community programs - building the continuum
• Continued assessments to ensure appropriate levels of care
• Transforming wrap around services to meet people where they are, rather than transferring person in need, unless it becomes a necessity
Delaware Health and Social Services
Our Services and Our Budget
must facilitate and empower individuals and communities to gain healthy outcomes, both in
physical wellness and emotional well being; to gaineconomic self sufficiency, which will eliminate orlimit long-term reliance on government, and to
protect 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
Special Guest AppearanceLily
Delaware Health and Social Services
Medicaid Eligibles
Delaware Health and Social Services
Delaware Health and Social Services
Delaware Health and Social Services
Delaware Health and Social Services
Budget Process• FY12 GF Budget $997,995.1
• FY13 Door Openers -Resources needed for increased volume, annualizationIncrease of 6% needed
• Requested New Dollars $ 69,482.2
• FY13 GF Target = $1,067,477.37% Increase over FY12
Delaware Health and Social Services
FY 13 Budget Request - $1,067,477.3
Door Openers - $59,557.6
DMMA – Medicaid $30,509.2
Delaware Health and Social Services
FY 13 Budget Request - $1,067,477.3
Door Openers (Continued)
DOJ/DPC Settlement $10,660.1
Delaware Health and Social Services
Door Openers (Continued)
DSS – Purchase of Care $ 8,549.6
DDDS - FYF FY 12 Placements FYF $ 2,897.3
DDDS - New Community Placements/ $ 3,938.5
Special School Grads
FY ‘12 Salary Policy Contingency $ 3,002.9
Delaware Health and Social Services
FY 13 Budget Request – (cont’d)
Major EnhancementsADRC (DSAAPD) $1,326.0
DHIN Transaction Fees (DMMA) $1,018.8
Disproportionate Share Match (DMMA) $4,000.0
DIMER/DIDER (Off. o/t Secretary) $ 507.5
Reduce Community Based Services Waiting List (DSAAPD) $ 500.0
Electronic Medical Records (one-time) (DSAMH) $ 500.0
Delaware Community Cooperative Agreement (DPH) $ 333.5
Increase Personal Needs Allowance (DMMA) $ 74.6
Other $1,719.6
Delaware Health and Social Services
FY 13 Budget Request – (cont’d)
Structural Changes ($42.9) & (13.0) FTE’s
• Mail Services to OMB (DMS) (1.0) FTE’s and ($42.9)
• Vacant FTE’s to Dept of State (DSAMH-DPC) (12.0) FTE’s
• IRM Consolidation (DMS, DPH, DCSE)• DSSC IPU Consolidation
Delaware Health and Social Services
FY 2013 Capital Budget Request Project Name
• Maintenance & Restoration• Minor Capital Improvement• Roof Replacement• IT Projects
Delaware Health and Social Services
Capital Budget Request (cont’d)• DPC Deferred Maintenance• DHSS Carvel• Drinking Water• Water Management Account• EMS Renovations• Psychiatric Hospital
Delaware Health and Social Services
Remaining Challenges:
– Super Committee Deliberations – Potential Forced
Federal Budget Reductions– Economic Spillover Impacts – Euro Zone Issues
Continued Domestic Economic Fragility– Shift from Institutional Based to Community Based
Services– Meeting USDOJ Mandates– Preparing the Department and State for Healthcare
Reform
Delaware Health and Social Services
Partnerships• Delaware State Housing Authority
State Rental Assistance Program
• Early Childhood Education – Providing cross cabinet support with a focus on Kindergarten readiness
• I-Adapt – Individual Assessment and Discharge Planning Teams• Workforce• Community Partners
Delaware Health and Social Services