Department of Social Services Budget Hearing to Joint Committee on Appropriations

The Department of Social Services is almost 60% federal funds, 40% general funds and exceeds $1.0Billion dollars in total. The largest portion of the general fund budget, 58%, is for medical services.

Gregory DeSautel, Secretary of Social Services, opened the briefing as the new Secretary, Brenda Tidball-Zeltinger, Deputy Secretary and William Snyder Director of Medical Services presented to the JCA on February 11th.

**It is important to note these budget briefing books represent Governor Daugaard’s budget.**

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The Secretary went thru the updated Federal Poverty Guidelines and General Fund Impacts from the Federal Medical Assistance Percentage.

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The Secretary emphasized the discretionary inflationary update of 2.5% for all providers and 1.0% for targeted provider groups.  Please refer to the last page for a snapshot of the subsets and their total general fund for 15 months.

The Division of Medical Services started with the population of those on Medicaid. Currently, there are 118,338 eligible; (64,675 are children of low-income families, 16,103 CHIP; 12,750 low income parents, 23,751 aged/blind/disabled and 1,059 pregnant women).

The department went thru the budgeting of Medicaid eligible in FY18 Actual Monthly Eligibles was 118,338 and appropriated was 118,475;  while FY19 Appropriated 119,420 and Revenue Budget 117,057 (2% decrease) and FY20 recommended budget 118,002. 

The JCA noted the Medicaid eligible number is a large driver of the state’s budget.

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 The largest share of the medical services from FY17 to FY18 include inpatient hospital $122.7M to $124.0M, outpatient hospital $64.4M to $61.9M, physician services $84.9M to $82.7M and prescription drugs $24.4M to $25.4M.

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Brenda Tidball-Zeltinger, Deputy Secretary, presented “Received-through Policy: Maximizing Federal Funding” . In FY20, the department will work on adding more hospitals, continue to work with new community base provider groups to maximize federal funding such as psychiatric residential treatment facilities, community support providers and nursing homes.  In addition, working with Indian Health Service (IHS) on a process to centralize/streamline referrals by embedding state staff in targeted IHS facilities.

The department discussed SB173 Special Appropriation, one-time funding for innovation grants to promote ideas to support early cost-effective care, seeking innovation solutions from providers, a competitive process to select, fund and evaluate new ideas.

To view the slide presentation and supporting documents.

The department went through SB147, Provider Rate Methodology Workgroup, and the findings along with the results of the cost reports submitted. 

​In addition, SB 173, the special appropriation for $5M Nursing Home Innovation grants was discussed as well as the $1M for primary and prenatal care grants to support early cost-effective care.

The $5M would provide funding for community nursing homes to develop and implement new and innovative approaches to nursing facility care and provide nursing facility administrators with the opportunity to implement ideas they have but are unable to support with existing funds.

The applications process will seek to find innovative solutions from providers thru a competitive selection process to evaluate new ideas. The application is still being developed.