1. Delaware Health and Social Services Fiscal Year 2014 Budget Hearing Office of Management and Budget Legislative Hall Senate Chambers Tuesday, November 13, 2012 Rita Landgraf Cabinet Secretary

2. Delaware Health and Social Services OFFICE OF THE SECRETARY State Service Centers Social Services Aging and Adults with Physical Disabilities Substance Abuse and Mental Health Long Term Care Residents Protection Developmental Disabilities Public Health Medical Examiner Child Support Enforcement Medicaid and Medical Assistance Management Services Visually Impaired Improve the quality of life for Delaware’s residents by promoting health and well-being, fostering self sufficiency and protecting vulnerable populations

3. Delaware Health and Social Services DHSS Accomplishments The First Four Years Public Health Transformation –Combating Infant Mortality –Enhanced Efforts in Reducing Prescription Drug Abuse –Healthy Lifestyles Groundwork

4. Delaware Health and Social Services DHSS Accomplishments The First Four Years (cont’d) State of Delaware and US DOJ Settlement Reforming Delaware’s Mental Health System

5. Delaware Health and Social Services DHSS Accomplishments The First Four Years (cont’d) Community Based Peer Support Enhanced Crisis Service HB 311 and HJR 17

6. 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

7. Delaware Health and Social Services State LTC Picture

8. 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

9. 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

10. 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

11. Delaware Health and Social Services Budget Process

12. Delaware Health and Social Services THE NEXT FOUR YEARS MOVING FORWARD:

13. Delaware Health and Social Services Moving Forward Quality Assurance Process Quality unit Information Technology (IT) Improvements Standard Functional Applications within DHSS Data Collection Improvements Analytical Capabilities improvements Infrastructure Improvements

14. Delaware Health and Social Services Medicaid Growth

15. Delaware Health and Social Services Food Supplement Program Growth

16. Delaware Health and Social Services

17. Budget Process FY13 GF Budget$1,047,299.5 FY14 Door Openers Resources needed for increased volume, annualization Increase of 6% needed Requested New Dollars $ 75,801.3 FY14 Total GF Request $1,123,100.8 7% Increase over FY13

18. 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

19. 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

20. 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

21. Delaware Health and Social Services FY 14 GF Budget Request - $1,123,100.8 Enhancements Supply enhancement to meet testing demand (OCME)$ 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

22. Delaware Health and Social Services FY 14 GF Budget Request - $1,123,100.8 Inflation/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

23. 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

24. Delaware Health and Social Services FY 14 GF Budget Request – $1,123,100.8 Other Items Base reductions DPC 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)

25. 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

26. 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

27. 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

28. Delaware Health and Social Services