1. Delaware Health and Social Services Fiscal Year 2014 JFC Hearing Legislative Hall Senate Hearing Room February 19 - 21, 2013 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 Where we are What we need to put in place Where we want to be Smaller, Smarter Government A service delivery system built around funding sources rather than around constituent needs Fiscal and administrative processes that are not as effective or efficient as they can and need to be Significant organization transition that will necessitate changes in organizational processes and staffing requirements A requirement for major IT changes that will affect how the department does business A process quality organization that reviews process outputs and focuses the department on good program design and risk abatement Detailed community service plans which are iterative to meet the on-going staffing needs Strong alliance with our sister agencies to enable putting the right systems, processes, and people in place. Permission from federal funders to achieve greater program design flexibility while maintaining integrity Cross-division and departmental partnerships Community partnerships Strong, client oriented, high integrity Community based services Processes built focused on needs of Delaware citizens vs. Divisional needs Organization design to have the right roles and skills in place to serve the health and social service needs of Delaware’s citizens. Charting the Path Forward

4. Delaware Health and Social Services Challenges or Opportunities More constituents in need of services but limited resources Producing a smaller, efficient government Optimize resources to meet the needs of our clients

5. Delaware Health and Social Services Challenges or Opportunities A Major Reform Effort within the Health Care Delivery System to promote access, prevention, positive outcomes and return on investment Health Reform is inclusive and seamless with Medicaid – federal state insurance plan focused on individuals meeting a FPL, elderly and individuals with disabilities

6. Delaware Health and Social Services Medicaid Growth

7. Delaware Health and Social Services Challenges or Opportunities Today, about 1 in 5 Delawareans is age 60+ By 2025, they will make up one-fourth of state’s population. And by 2030, the state’s older population is projected to have doubled from what it was in 2000 to 253,646.

8. Delaware Health and Social Services Challenges or Opportunities Healthy Lifestyles Groundwork Council on Health Promotion Disease Prevention The Collaborative for Healthy Weight A Community Cooperative Agreement

9. Delaware Health and Social Services Challenges or Opportunities Cont’d Healthy Lifestyles Groundwork Council on Health Promotion Disease Prevention The Collaborative for Healthy Weight A Community Cooperative Agreement

10. Delaware Health and Social Services Challenges or Opportunities State of Delaware and US DOJ Settlement Reforming Delaware’s Mental Health System

11. Delaware Health and Social Services Challenges or Opportunities Cont’d State of Delaware and US DOJ Settlement Reforming Delaware’s Mental Health System

12. Delaware Health and Social Services Challenges or Opportunities Moving LTC clients to community settings Integration of LTC facilities into DSAAPD Care Transitions Program

13. Delaware Health and Social Services Challenges or Opportunities Cont’d Moving LTC clients to community settings Integration of LTC facilities into DSAAPD Care Transitions Program

14. Delaware Health and Social Services Challenges or Opportunities Early Learning Challenge Providing Eligible Delawareans with Food Benefits – Focus on Children and Elders

15. Delaware Health and Social Services Challenges or Opportunities Cont’d Early Learning Challenge Providing Eligible Delawareans with Food Benefits – Focus on Children and Elders

16. Delaware Health and Social Services Food Supplement Program Growth

17. Delaware Health and Social Services Challenges or Opportunities USDA Bonus Award Recognition Improving Efficiency and Access via On-Line Application Upgrade

18. Delaware Health and Social Services Challenges or Opportunities $tand By Me® 50 Partner Organizations Almost 2,000 Served o Identify personal financial challenges o Establish goals and an action plan

19. Delaware Health and Social Services Challenges or Opportunities Enhancing Lives for Individuals with Disabilities Providing Choices Focus on Employment Enhancements Continued Efforts in Supporting Families And Caregivers

20. Delaware Health and Social Services Challenges or Opportunities Cont’d Enhancing Lives for Individuals with Disabilities Providing Choices Focus on Employment Enhancements Continued Efforts in Supporting Families And Caregivers

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

22. Delaware Health and Social Services Challenges or Opportunities Quality Assurance - Process Quality unit Information Technology (IT) Improvements Standard Functional Applications within DHSS Data Collection Improvements Analytical Capabilities improvements Infrastructure Improvements

23. Delaware Health and Social Services Challenges or Opportunities Cont’d Quality Assurance - Process Quality unit Information Technology (IT) Improvements Standard Functional Applications within DHSS Data Collection Improvements Analytical Capabilities improvements Infrastructure Improvements

24. Delaware Health and Social Services Important Partnerships CROSS DEPARTMENT INITIATIVE CROSS CABINET INITIATIVES DELAWARE STATE HOUSING AUTHORITY I-ADAPT (Individual Assessment and Discharge Planning Teams) COMMUNITY PARTNERS DHSS EMPLOYEES OUR CONSTITUENCY

25. Delaware Health and Social Services