Governor's Recommended Budget - State of South Dakota

SOCIAL SERVICES
GOVERNOR'S RECOMMENDED FY 2011 BUDGET

083 Medical and Adult Services

MISSION:
To provide medical assistance to eligible South Dakotans under Title XIX of the Social Security Act (Medicaid) and applicable state laws to enable them to have access to medical services necessary to maintain good health. To provide opportunities to enable older South Dakotans and adults who are disabled to live independent, meaningful, and dignified lives while maintaining close family and community ties by promoting in-home and community-based services to prevent or delay premature or inappropriate institutionalization. In accordance with the Older Americans Act and other applicable state and federal laws, Adult Services and Aging provides or purchases services for South Dakotans who meet defined program guidelines. Adult Services and Aging also provides services to victims of domestic violence and compensation to victims of violent crimes.

ACTUAL
FY 2008 ACTUAL
FY 2009 BUDGETED
FY 2010 REQUESTED
FY 2011 GOVERNOR'S RECOMMENDED
FY 2011 RECOMMENDED INC/(DEC)
FY 2011

FUNDING SOURCE:

   General Funds $208,597,653 $191,077,992 $189,400,278 $246,006,602 $233,657,854 $44,257,576

   Federal Funds 379,123,909 423,819,862 467,188,006 533,561,080 512,031,914 44,843,908

   Other Funds 1,551,415 1,462,967 5,044,538 2,891,012 2,991,730 (2,052,808)

      Total $589,272,977 $616,360,821 $661,632,822 $782,458,694 $748,681,498 $87,048,676

EXPENDITURE DETAIL:

   Personal Services $6,271,996 $6,822,172 $7,680,652 $7,680,652 $7,715,603 $34,951

   Operating Expenses 583,000,981 609,538,649 653,952,170 774,778,042 740,965,895 87,013,725

      Total $589,272,977 $616,360,821 $661,632,822 $782,458,694 $748,681,498 $87,048,676

Staffing Level FTE: 133.2 139.9 145.5 145.5 145.0 ( 0.5)

ACTUAL
FY 2008
ACTUAL
FY 2009
ESTIMATED
FY 2010
ESTIMATED
FY 2011

REVENUES:


Total
$0
$0
$0
$0

PERFORMANCE INDICATORS:

   MEDICAL SERVICES:

   Average Persons Eligible:

   Aged/Blind 5,593/84 5,546/84 5,481/84 5,420/84

   Disabled Adults/Children 11,226/2,680 11,444/2,815 11,647/2,941 11,854/3,071

   Low Income Family (LIF) Adults/Children 10,800/17,955 10,797/18,047 11,418/18,331 11,581/18,331

   DSS and DOC Foster Care Children 3,755 3,728 3,800 3,850

   Pregnant Women 1,903 1,873 1,855 1,833

   QMB 3,311 3,409 3,506 3,604

   Medical Services Programs for Children:

   Title XIX Funded 33,532 34,959 40,294 43,614

   Title XXI Funded, Under 140% of FPL 8,984 9,254 9,732 9,996

   Title XXI Funded 140%-200% of FPL 2,487 2,564 2,694 2,766

   Total Title XIX Eligibles 90,839 92,702 99,357 103,242

   Total Title XXI Eligibles 11,471 11,818 12,426 12,762

   Total Avg. Persons Eligible (XIX & XXI) 102,310 104,520 111,783 116,004

   Total Average Cost Per Title XIX Eligible $3,884 $4,088 $4,671 $4,925

   Average Cost Per Title XIX Eligible by Service:

   Physicians $710 $774 $825 $867

   Inpatient Hospital $983 $1,129 $1,256 $1,411

   Outpatient Hospital $371 $394 $414 $427

   Prescription Drugs $342 $366 $407 $428

   All Other Services $1,478 $1,425 $1,769 $1,792

   Program Utilization (Avg Mo Utiliz/Cost):

   Physician Services 29.29/$199.39 29.26/$212.52 31.28/$215.21 32.21/$219.97

   Inpatient Hospital 1.55/$5,371.09 1.65/$5,725.86 1.69/$5,954.30 1.73/$6,185.92

   Outpatient Hospital 7.05/$438.19 6.87/$477.81 7.06/$488.24 6.99/$508.55

   Other Medical 3.14/$321.35 3.13/$343.38 3.14/$364.38 3.14/$372.40

   Chiropractic Services 1.00/$34.83 1.05/$36.14 1.09/$36.14 1.14/$36.94

   Medicare Crossover 8.19/$197.13 8.58/$251.42 8.67/$206.99 8.76/$217.34

   Indian Health Services 22.38/$507.70 20.77/$479.29 32.38/$533.29 32.38/$533.29

   Prescription Drugs:

   Avg. Utilization/Prescriptions Per Month 23.65/2.67 23.14/2.69 23.77/2.69 23.92/2.69

   Average Cost Per Prescription $69.99 $68.75 $71.39 $72.96

   Adult Services:

   Average Eligible Clients 27,619 27,871 28,790 29,099

   Dental Average Utilization/Cost 5.07/$181.26 5.36/$186.23 5.52/$191.82 5.69/$197.57

   Optometrist Average Utilization/Cost 1.88/$92.35 1.69/$120.36 1.81/$120.36 1.81/$123.01

   Children's Services (EPSDT)

   Avg. Children - LIF/Foster Care 17,955/3,755 18,047/3,728 18,331/3,800 18,331/3,850

   Expanded Medical/Disabled 33,532/2,680 30,384/2,815 35,694/2,941 38,914/3,071

   Avg. Monthly Utilization/Cost:

   Screening 1.47/$68.08 1.11/$86.19 1.47/$86.19 1.47/$88.09

   Dental Services 7.84/$178.85 8.50/$182.14 8.93/$137.00 9.24/$168.12

   Optometric Services 1.53/$82.44 1.37/$105.26 1.53/$105.26 1.53/$107.58

   Treatment Services 1.73/$914.16 1.55/$1094.56 1.49/$1,094.56 1.49/$1,118.64

   Supplemental Medical Insurance (Buy-In):

   Part A Recipients/Premium 955/$416.55 969/$433.00 969/$452.00 969/$471.00

   Part B Recipients/Premium 15,456/$94.95 15,637/$96.40 15,914/$103.45 16,190/$115.50

   Balance Budget Act Expanded SMI/Premium 846/$94.96 932/$100.06 1,025/$103.45 1,128/$115.50

   Childrens Care Hospital:

   Avg. Residents/Per Diem Paid 58/$387.69 59/$461.02 65/$484.76 65/$484.76

   Renal Disease:

   Avg. Monthly Eligibles 10 6 6 6

   Avg. Monthly Cost Per Eligible $171.75 $64.71 $85.88 $85.88

   Managed Care Program Participants:

   Eligibles/Physicians in Primary Care 80,887/745 78,407/691 84,508/713 88,244/745

   Claims Processing:

   Claims Processed 4,137,672 4,677,770 5,030,235 5,220,180

   Claims Processed Per Eligible Person 40 45 45 45



   ADULT SERVICES AND AGING:

   Average Monthly Consumers Served 5,568 5,689 5,800 5,900

   Annual Unduplicated Consumers Served 8,291 8,476 8,662 8,853

   Title XIX Waiver Program Consumers Unduplicated 1,171 1,187 1,234 1,283

   In-Home Waiver - Unduplicated Consumers 165 142 148 154

   Assisted Living Waiver - Unduplicated Consumers 1,006 1,045 1,086 1,129

   In-Home Services (Non-Waiver)

   Nursing and Homemaker Aide Consumers 5,701 5,653 5,879 5,892

   Contracted Nursing and Homemaker Aide Hours 326,937 319,629 341,082 343,110

   Respite and Caregiver Consumers 695 637 731 833

   Community Support Services

   Adult Day Hours / Consumers 61,469 / 167 57,310 / 156 65,656 / 200 121,816 / 236

   Transportation Trips / Consumers 444,210/9,799 443,192/8,886 450,000/9,750 460,000/9,900

   Elderly Nutrition Program - Meals Served 1,529,471 1,488,328 1,552,575 1,552,575

   Nutrition Consumers Served Per Day 6,112 6,021 6,150 6,150

   Long Term Care Services

   Nursing Facilities - Consumers 3,647 3,609 3,609 3,609

   Assisted Living Centers - Consumers 695 726 726 726

   Adult Foster Care - Consumers 17 12 12 12

   Victims Services

   Unduplicated Victims Served 17,942 16,077 17,000 18,000

   Unduplicated Victims Sheltered 4,492 4,674 5,000 5,500

   Victims Compensation Claims Approved 196 238 280 340

generated 11/25/09 03:17:29 PM

	ACTUAL FY 2008	ACTUAL FY 2009	BUDGETED FY 2010	REQUESTED FY 2011	GOVERNOR'S RECOMMENDED FY 2011	RECOMMENDED INC/(DEC) FY 2011
FUNDING SOURCE:
General Funds	$208,597,653	$191,077,992	$189,400,278	$246,006,602	$233,657,854	$44,257,576
Federal Funds	379,123,909	423,819,862	467,188,006	533,561,080	512,031,914	44,843,908
Other Funds	1,551,415	1,462,967	5,044,538	2,891,012	2,991,730	(2,052,808)
Total	$589,272,977	$616,360,821	$661,632,822	$782,458,694	$748,681,498	$87,048,676

EXPENDITURE DETAIL:
Personal Services	$6,271,996	$6,822,172	$7,680,652	$7,680,652	$7,715,603	$34,951
Operating Expenses	583,000,981	609,538,649	653,952,170	774,778,042	740,965,895	87,013,725
Total	$589,272,977	$616,360,821	$661,632,822	$782,458,694	$748,681,498	$87,048,676

Staffing Level FTE:	133.2	139.9	145.5	145.5	145.0	( 0.5)

	ACTUAL FY 2008	ACTUAL FY 2009	ESTIMATED FY 2010	ESTIMATED FY 2011
REVENUES:
Total	$0	$0	$0	$0
PERFORMANCE INDICATORS:
MEDICAL SERVICES:
Average Persons Eligible:
Aged/Blind	5,593/84	5,546/84	5,481/84	5,420/84
Disabled Adults/Children	11,226/2,680	11,444/2,815	11,647/2,941	11,854/3,071
Low Income Family (LIF) Adults/Children	10,800/17,955	10,797/18,047	11,418/18,331	11,581/18,331
DSS and DOC Foster Care Children	3,755	3,728	3,800	3,850
Pregnant Women	1,903	1,873	1,855	1,833
QMB	3,311	3,409	3,506	3,604
Medical Services Programs for Children:
Title XIX Funded	33,532	34,959	40,294	43,614
Title XXI Funded, Under 140% of FPL	8,984	9,254	9,732	9,996
Title XXI Funded 140%-200% of FPL	2,487	2,564	2,694	2,766
Total Title XIX Eligibles	90,839	92,702	99,357	103,242
Total Title XXI Eligibles	11,471	11,818	12,426	12,762
Total Avg. Persons Eligible (XIX & XXI)	102,310	104,520	111,783	116,004
Total Average Cost Per Title XIX Eligible	$3,884	$4,088	$4,671	$4,925
Average Cost Per Title XIX Eligible by Service:
Physicians	$710	$774	$825	$867
Inpatient Hospital	$983	$1,129	$1,256	$1,411
Outpatient Hospital	$371	$394	$414	$427
Prescription Drugs	$342	$366	$407	$428
All Other Services	$1,478	$1,425	$1,769	$1,792
Program Utilization (Avg Mo Utiliz/Cost):
Physician Services	29.29/$199.39	29.26/$212.52	31.28/$215.21	32.21/$219.97
Inpatient Hospital	1.55/$5,371.09	1.65/$5,725.86	1.69/$5,954.30	1.73/$6,185.92
Outpatient Hospital	7.05/$438.19	6.87/$477.81	7.06/$488.24	6.99/$508.55
Other Medical	3.14/$321.35	3.13/$343.38	3.14/$364.38	3.14/$372.40
Chiropractic Services	1.00/$34.83	1.05/$36.14	1.09/$36.14	1.14/$36.94
Medicare Crossover	8.19/$197.13	8.58/$251.42	8.67/$206.99	8.76/$217.34
Indian Health Services	22.38/$507.70	20.77/$479.29	32.38/$533.29	32.38/$533.29
Prescription Drugs:
Avg. Utilization/Prescriptions Per Month	23.65/2.67	23.14/2.69	23.77/2.69	23.92/2.69
Average Cost Per Prescription	$69.99	$68.75	$71.39	$72.96
Adult Services:
Average Eligible Clients	27,619	27,871	28,790	29,099
Dental Average Utilization/Cost	5.07/$181.26	5.36/$186.23	5.52/$191.82	5.69/$197.57
Optometrist Average Utilization/Cost	1.88/$92.35	1.69/$120.36	1.81/$120.36	1.81/$123.01
Children's Services (EPSDT)
Avg. Children - LIF/Foster Care	17,955/3,755	18,047/3,728	18,331/3,800	18,331/3,850
Expanded Medical/Disabled	33,532/2,680	30,384/2,815	35,694/2,941	38,914/3,071
Avg. Monthly Utilization/Cost:
Screening	1.47/$68.08	1.11/$86.19	1.47/$86.19	1.47/$88.09
Dental Services	7.84/$178.85	8.50/$182.14	8.93/$137.00	9.24/$168.12
Optometric Services	1.53/$82.44	1.37/$105.26	1.53/$105.26	1.53/$107.58
Treatment Services	1.73/$914.16	1.55/$1094.56	1.49/$1,094.56	1.49/$1,118.64
Supplemental Medical Insurance (Buy-In):
Part A Recipients/Premium	955/$416.55	969/$433.00	969/$452.00	969/$471.00
Part B Recipients/Premium	15,456/$94.95	15,637/$96.40	15,914/$103.45	16,190/$115.50
Balance Budget Act Expanded SMI/Premium	846/$94.96	932/$100.06	1,025/$103.45	1,128/$115.50
Childrens Care Hospital:
Avg. Residents/Per Diem Paid	58/$387.69	59/$461.02	65/$484.76	65/$484.76
Renal Disease:
Avg. Monthly Eligibles	10	6	6	6
Avg. Monthly Cost Per Eligible	$171.75	$64.71	$85.88	$85.88
Managed Care Program Participants:
Eligibles/Physicians in Primary Care	80,887/745	78,407/691	84,508/713	88,244/745
Claims Processing:
Claims Processed	4,137,672	4,677,770	5,030,235	5,220,180
Claims Processed Per Eligible Person	40	45	45	45

ADULT SERVICES AND AGING:
Average Monthly Consumers Served	5,568	5,689	5,800	5,900
Annual Unduplicated Consumers Served	8,291	8,476	8,662	8,853
Title XIX Waiver Program Consumers Unduplicated	1,171	1,187	1,234	1,283
In-Home Waiver - Unduplicated Consumers	165	142	148	154
Assisted Living Waiver - Unduplicated Consumers	1,006	1,045	1,086	1,129
In-Home Services (Non-Waiver)
Nursing and Homemaker Aide Consumers	5,701	5,653	5,879	5,892
Contracted Nursing and Homemaker Aide Hours	326,937	319,629	341,082	343,110
Respite and Caregiver Consumers	695	637	731	833
Community Support Services
Adult Day Hours / Consumers	61,469 / 167	57,310 / 156	65,656 / 200	121,816 / 236
Transportation Trips / Consumers	444,210/9,799	443,192/8,886	450,000/9,750	460,000/9,900
Elderly Nutrition Program - Meals Served	1,529,471	1,488,328	1,552,575	1,552,575
Nutrition Consumers Served Per Day	6,112	6,021	6,150	6,150
Long Term Care Services
Nursing Facilities - Consumers	3,647	3,609	3,609	3,609
Assisted Living Centers - Consumers	695	726	726	726
Adult Foster Care - Consumers	17	12	12	12
Victims Services
Unduplicated Victims Served	17,942	16,077	17,000	18,000
Unduplicated Victims Sheltered	4,492	4,674	5,000	5,500
Victims Compensation Claims Approved	196	238	280	340