Fiscal Year 2014 JFC Hearing Legislative Hall Senate Hearing Room February 19 - 21, 2013

1. Fiscal Year 2014 JFC Hearing Legislative Hall Senate Hearing Room February 19 - 21, 2013 Rita Landgraf Cabinet Secretary

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

3. Charting the Path Forward Where we want to be What we need to put in place • 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. • 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 Where we are • 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 Smaller, Smarter Government

4. 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. 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. Medicaid Growth

7. 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. Challenges or Opportunities • Healthy Lifestyles Groundwork • Council on Health Promotion Disease Prevention • The Collaborative for Healthy Weight • A Community Cooperative Agreement

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

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

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

12. Challenges or Opportunities • Moving LTC clients to community settings • Integration of LTC facilities into DSAAPD • Care Transitions Program

13. Challenges or Opportunities Cont’d • Moving LTC clients to community settings • Integration of LTC facilities into DSAAPD • Care Transitions Program

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

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

16. Food Supplement Program Growth

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

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

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

20. 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. MOVING FORWARD: THE NEXT FOUR YEARS

22. 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. 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. 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