74th Legislative Session -- 1999

Committee: Joint Appropriations Subcommittee #2

Thursday, January 14, 1999

                                            P - Present
                                            E - Excused
                                            A - Absent

Roll Call
P      Sen. Dennert
P      Rep. Burg
P      Sen. Lange
P      Rep. Klaudt
P      Sen. Bogue
P      Sen. Hainje
P      Sen. Kleven
P      Rep. Derby
P      Rep. Putnam, Vice-Chair
P      Sen. Frederick, Chair


OTHERS PRESENT: See Original Minutes

The meeting was called to order by Chair Frederick.

South Dakota Department of Human Services

Mr. John N. Jones, Secretary, Department of Human Services, presented the committee with the Telecommunications Relay Services budget information ( Document #1).

Mr. Fred Romkema, South Dakota Association of Community Based Services (SDACBS), presented the committee with background information on the SDACBS ( Document #2). He noted the importance of decreasing the turnover rate of the Adjustment Training Center (ATC) care providers and emphasized that salary increases will play a substantial role in decreasing turnover. Mr. Romkema introduced Mr. Daryl Kilstrom, Executive Director, Mitchell ATC; Ms. Lori Adam, Client, Mitchell ATC; Ms. Connie De Mcranntle, Parent; Ms. Janet DeSmet, Vocational Training Instructor, Mitchell ATC; Ms. Amanda Chada, Vocational Training Instructor, Mitchell ATC; Ms. Beth Conroy, Supervisor, Mitchell ATC.

Ms. DeMcranntle testified as to the type of care required by her daughter who is a resident at the Mitchell ATC.

Ms. DeSmet testified as to her daily responsibilities and the type of care she provides for her patients. Representative Putnam inquired as to any specialized training she may have received. She has a high school degree and finds the ratio of seven clients to one direct care provider comfortable

most of the time. She said that turnover of staff can be stressful, but it is difficult to retain employees in positions paying low wages. Representative Putnam asked if $1 or $2 more per hour would make a difference. Ms. DeSmet believes that it would make a difference to other employees; the starting wage for direct care providers at the Mitchell ATC is approximately $7.60/hr.

Ms. Chada testified as to her job responsibilities at the Mitchell ATC. She described her educational background and several of the specific tasks she performs as a vocational training instructor. She also described some of the vocational training contracts her clients have fulfilled.
Ms. Conroy testified as to her responsibilities as a supervisor and described her education and experience. She acknowledged the orientation and training budget figures could vary and may be lower than those cited in Document #2.

Mr. Romkema noted that they are happy with the Governor's budget recommendation but stressed the need for as much funding as possible, and as much funding as possible for new 21 year olds and any new clients. They serve a few clients with traumatic brain injury and emphasized the need for continued funding in this area also.

Senator Frederick asked if reimbursement rates in the budget book were stable. Mr. Romkema said they were fairly stable and the real concern is a change in ICAP scores, not in ICAP reimbursement. He noted funding for 21 year olds is not guaranteed since it is balanced on attrition, which may not occur early in the fiscal year and may not happen in the right center.
They are concerned whether adequate funding exists for new clients. Previously there was enough to cover new clients, but now budgets are tight and the trend is toward waiting lists.

Senator Lawler testified as a parent of a handicapped child living in a group home in Aberdeen. At that ATC the turnover rate is 80% and new people are trained as well as possible. His daughter keeps only $30 out of $400 in wages; the remainder goes to co-payments. Senator Frederick responded that the committee is looking into waivers on that issue.

Secretary Jones noted that the Department is aware of turnover and training costs because they also deal with this problem at the Redfield facility, which has a >30 % turnover rate.

Ms. Kim Malsam-Rysdon, Department of Human Services, noted that the state has a waiver for its Developmental Disabilities services from the federal government, and it gives South Dakota some leeway on co-payments ( Document #3). Clients who work can keep up to $200/month without a co-payment.

Senator Bogue inquired as to extra income from estates, etc. Some of this type of money might go into a trust, e.g., an inheritance, but most unearned income is treated like regular income. Total copayment statewide is just under $1 million from the 19 ATCs.

Senator Frederick asked why Senator Lawler quoted $30/month. Ms. Malsam-Rysdon suggested Social Security laws may impact her particular situation. It is not really possible to change the waiver to increase what working clients can keep. ATCs are guaranteed payment for their census as of July 1st, clients turning 21 years old are always taken care of regardless of when attrition occurs.



Senator Richter wants ATCs to feel assured they will be covered for each new person. It may be policy and what has always been done, but there needs to be real assurance. Secretary Jones responded that risk belongs to the Department of Human Services not to the ATC. The ATC will be paid.

Senator Frederick asked whether a waiting list exists. Ms. Malsam-Rysdon responded there is a waiting list of 16 adults; two are out of state and none are in crisis. Secretary Jones noted if someone were in crisis and there were no room at an ATC, the individual would be placed in the Redfield facility.

Representative Richter asked for an update on the eight case managers who came in last year. They work with the ATCs to ensure they all work evenly. Early results indicate they are happy with the structure. Representative Richter also requested an organizational chart for the Yankton and Redfield facilities, including salaries.

Representative Derby requested a description of the Guardianship program. This program assists with legal decisions for individuals who have no other help. No changes to the program are planned.

Secretary Jones reminded the committee of the request for traumatic brain injury money that has not come through in the Governor's budget recommendation. He noted they plan to keep working for those funds.


MOTION:      ADJOURN

Moved by:      Representative Klaudt
Second by:      Senator Kleven
Action:      Prevailed by voice vote.



Deborah Rumrill

_________________________________

Committee Secretary
Randy D. Frederick, Chair


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