Committee: Joint Appropriations Subcommittee #2
South Dakota Department of Health
Mr. Bill Pike, LRC, presented the committee with budget information ( Document #1)
Ms. Doneen Hollingsworth, Secretary, Department of Health (DOH), presented the committee with
an overview of the Department and a budget summary ( Document #2). Secretary Hollingsworth
introduced staff members: Ms. Joan Adam, Division of Administration Director, DOH; Mr. Kevin
Forsch, Health System Development and Regulation Division Director, DOH; Mr. Rex Van
DenBerg, Health and Medical Services Division Director, DOH; and Ms. Linda Zeller, Finance
Officer, DOH.
Secretary Hollingsworth provided an overview of the Department. She noted South Dakota law
allows for three categories of hospitals: general, critical access, and specialized. Critical access
hospitals are generally small rural hospitals that have downsized. There is a limit on the number of
beds and number of staff they may maintain. They are networked with a larger hospital and in return
receive an enhanced Medicare reimbursement rate.
The Secretary noted a dramatic increase in the number of Assisted Living Centers (ALCs) licensed by the state. Mr. Forsch estimated approximately 90% of the 8,500 beds in ALCs are occupied. Secretary Hollingsworth reported that all air ambulances are licensed by the DOH.
Senator Lange noted McPherson County might provide insight on effective immunization
procedures. All vaccines for South Dakota go through the Department of Health and are provided
free of charge to each provider. Senator Lange asked whether the cost of not immunizing children
can be quantified. Secretary Hollingsworth noted there are national studies that have addressed that
issue.
The Secretary reported that in the Rural Health program the percentage of vacancies for mid-level
providers has decreased from 25% in 1991 to a handful in 1998. The program also successfully put
together a soft match for a federal grant for the Breast and Cervical Cancer Program.
The Public Health Laboratory has emphasized testing for other agencies. There is no backlog of
cases, and the laboratory works hard to be timely and therefore competitive.
The Office of Health Protection and Emergency Medical Services (OHPEMS) is expanding its
training focus.
Senator Kleven assumed the gavel.
Senator Hainje inquired as to the status of regional training and testing offered by (OHPEMS) The
DOH feels the new regional system is working well.
Secretary Hollingsworth reported on the Suicide Prevention program. The Department's role is
primarily to provide resource packets and point out services available in other agencies. The
Department also sponsored a satellite downlink on the subject.
The subdivision of Data, Statistics, and Vital Records has automated all birth records since 1929.
These records are now accessible at county deeds offices and can be ordered through the
Department's web site. The requested increase for 0.5 FTE in this subdivision is not for the
automation project.
Chair Frederick resumed the gavel.
Secretary Hollingsworth reviewed the Department's budget history over the past 4 years. This year's
request for a 0.5 FTE is for data entry of three forms resulting from a new state law regarding
abortions. There are approximately 1,000 abortions/year in the state.
Senator Bogue inquired why hospitals run the FPRP. The Secretary noted the money for that
program is expended on residents' salaries and not administrative costs. Senator Kleven requested
additional information on the status of the program.
Secretary Hollingsworth reviewed budget increase requests for the Health System Development and
Regulation Division. The Secretary noted the Department has no control over the costs, they just
receive the bill. She reported that $513,000 in license fees are collected and returned to the general
fund. The Department is also requesting a new FTE to conduct surveys of ALCs and abortion
clinics. Federal funds cannot be used for this position since ALCs do not have Medicare/Medicaid
requirements. Senator Frederick noted the importance of maintaining the integrity of ALCs. The
increase in number of licensed ALCs is related to the moratorium on nursing homes. In addition,
ALCs cost clients approximately one-third that of nursing homes ($1,000 - $1,500 vs. $3,000 -
$4,500).
Budgetary changes to the Division of Health and Medical Services include increases in general,
federal, and other funds, as well as two new FTEs. One FTE is requested for disease prevention
surveillance. There is no federal money available to fund the position.
Senator Lange asked for an explanation of the “Tar Wars”. This education program is for fifth
graders and requires minimal funding and staff time - approximately $2000. This is the only tobacco
prevention education program in the DOH. Most funding for tobacco education programs is in the
Department of Human Services. The DOH, the Department of Human Services, and the Department
of Education and Cultural Affairs collaborate to some extent regarding tobacco education.
The second FTE request is for facilitation of communication and coordination with private providers,
public agencies, and consumers regarding infant and prenatal care issues. South Dakota's infant
mortality rate is much higher than the national average. Senator Bogue noted the resources available
to the target population area are federal. He questioned the usefulness of the new FTE position. Mr.
Van DenBerg noted DOH already works with the federal providers in other medical services areas,
notably disease prevention. Senator Bogue proposed DOH working more closely with the
Department of Social Services instead to remove barriers prohibiting individuals from obtaining
medical services from the provider of their choice.
Representative Putnam assumed the gavel.
The Department requested a spending increase for the Public Health Laboratory in federal funds for
the purchase of a new piece of equipment and the supplies to use it, and a spending increase in other
funds related to contractual services and employee reclassification expenses.
Deborah Rumrill