Representative Clark asked if the cost of the developmental stages of technology within the vital records element of the department was covered by charging for copies of the vital records. Mr. Hofer replied that the Bureau of Information and Telecommunications has funds within its budget to place the vital records within E-Government.

Representative Clark asked if there are federal funds for the vital records database development. Mr. Hofer that it is already budgeted for FY2001 and there are no federal funds for the development in FY2002.

Mr. Kevin Forsch from the Division of Health Systems Development and Regulation was introduced. He explained the purpose of his division. (See Document #2, pages 7, 8, 9, and 10)

Senator Kleven asked why the licensing for bed and breakfast establishments is down while the licenses for food and lodging establishments are remaining stable. Mr. Forsch explained that regulations have increased for bed and breakfast establishments so fewer licenses are being applied for.

Representative Pummel asked who provided the funds for licensing EMT's and the training they received. Mr. Forsch explained that the Department of Highway Safety supplied the funds for Avera to train them and his division licensed them after training.

Representative Pummel wanted clarification on the amount that Avera was paid to provide the training for EMT's. Mr. Forsch replied that Avera receives $70,000 per year.

Representative Derby inquired about a bill that was passed dealing with ADF's Mr. Forsch replied that the bill passed stated that a public entity could apply to have an ADF placed in their establishment for use with heart attack or code blue victims. They are in place so that when the establishments request emergency aid, they can notify the emergency personnel that the ADF is present for their use. The department's role is to explain the usage of the ADF, not to track or log purchase or usage.

Senator Madden asked if the federal funds recommended in their budget for the long-study of uninsured people could be used in other areas. Mr. Forsch said that the funds were specifically given for that study and couldn't be used in any other area.

Senator Drake asked if the critical access hospitals had a cap on how long patients could remain in the hospital for any given medical reason. Mr. Forsch explained that there is a limitation placed on the critical access hospitals for how long a patient may stay, but they have the flexibility to change the average.

Senator Drake asked if the assisted living facilities are causing problems within the nursing home community because they are taking away from the funding of nursing home facilities and if it is cheaper to place someone in assisted living rather than a nursing home, and if we are artificially driving up the cost of the budget by allowing the number of assisted living facilities to be licensed. Mr. Forsch replied that assisted living facilities are a necessity, that a lot of people are turning to them because of the actuality of their need and that nursing homes can declare a portion of their beds to be assisted living quarters rather than nursing home quarters without any expense besides licensing.

Senator Kleven asked if nursing homes had to have a certain percentage of occupancy in order to receive Medicare reimbursements from the federal government. Mr. Forsch explained that the nursing homes had to run at a 90% occupancy level.

Representative Pummel asked Mr. Forsch to explain how critical access hospitals receive a higher Medicare reimbursement rate when they convert. Mr. Forsch replied that when a hospital converts to having a total of twenty-five inpatient beds, limits the number of hospital stays, and staffs down their emergency room to include only an on-call physician, they are given aid by the federal government. This allows rural hospitals to keep their doors open.

Ms. Lori Gill, Division of Health and Medical Services, was introduced and explained the role of the division.

Representative Clark inquired about the Disease Prevention portion of Document #1, page 3, containing $206,000 from other funds. Ms. Gill referred to page five of Document #1 and explained that these funds were for varicella vaccine donations.

Representative Pummel asked if WIC is available in every city. Ms. Gill stated that they are in each city in either the community health office or the public health office.

Representative Clark asked if there is a fee for the services provided by Family Planning. Ms. Gill stated that there is a recommended donation amount given to each customer but they aren't required to pay a fee.

Senator Drake asked why the WIC programs are not shown to be in each city according to page thirteen of Document #2. Ms. Gill explained that the state may not have an office in each city, but if they do not, then the county or city does have one. (See map on page 13 of Document #2 for state- funded offices.)

Representative Clark asked if the Department is planning on adding to the “All Women Count” screening and if so, who would be screened. Ms. Gill replied that they are adding more tests to the screening to include blood-pressure and glucose level testing and that the women included are those who are already involved in the program and being screened otherwise.

Representative Clark inquired about the Breast and Cervical Cancer Control Program and if it included Native American women. Ms. Gill replied that it did and that they are trying to reach the Native American women.

Senator Drake addressed his concern about the databases that the Department is compiling and who would have access to the databases. Ms. Hollingsworth came forward to address Senator Drakes question and replied that the breast/cervical cancer database would contain no personal information but would only contain results of testing. She also stated that this information would not be shared with insurance providers.

Representative Clark addressed the $490, 929 from federal funds for the Well-Integrated Screening of Women and asked if these federal funds must be matched by the state. Ms. Hollingsworth stated that they do have to be matched by the state, but they will not ask for an increase in the budget to do so, but the Department will solicit donations for the funds.

Ms. Hollingsworth gave an overview of the department giving their accomplishments since last year.
Representative Clark asked to address the Bright Start Program and asked if Early Head-Start was virtually the same thing. Ms. Hollingsworth stated that they were similar but not the same and that they do share referrals.

Senator Drake inquired as to the number of patients each nurse within the Bright Start Program is responsible for, what their workload is, and if they also give aid to those on reservations. Ms. Hollingsworth stated that the nurses are monitoring the new mothers and newborns; they provide healthcare solutions; they have up to twenty clients each, and their workload is intense. They have just two pilot Bright Start Programs in effect as of now, in Rapid City and Sioux Falls.

Representative Pummel asked if the Department monitored the number of refused vaccinations due to religious reasons. Ms. Hollingsworth replied that they have less than .05 % that refuse.

Senator Greenfield asked how long the Bright Start program nurses continued to aid mothers after the baby was born. Ms. Hollingsworth replied that they help the mother and child until the child is three years of age.

Senator Drake asked if some of the projected ending balances of other funds could be put toward the diabetes screening. Ms. Hollingsworth stated that there is no prohibition to them using the funds for the screening. However, the Department would prefer volunteered funds and donated materials so the Department could allow a 60-day reserve in the other funds.

Senator Clark asked if the screening by nonprofit organizations was enough and why did the Department want to duplicate this screening. Senator Clark also addressed the issue that the diabetes screening is a one-time test and if it would be as effective as continual screening is. Ms. Hollingsworth replied that they are not trying to replace what the nonprofit organizations do. They are just making a huge one-time effort to not only provide a screening, but also mass-produce materials that give information about diabetes and to distribute this information as well.

Senator Greenfield asked what the $500,000 is for if the Department is going to get donated materials and volunteer workers. Ms. Hollingsworth stated that the recommended funds would cover television spots, advertising in other areas, and production and distribution of materials.

Senator Drake questioned the accuracy of the screening because of the lack of instruction to those who will come to be tested, i.e., they will have eaten. Ms. Hollingsworth stated that those who administer the tests are able to make adjustments to the readings based on the information given them by the clients being screened.

Senator Madden asked if there is documentation of the monies saved by the state by increasing awareness and early detention of diabetes. Ms. Hollingsworth replied that the department did not do a survey as to the amount of funds saved by the state but that the government has and it is the #1 cost in America to federal agencies.

Representative Clark asked if the one-time test didn't give positive results the first time a person was tested, and that same person then believed they didn't have diabetes and were not tested again in another year, what is the positive result of the one-time test they are asking to be funded. Ms. Hollingsworth replied that it will raise the awareness of diabetes and hopefully will draw some of the people who would not generally go and get tested by the nonprofit organizations or anywhere else.

Senator Dennert asked why there is an increase of approximately 25% in the recommended budget compared to FY2000. Ms. Hollingsworth replied that she did not feel the increase was that dramatic considering the new costs of inflation, etc.

Senator Drake asked why the Department is requesting a budget for 303.5 FTE positions when they only employ 289 FTE and where the extra funds remain. Ms. Hollingsworth replied that the federal

funds remain and they are hiring at this time.

Representative Clark addressed the lab bond payment. She asked if the payment is paid out of the federal funds why there is an additional $1, 926 recommended from the general fund. Ms. Hollingsworth replied that the increase is for the increase in 1/3 of the bond fee that has to be paid by the general fund. Ms. Hollingsworth also stated that 2/3 of the bond payment comes from the general fund and 1/3 is paid by the lab fees.

Senator Drake expressed that the lab bond payment issue needed to be further addressed as well as the FTE's budgeted.

The committee recessed at 11:05AM

The committee reconvened at 11:20 AM

Animal Industry Board

Dr. Sam Holland was introduced.

Dr. Holland explained the budget total and the $60,000 increase in funds needed. He explained the increase is for testing of cattle for Johnes Disease.

Senator Drake asked if there is a vaccine for Johnes Disease once it is found. Dr. Holland stated that there is a vaccine available but not used. If the cattle test positive, they are sent to slaughter as there are not any regulations stating that they cannot be eaten.

The rendering aspect of cattle farming was generally discussed between the committee members and Dr. Holland.

LeAnn Allstot