Division of Public Assistance January 29, 2015 Department of Health & Social Services Ronald Kreher, Director

2 Mission: » To promote self-sufficiency and provide for basic living expenses to Alaskans in need in order to support the health, safety and well being of all Alaskans.

Integration of Medicaid with Department Services 3

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Making Government Work 5

Field Services » Standardized LEAN business process model implemented in all field offices ◆ Reduced application cycle time ◆ Improved timely issuance of ongoing benefits » Universal, balanced workload for field offices ◆ Staff in specialized units and offices being trained in all programs » Use of technology for distance-delivery of training reduces training time and travel costs ◆ Reduced costs by almost 50% ◆ Cut time to train staff in all programs in half (6 months vs 12 months) ◆ Most staff become proficient in all programs in half the time (12 months vs 24) » New Denali Care Card replaced “coupons” ◆ Estimated savings up to $350.0 annually » Efficient and effective administration of Food Stamp Program ◆ $2,074.8 in bonus funds since SFY2009 6

Fraud Control » Dedicated research analyst for Fraud Control Unit optimizes data mining » Streamlined fraud process to close cases or reduce benefits to households with ineligible members ◆ Changes resulted in an increase of $3,200.0 in state/federal cost avoidance over prior year Women, Infants, and Children Supplemental Nutrition Program (WIC) » Successful implementation of new benefit issuance system for Women, Infants and Children (WIC)Program » Consolidated WIC program service areas from 18 to 13 ◆ Reduced overall administrative costs 7

Child Care Program Office » Improved internal Administrative Hearings process resulting in reduced hearing requests as well as staff time and costs related to hearings » Implemented improved Child care Licensing and Complaint and Investigation Process April 1, 2013 ◆ 4/1/13 : 39 outstanding investigations and 138 days to complete investigation and issue a report ◆ July 1, 2013: 12 outstanding investigation s and 42 days to complete investigation and issue a report 8

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Funding Differences 10 Unrestricted General Funds reduction attributed to overall reduction in departmental expenditures. Designated General Funds increase in Permanent Fund Dividend Hold Harmless (PFDHH) related to anticipated program growth. Federal Funds decrease associated primarily to expiring ARRA funding. Other Funds increase as a result of growth in PFDHH.

FY2015 Governor’s Operating Request 11 Public Assistance FY2014 Mgmt Plan Adjusted Base FY2015 Governor 14 Mgmt Plan to Governor Adjusted Base to Governor Unrestricted General Funds $165,967.8$165,891.0$165,841.0-$126.8-$50.0 Designated General Funds $17,642.7 $17,892.7$250.0 Federal Funds $133,904.5$132,889.2$133,046.0-$858.5 $156.8 Other Funds $13,964.4$14,093.9$13,997.4$33.0-$96.5 Total $331,479.4$330,516.8$330,777.1-$702.3$260.3 Position Total (PFT)

Division of Public Assistance – FY2013 Actuals (Undesignated General Fund, Designated General Fund, Other, Federal) 12 Division Total - FY2013 (Actuals UGF/DGF/Other/Fed Undesignated GF166,017.8 Designated GF15,907.4 Other Funds11,929.1 Federal Funds112,697.1 Total $ 306,551.4

FY2014 Management Plan 13

Priority 1: Health & Wellness Across the Lifespan 14

Priority 1 - Division of Public Assistance Contribution 15 The Division’s Family Nutrition Program supports Alaskans’ lifelong heath and wellness through: Science-based nutrition education Breastfeeding Support Delivery of healthy supplemental foods though Family Nutrition Programs Women, Infants and Children Program (WIC) Commodity Supplemental Food Program Farmer’s Market Nutrition Program Senior Famer’s Farmers Market Program Supplemental Nutrition Education Program

16 Breastfed infants have less respiratory infections and reduced risks for obesity Breastfeeding moms have reduced risk for breast & ovarian cancer, Type 2 diabetes, and postpartum depression Communities with WIC approved stores have access to whole grains/breads, fruits and vegetables, eggs, low sugar cereals, and milk WIC approved grocery stores put $1.5 million of healthy food sales into local economies each month Low income senior citizens maximize limited food dollars by receiving Commodity Supplemental Food Program boxes Healthy Outcomes For Alaskans of All Ages

Priority 2: Health Care Delivery and Access 17

Priority 2 - Division of Public Assistance Contribution 18 For many low-income Alaskans, access to affordable health care begins with an application for Medicaid, Denali KidCare, or Chronic and Acute Medical Assistance.

Core Service 2.2 Facilitate access to affordable health care for Alaskans 19 3,000 - Approximate number of Medicaid applications received monthly 17 - Average number of days from application date to decision date 148,686 - Number of annual unduplicated recipients in FY , Average number of recipients in FY % - Medicaid benefit determination accuracy rate 95.5% - Denali KidCare benefit determination accuracy rate Percentage of timely benefit issuances for ongoing cases

20 Income Limits for MAGI Based Medicaid Categories Effective January 1, 2014 Household Size Parents and other Caretakers and Under 21 Medicaid Pregnant Women Children Under Age 19 (with Insurance) Children Under Age 19 (without Insurance Approx. 130% FPL*200% FPL 177% FPL203% FPL 11,3522,392 2,1172,428 22,1103,230 2,8593,279 32,5254,069 3,6014,130 42,9394,907 4,3434,981 53,3545,745 5,0855,832 63,7686,584 5,8276,683 74,1827,422 6,5697,533 84,5968,260 7,3118,384 95,0119,099 8,0539, ,4259,937 8,79410,086 Ea. Addl *FPL varies depending household size

Priority 3: Safe and Responsible Individuals, Families, & Communities 21

Priority 3: Division of Public Assistance Contribution 22 The Division helps families with dependent children find and keep a job working families have safe, affordable, quality child low-income Alaskans have warm homes ensure families and individuals have food security

CORE SERVICE 3.1 Strengthen Alaska Families Objective Increase the number of Alaska families who are employed Effectiveness Measure a - Percent of individuals receiving employment related services from the department who achieve employment Strategies: » Integrate service delivery within the division, partner divisions and other agencies serving common clients » Leverage technology to better identify common clients to improve case management business processes Actions: » Coordinate and integrate department level initiatives that provide supports for at-risk families with dependent children » Incorporate Master Client Index into development of Alaska’s Resource for Integrated Eligibility Services (ARIES). 23

Objective Increase the number of Alaska families with access to safe, affordable, high quality child care » Effectiveness Measure a - Percent of child care licensed facilities participating in the Alaska Child Care Assistance Program (CCAP) Strategies: » Educate parents about high quality child care » Develop and implement a Quality Rating and Improvement System (QRIS) Actions: » Targeted and widespread distribution of education materials about high quality child care » Update the QRIS state plan, develop a timeline, and secure funding for implementation. 24

Caseload Projections 25

Division’s 5 year look ahead 26