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LEADERSHIP AGENDA

ECONOMIC INDICATORS

DEPARTMENT PERFORMANCE

DEPARTMENT PERFORMANCE

Human Services

Chuck Palmer, Director

Mission Statement:
To help Iowans achieve healthy, safe, stable, and self-sufficient lives through the programs and services we provide.

Measures:
Preventing hunger
Children safe from re-abuse
Children's health care access
Child support due that is collected
Dollars saved through the Pharmaceutical Preferred Drug List (Iowa Medicaid) program

•  Performance Plan - How we measure our progress


•  Strategic Plan - How we plan for progress


•  Performance Report - How we report for progress


• Department Home Page - Learn more about this department

Why this is important:
Food Assistance prevents hunger and helps Iowans with low incomes meet their basic nutritional needs and increases their nutritional levels. Preventing hunger is one of the building blocks in all social services; it does not solve all of a family's problems, but other problems are more manageable if hunger is not an issue. Many people receiving Food Assistance are on fixed incomes. Food Assistance allows seniors to avoid making the difficult choice between buying food or prescription drugs. In additon, the Food Assistance program stimulates the economy for the benefit of all Iowans. The U.S. Department of Agriculture has estimated that every $5 of Food Assistance benefits generates $9.20 in local and state economic activity. The Food Assistance program brought $590.4 million into Iowa's economy in FY 2012, a 5.67% increase from the previous year. These funds generated an estimated $1.09 billion in overall economic activity. In FY 2012 a monthly average of 187,483 households and 402,510 individuals received benefits through the Food Assistance program. This was an increase of 10.7% more individuals and 3.8% more dollars over the previous year. Participation in Food Assistance is at an all-time high in Iowa and is expected to continue to increase with over 438,000 individuals projected to be participating by the end of FY 2013.

The Commodity Supplemental Food Program serves working families and the elderly with low-incomes who are living in Central Iowa. The Program serves approximately 2,991 Iowans per month, or 35,892 annually. Ninety-five percent (95%) of those served are elderly.

The Emergency Food Assistance Program distributes food to eight food banks, which then distribute the food to Iowans with low incomes throughout Iowa. Emergency food was distributed to nearly 268,000 individuals each month, or more than three million individuals annually. In FY 2012, 4.2 million pounds of comodities were distributed through this program.

What we're doing about this:
Recognizing that many eligible Iowans are still not receiving Food Assistance, DHS continues to find ways to make this important nutrition benefit available to all who qualify. Of particular concern are senior citizens and working families who may not realize that they could get help. DHS is able to reach out to seniors and the low-income public in several ways through collaboration with the Food Assistance Nutrition Program. DHS provides information on good nutrition, the benefits of activity, and how Food Assistance can help.

The Food Assistance Program is also achieving results by promoting its multi-program online application, continuing to support Electronic Benefits Transfer (EBT) access at Farmer's Markets, and utilizing a statewide Customer Service Center for clients to call to report changes. The online application for Food Assistance, the Family Investment Program, Medical Assistance, and Child Care Assistance is available at www.OASIS.Iowa.gov.

Why this is important:
This measure is an indicator of the safety of children and the effectiveness of efforts made by communities, providers, and the Department to work together to ensure children are safe from repeat abuse or neglect. Child neglect is considered "denial of critical care", failure on the part of a person responsible for the care of a child to provide for the adequate food, shelter, clothing, or other care necessary for the child's health and welfare when financially able to do so or when offered financial or other reasonable means to do so. In FY 2011, 79% of child abuse in Iowa was related to denial of critical care.

Additionally, the Department seeks outside multi-disciplinary oversight to ensure the child protection system is keeping children in Iowa safe from abuse. The Iowa Child Death Review Team and Citizen Review Panels identify strengths and weaknesses of the child protective service system as a whole. The Death Review Team reviews all records pertinent to the deaths of children ages 17 and younger, in order to recommend to the legislature initiatives and changes that will reduce or prevent such deaths in the future. The Citizen Review Panels specifically review current policy, review consistency of practice with current policy, analyze trends, and recommend policy based on their reviews.


What we're doing about this:
The Department continues to research and implement best practices in child welfare to improve our results success. The use of Family Team meetings to provide the family with support and focus on the safety of children, standardized risk and safety assessment tools, statewide safety training with providers and department staff, expansion of the service array to include Safety Services and Family Safety, and Permanency Services, centralized abuse registry and assessment ensure consistency statewide, engaging community partners in the development of community based child welfare services and supports, standardization of data and the integration of a quality assurance review process into everyday practice.

Why this is important:
Access to health care improves health, wellness, and quality of life. Healthy children are able to attend school, learn, grow, develop healthy lifestyles, and become productive adults. Iowa provides public health insurance to over 219,200 in Medicaid, 25,572 in Medicaid Expansion, and 39,884 in hawk-i. In addition to expanding coverage for children living in families whose income is less than 300% of the federal poverty level, SF 389 authorized the Department to take advantage of newly passed federal legislation that gives states the authority to find and enroll more children. The department has implemented presumptive eligibility and express lane eligibility for children.


What we're doing about this:
The Department conducts grassroots and media activities with the Department of Public Health and works cooperatively with schools, medical providers, businesses, the Department of Revenue, faith-based, and other organizations.

Why this is important:
Current child support collected in the month due helps families have predictable income to use for the needs of the children. Current support also helps families avoid the need for public assistance. In State Fiscal Year 2012, the Child Support Recovery Unit served 184,955 cases. Those cases represent 651,042 parents and children.


What we're doing about this:
Workers in the Child Support Division locate absent parents, secure income-withholding orders, and in the case of non-paying obligors, offset tax refunds and apply license sanctions. Seventy-two point six percent (72.6%) of child support due was collected and a total of $332.4 million in child support was collected in 2012.

Why this is important:
The implementation of the Preferred Drug List (PDL) and the receipt of Supplemental Drug Rebates from drug manufacturers have played a critical role in containing the costs of prescription drugs in the Iowa Medicaid program. The PDL was implemented in January 2005 and has saved the state nearly $247 million to date (state dollars), or an average of 52% of the drug budget. Members continue to have rapid access to medically necessary non-preferred drugs through an extremely efficient Prior Authorization system that provides determinations in an average time of less than two hours. Since PDL implementation, supplemental rebates have averaged approximately $5 million (state dollars) annually. The PDL has also increased the federal rebates to the point where the state currently collects over 50% of everything it spends on drugs back in the form of rebates. The annual state share of these combined rebates (minus federal offset rebates related to the Affordable Care Act [ACA]) is nearly $54 million.

The Affordable Care Act (ACA), effective January 1, 2010, impacted the program's rebate amounts. Changes to the program helped mitigate the impact. However, with the first ten quarters of data the rebate offset loss represents 7.6% of all rebates and the total bill is still yet unknown. Even with the resulting loss of rebates the savings exceeded the original projected target.


What we're doing about this:
DHS implemented a Preferred Drug List and negotiated for Supplemental Rebates beginning January 2005. The federal Medicare Part D drug program shifted drug costs out of the Iowa Medicaid program for dually eligible Medicaid members to the federal Medicare program, resulting in a reduction of expenditures from 2006 to 2007, as seen on the chart. In 2006, the Department collaborated in the creation of the Sovereign States Drug Consortium that leverages their collective covered lives to negotiate for discounts in drug costs. Since its inception, this group, authorized by the federal government, has allowed the state to obtain better supplemental rebates. There are currently seven states in the group representing approximately 2 million eligibles and over $1.1 billion in drug expenditures. An average of $37 million (state dollars) have been saved annually over the last six years through the Preferred Drug List and the rebate program.

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