Health and Social Services Agencies and Services

The Oklahoma Health Care Authority is the second largest state agency as measured by appropriations,at $1.0 billion in FY 2021. With the addition of federal and revolving funds, this agency spent $5.6 billion in FY ’19, making it the single largest state agency in total spending. OHCA offers two major programs.

• Medicaid, called SoonerCare in Oklahoma, offers insurance to people if they fall under certain income guidelines and eligibility categories. Medicaid is a large insurer and significant driver in the economy in Oklahoma, covering 25 percent of Oklahomans. Medicaid is a critical source of coverage for long-term care services, whether in an institutional setting or at home, for frail seniors and for those with cognitive and physical disabilities. Most working-age adults are excluded from Medicaid in Oklahoma regardless of how little they make, but some 200,000 will be served when Medicaid is expanded to adults with incomes up to 138 percent of the federal poverty level in 2021.
• Insure Oklahoma, started in 2007, offers insurance to some individuals not eligible for Medicaid and provides premium assistance for low-income employees of participating small businesses (up to 250 employees). Some Insure Oklahoma members will be served by Medicaid after it expands.

The Department of Human Services (DHS) received appropriations of $714 million in FY 2021. Appropriations grew 28 percent since FY 2009, while the total state budget increased eight percent. The agency also receives approximately $1.4 billion in federal grants. DHS has the most employees of any state agency, employing 6,000 people in FY 2020. DHS offers several important assistance programs. 

• The federally-funded Supplemental Nutrition Assistance Program (SNAP, formally known as food stamps), provides those who meet income guidelines with help purchasing food. Over 800,000 Oklahomans now receive SNAP assistance. This program cost $805 million in FY 2019 and is fully funded by the federal government.
• Child care subsidies, paid with both federal and state dollars, help pay the costs of child care for low- and moderate-income parents who are working or in school. In 2019 DHS spent $145 million on subsidies, serving just under 50,000 children.
• Temporary Assistance for Needy Families (TANF), a federal block grant, helps fund job training, work supports, and, in some instances, short-term cash payments for low-income single parents.  About 13,500 families receive cash assistance through TANF, representing less than one percent of the population. This program is much smaller than food stamps, with annual spending of just under $35 million spent on cash assistance and work programs in FY 2019.
• Child Welfare Services investigates child abuse and neglect, provides preventive programs, finds safe homes for children and supports family reunification wherever possible. The Pinnacle Plan, announced in 2012, transformed the state’s child welfare system that serves the more than 10,000 children who have been placed in state custody.
• Other DHS programs:
  • provide medical care and other assistance for those with developmental disabilities;
  • investigate child abuse and protect children;
  • provide transportation, meals, and care for seniors who can live at home; and
  • collect child support from absent parents of children who are eligible for DHS services.

Appropriations to the Department of Mental Health and Substance Abuse Services in FY 2021 were $335 million. The department receives an additional $140 million from federal and other sources. This agency supports community-based mental health care through contracts with a network of local community mental health centers, alcohol and substance abuse treatment programs, and operates state mental hospitals for adults and youth.

The Office of Juvenile Affairs appropriation in FY 2021 was $93 million. This agency provides residential services for juvenile offenders, follow-up and aftercare for juveniles released from detention and counseling and other preventive programs.

The Oklahoma State Department of Health received approximately $58 million in state appropriations in FY 2021 and approximately $190 million in federal grants. This agency helps eligible families with family planning, children’s health, child abuse prevention, dental care, and identification of developmental, speech and hearing, and other problems in children. The Department of Health also offers community health services, prevents and controls communicable diseases, and regulates many health care providers.

Several other health and social services agencies receive state appropriations.

• The University Hospitals Authority and Trust operates the teaching hospital known as the OU Medical Center, through a contract with a non-profit medical provider. Appropriations to the agency ($67 million in FY 2021) help pay for the cost of providing health care to the indigent and support medical education and research. The Oklahoma State University Medical Center received $45 million in appropriations for the same purposes.
• The Department of Veterans Affairs received approximately $33 million in FY 2021 appropriations primarily to operate seven nursing care facilities – in Talihina, Sulphur, Claremore, Norman, Lawton, Clinton, and Ardmore – for veterans.
• The Department of Rehabilitative Services received $35 million in FY 2021 appropriations. The agency manages vocational rehabilitation programs, operates state schools for the deaf and the blind, and determines if people qualify for Social Security disability payments. Most of the agency’s funding, $83 million in FY 2019, comes from federal grants.
• The J.D. McCarty Center, which received $5 million in FY 2021 appropriations, provides residential care and camps for children with developmental disabilities. 

The only significant non-appropriated agency in this area is the Oklahoma Tobacco Settlement Endowment Trust. It was created by 2000 upon passage of State Question 692 to preserve and allocate money Oklahoma received in a legal settlement with major tobacco companies. The settlement will be paid out in perpetuity and is restricted for use in combating cancer, reducing tobacco use, and improving Oklahomans’ health. TSET allocated just over $52 million in investment earning in FY 2019. In 2020 voters rejected a state question that would have shifted half the settlement from the TSET endowment to pay for Medicaid services.

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