Health and Social Services Agencies and Services
The Oklahoma Health Care Authority is the second largest state agency as measured by appropriations, at $991 million in FY 2017. With the addition of federal and revolving funds, this agency will spend over $5.8 billion in FY ’16, making it the single largest state agency. It 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 27 percent of Oklahomans. Two-thirds of the people covered are children but more than half of costs are for aged, blind, and disabled persons. Medicaid is a critical source of coverage for long-term care services, whether in an institutional setting or at home, for frail seniors and those with cognitive and physical disabilities. Most working-age adults, however, are excluded from Medicaid in Oklahoma regardless of how little they make. The state has refused to extend coverage to this population under the Affordable Care Act.
- Insure Oklahoma, started in 2007, offers insurance to certain categories individuals not eligible for Medicaid and provides premium assistance for low-income employees of participating small businesses (up to 250 employees).
The Department of Human Services (DHS) received appropriations of $652 million in FY 2017. Appropriations grew 20 percent since FY 2011, while the total state budget was approximately $6.8 billion in both years. The agency also receives approximately $1.5 billion in federal grants and other revenue. DHS has the most employees of any state agency, employing over 7,300 people in FY 2015, although the agency has been forced to reduce its workforce significantly due to recent budget cuts. DHS operates several significant 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 8500,000 Oklahomans now receive SNAP assistance. This program cost $860 million in FY 2015 and is fully funded by the federal government.
- 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 12,000 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 $200 million in FY 2014. Less than 10 percent of total spending goes to basic cash assistance.
- Under the Pinnacle Plan, announced in 2012, OKDHS is committed to transforming 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;
- subsidize child care for eligible working families; 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 2017 were $325 million; it receives an additional $100 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 2017 was $92 million, making up over 80 percent of its funding. Nearly half the department’s spending is to house juvenile offenders. This agency also provides follow-up and aftercare for juveniles released from detention and counseling and other preventive programs.
The Oklahoma State Department of Health received approximately $55 million in state appropriations in FY 2017 and approximately $200 million in federal grants, as well as substantial amounts from fees and local property taxes that help operate county health departments. 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 operates the teaching hospital known as the OU Medical Center, through a contract with a private medical provider. Appropriations to the agency ($35 million in FY 2017) help pay for the cost of providing health care to the indigent.
- The Department of Veterans Affairs received approximately $31 million in FY 2017 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 $27 million in FY 2017 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.
- The J.D. McCarty Center, which received $4 million in FY 2017 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 $45 million in investment earning in FY 2016.