Latest news with #MattAlthoff
Yahoo
6 days ago
- Business
- Yahoo
Federal action could make SD's Medicaid work requirements ‘an exercise in futility,' official says
South Dakota Department of Social Services Secretary Matt Althoff speaks at a press conference in Sioux Falls on April 25, 2025. (Makenzie Huber/South Dakota Searchlight) South Dakota's proposal to implement work requirements for Medicaid expansion could be 'an exercise in futility' now that the federal government is also considering it, said state Department of Social Services Secretary Matt Althoff. The state began drafting its proposal immediately following the end of the state legislative session in March, Althoff said, before debates about work requirements heated up at the congressional level. Department officials presented their plan at the state Board of Social Services meeting Friday morning via video conference, just before the first of two public hearings on the proposal. 'Respectfully, humbly, we ask for your grace,' Althoff told board members, 'because we're asking for your feedback on something that might be obsoleted by the vote of 100 senators and the stroke of a pen from our president.' Health care advocates form coalition urging Republicans to take their 'Hands Off Medicaid' Medicaid is government-funded health insurance for people with low incomes. South Dakotans voted in 2022 to expand Medicaid to adults with incomes up to 138% of the poverty level, a decision that allowed the state to capitalize on a 90% federal funding match — funding that could be in jeopardy, pending the outcome of congressional action. Last year, voters passed another constitutional amendment to let the state seek approval from the federal government to impose work requirements on expansion enrollees. At the federal level, proposed Medicaid work requirements would mandate those between ages 19 and 65 who rely on the program to work, participate in community service, or attend an educational program for at least 80 hours each month. The work requirement would be applied at the time of application, and Medicaid renewal would be changed to every six months instead of an annual basis. South Dakota's plan would require adult Medicaid recipients work, train, attend school or serve as a caretaker for a child or elderly or disabled person in their home unless they meet an exception. Compliance with the state-level work rules would be reviewed on an annual basis, at the time of Medicaid renewal, rather than at the time of application. The state would not require a set number of hours of work or education time. Heather Petermann, Medicaid director at the department, said the requirement would be a 'complement' to Medicaid to 'encourage' work without 'trying to track arbitrary work hours.' 'This approach really recognizes that for many individuals who need assistance with health care, that comes first,' Petermann said. 'Then it allows them to maintain their health so that they can work, or obtain the health needed to seek employment.' The federal government also has more exceptions in its proposal than the state, including tribal community members, people who are in foster care or were in foster care who are younger than 26, and people released from incarceration in the last 90 days. South Dakota would allow exceptions for people who are: Pregnant or postpartum. Disabled, as determined by the Social Security Administration. Diagnosed with cancer or another serious or terminal medical condition by a physician. In an intensive behavioral health treatment program, hospitalized or living in a nursing home. In an area with unemployment 20% or more above the national average and are exempt from Supplemental Nutrition Assistance Program requirements for able-bodied adults without dependents. As of last month, 30,542 South Dakotans were covered by the Medicaid expansion. The state estimates 80% of them already work or qualify for an exception. SD seeks Medicaid work rules in spite of similar moves by Congress The proposed state-level work requirement would reduce enrollment by an estimated 5-10% in the first year. That would save the Medicaid program between $48.9 million and $71 million in the first year, the department says. The federal proposal as it stands now will cost more administratively than South Dakota's proposed work requirements, Althoff added. States 'will be asked to absorb' costs if the federal proposal is adopted. The state's proposal requires less administrative oversight to reduce anticipated costs, due in part to the state's tight budget approved by the Legislature this year. 'That's just sort of naming the tension about how not having new funds is sort of an important wrinkle to our development process,' Althoff said. 'It's really having to be done within an existing budget.' Board member Colleen Winter said the proposal is 'respectful' of the individuals the department serves. Work requirements are already in place for some federal programs, such as SNAP, and state efforts, such as child care assistance and parental reunification expectations within Child Protection Services. While more than 20 people sat in on a virtual public hearing regarding the state's proposed Medicaid work requirements on Friday, only one member of the public spoke. Attorney Nathaniel Amdur-Clark spoke on behalf of the Great Plains Tribal Leaders Health Board. He said his client wants to see an exception for Indian Health Service beneficiaries. Native Americans who are tribal enrolled members are eligible to receive health care services through the federal Indian Health Service. Those individuals are eligible for Medicaid coverage even if they do not meet other Medicaid requirements, such as income limits, 'to implement and further trust and treaty obligations the U.S. has to provide health care' for tribal members, Amdur-Clark said. Though Althoff and Petermann did not respond to Amdur-Clark's comments about IHS patients, they did address the subject during the earlier board meeting. Petermann said the proposal includes 'geographic exemptions,' including areas of the state with 'high unemployment.' 'Things like that would also apply to tribal members and American Indians, but we otherwise did not call out or exclude American Indians,' Petermann said. 'The approach is that this is a benefit and we want that dignity and pride to be part of the benefit for everybody, so they would be treated the same in this approach.' Amdur-Clark added that there are technical concerns regarding exemptions in the proposal and that more work is needed to achieve 'real tribal consultation.' The department met with some tribal leaders last week to discuss the proposal, Althoff said. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX Shelly Ten Napel, CEO of the Community HealthCare Association of the Dakotas, said in an emailed statement that her organization is monitoring state and federal work requirement proposals closely. The group did not give input at the first public meeting, but plans to share its perspective on state work requirements during the public comment period. Ten Napel opposed last year's ballot measure authorizing the state's pursuit of work requirements. Compared to the work requirement proposal being considered in Congress, Ten Napel said, the state proposal is 'overall pretty reasonable.' Gov. Larry Rhoden's administration 'did a careful job of responding to concerns' raised during the debate last year, Ten Napel said, including administrative burdens and exceptions. 'We look forward to working with them to ensure smooth implementation of the new rules if they are approved by the Centers for Medicare and Medicaid Services,' Ten Napel said in the statement. 'We also encourage members of Congress to take a careful look at the common sense approach South Dakota is taking and rethink some of the heavy-handed rules currently under consideration in the Big Beautiful Bill.' The 'big beautiful bill' is the budget reconciliation legislation that the U.S. House sent to the Senate last week, including a Medicaid work requirements provision. Petermann said during the board meeting that South Dakota could perhaps seek to impose its own work requirements, even if the federal legislation passes. 'For example, some of the draft language does include references to things like 'the provisions from the federal legislation cannot be waived,' but we don't know whether that means states still could or couldn't have something that is less or more restrictive, as long as it has the same components,' Petermann said. 'We really don't know for sure yet.' If the state moves forward, it will submit an application to the Centers for Medicare and Medicaid Services in July or August. After that, the proposal would go through a federal comment period and application review. The department's next public hearing on the proposed Medicaid work requirements is set for 11 a.m. Central on June 12 at the Sioux Falls office of the Department of Social Services, and online.
Yahoo
6 days ago
- Business
- Yahoo
Social Services explains Medicaid work proposal
PIERRE, S.D. (KELO) — South Dakota's proposal to place work, training and education requirements on some of the adults who receive Medicaid benefits might not be submitted for federal approval, according to several of the state government officials who have overseen its design. South Dakota Social Services Secretary Matt Althoff and state Medicaid director Heather Petermann outlined the proposal called SD Career Link on Friday, first to an advisory board, and later at a general public meeting. SFPD: 7 confirmed overdose deaths so far in 2025 They said Congress is considering a variety of stricter Medicaid work requirements that recently received approval from the U.S. House of Representatives as part of the 'One Big Beautiful Bill Act' and now await formal action in the U.S. Senate. South Dakota's possible changes would affect only those men and women who became eligible for Medicaid benefits after South Dakota voters in 2022 approved expanding the maximum household income to qualify. What had been 100% of the federal poverty level was raised to 138%. In April, South Dakota provided Medicaid benefits to 147,234 women, men and children. Those include 30,542 men and women who became eligible as a result of the expanded income threshold. The proposed work, training and education requirements would apply only to those in the expansion group. Althoff said South Dakota already has work, training and education requirements for adults whose households receive SNAP, TANF and child-assistance benefits. He said work is a component for many of the department's programs. 'Some of what we're doing today has become an exercise in futility,' Althoff acknowledged to the state Board of Social Services on Friday morning. He said South Dakota's proposal would continue to go forward on a contingent basis because of uncertainty about the federal legislation at the congressional level and the Trump White House. South Dakota's proposal would need approval from the federal Centers for Medicare and Medicaid Services. Board member Howard Grinager of Sioux Falls asked whether South Dakota could still submit its plan as a variation that works best for South Dakota, even if Congress passes its legislation. Althoff replied that he doesn't know what will happen in Congress or whether President Donald Trump would sign Medicaid-related legislation into federal law. 'So everything is entirely speculative,' Althoff said. 'It's premature for me to answer that question.' South Dakota's proposal wouldn't require applicants to provide any proof of work, training or education up front. Their compliance would be checked when they apply for renewals each year. The federal legislation as passed by the U.S. House, on the other hand, would require applicants to show right away that they are working at least 80 hours per month, or spending at least 80 hours per month in community service, or attending work training at least 80 hours per month, or taking education courses on at least a half-time basis, or some combination totaling at least 80 hours per month. The federal legislation also more aggressively calls for renewals twice a year, while South Dakota currently requires annual renewals. The federal legislation exempts all people who are Indian Health Service beneficiaries, as well as people who have recently been released from incarceration in prisons and jails, while South Dakota's proposal doesn't at this point. Medicaid director Petermann said approximately 80% of the roughly 30,000 adults currently enrolled under the expanded income threshold would already meet South Dakota's proposed work, training and education requirement or would be specifically exempt. She said South Dakota's proposed exemptions would include adults with mental and physical disabilities, pregnant and postpartum women, and people living in a geographic area with high unemployment rates. There also would be what Petermann described as 'good cause exemptions' that would be reviewed internally for acceptance. As to the proposal's potential impact, Petermann said that is difficult to estimate. She said the expectation is a 5 to 10% reduction after the first year, and the numbers would stabilize in subsequent years. Added Althoff, 'There are a lot of assumptions the department has no control over.' South Dakota currently is in the middle of a public-comment period on the proposal. A second public session is scheduled for June 12 in Sioux Falls. Written public comments will be accepted through June 18. Althoff said South Dakota's three members of Congress have been in 'active dialogue' with Gov. Larry Rhoden's administration. Board member Colleen Winter of Pierre, a former state Department of Health employee, asked about administrative costs for monitoring. Petermann said there would be some costs for system upgrades. 'We don't know for sure how much those things would cost at this point, especially because you have to have approval first,' Petermann said. Althoff added, 'The voters voted on something that didn't have a cost component to it.' He said the Medicaid expansion benefits have been running less than two calendar years and state government is still watching and learning about how much the expansion beneficiaries are costing and how frequently they're using the services. The department would need to administer the work, training and education portion within the existing budget, according to Althoff. 'Not having new funds and new money for that is an important wrinkle to our process,' he said. Board member Grinager said the message behind the proposal is that work has a beneficial part in people's lives. 'It's not just a requirement for requirement's sake. We're going to start gently and let people work into it,' he said. 'So I really appreciate the approach that you, our department, has taken in putting this together.' Said Winter, 'It's very respectful of the individuals that we serve and are in need of services.' The public information session that followed was offered primarily by teleconference. It drew only a handful of people to the call and the only ones in the meeting room were DSS officials and a news reporter. One person spoke during the public comment period. Nathaniel Amdur-Clark, a lawyer representing the Great Plains Tribal Chairmen's Association, said the department wasn't following the federal pattern of government to government consultations with each tribe. Amdur-Clark said the proposal as currently written would have 'serious and deleterious effects' on tribal populations. He called for a specific exemption for Indian Health Service beneficiaries and pointed out a variety of other issues with the proposal, including a lack of follow-up with people who lost Medicaid coverage as a result of work, training and education requirements. Althoff said there was a tribal consultation meeting last week. He said there is a convention in South Dakota that there are quarterly meetings that rotate locations. 'There's also ways to arrive at a convention colloquially,' Althoff said. He said there was 'some very robust exchange and outstanding feedback received from that group last week.' When no one else responded to several prompts for comments, Althoff gave a closing summary. He stated, 'There's been no final determinations made.' He added that the department was responding to the wishes of South Dakota voters who last year approved allowing state government to pursue additional requirements. Althoff described the proposal as 'a very light touch approach to the requirement aspect' and 'a hope-filled approach,' noting that people would be allowed to seek medical care and have a year to find work or training or education. That, he said, is intended to offer 'a lift up' rather than be 'a hammer or lever.' Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
26-04-2025
- Health
- Yahoo
Life saving drug to be made more available in South Dakota
SIOUX FALLS, S.D. (KELO) — The state of South Dakota is partnering with Emily's Hope to provide life-saving medication kits to reverse opioid overdoses. Under this new program, people can get Naloxone kits anonymously at distribution boxes set up in high-traffic areas around the state. The Department of Health, Social Services and the Attorney General's office are working together in hopes of saving lives. Influenza, Whooping Cough seeing decline in SD Boxes like this will be placed at various locations around South Dakota. People can simply open a box and grab a Naloxone kit free of charge, no questions asked. The nasal spray rapidly reverses an overdose and is proven to save lives. Secretary of Social Services, Matt Althoff, says the goal is to get the life-saving drug into the hands of people who are most likely to need it. 'The anonymous distribution is a critical component that we realize, our goal, of course, is to create that safety net, always strengthening it, always making sure it's even broader,' said Althoff. The program is using funds from a settlement with opioid companies. Attorney General Marty Jackley secured $78.6 million as South Dakota's share. 'I'm a strong voice that those dollars need to not sit in trust funds for state government, they need to be put to use. And putting to use is why we are here today,' said Jackley. South Dakota Secretary of Health, Melissa Magstadt, has put it to use herself. She's very familiar with the impact Naloxone can have in the right hands. 'I have administered Naloxone myself, and actually seen patients wake up and come back after an overdose of opioids, its a very powerful medicine to save lives,' said Magstadt. Magstadt says Naloxone has already saved countless lives in South Dakota Emily's Hope founder, Angela Kennecke, likens naloxone to other life-saving tools like defibrillators and EpiPens. 'We will have the boxes in as many places as possible, I would like to see them by every defibrillator, everybody who has a defibrillator and if people want it in their homes, we will give it to them as well,' said Kennecke. This new initiative aims to distribute 20 thousand kits statewide. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
02-04-2025
- Health
- Yahoo
South Dakota behavioral health loses federal COVID funds
SIOUX FALLS, S.D. (KELO) – Millions of dollars worth of federal COVID-19 relief money will now be terminated from behavioral health initiatives in South Dakota. Jury chosen in DSS embezzlement trial According to the South Dakota Department of Social Services (DSS), the United States Department of Health and Human Services (HHS) terminated $2,982,719 in DSS' supplemental block grant awards from the American Rescue Plan Act (ARPA). The money supported a range of behavioral health treatment and prevention activities through DSS, said Matt Althoff, DSS Cabinet Secretary, in a statement to KELOLAND News. Although contracts are being terminated or amended, said Althoff, DSS does not anticipate any staff layoffs as a result of these cancellations. According to Althoff, DSS notified vendors and contractors of the immediate end of work and contracts related to these funding streams. The grants would've ended by September 30, 2025, according to the DSS website, Signed by former President Joe Biden in 2021, the American Rescue Plan Act is designed to fiscally aid Americans impacted by the effects of the COVID-19 pandemic. This is a developing story. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
