The Oklahoma Health Care Authority is the third largest agency as measured by appropriations, at $993 million in FY '11. This is the fastest growing appropriation of all state agencies. In FY 2000 the OHCA got 7 percent of all appropriations; by FY '11 its share was up to 15 percent. With the addition of federal and revolving funds, this agency will spend $4.6 billion in FY '11, making it the single largest state agency. It offers two major programs.

• Medicaid, called SoonerCare in Oklahoma, offers insurance to people eligible through income guidelines. Medicaid is a large insurer and significant driver in the economy in Oklahoma, covering 21 percent of Oklahomans. Two-thirds of the people covered are children but more than half of costs are for aged, blind, and disabled persons.
• Insure Oklahoma, started in 2007, offers insurance to individuals not eligible for Medicaid and to small businesses (up to 250 employees).

The Department of Human Services (DHS) received appropriations of $543 million in FY '11. Appropriations grew 35 percent since FY '02, well over the 22 percent growth in the total budget. The agency also receives approximately $1.4 billion in federal grants and other revenue. It 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 600,000 Oklahomans now receive SNAP assistance. This program cost $860 million in FY' 10, with more Oklahomans eligible as a result of the recession.
• 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.  Less than 10,000 families receive cash assistance through TANF, about one-third the number that participated in 1997. This program is much smaller than food stamps, with annual costs $58 million in FY ‘01.
• Other DHS programs:
  • provide medical care and other assistance for the developmentally disabled;
  • 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 '11 were $188 million; it received 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 state mental hospitals for adults and youth.

The Office of Juvenile Affairs appropriation in FY '11 was $95 million, making up nearly all of its spending. 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 $64 million in state appropriations in FY ‘11 and approximately $130 million in federal grants, as well as $160 million from fees and local property taxes that help operate community health programs. 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 ($39 million in FY '11) help pay for the cost of providing health care to the indigent.
• The Department of Veterans Affairs received approximately $36 million in FY '11 appropriations to operate seven nursing care facilities for veterans.
• The Department of Rehabilitative Services 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 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 voters in 2000 to preserve and allocate money Oklahoma received in a legal settlement with major tobacco companies. The settlement will be paid out over 25 years and is restricted for use in combating cancer, reducing tobacco use, and improving Oklahomans' health.

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