can be privatized. She invited the committee to assist the department in determining what should
be privatized.
Sen. Suazo asked that adoptive services of children in state custody also be reviewed.
Ms. Arnold-Williams said that a review is taking place to see if adoptive services should be
privatized. Sen. Suazo also asked for information on legal services for immigrants. Sen. Taylor
said that the adoption people are making headway in schools educating students about adoption.
He recommended that a brochure be printed to help them. He said a $1 million savings to the
state would be realized within two years if 1 percent of unwed teens receive this information. He
asked that this issue be discussed in one of the committee meetings and a bill be prepared to fund
this effort.
Dr. Richard Melton, director of the Department of Health, discussed the organization
chart distributed in the packet. He turned to Dr. Scott Williams, deputy director, who distributed
two handouts outlining statistical health information.
Dr. Williams outlined some of the prominent issues. He explained that the department's
main function is to deal with controlling infectious diseases. He noted that many exposures are
made in day care facilities. He reviewed statistical information on infant mortality,
cardiovascular disease, obesity, and other health related matters . He said that motor vehicle
accidents and suicide are the leading causes of death in the state for teens. He explained that air
quality is also a big issue in health.
Dr. Melton said that the department will be looking at several issues this year including
the licensure of day care facilities, the relationship between the state and local health providers,
development of a fee schedule, an audit of the Office of Health Data Analysis, the abortion
video, Medicaid reform, emergency medical technician exposure to HIV, outcome measures, the
FACT initiative, and an aging and disability study.
Rep. Dayton asked if statistical accident data is available for cars and also motorcycles
for drivers with/without helmets. Rep. Saunders asked for a breakdown of accidents per miles
driven and fatalities. Rep. Davis asked for more information on the causes of suicide and data on
suicide attempts. Dr. Williams said that a study is being done on suicide to determine causes and
windows for intervention.
4. Overview of Legislation
Mr. Loftis directed committee members to the handout, "1997 Health Legislation." He
outlined the major legislation passed in the 1997 General Session. He noted issues such as
medical education, health care products, insurance, licensing, managed care, Medicaid,
malpractice, rural health care, and tobacco were addressed.
Mr. Loftis outlined the welfare reform legislation including the Single Parent
Employment Demonstration (SPED) which has been implemented statewide. The state is also
complying with federal welfare reform. He noted that the federal government is now providing
block grants and permitting the state to develop its own programs. He explained that the federal
government has developed stricter time limits for assistance and that the state has created the
new Department of Workforce Services.
Ms. Hancock outlined the legislation passed in the Human Services area. She discussed
child abuse protection, guardian ad litem amendments, adoption of children in DCFS custody,
child day care licensing, foster care citizen review board amendments, expanded conservatorship
and guardianship services for the elderly and disabled, informed consent amendments, the
children's justice center program, Child Welfare Reform Act amendments, and disability.
5. Potential Studies for 1997 Interim
Chair Stephens asked that the members outline their top five preferences and hand them in at the
end of the meeting. Mr. Andrews directed members to a list of potential study items in the
packet. He said that Rep. Jones asked that the committee study allowing the state to provide
insurance benefits to employees of nonprofit charitable entities.
Sunset and Repealer Statutes -- Mr. Andrews explained that there are several statutes in the health and human services area subject to sunset review this year. He said there are no
statutes in the area subject to the new repealer section of the code. He outlined related audits by
the Legislative Auditor General.
Sen. Peterson suggested that insurance underwriting practices be studied. Rep. Davis
suggested that mental health insurance regulation and health benefits should be studied. Rep.
Dayton said that emergency injections didn't receive adequate study and asked it be restudied.
Rep. Killpack recommended that the Office of Recovery Services and noncustodial parents be
studied. Sen. Suazo suggested studying the issue of utilizing funds to continue aid to legal
immigrants. Rep. Seitz suggested studying the coordination of tobacco programs and penalties
for sale of tobacco to youth. Rep. Baca suggested that the committee study the safety of children
in foster care and the negative effects of mediation on child support receivers. Sen. Peterson
suggested giving input on what might be included in a tobacco suit settlement, including
provisions for cessation patches for low income individuals. Rep. Holladay asked to study
providing vouchers for the aged and/or disabled. Rep. Davis suggested studying issues
surrounding children at risk, the FACT program, and child welfare reform. Rep. Saunders
suggested studying day care center disease rates. Rep. Carlson requested a study of the high rate
of certain diseases and suicide in Utah and their prevention, and also review the high-risk
insurance pool study, when available. Rep. Davis asked for ample time to study selected issues
rather than giving many issues a cursory review. The committee members agreed. Rep.
Holladay asked to study the expanding of underwriting of health care for individual markets.
Rep. Baca suggested studying student safety, the forensic facility for the mentally ill in the
justice system, and licensure.
Chair Stephens invited the audience to make suggestions for study items. Mr. Patrick
Johnson, Health Policy Commission, said he would be willing, in the committee's May meeting,
to give a brief report of the commission's work as it progresses. Dr. Melton said his department
will be happy to cooperate with the committee's study as called upon.
6. HIV Testing Procedures
Ms. Hancock reviewed how recent statutory changes affecting the testing of emergency
medical service providers and public safety officers following a significant exposure to HIV have
resulted in conflicts between the health code and the judicial code. Ms. Hancock turned to the
back of the packet for information on statutory requirements and disease testing provisions to
consider how to resolve these conflicts. She explained that there was a study by the Health
Interim Committee in 1988 of emergency medical providers to request that the individual for
whom service was provided be required to be HIV tested as the result of a significant exposure.
The individual is asked to submit to testing. If they consent, testing is done. The emergency
medical provider is notified but must keep the information private. The emergency medical
provider can also request workers' compensation.
In 1995 the legislature passed another bill which included the same category of public
safety officers and emergency medical services providers, and also "any other person" who can
request testing. The court can order the testing. The order would contain the person's name and
address and the court can disclose the information making the confidentiality guarantee vague.
She provided a handout outlining the conflicts and issues that are a part of the problem and
requested that the committee provide guidance as how it would like to study this issue.
Rep. Valentine, sponsor of a 1997 "protected" bill that was not considered by the
Legislature said that there are answers needed and has authorized release of his bill to facilitate
study. He said there needs to be a balance between protection of EMS providers and privacy
rights of the individual. Rep. Killpack suggested that other health care providers need this
protection as well. Ms. Hancock said that health care providers are treated differently from
emergency providers but added that this issue could be added to the study. Rep. Bacca asked
whether there are provisions to protect individuals who might be exposed to HIV by health care
providers.
Rep. Valentine suggested that there are several issues that need to be addressed before
draft legislation is requested. Rep. Davis suggested legislation be brought forward with the HIV
testing report issues when that report is presented. Rep. Carlson said that the issue be studied
first to assist staff in bill preparation. Rep. Davis suggested a sponsor should bring a bill to be
studied. Rep. Valentine said he would take up the EMT scope of the bill but leave to others the
additional issues raised by committee members.
8. Adjournment-- Rep. Stephens adjourned the meeting at 11:30 a.m.
F:\USERS\HHS\WPFILES\ADGMIN\MINUTE04.WPD