Disabilities (DSPD) should develop a more effective monitoring system to provide assurances that individuals' needs are being met and that the state receives full value for dollars spent. She stressed that DSPD has a long list of individuals waiting for services that it cannot afford to supply, and excessive costs deny services to others. The report shows that in fiscal year 1997: (1) the average cost of former USDC residents in the HCBS program was 10 percent less than that of USDC residents ($83,785 per year vs. $92,766); and (2) the average cost of former ICF/MR residents in the HCBS program was 25 percent more than that of ICF/MR residents ($57,901 per year vs. $46,355). She cautioned that cost comparisons require careful analysis.

3.    Portability Study
    Chair Tanner explained that 1998 H.B. 372, Portability of Funding for Health and Human Services, requires the Division of Services for People With Disabilities and the Division of Health Care Financing to "conduct a study to identify alternatives for increasing the portability of state and federal funding for services to persons with disabilities."

    Rep. Hogue, sponsor of H.B. 372, informed the committee that meetings were held during the summer with interested parties. He introduced Mr. Michael Deily, Division of Health Care Finance, and Ms. Sue Geary, Division of Services for People With Disabilities, who presented a joint report titled Division of Services for People With Disabilities and Division of Health Care Financing, Joint Report to the Health and Human Services Legislative Interim Committee . Ms. Geary discussed forces that might increase the state's vulnerability to legal challenges including waiting list practices and choice and portability. Mr. Deily discussed the barriers to portability of funding at both federal and state levels. He said that because the ICF/MR Program is an entitlement, funding cannot be capped and waiting lists cannot be established. He emphasized that no clear public policy is in place at the state level to guide future development of a single unified developmental disabilities service system. Ms. Geary then reviewed ICF/MR and HCBS program expenditures.

    Ms. Geary reported that the university-affiliated Center for Persons with Disabilities at Utah State University has been contracted to perform a portability preference study for the purpose of obtaining a reasonable estimate of the preferred service delivery setting of persons currently receiving services and supports and persons on the DSPD waiting list. This study is scheduled to be completed during the first quarter of 1999.

    Mr. Deily then reviewed the following recommendations from the report:
    (1) Upon completion of the preference study and the projected estimate of expenditures projects, a more in-depth cost study should be completed which addresses actual costs for providing services in each of a set of defined service delivery settings; and
    (2) the task force organized to guide the completion of this report should continue to function with an additional responsibility to support Lieutenant Governor Walker's Disability Issues Work Group's efforts to develop a long range plan to address legal, funding, and other system issues related to individuals with developmental disabilities.

    Rep. Hogue, Mr. Deily, and Ms. Geary responded to questions from the committee including inquiries regarding the divisions' failure to comply with the requirement in statute for a final report at today's meeting, Utah's definition of "disability," waiting list problems, and differences in the Legislative Auditor's reported costs and the portability report expenditures .

    Sue Bailey, representing community providers, distributed Audit Exceptions, and discussed concerns with the audit. She said that the system is in transition, and recommended the committee evaluate the results of the new system in about three years.

    Ms. Charmaigne Costley, The Arc of Utah, distributed a handout titled The Arc, and said the audit did not take into account quality of life issues.

    Ms. Mary Paulsen discussed residential services. She suggested compiling a 20 year history, and recommended the committee read Life Worth Living, by William H. Thomas.

        4.    Genetic Testing Privacy Act
    Mr. Chet Loftis distributed a revised version of draft legislation Genetic Testing Privacy Act . He reviewed handouts outlining modifications made to the bill, key concepts of the legislation, and key policy issues. Mr. Loftis explained that the bill has been modified to take into account the comments made and concerns expressed during and after the last interim committee meeting. He then discussed those changes in the legislation with the committee.

    Chair Stephens said that Utah needs a law to protect this sensitive information, adding that 34 states have genetic testing privacy laws.

     MOTION: Sen. Montgomery moved to pass draft legislation Genetic Testing Privacy Act as a committee bill. The motion passed unanimously. Rep. Short was absent for the vote.

        5.    Public Mental Health and Substance Abuse System Reform
    Ms. Hancock reported that statutes governing substance abuse have been incorporated into draft legislation Public Mental Health and Substance Abuse System Reform. Those provisions are identical to the mental health provisions. Ms. Hancock reviewed the handout Changes Made to the Mental Health System Reform Bill, showing the following changes to the bill:
    (1) The definition of "public funds" and the provisions relating to the use of public funds do not limit or prohibit an organization exempt under Section 501(c)(3) from using public funds for any business purpose or in any financial arrangement that is otherwise lawful for that organization.
    (2) The counties' contracts with their private providers are no longer required to be "approved" by the division. Instead, the division is to "review and make recommendations regarding" those contracts.
    (3) The term "oversee" was removed from the division's responsibility.
    (4) The ability to "question" the local authorities was removed from the division's responsibility.

    Mr. John Tanner, Utah Behavioral Healthcare Network, Inc., discussed his concerns with the bill, and said the public fund issues appear to be resolved with the changes in the legislation.

    Commissioner Mary Callaghan, Salt Lake County, said she felt the legislation was punitive.

    Mr. Lynn Lemon, Cache County Executive, said some of the language in the bill is offensive to local officials and requested the language be removed.

    Commissioner David Gardner, Utah County, recommended the language "receivership" be changed to "conservatorship."

    Ms. Robin Arnold-Williams, Department of Human Services, informed the committee of needed technical corrections to the substance abuse language.

    Chair Stephens reminded the committee that one year ago the committee heard the report from the Legislative Auditor that exposed an abuse of funds. She responded to the public comment and noted that it is the responsibility of the Legislature to prevent the misuse of funds.

        6.    Enhanced Penalties for Use of a Substance In a Sexual Offense
    Mr. Paul Boyden, Prosecutors Association, reviewed the existing statute and penalties for rape. He argued that cases involving the use of a substance would be adequately covered under existing law, and cautioned that a bill may be premature. The main feature of the draft bill under consideration by the committee, Enhanced Penalties for Use of a Substance In a Sexual Offense, is that it provides for minimum mandatory penalties in the case where certain substances are used in the commission of a rape.

    No action was taken on the bill by the committee.

        7.    Visitation Mediation Program
    Mr. Richard Schwermer, Administrative Office of the Courts, told the committee that S.B. 116, sponsored by Sen. Peterson in 1997, created the child visitation mediation program in the Third District Court.
    
    Mr. Guy Galli, Visitation Mediation Program Administrator, presented a report to the committee titled Utah's Third District Pilot Visitation Mediation Program. He explained that the purpose of the program was developed on the premise that children's best interests are served when they have a relationship with both parents. He stated that the purpose of the program is to

help parents resolve their visitation disputes without formal court intervention. Mr. Galli also discussed program administration, funding, and evaluation.

    Sen. Peterson reported that the visitation mediation program has been successful in helping families resolve disputes.         
        
8.    Taxation of Medical Purchases
    Mr. Jerry Crouch, American Association of Retired Persons (AARP), asked the committee to consider a request to grant an exemption from sales tax for purchases of eyeglasses and hearing aids. He distributed handouts AARP and Eyeglasses and Hearing Aids: Excerpts from Sales Tax Statutes.
    
          9.    Other Business
    Mr. Mark Andrews commented that last year the Health and Human Services Interim Committee discussed the need to increase communication, collaboration, and coordination among Utah's tobacco service providers. Utah Substance Abuse and Anti-Violence Coordinating Council mailed Utah's Tobacco Service Provider Inventory, Results and Recommendations for Action to the committee prior the meeting.

    The next committee meeting will be held on November 18, 1998.

10.     Adjourn

    MOTION: Rep. Dayton moved to adjourn the meeting at 5:00 p.m.