Utah Legislature 81118HHS

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MINUTES OF THE
HEALTH AND HUMAN SERVICES INTERIM COMMITTEE
November 18, 1998 - 2:00 p.m. -- Room 405 State Capitol

Members Present:
    Sen. Robert F. Montgomery
    Sen. Millie M. Peterson
    Sen. Pete Suazo
    Rep. Loretta Baca
    Rep. Gene Davis
    Rep. Margaret Dayton
    Rep. Bryan D. Holladay
    Rep. Robert H.M. Killpack
    Rep. Carl R. Saunders
    Rep. Raymond W. Short

Members Excused:
    Rep. Nora B. Stephens, House Chair

Members Absent:
    Sen. Nathan C. Tanner, Senate Chair
    Sen. Craig Taylor
    Rep. Mary Carlson
    Rep. J. W. "Bill" Hickman

Staff Present:
    Mr. Mark D. Andrews
     Research Analyst
    Ms. Janetha W. Hancock
     Associate General Counsel
    Mr. R. Chet Loftis
     Associate General Counsel
    Ms. L. Kaye Clark
     Secretary

Note:    A list of others present and a copy of materials distributed in the meeting are on file in the Office of Legislative Research and General Counsel.

1.    Call to Order and Approval of October 21, 1998 Minutes
    Rep. Short called the meeting to order at 2:25 p.m. Rep. Holladay took over as acting chair of the meeting.

     MOTION: Rep. Saunders moved to approve the minutes of the October 21, 1998 meeting. The motion passed unanimously.

        2.    Admission to Nursing Facilities
    Rep. Short explained that draft legislation Medicaid Choice Certificate, would require a Medicaid applicant to be informed of the full range of services offered by the Division of Aging and Adult Services, the local area agencies on aging, and the local area agencies on high risk adults prior to admission to a nursing care facility.

    Ms. Shauna O'Neill, Salt Lake County Aging Services, reviewed the impartial assessment process required by this bill for those considering admission into a nursing home. She said that the purpose of the preadmission assessment is to provide the applicants and their families with sufficient information regarding available resources to make an informed decision that best meets their needs.

    Mr. Loftis reviewed the definitions in the legislation. He explained that the "long term care pamphlet" is a pamphlet prepared by the Division the of Aging and Adult Services that provides information about services available to aged and high-risk adults. He told the committee that a "Medicaid choice certificate" is a component of the preadmission assessment. Mr. Loftis also discussed the preadmission process, penalties for failure of nursing homes to comply, and current Medicaid residents' eligibility.

    Ms. Helen Goddard, director of Aging and Adult Services, said she prepared the fiscal note for the bill; however, it does not include the cost of preparing the pamphlet. She estimated the total cost of the bill will be $921,690 including the state's share of $460,845. She anticipates that in the long run it will save the state a significant amount of money.

    Ms. Joan Gallegos, Utah Health Care Association, spoke in support of the legislation.

    Sen. Montgomery took over as acting chair of the committee for the remainder of the meeting.

    MOTION: Rep Short moved to adopt Medicaid Choice Certificate, as a committee bill. Rep. Davis expressed concern about the fiscal note for the bill. The motion passed unanimously. Reps. Baca and Holladay were absent for the vote.

3.    Long-term Care for the Mentally Ill
    Dr. Meredith Alden, director, Division of Mental Health, distributed the handout Utah Intensive Community Support Program Institution Alternative Proposal. She explained that there is a consensus throughout the Utah Public Mental System (UPMHS) that there is a shortage of secure placements in the treatment array. She explained that the UPMHS has proposed a program that is designed as an alternative to traditional institutional treatment and would establish a new level of care for consumers of mental health services. Dr. Alden discussed the key features of the program and said the budget for the program is estimated at $3,562,352.

    Mr. Jack Tanner, Utah Behavioral Health Network, provided background information regarding the need for the proposed Utah Intensive Community Support Program. He stated that research suggests that the program will result in improved cost efficiency, more clients served, better treatment outcomes, and a higher quality of life for the persons served. He reviewed the budget considerations for the program and compared these expenses to providing care at the Utah State Hospital.

    Ms. Marilyn Mitchell, Utah Alliance for the Mentally Ill, distributed the handout NAMI Utah, PACT: Program of Assertive Community Treatment. She concluded that 25 years of documented treatment show that the PACT model has many advantages over institutional care.

        4.    Privatization of Adoption
     Mr. LeRoy Franke, Division of Child and Family Services, and Ms. Mary Linda Smith, Adoption Exchange, reported that the Adoption Advisory Council of the Board of Child and Family Services has been working with the Department of Human Services to determine whether activities associated with the adoption of children in the custody of the state should be further privatized. Mr. Franke updated the committee on these efforts. He discussed the findings in the following areas: 1) recruitment, training, and assessment of adoptive families; 2) creating a pilot program for a permanency specialist and an adoption exchange; and 3) post-adoption support. Ms. Smith then discussed the adoption exchange initiatives with the committee.

    Ms. Hancock requested a report on how the department is implementing certain statutes.
Mr. Franke responded that due to lack of funding, the department is not complying formally or contractually. He said more needs to be done to meet the intent of the statute. Rep. Short expressed concern over the lack of compliance with the statute. Rep. Killpack stressed that action should always be based on what is in the best interest of the child. Ms. Robin Arnold- Williams added that limitations in statute control the time frame for placement of a child.

         5.    Report of the Child Care Task Force
    Sen. Blackham and Rep. Sheryl Allen, co-chairs of the Child Care Task Force, distributed the Report of the Legislative Child Care Task Force, and presented the recommendations of the task force and draft legislation for the 1999 General Session.

    Sen. Blackham highlighted the proposed legislation Child Literacy Programs. He explained that this bill establishes training programs for teachers, families, and child care providers, and would piggyback the governor's reading initiative. Next, Sen. Blackham reviewed draft legislation Child Care Provider Criminal Background Check Amendments, which requires a national criminal background check as part of the licensing application and renewal. Finally, Sen. Blackham explained that the task force desires to continue its intensive study of child care issues and therefore, supports the draft legislation Child Care Task Force Reauthorization.

    Rep. Allen presented to the committee draft legislation Credit for Contributions to Child Care, that provides a corporate tax credit equal to 25 percent of the value of donation of real or tangible personal property. She noted that 3 states offer a credit for similar contributions. Rep. Allen also discussed draft legislation Child Care Commission Resolution. This bill creates a business directed commission to unleash the private resources needed to solve the child care issues of businesses and promote the improvement of child care generally.

    Ms. Mary Ann Jordan gave public comment and spoke against the draft legislation regarding the child literacy program. Rep. Allen responded that this will be an outreach program and not a mandate.

     MOTION: Sen. Peterson moved to pass all the proposed legislation as committee bills.

    SUBSTITUTE MOTION: Rep. Short moved to divide the motion and vote on each bill separately. The motion passed unanimously. Rep. Killpack was absent for the vote.

     MOTION: Sen. Suazo moved to adopt as a committee bill draft legislation Child Literacy Programs. Rep. Dayton spoke against the bill. Sen. Peterson and Rep Holladay spoke in favor of the bill. Rep. Short asked about the role of the State Board of Education in the literacy program. Rep Allen said the board supports the legislation. The motion failed, with all members present voting in favor except Reps. Dayton, Saunders, and Short who voted against the bill. Rep. Killpack was absent for the vote.

     MOTION: Rep. Short moved to adopt as a committee bill Child Care Provider Criminal Background Check Amendments. The motion passed unanimously. Rep. Killpack was absent for the vote.

    MOTION: Sen. Peterson moved to adopt as a committee bill Credit for Contributions to Child Care.

    SUBSTITUTE MOTION: Rep. Short moved that the committee take no action on this bill and send it to the Revenue and Taxation Standing Committee for a hearing. Sen. Peterson said the Rules Committee will decide which committee will hear the legislation. The motion failed with Reps. Dayton, Saunders, and Short voting in favor of the motion.

    The committee then voted on the original motion. The motion passed. Reps. Dayton and Short voted against the motion. Rep. Killpack was absent for the vote.

     MOTION: Sen. Peterson moved to adopt as a committee bill Child Care Commission Resolution. The motion passed unanimously. Reps. Davis and Killpack were absent for the vote.

    MOTION: Sen. Peterson moved to adopt as a committee bill Child Care Task Force Reauthorization. The motion passed with Rep. Dayton voting in opposition. Reps. Davis and Killpack were absent for the vote.

    Sen. Blackham discussed the other proposals of the task force, including securing the maximum available federal funds. These proposals were not presented in the form of legislation.

6.    Report of the Health Policy Commission
    Mr. Patrick Johnson, Health Policy Commission, introduced Sen. Nielson, sponsor of the draft legislation Long Term Care Amendments, and Mr. Kendall Surfass and Cathy Chambless, both with the Long Term Care Technical Advisory Group.
    Sen. Nielson explained that the bill creates an income tax deduction for long term care insurance premiums and out-of-pocket long term care expenses, and allows the use of medical savings accounts for long term care insurance and expenses. He reviewed the changes to the bill made during the Revenue and Taxation Interim Committee. Those changes included eliminating the deduction for unreimbursed out-of-pocket expenses. Mr. Surfass commented that this bill encourages personal responsibility and allows individuals to prepare for their long term care needs. Ms. Joan Gallegos, Utah Health Care Association, spoke in favor of the bill.

    MOTION: Rep. Davis moved to pass as a committee bill Long Term Care Amendments as amended by the Revenue and Taxation Interim Committee. Sen. Suazo asked about the fiscal note. Sen. Nielson estimated the fiscal note at $6-7 million (amended version of the bill). The motion passed unanimously. Rep. Killpack was absent for the vote.

         7.    Follow-up on Portability Study
    Representative Hogue distributed Barriers to Portability Of Services Between Health and Human Services to the committee as required by 1998 H.B. 372 . A more detailed report with recommendations will be provided prior to the 2000 Annual General Session.

    Mr. Michael Deily, director, Division of Health Care Financing , reported that in response to the issues presented by the committee members during the October interim committee meeting, the decision was made to redirect the efforts of the Portability Study Task Force. He informed the committee that the contract with Utah State University for a study was canceled. In lieu of the contracted study, the Department of Human Services and the Division of Health Care Financing will collaborate in a mail survey to determine each person's desired service setting. Mr. Deily told the committee that the estimated total cost to the State and facilities if individuals move to the facilities or services of their choice will be computed by using the results of the mail survey and existing data on State expenditures in the two programs .

8.     Other Business
    Mr. Loftis reviewed information in the packet regarding the tobacco suit settlement. He explained the process by which the $836 million will come to Utah over 25 years. The committee discussed the impact on funds for the Children's Health Insurance Program (CHIP).

    The Juvenile Justice Task Force Report and the FACT Report to the Legislative Interim Committees were distributed to the committee.

        9.    Adjourn

    MOTION: Sen. Peterson moved to adjourn the meeting at 5:00 p.m. The motion passed unanimously.

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