MINUTES OF THE

FUNDING OF STATE AND COUNTY HEALTH AND HUMAN SERVICES TASK FORCE

Thursday, June 27, 2002 - 9:00 a.m. - Room 403 State Capitol

Note: A list of others present and a copy of materials can be found at http://image.le.utah.gov/imaging/history.asp or by contacting the committee secretary, Alicia Laughlin, at 538-1032.

1. Committee Business

Chair Seitz called the meeting to order at 9:03 a.m.

MOTION: Sen. Walker moved to approve the minutes of the June 13, 2002 meeting. The motion passed unanimously, with Sen. Davis, Sen. Jenkins, Rep. Hogue, and Dir. Steadman absent for the vote.

Mr. Spencer Pratt, Office of the Legislative Fiscal Analyst (OLFA), distributed "Department of Health Federal Funds." He addressed the issue of federal grants made to the Department of Health and responded to Task Force questions.

Mr. Thor Nilsen, OLFA, distributed "Department of Human Services Federal Funds." He also addressed the issue of federal grants made to the Department of Human Services and indicated that state agencies are allowed to increase the authority to spend federal funds by submitting work program revisions through the Governor's Office of Planning and Budget without legislative authority.

Mr. Stephen Jardine, Budget Analyst, Governor's Office of Planning and Budget (GOPB), stated that most of the federal grants do not go through the funding formulas that other funds must go through when they are dispersed to local health, mental health, substance abuse, or aging area authorities.

2. Issues and Concerns of County Governing Bodies

Mr. Lynn Lemon, County Executive, Cache County, distributed "Providing Health & Human Services From Rural Counties Perspective." He presented the county's funding concerns for providing health and human services through the counties, specifically the rural counties. He indicated that if the counties do not provide the service, clients must go without or travel to the larger metropolitan areas of the state to receive the services. He suggested that decreasing the reporting requirements would help them to provide more services.

Sen. Walker asked about the possibility of the State and counties coming together to streamline the reporting process. Ms. Robin Arnold-Williams, Executive Director, Department of Human Services, indicated that there are a few programs that have general funds that they could discuss with the counties and also indicated that she would like to have legislative staff be a part of the discussion.

Rep. Hogue asked about the reporting of data electronically. Mr. Lemon indicated that a program has been provided to aid in reporting information electronically. He also indicated that a substantial amount of energy is used to gather information and that a lot of time is spent keeping track of what the counties are doing. He suggested that they should be allowed to focus more upon providing the services. Rep. Hogue suggested that better communication be developed between the State and counties.

Ms. Camille Cain, Commissioner, Weber County, distributed "Health and Human Services Task Force: Submitted by the Utah Association of Counties," which included background information, county concerns, and recommendations. She requested that the Task Force think of the health and human services funding process in terms of a partnership. She suggested that the State and counties come together to formulate program plans and discuss the various populations that need to be served. She also requested that the Task Force consider the continuum of care that is required by statute.

Rep. Pace suggested that the counties point out conflicting statutes. She also recommended that the counties give input to the Task Force on filtering out those people who are receiving services and do not need them so that decision-makers can channel the funds most effectively. Comm. Cain indicated that there are some areas that require a change in statute in order to effectively provide the services to those with the most critical needs.

Rep. Jones asked how they would like to have more cooperation and input in the budgetary process. Comm. Cain suggested that the formal state process should include local government so that both parties can participate. Rep. Jones asked if this recommendation would require legislation. Ms. Arnold-Williams indicated that statutory changes would be required in order to accomplish the county's request.

Rep. Pace suggested that a meeting be held with all 29 counties before the initial budgets are due to receive input and discuss their concerns which would allow more flexibility for funding at the local level.

Rep. Seitz said that recommendations from all stakeholders would be combined for the August meeting so that the Task Force can begin creating a plan.

3. Principles (continued)

Mr. Jardine distributed "Principles" which included the changes proposed by the Governor's Office of Planning and Budget to the principles adopted by the Task Force in the June 13 meeting. He indicated that the principles presented are an informal set of guidelines to direct the Task Force. If the principles are to be codified, the GOPB would like further input.

Mr. Michael Cragun, Commissioner, Davis County, distributed "Principles" with additional changes made by the Association of Counties to the adopted principles. He spoke in favor of Comm. Cain's suggestion that the principles be put in code. He addressed the recommended changes.

4. Health Services (continued)

Mr. Michael Deily, Director, Division of Health Care Financing, distributed "Medicaid Expenditure Growth FY 1999" and "Utah Department of Health, Division of Health Care Financing: State-Local Roles and Responsibilities." He gave an overview of Medicaid expenditures and indicated the reasons that contributed to the FY 1999 growth. He addressed the programs that exist and explained the duplications in statute. Mr. Deily also discussed how the Department has adjusted services and co-pays to deal with the decreasing state Medicaid budget.

Rep. Jones asked about the success of the Tobacco Cessation Program. Ms. Ladine Larsen, Health Promotion, Tobacco Program, stated that while it is early in the program to give a definitive answer, the program is at least as effective as other cessation programs. She indicated that they hope to improve the program with increased funding.

Mr. David Cunningham, distributed "Local Health Departments Funding Report," which addressed the required services, funding history, and recommendations of the Department. He spoke in favor of having a partnership with the State. He suggested that creating a position where the local health departments are represented at the State Health Department would create a crucial partnership.

Mr. Charles Brokopp, Director, Division of Epidemiology and Laboratory Services, distributed a packet "Utah Department of Health: Major Statutes Governing Division Programs." He gave an overview on the Division's roles and responsibilities and listed the services the Division provides. He indicated that the Division provides some of the most critical public health services that are part of every state and local health department. He concluded with the Division's recommendations.

5. Substance Abuse

Mr. Lloyd Berentzen, Deputy Director, Bear River Health Department and Mr. Brock Alder, Division Director, Bear River Division of Substance Abuse, distributed a summary of issues important to multi-county substance abuse providers. They indicated that there are more needs than they are able to provide.

Comm. Cox asked how much input the Department has regarding funding decisions. Mr. Berentzen stated that there is not a local process available where they have the opportunity to decide which programs should be funded over another. He indicated that the funds are proprietary and once they find out what the available funding sources are, they make the adjustments internally.

Mr. Patrick J. Fleming, Director, Division of Substance Abuse, distributed "Presentation to the Task Force on the Funding of State & County Health and Human Services." He presented an overview on the required services of Substance Abuse, the funding history, and the duplication of services in statute. He concluded with recommendations to the Task Force.

6. Conflicts in State Human Services Law - To be discussed at the next meeting.

7. Other Items / Adjourn

MOTION: Comm. Cox moved to adjourn the meeting. The motion passed unanimously with Sen. Davis and Sen. Jenkins absent for the vote.

Chair Seitz adjourned the meeting at 12:10 p.m.