Agency: Human Services Line Item: Substance Abuse & Mental Health Function The Division of Substance Abuse and Mental Health (DSAMH) is the state's public mental health and substance abuse authority. It has the duty to consult and coordinate with local substance abuse and mental health authorities regarding programs and services. The DSAMH sets policy for programs funded with state and federal money by establishing rules and minimum standards for local substance abuse and mental health authorities. The DSAMH also oversees the Utah State Hospital in Provo.
State statute assigns the responsibility to provide substance abuse and mental health services to the local authorities (counties). The local authorities provide services directly or contract with private providers (such as Davis Behavioral Health in Davis County). Counties may elect to perform their local authority responsibilities singularly or through an interlocal agreement between multiple counties. In Utah, counties are currently organized as thirteen (13) local mental health authorities and thirteen (13) local substance abuse authorities. Counties are required to provide at a minimum the services mandated by state statute and must provide matching funds equal to at least twenty percent (20%) of most state General Fund. The Public Local Mental Health Authority System The state public mental health system serves adults with serious mental illness and children with serious emotional disturbances. Many of the recipients do not have private insurance and have limited financial resources. Local authorities, through consultation with the DSAMH, have established schedules that base fees on income levels and family size. Mental health services are funded by a variety of revenue streams including state General Fund revenue, county funds, Medicaid and Medicare, other third party payers, and client fees. Medicaid is the primary funding stream for mental health services. In addition, the state applies for and receives a federal Mental Health Services Block Grant (MHBG). Funding from the MHBG supplements other sources of revenue for mental health services in the state. Local mental health authorities review and evaluate the mental health needs and services of their local populations including those of incarcerated individuals. They prepare annual plans for mental health funding and service delivery for adults, youth, and children. These plans are submitted to and approved by the DSAMH and include the following services mandated by Utah Code: - Inpatient care and services;
- Residential care and services;
- Outpatient care and services;
- 24-hour crisis care and services;
- Psychotropic medication management;
- Psychosocial rehabilitation, including vocational training and skills development;
- Case Management;
- Community supports, including in-home services, housing, family support services, and respite services;
- Consultation and education services, including case consultation, collaboration with other county service agencies, public education, and public information; and
- Services to incarcerated persons (UCA 17-43-301).
Local mental health centers also provide additional services including housing, clubhouses, consumer drop-in centers, employment and rehabilitation, services to the homeless, forensic evaluations, family respite, nursing home and hospital alternatives, and consumer education. The Public Local Substance Abuse Authority System The state public substance abuse system serves any person in need of substance abuse services. Local authorities are required to charge a fee for substance abuse services rendered. However, no individual may be refused service because of an inability to pay. Local authorities through consultation with the DSAMH have established schedules that base fees on income levels and family size. Because of funding limitations, individuals may experience delays in the availability of services.
Priorities for services include the following: - Pregnant women;
- Intravenous (IV) Drug Users;
- Women with dependent children; and
- All others.
In addition to the priority populations listed above, significant public resources are focused on individuals in the criminal justice system (see also the separate section of this report on drug courts).
Annually, the state applies for and receives a federal Substance Abuse Prevention and Treatment (SAPT) Block Grant. Funding from this grant supplements the General Fund appropriations for substance abuse services in the state. This federal grant requires that the state, through the local substance abuse authorities, provide a continuum of the following services:
- Detoxification;
- Prevention services;
- Outpatient services;
- Intensive outpatient services; and
- Residential treatment programs.
Statutory Authority Utah Code Title 62A Chapter 15 describes the functions and responsibilities of Utah's public mental health and substance abuse treatment and prevention systems. Included in this chapter are the following: - Section 103: Creation and responsibilities of the Division of Substance Abuse and Mental Health including oversight of the Utah State Hospital
- Section 105: Authority and responsibilities of the DSAMH
- Section 107: Authority to assess fees
- Section 108: Formula for the allocation of funds to local substance abuse and mental health authorities
- Section 110: Contracts for substance abuse and mental health services (provisions and responsibilities)
- Section 201: Teen Substance Abuse Intervention and Prevention Act
- Section 301: Commitment of minors to drug or alcohol programs or facilities
- Section 401: Alcohol training and education including programs for DUI drivers
Utah Code Title 17, Chapter 43 describes the functions and responsibilities of the counties related to the public mental health and substance abuse treatment and prevention systems. Included in this chapter are the following: - Section 201: Responsibilities of the local substance abuse authorities
- Section 202: Requirements prior to distributing public funds
- Section 204: Requirement to charge fees for substance abuse services
- Section 301: Responsibilities of the local mental health authorities including the physical custody of minors committed by a judicial court
- Section 303: Responsibility for the oversight of public funds
- Section 304: Contracting for mental health services
- Section 306: Fees for services including authority to receive funds from other sources
- Section 308: Specific treatments prohibited
- Section 309: Powers and responsibilities of local mental health advisory councils
In addition to state law, many functions provided by DSAMH have provisions detailed in federal law. Those federal law references, where available, follow: SUMMARY:
- Public Law 102-321 (US Code Part B, Subpart II and Subpart III): Block Grants for Prevention and Treatment of Substance Abuse
- 45 CFR 96.45, 96.51, and 96.120-131: Substance Abuse Prevention and Treatment Block Grant (Interim Final Rule)
- Title XXXI of the Public Health Service Act as amended by Public Law (P.L.) 102-321 and P.L. 106-321 (Children's Health Act of 2000)
- Definition of Adults with SMI and Children with SED, as published in the Federal Register May 20, 1993 (Volume 58, No.l 96)
DETAIL Public Law 102-321 enacted by the 102nd Congress on July 10, 1992, was intended to amend the Public Health Service Act in order to restructure the Alcohol, Drug Abuse, and Mental Health Administration and the authorities of such Administration. The table of contents for the Federal Public Health Service Act is as follows: - Title I - Reorganization of Administration and Institutes
- Title II - Block Grants to States Regarding Mental Health and
Substance Abuse
- Title III - Model Comprehensive Program for Treatment of
Substance Abuse
- Title IV - Children of Substance Abusers
- Title V - Home-visiting Services for At-risk Families
- Title VI - Trauma Centers and Drug Related Violence
- Title VII - Studies
- Title VIII - General Provisions
The Children's Health Act of 2000 Title XXXI Provisions Relating to Services for Children and Adolescents - Section 3101: Children and Violence
- Section 3102: Emergency Response
- Section 3103: High Risk Youth Reauthorizations
- Section 3104: Substance Abuse Treatment Services for Children and Adolescents
- Section 3105: Comprehensive Community Services for Children with Serious Emotional Disturbance
- Section 3106: Services for Children of Substance Abusers
- Section 3107: Services for Youth Offenders
- Section 3108: Underage Drinking
- Section 3109: Services for Individuals with Fetal Alcohol Syndrome
- Section 3111: Suicide Prevention
- Section 3112: General Provisions
Intent Language The Legislature intends the DORA (Drug Offender Reform Act) program report to the Office of the Legislative Fiscal Analyst by September 1, 2012 regarding how it has implemented the five strategies intended to strengthen the DORA program recommended by the Utah Criminal Justice Center in its November 2011 Drug Offender Reform Act: DORA Statewide Report. If these strategies have not been implemented, the Legislature further intends the DORA program provide specifically why each recommendation has not been adopted. The Legislature intends that the FY 2013 appropriation increase of $551,400 for DORA be used to treat probationers, and that the DORA Oversight Committee, the Division of Substance Abuse and Mental Health, and the Department of Corrections, in cooperation with the Utah Association of Counties, study and develop recommendations to the Legislature for expansion of treatment and supervision models for DORA parolees in future years. The Legislature intends the Division of Substance Abuse and Mental Health and Salt Lake County report to the Office of the Legislative Fiscal Analyst by September 1, 2012 regarding current Salt Lake County efforts to reduce inpatient placements in both community inpatient hospital settings and the Utah State Hospital for individuals with mental illness in order to maintain individuals in the least restrictive and most enabling settings. Under Section 63J-1-603 of the Utah Code the Legislature intends that the appropriations provided for the Division of Substance Abuse and Mental Health line item for the Drug Courts in Item 13 of Chapter 4 Laws of Utah 2011 not lapse at the close of Fiscal Year 2012. The use of any nonlapsing funds is limited to "Other Charges/Pass Through" expenditures. Under Section 63J-1-603 of the Utah Code the Legislature intends that the appropriations provided for the Division of Substance Abuse and Mental Health line item for State Substance Abuse Services and Local Substance Abuse Services in Item 13 of Chapter 4 Laws of Utah 2011 not lapse at the close of Fiscal Year 2012. The use of any nonlapsing funds is limited to "Other Charges/Pass Through" expenditures. Under Section 63J-1-603 of the Utah Code the Legislature intends that up to $50,000 of appropriations provided for the Division of Substance Abuse and Mental Health line item in Item 13 of Chapter 4 Laws of Utah 2011 not lapse at the close of Fiscal Year 2012. The use of any nonlapsing funds is limited to computer equipment and software, capital equipment or improvements, equipment, or supplies. Performance During the 2012 General Session of the Legislature, Issue Brief -- FY2013 -- DHS -- Substance Abuse and Mental Health -- Output and Outcome Measures was presented showing a seven year history of DSAMH output and outcome measures. An update of these output and outcome measures will be provided during the 2013 General Session of the Legislature. Funding Detail For analysis of current budget requests and discussion of issues related to this budget click here. Sources of Finance (click linked fund name for more info) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp | General Fund | $85,334,700 | $80,669,100 | $79,073,800 | $83,504,000 | $86,736,000 | General Fund, One-time | $6,064,100 | $3,199,100 | $1,791,600 | $1,241,400 | $3,400,000 | Federal Funds | $24,474,100 | $23,996,900 | $24,662,000 | $26,142,100 | $24,854,100 | American Recovery and Reinvestment Act | $970,000 | $1,658,500 | $1,016,000 | ($38,400) | $0 | Dedicated Credits Revenue | $3,793,000 | $3,340,600 | $3,292,500 | $3,350,300 | $3,214,400 | GFR - Intoxicated Driver Rehab | $1,500,000 | $1,500,000 | $1,500,000 | $1,500,000 | $1,500,000 | GFR - Tobacco Settlement | $1,647,200 | $2,166,300 | $2,325,400 | $2,325,400 | $2,325,400 | Transfers - Child Nutrition | $64,100 | $73,900 | $71,600 | $0 | $71,600 | Transfers - Commission on Criminal and Juvenile Justice | $92,800 | $242,200 | $317,000 | $305,100 | $305,100 | Transfers - Medicaid | $11,099,000 | $13,487,800 | $12,347,100 | $7,772,400 | $7,889,900 | Transfers - Other Agencies | $2,700 | $700 | $90,000 | $74,000 | $23,000 | Transfers - State Office of Education | $0 | $0 | $0 | $73,500 | $0 | Transfers - Within Agency | $0 | $0 | ($6,900) | $0 | $0 | Beginning Nonlapsing | $343,700 | $89,100 | $114,700 | $249,500 | $0 | Closing Nonlapsing | ($89,100) | ($114,700) | ($249,500) | ($208,800) | $0 | Lapsing Balance | ($243,600) | ($1,842,100) | ($149,200) | ($48,000) | $0 | Total | $135,052,700 | $128,467,400 | $126,196,100 | $126,242,500 | $130,319,500 |
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| | | | | | Programs: (click linked program name to drill-down) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp |
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Administration - DSAMH | $3,213,000 | $2,905,600 | $2,550,600 | $2,620,700 | $2,573,600 | Community Mental Health Services | $5,432,700 | $4,689,700 | $5,116,000 | $5,288,800 | $8,982,200 | Mental Health Centers | $29,984,800 | $27,341,300 | $23,981,500 | $27,862,700 | $27,426,000 | Residential Mental Health Services | $965,100 | $958,000 | $926,400 | $177,800 | $230,800 | State Hospital | $54,398,600 | $54,190,500 | $55,209,800 | $51,749,900 | $52,834,300 | State Substance Abuse Services | $6,797,400 | $6,556,800 | $7,432,300 | $7,654,900 | $6,982,200 | Local Substance Abuse Services | $24,626,200 | $24,283,800 | $23,461,600 | $23,342,900 | $23,451,100 | Driving Under the Influence (DUI) Fines | $1,479,700 | $1,468,200 | $1,454,500 | $1,452,000 | $1,500,000 | Drug Offender Reform Act (DORA) | $3,566,800 | $2,096,500 | $2,139,500 | $2,139,500 | $2,590,900 | Drug Courts | $4,413,200 | $3,659,900 | $3,889,800 | $3,953,300 | $3,748,400 | Drug Boards | $175,200 | $317,100 | $34,100 | $0 | $0 | Total | $135,052,700 | $128,467,400 | $126,196,100 | $126,242,500 | $130,319,500 |
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| | | | | | Categories of Expenditure (mouse-over category name for definition) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp |
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Personnel Services | $46,364,900 | $45,681,800 | $46,669,400 | $44,752,400 | $44,467,100 | In-state Travel | $41,000 | $32,000 | $24,300 | $75,500 | $25,300 | Out-of-state Travel | $30,400 | $11,400 | $18,100 | $35,600 | $15,100 | Current Expense | $12,163,300 | $11,622,300 | $11,998,700 | $10,791,000 | $11,995,900 | DP Current Expense | $2,394,400 | $2,384,500 | $2,365,600 | $2,175,200 | $2,445,100 | DP Capital Outlay | $8,500 | $8,300 | $0 | $0 | $0 | Capital Outlay | $0 | $144,900 | $87,000 | $0 | $0 | Other Charges/Pass Thru | $74,050,200 | $68,582,200 | $65,033,000 | $68,412,800 | $71,371,000 | Total | $135,052,700 | $128,467,400 | $126,196,100 | $126,242,500 | $130,319,500 |
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| | | | | | Other Indicators | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp |
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Budgeted FTE | 796.6 | 825.2 | 825.2 | 782.4 | 787.6 | Actual FTE | 798.1 | 793.1 | 795.8 | 780.6 | 0.0 | Vehicles | 48 | 48 | 46 | 46 | 46 |
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Subcommittee Table of ContentsProgram: Administration - DSAMH Function The Division of Substance Abuse and Mental Health (DSAMH) coordinates all public substance abuse prevention and treatment programs as well as all public mental health programs in the state. The DSAMH also provides consultation and technical assistance to the local authorities and centers, administers state and federal grants, collects data, evaluates programs, and prepares required reports. It is responsible for development of administrative, fiscal, and service standards for local mental health centers and substance abuse authorities. The DSAMH also has general oversight of the State Hospital and works with the State Office of Education and other agencies for the establishment of substance abuse prevention programs. It also administers the Driving under the Influence (DUI) Education program and the alcohol servers program. Funding Detail Sources of Finance (click linked fund name for more info) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp | General Fund | $1,665,400 | $1,507,500 | $1,344,400 | $1,181,600 | $1,304,300 | General Fund, One-time | $0 | ($64,400) | $0 | $1,400 | $0 | Federal Funds | $1,448,800 | $1,331,200 | $1,039,200 | $1,192,900 | $1,161,900 | American Recovery and Reinvestment Act | $0 | $0 | $0 | $54,000 | $0 | Dedicated Credits Revenue | $68,400 | $50,900 | $69,300 | $70,100 | $56,600 | Transfers - Medicaid | $34,700 | $33,000 | $44,800 | $54,600 | $50,800 | Transfers - Other Agencies | $0 | $700 | $53,000 | $56,300 | $0 | Beginning Nonlapsing | $0 | $50,000 | $3,300 | $13,500 | $0 | Closing Nonlapsing | $0 | ($3,300) | ($3,400) | ($3,700) | $0 | Lapsing Balance | ($4,300) | $0 | $0 | $0 | $0 | Total | $3,213,000 | $2,905,600 | $2,550,600 | $2,620,700 | $2,573,600 |
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| | | | | | Categories of Expenditure (mouse-over category name for definition) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp |
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Personnel Services | $2,776,300 | $2,597,700 | $2,234,500 | $2,287,300 | $2,296,800 | In-state Travel | $30,000 | $26,100 | $13,300 | $25,300 | $13,300 | Out-of-state Travel | $21,200 | $6,800 | $3,400 | $14,800 | $4,400 | Current Expense | $282,400 | $192,400 | $183,200 | $215,800 | $163,800 | DP Current Expense | $103,100 | $82,600 | $116,200 | $77,500 | $95,300 | Total | $3,213,000 | $2,905,600 | $2,550,600 | $2,620,700 | $2,573,600 |
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| | | | | | Other Indicators | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp |
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Budgeted FTE | 33.5 | 31.2 | 31.2 | 28.4 | 27.2 | Actual FTE | 33.5 | 31.7 | 31.7 | 27.2 | 0.0 |
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Subcommittee Table of ContentsProgram: Community Mental Health Services Function The Community Mental Health Services program develops, coordinates, and evaluates mental health services. The program is funded with the following federal grants: - Information Systems Grant: This federal grant is used to develop common data indicators across all of the mental health centers that are consistent, compatible, and conform to national indicators.
- Homeless Mentally Ill: The division distributes this federal PATH grant to mental health centers for specialized services to the homeless mentally ill. This is an annual grant.
- Mental Health Block Grant: This grant, most of which is passed through to the local mental health authorities on a formula basis, provides funding for the development of a statewide system of care for adults with serious mental illness and children with serious emotional disturbances.
- Passages Grant: A new SAMHSA grant awarded to DSAMH on October 1, 2009 for the development of transitional services for young adults with serious emotional disturbance in two of Utah's most rural counties - San Juan and Tooele.
- System of Care Expansion Planing Grant: A new SAMHSA grant awarded to DSAMH on July 1, 2012 to develop a comprehensive strategic plan for improving and expanding services provided by systems of care for children and youth with serious emotional disturbances and their families.
The following state-funded programs are also budgeted in this program: - Competency Evaluations for Adults and Juveniles: The state is responsible for determining an individual's competency to stand trial for a crime. A new law gave the Division the authority to perform the evaluations for children/youth in addition to adults.
- Omnibus Budget Reconciliation Act (OBRA) of 1987: This act requires the state to assess the appropriateness of placement for mentally ill persons residing in nursing facilities. This assessment is done using the Preadmission Screening and Resident Review (PASRR).
- Pre-school Autism Program: This program provides funds to several areas of the state to develop and operate programs for pre-school children with autism.
Funding Detail Sources of Finance (click linked fund name for more info) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp | General Fund | $2,710,800 | $2,585,600 | $2,509,300 | $6,210,400 | $6,576,400 | General Fund, One-time | $113,900 | $19,800 | $0 | $0 | $3,500,000 | Federal Funds | $1,982,000 | $1,434,000 | $1,859,700 | $1,939,100 | $1,875,900 | Dedicated Credits Revenue | $74,200 | $55,600 | $65,800 | $10,100 | $20,000 | Transfers - Medicaid | $551,100 | $599,200 | $678,900 | ($2,912,400) | ($2,990,100) | Transfers - Other Agencies | $0 | $0 | $6,100 | $17,700 | $0 | Beginning Nonlapsing | $15,700 | $0 | $0 | $31,800 | $0 | Closing Nonlapsing | $0 | $0 | ($3,800) | ($7,900) | $0 | Lapsing Balance | ($15,000) | ($4,500) | $0 | $0 | $0 | Total | $5,432,700 | $4,689,700 | $5,116,000 | $5,288,800 | $8,982,200 |
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| | | | | | Categories of Expenditure (mouse-over category name for definition) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp |
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Personnel Services | $60,200 | $58,600 | $152,200 | $152,400 | $162,300 | In-state Travel | $4,200 | $3,600 | $3,800 | $5,500 | $6,600 | Out-of-state Travel | $6,100 | $3,700 | $9,100 | $11,400 | $9,100 | Current Expense | $2,101,700 | $1,755,800 | $1,613,400 | $1,797,800 | $1,936,400 | DP Current Expense | $127,900 | $143,200 | $110,200 | $174,900 | $134,600 | DP Capital Outlay | $8,500 | $0 | $0 | $0 | $0 | Other Charges/Pass Thru | $3,124,100 | $2,724,800 | $3,227,300 | $3,146,800 | $6,733,200 | Total | $5,432,700 | $4,689,700 | $5,116,000 | $5,288,800 | $8,982,200 |
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| | | | | | Other Indicators | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp |
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Budgeted FTE | 0.7 | 1.0 | 1.0 | 1.0 | 2.7 | Actual FTE | 0.7 | 0.9 | 1.0 | 1.9 | 0.0 |
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Subcommittee Table of ContentsProgram: Mental Health Centers Function State statute assigns mental health local authority responsibility to each county. Counties may elect to perform their local authority responsibilities singularly or through an interlocal agreement between multiple counties. Currently, there are thirteen (13) local mental health authorities. The Division of Substance Abuse and Mental Health (DSAMH) is the state's public mental health authority. DSAMH has the duty to consult and coordinate with local mental health authorities regarding programs and services. The DSAMH also sets policy for programs funded with state and federal money and accomplishes this objective by establishing rules and minimum standards for local mental health authorities. DSAMH establishes minimum quality standards, funding formulas for distribution of public funds, and other public mental health services with input from various stakeholders. Following is a list of mental health local authorities, the counties served, and the agency or organization through which services are provided: - Interlocal agreement between Box Elder, Cache, and Rich counties known as District 1 Mental Health Authority -- services provided through Bear River Mental Health, a private, not-for-profit entity
- Interlocal agreement between Carbon, Emery, and Grand counties -- services provided by Four Corners Community Mental Health Center, Inc., a private, not-for-profit entity
- Interlocal agreement between Juab, Millard, Piute, Sevier, Wayne, and Sanpete counties – services provided by Central Utah Mental Health/Substance Abuse Center doing business as Central Utah Counseling Center, a governmental entity formed via the interlocal agreement
- Davis County – services provided through a contract with Davis Behavioral Health Inc., a private, not-for-profit entity
- Salt Lake County, Division of Behavioral Health Services – contracts with OptumHealth Inc. (a subsidiary of United Health Group, a for-profit entity) who sub-contracts with service providers
- San Juan County – services provided through San Juan County Substance Abuse/Mental Health Special Service District operating as San Juan Counseling, a service district organized under the Utah Special Services District Act
- Interlocal agreement between Beaver, Garfield, Iron, Kane, and Washington counties – services provided by Southwest Behavioral Health Center also known as Southwest Center, a governmental entity formed via the interlocal agreement
- Summit County – services provided through a contract with Valley Mental Health, Inc., a private, not-for-profit entity
- Tooele County – services provided through a contract with Valley Mental Health, Inc., a private, not-for-profit entity
- Interlocal agreement between Daggett, Duchesne, and Uintah counties – services provided by Uintah Basin Tri-County Mental Health and Substance Abuse Local Authority doing business as Northeastern Counseling Center, a governmental entity
- Wasatch County – services provided by Heber Valley Counseling, a department of Wasatch County
- Utah County – services provided by Wasatch Mental Health Services Special Service District, organized under the Utah Special Services District Act and operating as Wasatch Mental Health
- Interlocal agreement between Morgan and Weber counties – services provided by Weber Human Services, a governmental entity formed via the interlocal agreement
Funding Detail Counties obtain funds from various sources including state General Fund, the federal community mental health block grant, federal Medicaid funds, private pay insurance, and client fees. Counties are required to "match" (i.e. - provide from county resources) no less than twenty percent (20%) of an amount equal to most of the General Fund received from the state division of Substance Abuse and Mental Health [UCA 17-43-301(4)(a)(x)] Sources of Finance (click linked fund name for more info) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp | General Fund | $25,022,200 | $22,372,400 | $21,846,400 | $25,182,400 | $25,182,400 | General Fund, One-time | $2,736,000 | $2,725,300 | $613,900 | $0 | $0 | Federal Funds | $2,242,100 | $2,243,600 | $1,522,200 | $2,680,300 | $2,243,600 | Closing Nonlapsing | $0 | $0 | ($1,000) | $0 | $0 | Lapsing Balance | ($15,500) | $0 | $0 | $0 | $0 | Total | $29,984,800 | $27,341,300 | $23,981,500 | $27,862,700 | $27,426,000 |
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| | | | | | Categories of Expenditure (mouse-over category name for definition) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp |
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Other Charges/Pass Thru | $29,984,800 | $27,341,300 | $23,981,500 | $27,862,700 | $27,426,000 | Total | $29,984,800 | $27,341,300 | $23,981,500 | $27,862,700 | $27,426,000 |
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Subcommittee Table of ContentsProgram: Residential Mental Health Services Function The purpose of this program is to provide community-based residential services to children and youth in order to prevent or reduce inpatient hospitalizations. Funding is allocated to mental health providers where adolescents and children are placed. Once children are stabilized, the funding is used to provide wrap-around services that will keep children and youth in their families and communities. The wrap-around services that are developed are specific to the child and family's needs. Funding Detail Sources of Finance (click linked fund name for more info) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp | General Fund | $1,045,300 | $1,038,500 | $972,600 | $855,200 | $898,900 | Transfers - Medicaid | $0 | $0 | ($10,800) | ($657,000) | ($668,100) | Closing Nonlapsing | ($50,000) | $0 | ($35,400) | ($20,400) | $0 | Lapsing Balance | ($30,200) | ($80,500) | $0 | $0 | $0 | Total | $965,100 | $958,000 | $926,400 | $177,800 | $230,800 |
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| | | | | | Categories of Expenditure (mouse-over category name for definition) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp |
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Current Expense | $30,000 | $0 | $0 | $0 | $0 | Other Charges/Pass Thru | $935,100 | $958,000 | $926,400 | $177,800 | $230,800 | Total | $965,100 | $958,000 | $926,400 | $177,800 | $230,800 |
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Subcommittee Table of ContentsProgram: State Hospital Function The Utah State Hospital (USH) is an Institution for Mental Disease (IMD) that complements the local mental health centers by providing specialized services not available in community settings. The hospital's population includes adults and children for whom no appropriate, less restrictive environment is currently available. Various services are provided for four groups of people: 1) pediatric services for children and adolescents, 2) forensic services for those found not guilty of crimes by reason of insanity, guilty and mentally ill, or not competent to proceed with court actions, 3) adult services for adults who are civilly committed, and 4) Acute Recovery Treatment Unit (ARTC) for acute care of adults from four rural mental health centers—Central Utah MHC, Four Corners MHC, Northern Counseling Center, and San Juan MHC. The adult patients in the Utah State Hospital are not eligible for Medicaid funding because of regulations associated with the federal Omnibus Reconciliation Act (OBRA) of 1987. These regulations define any nursing facility with 40 percent or more mentally ill residents as an IMD and then prohibit Medicaid funding for residents between the ages of 22 and 65 living in an IMD. Adult services provide 152 beds to the community mental health centers as prescribed by state statute. Pediatric services provides 72 beds to the community mental health centers as prescribed by state statute. The beds available for use by the local mental health centers are allocated according to population. UCA 62A-15-611 governs the adult allocation and UCA 62A-15-612 governs the pediatric allocation. The statute indicates that as the state population changes, the distribution of beds available to the local centers should be reviewed and reallocated. Funding Detail Sources of Finance (click linked fund name for more info) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp | General Fund | $39,872,000 | $40,620,600 | $40,415,400 | $36,128,300 | $38,276,500 | General Fund, One-time | ($215,000) | ($2,373,900) | ($882,700) | $1,140,000 | ($100,000) | American Recovery and Reinvestment Act | $970,000 | $1,658,500 | $1,016,000 | ($92,400) | $0 | Dedicated Credits Revenue | $3,305,100 | $3,084,900 | $3,055,400 | $3,223,700 | $3,088,900 | Transfers - Child Nutrition | $64,100 | $73,900 | $71,600 | $0 | $71,600 | Transfers - Medicaid | $10,513,200 | $12,855,600 | $11,634,200 | $11,287,200 | $11,497,300 | Transfers - Other Agencies | $2,700 | $0 | $15,200 | $0 | $0 | Transfers - State Office of Education | $0 | $0 | $0 | $73,500 | $0 | Transfers - Within Agency | $0 | $0 | ($6,900) | $0 | $0 | Beginning Nonlapsing | $0 | $0 | $0 | $4,700 | $0 | Closing Nonlapsing | $0 | $0 | ($4,700) | ($15,100) | $0 | Lapsing Balance | ($113,500) | ($1,729,100) | ($103,700) | $0 | $0 | Total | $54,398,600 | $54,190,500 | $55,209,800 | $51,749,900 | $52,834,300 |
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| | | | | | Categories of Expenditure (mouse-over category name for definition) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp |
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Personnel Services | $43,528,400 | $43,025,500 | $43,995,600 | $41,901,400 | $41,589,400 | In-state Travel | $4,200 | $2,300 | $2,500 | $3,800 | $2,500 | Out-of-state Travel | $2,000 | $900 | $1,200 | $2,600 | $1,200 | Current Expense | $8,792,900 | $8,911,000 | $9,140,000 | $8,044,700 | $9,191,600 | DP Current Expense | $2,071,100 | $2,069,300 | $1,983,800 | $1,797,400 | $2,049,600 | DP Capital Outlay | $0 | $8,300 | $0 | $0 | $0 | Capital Outlay | $0 | $144,900 | $87,000 | $0 | $0 | Other Charges/Pass Thru | $0 | $28,300 | ($300) | $0 | $0 | Total | $54,398,600 | $54,190,500 | $55,209,800 | $51,749,900 | $52,834,300 |
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| | | | | | Other Indicators | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp |
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Budgeted FTE | 762.4 | 793.0 | 793.0 | 753.0 | 752.8 | Actual FTE | 763.9 | 760.5 | 763.1 | 746.6 | 0.0 | Vehicles | 48 | 48 | 46 | 46 | 46 |
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Subcommittee Table of ContentsProgram: State Substance Abuse Services Function By state statute, DSAMH has the authority to retain a portion of federal and state dollars to fund statewide substance abuse programs. In addition, DSAMH has applied for and received a number of discretionary grants that it allocates to expand substance abuse services. Examples of the statewide services funded by DSAMH are: - State Office of Education - provides curriculum and training in drug abuse prevention for Utah schools.
- University of Utah - provides counseling education, clinical services, evaluation, and data analysis and operates the Utah School of Alcoholism and Other Drug Dependencies.
- Women's Residential Treatment - includes four residential facilities located in Salt Lake, Weber, Utah, and Washington counties which serve women and children from all areas of the state.
- Women's Treatment -- funding for outpatient and inpatient services for women is allocated on a formula to all local authorities.
Among the discretionary grants received by DSAMH are: - Award for Strategic Prevention Framework -- State Incentive Grant (SPF-SIG) - received by DHS September of 2006. This grant, originally set to expire in 2011 was extended through September 2012. The grant is to: 1) prevent the onset and reduce the progression of substance abuse, including childhood and underage drinking, 2) reduce substance abuse related problems in the community, and 3) build the infrastructure and capacity of prevention programs at the state and community level.
- Access to Recovery Grant received by DHS September 2010. This grant is to provide client choice among substance abuse clinical treatment and recovery support service providers, expand access to a comprehensive array of clinical treatment and recovery support options (including faith-based programmatic options), and increase substance abuse treatment capacity).
- Strategic Prevention Enhancement Grant received by DHS September 2011. These awards are designed to strengthen and extend SAMHSA's national implementation of the Strategic Prevention Framework (SPF), so as to bring the SPF to scale and support communities of high need nationwide.
Funding Detail Sources of Finance (click linked fund name for more info) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp | General Fund | $1,249,100 | $2,839,100 | $2,794,500 | $2,794,500 | $2,794,500 | General Fund, One-time | $1,589,100 | $0 | $0 | $0 | $0 | Federal Funds | $3,485,100 | $3,618,300 | $4,663,100 | $4,776,200 | $4,115,800 | Dedicated Credits Revenue | $345,300 | $149,200 | $102,000 | $46,400 | $48,900 | Transfers - Other Agencies | $0 | $0 | $15,700 | $0 | $23,000 | Beginning Nonlapsing | $128,800 | $0 | $49,800 | $192,800 | $0 | Closing Nonlapsing | $0 | ($49,800) | ($192,800) | ($155,000) | $0 | Total | $6,797,400 | $6,556,800 | $7,432,300 | $7,654,900 | $6,982,200 |
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| | | | | | Categories of Expenditure (mouse-over category name for definition) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp |
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Personnel Services | $0 | $0 | $287,100 | $411,300 | $418,600 | In-state Travel | $2,600 | $0 | $4,700 | $8,200 | $2,900 | Out-of-state Travel | $1,100 | $0 | $1,400 | $6,400 | $400 | Current Expense | $956,300 | $763,100 | $1,037,100 | $704,300 | $704,100 | DP Current Expense | $92,300 | $89,400 | $155,400 | $125,400 | $165,600 | Other Charges/Pass Thru | $5,745,100 | $5,704,300 | $5,946,600 | $6,399,300 | $5,690,600 | Total | $6,797,400 | $6,556,800 | $7,432,300 | $7,654,900 | $6,982,200 |
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| | | | | | Other Indicators | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp |
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Budgeted FTE | 0.0 | 0.0 | 0.0 | 0.0 | 5.0 | Actual FTE | 0.0 | 0.0 | 0.0 | 4.9 | 0.0 |
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Subcommittee Table of ContentsProgram: Local Substance Abuse Services Function State statute assigns substance abuse local authority responsibility to each county. Counties may elect to perform their local authority responsibilities singularly or through an interlocal agreement between multiple counties. There are currently organized thirteen (13) local substance abuse authorities. The Division of Substance Abuse and Mental Health (DSAMH) is the state's public substance abuse authority. It has the duty to consult and coordinate with local substance abuse authorities regarding programs and services. The DSAMH sets policy for programs funded with state and federal money. It accomplishes this objective by establishing rules and minimum standards for local substance abuse authorities. It establishes minimum quality standards, funding formulas for distribution of public funds, and other public and substance abuse policies with input from various stakeholders. Following is a list of substance abuse local authorities, the counties served, and the agency or organization through which services are provided: - Interlocal agreement between Box Elder, Cache, and Rich counties known as District 1 Substance Abuse Authority -- services provided through Bear River Health District
- Interlocal agreement between Carbon, Emery, and Grand counties -- services provided by Four Corners Community Mental Health Center, Inc., a private, not-for-profit entity
- Interlocal agreement between Juab, Millard, Piute, Sevier, Wayne, and Sanpete counties – services provided by Central Utah Mental Health/Substance Abuse Center doing business as Central Utah Counseling Center, a governmental entity formed via the interlocal agreement
- Davis County – services provided through a contract with Davis Behavioral Health Inc., a private, not-for-profit entity
- Salt Lake County, Division of Behavioral Health Services – services provided by the county mainly through subcontracts with private substance abuse service providers
- San Juan County – services provided through San Juan County Substance Abuse/Mental Health Special Service District operating as San Juan Counseling, a service district organized under the Utah Special Services District Act
- Interlocal agreement between Beaver, Garfield, Iron, Kane, and Washington counties – services provided by Southwest Behavioral Health Center also known as Southwest Center, a governmental entity formed via the interlocal agreement
- Summit County – services provided through a contract with Valley Mental Health, Inc., a private, not-for-profit entity
- Tooele County – services provided through a contract with Valley Mental Health, Inc., a private, not-for-profit entity
- Interlocal agreement between Daggett, Duchesne, and Uintah counties – services provided by Uintah Basin Tri-County Mental Health and Substance Abuse Local Authority doing business as Northeastern Counseling Center, a governmental entity
- Wasatch County – services provided by Heber Valley Counseling, a department of Wasatch County
- Utah County – services provided by Utah County Division of Substance Abuse through subcontracts with private substance abuse service providers
- Interlocal agreement between Morgan and Weber counties – services provided by Weber Human Services, a governmental entity formed via the interlocal agreement
Funding Detail Counties obtain funds from various sources including state General Fund and the federal Substance Abuse Prevention and Treatment (SAPT) block grant. Counties are required to "match" (i.e. - provide from county resources) no less than twenty percent (20%) of an amount equal to most of the state General Fund received from the Division of Substance Abuse and Mental Health [UCA 17-43-201(4)(k)] Sources of Finance (click linked fund name for more info) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp | General Fund | $9,719,100 | $8,836,200 | $8,836,200 | $8,836,200 | $8,836,200 | General Fund, One-time | $391,000 | $882,900 | $0 | $0 | $0 | Federal Funds | $14,516,100 | $14,564,700 | $14,627,100 | $14,506,700 | $14,614,900 | Closing Nonlapsing | $0 | $0 | ($1,700) | $0 | $0 | Total | $24,626,200 | $24,283,800 | $23,461,600 | $23,342,900 | $23,451,100 |
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| | | | | | Categories of Expenditure (mouse-over category name for definition) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp |
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Other Charges/Pass Thru | $24,626,200 | $24,283,800 | $23,461,600 | $23,342,900 | $23,451,100 | Total | $24,626,200 | $24,283,800 | $23,461,600 | $23,342,900 | $23,451,100 |
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Subcommittee Table of ContentsProgram: Driving Under the Influence (DUI) Fines Function The DSAMH oversees the Intoxicated Driver Rehabilitation Account. All courts levy a surcharge on fines. Of the amount collected by these surcharges, 7.5 percent is allocated to the DUI Fines program. These fees on fines are appropriated to the DSAMH and distributed to each county by formula based on county population. These funds are to be used to support education and provide intervention and treatment services for drivers convicted of driving under the influence. Funding Detail Sources of Finance (click linked fund name for more info) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp | GFR - Intoxicated Driver Rehab | $1,500,000 | $1,500,000 | $1,500,000 | $1,500,000 | $1,500,000 | Lapsing Balance | ($20,300) | ($31,800) | ($45,500) | ($48,000) | $0 | Total | $1,479,700 | $1,468,200 | $1,454,500 | $1,452,000 | $1,500,000 |
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| | | | | | Categories of Expenditure (mouse-over category name for definition) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp |
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Other Charges/Pass Thru | $1,479,700 | $1,468,200 | $1,454,500 | $1,452,000 | $1,500,000 | Total | $1,479,700 | $1,468,200 | $1,454,500 | $1,452,000 | $1,500,000 |
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Subcommittee Table of ContentsProgram: Drug Offender Reform Act (DORA) Function Senate Bill 202, Drug Offender Reform Act (DORA), was passed during the 2009 General Session of the Legislature reducing the scope of DORA from a statewide initiative for both probationers and parolees to serving probationers only in six local substance abuse authority areas. DORA was designed to expand offender access to treatment, provide for smarter sentencing by judges, and provide increased community supervision. This legislation was predicated on a three-year DORA pilot program, created in 2005, which operated in the Third Judicial District Court in Salt Lake County as well as a statewide initiative enacted in 2007 via Senate Bill 50 of the same title. Senate Bill 202 requires the Utah Substance Abuse and Anti-Violence Coordinating Council (USAAV) to provide ongoing oversight for implementation and program functioning, evaluation of impacts and results, development of an implementation plan, and approval of plans submitted by local substance abuse authorities for DORA. The Department of Human Services then allocates funds for approved plans and monitors contracts according to approved plans and contractual requirements. Funding Detail The Legislature appropriated approximately $3.5 million ongoing funding for Fiscal Year 2013 for DORA treatment and supervision. Of that amount, $2,590,900 was allocated to the Department of Human Services for the purposes of assessing and treating drug offenders in the substance abuse authority areas identified by USAAV which include Cache, Weber, Davis, Salt Lake, Utah, and Washington/Iron counties. Sources of Finance (click linked fund name for more info) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp | General Fund | $2,843,300 | $83,300 | $79,100 | $2,039,500 | $2,590,900 | General Fund, One-time | $700,000 | $2,009,400 | $2,060,400 | $100,000 | $0 | Beginning Nonlapsing | $68,300 | $0 | $0 | $0 | $0 | Lapsing Balance | ($44,800) | $3,800 | $0 | $0 | $0 | Total | $3,566,800 | $2,096,500 | $2,139,500 | $2,139,500 | $2,590,900 |
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| | | | | | Categories of Expenditure (mouse-over category name for definition) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp |
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Other Charges/Pass Thru | $3,566,800 | $2,096,500 | $2,139,500 | $2,139,500 | $2,590,900 | Total | $3,566,800 | $2,096,500 | $2,139,500 | $2,139,500 | $2,590,900 |
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Subcommittee Table of ContentsProgram: Drug Courts Function Utah's first drug court was started in 1996 in Salt Lake County with funds from the U.S. Department of Justice, Salt Lake County, and other sources. Currently, 42 of the 45 drug courts operating in the state receive funding from the Department of Human Services. Drug Courts is a judicial process that offers nonviolent drug abusing offenders intensive court-supervised drug treatment as an alternative to jail or prison. The local area substance abuse authorities and private contractors provide treatment services. Each drug court has its own eligibility criteria. However, most look at both a potential participant's legal history as well as the clinical severity of the addiction. In most drug courts, offenders enter a guilty plea which is then held in abeyance for the duration of the program. The charges are then dismissed upon successful completion of the program. Drug court participants are enrolled in the program for approximately 73 weeks. Treatment counselors develop individualized treatment plans. The participants are randomly tested for drug use from one to four times a week. The drug court judge reviews compliance with the treatment plan during weekly court reviews. In most programs, participants must be clean for at least six months to graduate. Failure to comply with any element of the program or having a positive drug test may result in immediate court action such as being taken to jail. Compliance and progress in the program are rewarded with praise from the court and a gradual decrease in supervision. Statutory Authority UCA 78A-5-201 defines the drug court program, allows for its expansion, sets criteria for participation in the program, and establishes reporting requirements. It also lays out a coordinated disbursement process involving the executive directors of the departments of Human Services and Corrections as well as the State Court Administrator. Utah has four distinct drug court models In Utah, four distinct drug court models exist. In addition to the adult felony drug courts, there are programs that focus on juveniles, adult misdemeanants, and parents involved in civil child welfare custody cases. Adult Felony Drug Courts: Utah has twenty-two functioning adult drug courts located in Carbon, Emery, Grand, Weber, Davis, Iron, Juab, Millard, Tooele, Salt Lake, Utah, Washington, Box Elder, Cache, Uintah, Wasatch, Sanpete, San Juan, and Sevier counties. Twenty-two of these programs receive funding from the Department of Human Services. Juvenile Drug Courts: There are seven juvenile drug courts in Utah, Weber, Tooele, and Salt Lake counties. Juvenile drug courts involve parents and the schools in the creation of the treatment plan. All seven of these programs receive funding from the department. Misdemeanor Drug Courts: Six misdemeanor drug courts have been established in Salt Lake and Davis counties. These programs are operated at the justice court level. These programs focus on offenders who have been arrested on alcohol or marijuana charges. None of these programs receive funding from the department. Dependency Drug Courts: Thirteen dependency drug courts deal with cases where a parent's substance abuse could result in loss or restriction of parental rights. Their primary purpose is to assist in determining whether reasonable efforts have been made in reunification cases involving substance-abusing parents. They operate similarly to adult and juvenile drug courts. There are operational dependency courts in Salt Lake, Grand, Emery, Weber, Carbon, Washington, and Utah counties. All thirteen dependency drug courts receive funding from the Department of Human Services. Allocation from Tobacco Settlement Funds UCA 51-9-201 allocates funds from the General Fund Restricted -- Tobacco Settlement Account first to the Office of Attorney General for ongoing enforcement and defense of the Tobacco Settlement Agreement, second to the State Tax Commission for ongoing enforcement of business compliance with the agreement, third to the Department of Health for the Children's Health Insurance Program, fourth to the Department of Health for alcohol, tobacco, and other drug programs, then to drug courts, and finally to the University of Utah Health Sciences Center. Funding Detail Drug courts also receive funding directly from federal and local agencies. Sources of Finance (click linked fund name for more info) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp | General Fund | $1,207,500 | $785,900 | $275,900 | $275,900 | $275,900 | General Fund, One-time | $749,100 | $0 | $0 | $0 | $0 | Federal Funds | $800,000 | $805,100 | $950,700 | $1,046,900 | $842,000 | GFR - Tobacco Settlement | $1,471,700 | $1,815,400 | $2,325,400 | $2,325,400 | $2,325,400 | Transfers - Commission on Criminal and Juvenile Justice | $92,800 | $242,200 | $317,000 | $305,100 | $305,100 | Beginning Nonlapsing | $130,900 | $38,800 | $27,500 | $6,700 | $0 | Closing Nonlapsing | ($38,800) | ($27,500) | ($6,700) | ($6,700) | $0 | Total | $4,413,200 | $3,659,900 | $3,889,800 | $3,953,300 | $3,748,400 |
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| | | | | | Categories of Expenditure (mouse-over category name for definition) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp |
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In-state Travel | $0 | $0 | $0 | $32,700 | $0 | Out-of-state Travel | $0 | $0 | $3,000 | $400 | $0 | Current Expense | $0 | $0 | $24,000 | $28,400 | $0 | Other Charges/Pass Thru | $4,413,200 | $3,659,900 | $3,862,800 | $3,891,800 | $3,748,400 | Total | $4,413,200 | $3,659,900 | $3,889,800 | $3,953,300 | $3,748,400 |
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Subcommittee Table of ContentsProgram: Drug Boards Function Drug Boards provide community-based services to drug involved parolees to help them reintegrate into their communities after release from prison. Drug Boards is a program similar to drug courts, but is offered by the correctional system to individuals leaving prison and entering parole. Instead of judges and a courtroom, the official in charge is a representative from the Board of Pardons and the location is a hearing room. In this case, the potential punishment is the threat of having parole lifted and returning to prison. Progress in the program is rewarded with praise from the board and support from peers and continued parole. Funding for this program was eliminated in the 2010 General Session of the Legislature as part of required budget reductions. Funding Detail The 2000 Legislature appropriated a total of $510,000 from the Tobacco Settlement Restricted Account to start a pilot drug board program in Davis and Weber counties. This amount included $77,400 to the Board of Pardons, $81,700 to the Department of Corrections, and $350,900 to the Department of Human Services. This program was eliminated in the 2010 General Session of the Legislature as part of required budget reductions. Sources of Finance (click linked fund name for more info) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp | GFR - Tobacco Settlement | $175,500 | $350,900 | $0 | $0 | $0 | Beginning Nonlapsing | $0 | $300 | $34,100 | $0 | $0 | Closing Nonlapsing | ($300) | ($34,100) | $0 | $0 | $0 | Total | $175,200 | $317,100 | $34,100 | $0 | $0 |
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| | | | | | Categories of Expenditure (mouse-over category name for definition) | 2009 Actual | 2010 Actual | 2011 Actual | 2012 Actual | 2013 Approp |
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Current Expense | $0 | $0 | $1,000 | $0 | $0 | Other Charges/Pass Thru | $175,200 | $317,100 | $33,100 | $0 | $0 | Total | $175,200 | $317,100 | $34,100 | $0 | $0 |
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