MINUTES OF THE
SOCIAL SERVICES APPROPRIATIONS SUBCOMMITTEE
Tuesday, February 12, 2019 • 7:59 a.m. • 30 House Building


Members Present:
Sen. Allen M. Christensen, Senate Chair
Rep. Paul Ray, House Chair
Rep. Raymond P. Ward, House Vice Chair
Sen. Luz Escamilla
Sen. Keith Grover
Sen. Daniel Hemmert
Sen. Todd Weiler
Rep. Kim F. Coleman
Rep. Jennifer Dailey-Provost
Rep. Brad M. Daw
Rep. Sandra Hollins
Rep. Marsha Judkins
Rep. Adam Robertson
Rep. Travis M. Seegmiller
Rep. Norman K. Thurston

Members Absent:
President J. Stuart Adams
Sen. Kirk A. Cullimore

Staff Present:
Mr. Russell T. Frandsen, Fiscal Analyst
Ms. Clare Tobin Lence, Fiscal Analyst
Ms. Maddy Oritt, Fiscal Analyst
Ms. Paula Morgan, Committee Secretary

Note: A copy of related materials and an audio recording of the meeting can be found at www.le.utah.gov.

Rep. Ray called the meeting to order at 8:13 AM
1. Public Input on Topics on Today's Agenda
Dave Parke, Owner, Home Instead Senior Care, along with Heather Alvarez shared the services available through their business and spoke in support of an adjustment in the Medicaid Rate Increase.
Brent Hogue, Area Vice President, Maxim Healthcare, gave details of patients served by their care and spoke in support of Medicaid Rate Increase.
Beth Noyce, Executive Director, Utah Association of Home Care, spoke on behalf of her sister who had a traumatic brain injury. She spoke in support of the Medicaid rate increase for services.
Joleen Huber, Owner/Operator, Caregiver Support Network, shared information about those they have to deny service to because of the low rates paid by Medicaid and spoke in support of the Medicaid rate increase.
Ed Dieringer, Physical Therapist, explained the nature of home health care and spoke in support of the Medicaid rate increase in order to support those who desire to stay in their home to be cared for.
Brent Jones, President, CNS Home Health, introduced Scott Acton, CFO, CNS Home Health. Mr. Jones specified areas where funding has not been adequate. Mr. Acton shared concern about the number of eligible beneficiaries that will become part of that program and supported the Medicaid Rate increase proposal.
Danny Harris, Advocacy Director, American Association of Retired Persons (AARP), spoke in support of the State Alzheimer' s Plan and also the funding for the Adult Protective Services Program.
Michelle Goldberg, Family Medicine Physician and Medical Director, Fourth Street Clinic, testified in support of the Health Care Workforce Financial Assistance support.
Kevin Whatcott, Owner, Home Health Care Services, spoke in support of the increase in Medicaid.
Heather Dopp, Citizen, Maternal Mental Health, shared her experience and spoke in support of funding for mental health support.
Jessica Huish, Citizen, shared her experience and requested support for Maternal Mental Health appropriations request.
Patti Cook, Volunteer, Action Utah, shared her personal experience and spoke in support of funding for Maternal Mental Health.
Lindsay Aerts, shared her personal experience. She encouraged protocol for providers and spoke in support of Maternal Mental Health appropriations request.
Dr. Scott Jacob, Chair -Elect Utah Section- American College of Obstetricians and Gynecologists, spoke in support of funding for Maternal Mental Health by sharing experience he has had with patients and emphasized the importance of the funding to help recduce maternal deaths in Utah.
Dr. Neal Davis, Pediatrician, Medical Director for Pediatric Community-based care from Intermountain Healthcare, spoke in support of the Maternal Mental Health Care appropriations request.
Rep. Ray thanked everyone who spoke to the Committee.
5a Staff Discussion of Alternative Funding Sources
Russell Frandsen, Fiscal Analyst, shared information about some Alternative Funding Sources available from the Building Block List Ongoing Funding. Items EL, EN, EO, ER, ES, EV, AI, and AJ,
2. Requests for Appropriation
5b Maternal Mental Health Support
5b1-Maternal Mental Health Support Appropriations Request
Rep. Dailey-Provost presented information about requested funding for Maternal Mental Health.
Gwen Latendresse, Nurse Researcher, Telehealth Pilot Project, explained the purpose of the project and how it works in rural Utah. She shared results from their 15 month run and requested funding for maternal Mental Health so the program can continue.
Kelsie Oliver, parent, shared her experience with postpartum depression and spoke in support of the funding for Maternal Mental Health.
Amy-Rose White, Licensed Clinical Social Worker, psychotherapist, Founder of Postpartum Support Utah, testified about the reality of postpartum mental health issues. and requested support of the bill.
Rep. Ray asked what the funding of $250,000 would support.
Rep. Dailey-Provost directed the question to Erin Jemison.
Erin Jemison, Policy Director, YWCA, Policy Committee Chair, Maternal Mental Health Utah explained what the funding would support. Rep. Ray indicated that there are two funding requests which were one-time and ongoing and Rep. Provost explained how that funding would work.
5c One Time money for Health Care Work Force Assistance
Health Care Workforce Assistance (HCWFA)
Rep. Ray Ward explained the request for one time money for HCWFA
Mark Babitz, Deputy Director, Utah Department of Health (UDOH), explained why the request for funding is being made with comment from Rep. Ward.
Sen. Christensen asked for clarification about the providers in the rural areas.
Matt McCullough, Director, Office of Primary Care, UDOH, explained that the program would be in the rural areas. He also explained the problem occurring because more and more are turning to the HCWFA program.
Rep, Ward explained the amount being requested.
Barbara Munoz, Program Director, Utah Academy of Family Physicians also spoke to the HCWFAP and referenced areas and people who have benefited by the program.
5d Update of Physical/Occupational Therapy Medicaid Payments
Occupational and Physical Therapy medicaid Payments request and the importance of therapy in place of opioid use.
Rep. Ward explained the purpose for the request. He indicated that the number contracting with Medicaid has decreased in physical therapy and shared the importance of those services for patients.
Mark Anderson, Physical Therapist, presented information about costs for education and payment for his services vs payment for physical therapy today. He also spoke about the increase in therapists but decrease in Medicaid providers in that group. He emphasized the importance of physical therapy in helping to decrease the use of opioids for pain relief.
Rep. Ward clarified that this proposal transitions Medicaid over to use the same system as surrounding states.
Rep. Ray asked for clarification of the standard of education necessary currently to become a physical therapist. Mr. Anderson clarified.
Rep. Daw commented on the importance of physical therapy to help bodies heal as compared to the use of opioids. Rep Ward commented.
5e H.B. 58 Overdose and Fatality Review
HB 58 Overdose and Fatality Review and the Need for Funding.
Rep. Steve Eliason shared information about data which has been gathered in relation to the proposed request and the purpose of the funding request.
Rep. Ward asked how having data would result in better outcomes.
Rep. Eliason responded that having it more formalized and distributing the information to others and working with others would help the process be beneficial in the prevention of suicide.
Heather Borski, Director, Division of Disease Control, Utah Department of Health (UDOH), informed the committee about the goals of the Department, to see risk factors, trends, hot spots to reduce and prevent opioid deaths.
Rep. Eliason finished by summing up what is happening with the data he receives and shared that the goal for the request has been cut in half. Ms. Borski spoke about the current grant running out in July 2019.
5f Medicaid Select Health Accountable Care Organization Tax
Sen. Hemmert explained that this has to do with a tax reimbursement to Select Health.
5g Medicaid Accountable Care Organization Funding
Sen. Hemmert requested an increase to the base budget amount.
5h Community Rehab Clinic/Rocky Mountain University
Rep. Maloy requested $100,000 for the Rocky Mountain University Foundation Community Rehabilitation Clinic in Provo and indicated what the funds would be used for.
Vic Deauvono, Chairman, Rocky Mountain University Foundation, spoke to explain the services rendered and the purpose of the Clinic.
Cody Fowlke explained his involvement and treatment with the clinic with input from Mr. Deauvono.
5i Dental Provider Reimbursement request
Sen. Allen Christensen gave background and explained the reason for the request.
Rep. Ray commented about constituents calling him in frustration about not being able to find service for kids on medicaid. Sen. Christensen responded.
3. Managed Dental Care in Medicaid - Results of New Five Year Contracting Cycle
Nathan Checketts, Deputy Director, Utah Department of Health, began and explanation and introduced Emma Chacon to explain how the program is working..
Emma Chacon, Operations Director, Medicaid, explained the information about current managed dental care and reviewed what is happening currently.
4. Update on Changing Estate Collections From Waiver to Deferral for Surviving Spouse
Emma Chacon, Program Director, Medicaid, explained the request.
5j Utah Anti-Bullying Coalition
5l-Utah Anti-Bullying Coalition - RFA Supporting Docs - Ray
Rep. Ray introduced the Utah Anti-Bullying Coalition request.
Kevin Bischoff, Director of Development, Utah Anti-Bullying Coalition, explained the funding efforts received last year and the use of the funding. He also explained the need of funding so that other schools could receive the training through the
Pam Hayes, Program Director, explained the programs and results the program has had.
Mauricio Goytan, Parent, spoke on the result his daughter had in her experience with the coalition.
Ms. Hayes continued explaining the programs available through the program ambassadors.
Rep. Daw asked a question about cyber bullying. Ms. Hayes responded about the cyber bullying program available.
5k Home Health Care Services
Rep. Dunnigan presented a request for $4.4 million.
Clay Watson Physical Therapist, explained the importance of home health care and indicated the value it is compared to skilled nursing care.
Matt Hansen, President Utah Association for Home Health Care, shared information about the request and quoted statistics about Home Health Care Providers and the lack of increase in reimbursement.
Rep. Daw had a question about trends in 2018 and Mr. Watson responded along with Mr. Hansen
Rep. Judkins asked if this request overlaps with physical and occupational therapy requests. Mr. Watson replied that this is a different ask because this is specific to home care and the actual kinds of services. Mr. Hansen commented on the continuum of care they perform.
Rep. Dailey-Provost pointed out the huge benefit of Home Health Care and the value for the dollar it is and asked why there would not be a larger request to meet the current need. Rep. Dunnigan and Mr. Hansen explained that the need is there and more funds could be used and this request is for fee for services.
Rep. Ray asked how much is being paid per hour to providers and Mr. Watson referred to the handout to reference the hourly rates and other rates. There was continued discussion.
Rep. Ward asked if this is the same request they had heard earlier on Home Health Care. Mr. Watson anwered in the affirmative.
Rep. Dunnigan concluded his comments.
5. Status Update of Moving Certain Medicaid Claims to Higher Federal Match Rate
Tonya Hales, Assistant Director, Division of Medicaid and Health Financing, explained moving more Medicaid claims from American Indian and Alaskan native Medicaid clients to a higher match rate.
6. Medicaid Restrictions on Opioid Supply
Nathan Checketts, Deputy Director, Utah Department of Health, gave an overview of the program.
Jennifer Strohecker, Pharmacist, Medicaid Program, explained the program being used currently and the steps being taken to restrict use of opioids.
Rep. Ward commented on the challenges of opioids being provided. Ms. Strohecker replied that they are encouraging providers to use the Prescription Drug Monitoring Program (PDMP) so that it would be more difficult to obtain opioids.There was continued discussion of how providers are contacted.
Rep. Ray wondered if only a decrease in time of opioid supply would be available and if the dosage time could be reduced. Ms. Strohecker replied that providers seem to be dosing for less time. Mr. Checketts also responded.
Rep. Ray summed up the day and suggested preparations for the next voting days.
MOTION: Rep. Ward moved to adjourn at 10:38 AM. The motion passed with a vote of 8-0-9.
Yeas - 8Nays-0Abs-9
Sen. A. Christensen
Rep. J. Dailey-Provost
Rep. B. Daw
Rep. S. Hollins
Rep. M. Judkins
Rep. P. Ray
Rep. R. Ward
Sen. T. Weiler
Sen. J. Adams
Rep. K. Coleman
Sen. K. Cullimore
Sen. L. Escamilla
Sen. K. Grover
Sen. D. Hemmert
Rep. A. Robertson
Rep. T. Seegmiller
Rep. N. Thurston