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MINUTES OF THE
SOCIAL SERVICES APPROPRIATIONS SUBCOMMITTEE
Tuesday,
August 20, 2019
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8:00 a.m.
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Fourth Street Clinic, 409 West 400 South, Salt Lake City, 84101
Members Present:
Sen. Allen M. Christensen, Senate Chair
Rep. Paul Ray, House Chair
Rep. Raymond P. Ward, House Vice Chair
Sen. Luz Escamilla
Sen. Todd Weiler
Rep. Kim F. Coleman
Rep. Jennifer Dailey-Provost
Rep. Sandra Hollins
Members Absent:
President J. Stuart Adams
| Sen. Kirk A. Cullimore
Sen. Keith Grover
Sen. Daniel Hemmert
Rep. Brad M. Daw
Rep. Marsha Judkins
Rep. Adam Robertson
Rep. Travis M. Seegmiller
Rep. Norman K. Thurston
Staff Present:
Ms. An Bradshaw, Committee Secretary
Ms. Clare Tobin Lence, Finance Manager
Ms. Maddy Oritt, Financial Analyst
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Note: A copy of related materials and an audio recording of the
meeting can be found at www.le.utah.gov.
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| Chair Christensen called the meeting to order at 8:31 a.m. |
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| 2. Fiscal Note and Budget Item Follow-Up Report 2019 |
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| 4a-Issue Brief - 2019 Interim - Fiscal Note and Budget Item Follow-Up Report - Social Services |
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| Ms. Clare Tobin Lence, Finance Manager, Office of the Legislative Fiscal Analyst (LFA), presented the report to the committee. |
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| Rep. Dailey-Provost asked a clarifying question and Ms. Lence responded. |
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| Chair Christensen asked about funding and expenditures and Ms. Lence responded. |
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| Rep. Ward asked for more information and Ms. Lence responded. |
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| Ms. Maddy Oritt, Financial Analyst, LFA, presented information on the Intergenerational Poverty grants.. |
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| Ms. Lence continued with her presentation, discussing the funding of Suicide Prevention and Medical Examiner Provisions. |
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| Ms. Oritt presented information regarding Operation Rio Grande. |
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| Ms. Lence presented information regarding the efforts of the Department of Health (DOH) to limit initial presciptions for short-acting opiates. |
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| Sen. Weiler asked for more information about the limitations placed on prescribing opiates and Ms. Lence, Chair Christensen, and Rep. Ward responded. |
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| Ms. Lence presented information on the Child Welfare Amendments. |
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| Rep. Ward asked about the reporting methods used and Ms. Lence responded. |
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| Ms. Diane Moore, Director, Division of Child and Family Services (DCFS), provided additional information on the methods used when reporting data. |
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| Ms. Oritt explained the funding of the Talent Ready Utah Amendments. |
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| Ms. Lence reported on the Utah Statewide Stroke and Cardiac Registry Act. |
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| Ms. Lence discussed UCOOP for Outreach, Diversion and Partnerships to Support the Utah DEA360 Program. |
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| Ms. Oritt presented information on the Work is the Way Initiative. |
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| Chair Christensen asked if there were measurable benefits to the program and Rep. Dailey-Provost and Ms. Oritt responded. |
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| Ms. Lence presented information on Require a 90 Day Supply Generic Drugs in Medicaid. |
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| 5a-Internal Audit Presentation |
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| 3. Accountable Process Budget Review - Internal Audit Budgeted Levels |
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| Ms. Lence presented the report and recommended possible actions to the committee. |
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| Ms. Oritt discussed the types of audits that are done. |
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| Ms. Lence discussed funding sources. |
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| Ms. Oritt discussed resources and funding for internal audits and provided examples of the methodology used by North Carolina. |
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| Dr. Joe Miner, Executive Director, DOH, introduced Ms. Melanie Henderson, Internal Audit Director, DOH. |
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| Ms. Henderson discussed the strategic budget auditing methods used by the department. |
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| Chair Christensen asked for clarification on what is considered high risk and Ms. Henderson responded. |
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| Rep. Ward asked about the auditing of fees and services and Ms. Henderson and Dr. Miner responded. |
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| Rep. Dailey-Provost asked for more information about the need for additional full-time employees (FTEs) and Ms. Henderson responded. |
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| Chair Christensen asked about funding FTEs and Dr. Miner responded. |
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| Chair Christensen asked about the high compliance and low conflict of interest rates of the DOH and Ms. Henderson and Dr. Miner responded. |
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| Rep. Ward asked how DOH defines conflict of interest. |
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| Mr. Mark Brasher, Deputy Director, Department of Human Services (DHS), introduced Mr. Richard Sallstrom, Fiscal Audit Director, DHS. |
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| Mr. Sallstrom discussed the department's efforts to find and prosecute fraud. |
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| Rep. Ward asked for examples of employee and provider fraud and Mr. Sallstrom responded. |
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| Mr. Sallstrom discussed the department's efforts to find or avoid conflict of interest with department employees. Mr. Brasher also provided information. |
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| Chair Christensen asked for additional information about conflict of interest and Mr. Brasher responded. |
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| Rep. Dailey-Provost asked if a reported conflict of interest triggers a certain response. Mr. Sallstrom and Mr. Brasher responded. |
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| Rep. Ward asked about filling a vacant auditor position and Mr. Brasher responded. |
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| Sen. Escamilla asked how the department quantifies the impact of fraud on the department and Mr. Brasher and Mr. Sallstrom responded. |
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| Rep. Ward asked about audit methods and Mr. Brasher and Ms. Lence responded. |
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| Chair Christensen asked about the relationship between DHS and the Office of Inspector General (OIG) and Mr. Brasher responded. |
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| 5c-TRH Report and Follow Ups |
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| 5d-DWS FY 19 - Internal Audit Plan |
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| Mr. Van Christensen, Director, Internal Audit, Department of Workforce Services (DWS), talked about the department's efforts to look for, address, and prevent conflict of interest and fraud. |
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| Rep. Hollins asked about staffing levels and Mr. Christensen responded. |
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| Sen. Escamilla asked about security reviews and processes at the homeless shelter and Mr. Christensen responded. |
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| 4. Accountable Process Budget Review - DWS Administration Fees |
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| 6-DWS - Fee Recommendations |
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| Ms. Oritt explained the budget review to the committee. |
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| Sen. Escamilla asked about fees and transparency and Ms. Oritt responded. |
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| Rep. Ward asked about the costs for GRAMA requests and Ms. Oritt responded. |
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| 5. Behavioral Health Funding Reductions from S.B. 96 (Medicaid Expansion) |
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| 7a-Expansion Report - DOH - 8-8-2019 |
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| Ms. Lence explained the S.B. 96 funding reductions to the committee. |
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| Mr. Nate Checketts, Deputy Director, DOH, explained the costs and enrollment changes due to the Medicaid expansion. |
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| Rep. Ward asked about the estimates used by the department and Mr. Checketts responded. |
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| Chair Christensen asked how many of the 36,000 people who signed up were transferred from the Primary Care Network (PCN) and Mr. Checketts responded. |
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| Mr. Doug Thomas, Director, Division of Substance Abuse and Mental Health, DHS, provided information on the impact of the Medicaid expansion on mental health and substance use disorder care. |
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| 7b-Davis Behavioral Health - Medicaid Expansion |
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| Mr. Brandon Hatch, Director, Davis Behavioral Health, discussed the impact of the Medicaid expansion to county behavioral health departments. |
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| Chair Christensen asked about the impact on the number of people covered and the budgets and Mr. Hatch and Mr. Thomas responded. |
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| Rep. Ward asked for clarification on those for whom services are provided by the county departments and Mr. Hatch and Mr. Thomas responded. |
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| Rep. Ray asked what will happen if nothing is done to increase funding before the next session and Mr. Hatch responded. |
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| Mr. Lloyd Berentzen, Department Director, Bear River Health Department, discussed the reductions to services provided due to lack of funding. |
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| Ms. Lence was invited by Chair Christensen to explain possible processes to provide funding for county health programs. |
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| Rep. Ward talked about the enrollment in Medicaid and funding allocated for one-time spending. |
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| Rep. Dailey-Provost asked for clarification on funding and Chair Christensen responded. |
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| Mr. Checketts discussed possible waivers and expansion of Medicaid. Mr. Hatch and Mr. Thomas provided additional information. |
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| Rep. Ward asked about reasons for Medicaid ineligibility and Mr. Thomas and Mr. Berentzen responded. |
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| 6. Accountable Process Budget Review - Unemployment Compensation Fund |
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| 9-Unemployment Compensation Fund |
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| Ms. Oritt introduced the topic to the committee. |
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| Mr. Kevin Burt, Director, Unemployment Insurance, DWS, provided information on the fund and compared it to other states. |
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| Rep. Ray commended DWS for their good work. |
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| The committee and audience were invited to attend a tour of the facilities of the Fourth Street Clinic. |
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| Chair Christensen recessed the meeting at 10:57 a.m. |
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