MINUTES OF THE
SOCIAL SERVICES APPROPRIATIONS SUBCOMMITTEE
Friday, January 29, 2021 • 8:00 a.m. • 30 House Building


Members Present:
Sen. Jacob L. Anderegg, Senate Chair
Rep. Paul Ray, House Chair
Rep. Raymond P. Ward, House Vice Chair
Sen. Luz Escamilla
Sen. John D. Johnson
Sen. Michael S. Kennedy
Sen. Daniel W. Thatcher
Sen. Todd D. Weiler
Rep. Steve R. Christiansen
Rep. Jennifer Dailey-Provost
Rep. Sandra Hollins
Rep. Marsha Judkins
Rep. Michael L. Kohler
Rep. Michael J. Petersen
Rep. Candice B. Pierucci
Rep. Norman K. Thurston

Members Absent:
President J. Stuart Adams

Staff Present:
Russell T. Frandsen, Finance Officer
Clare Tobin Lence, Finance Manager
Kimberly D. Madsen, Financial Analyst
An Bradshaw, Committee Secretary

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

1. 8:00 Call to Order
Chair Anderegg called the meeting to order at 8:14 a.m.
2. 8:00 Unfinished Items from the Previous Agenda
There were no unfinished items from the previous agenda.
3. 8:00 Public Input on Topics on Today's Agenda
Matt Hansen, Executive Director, Homecare and Hospice Association, thanked the committee for funding Medicaid service providers.
Dr. Roger Adams, Avesis, Inc., spoke against the fee-for-service system and in support of privately managed care.
Dr. David Stewart, MCNA Dental, also speaking on behalf of Dr. Barney Olsen, spoke against switching back to a fee-for-service system.
4. 8:15 Medicaid Spending Statewide - Issue Brief
4a-Issue Brief - 2021 General Session - Medicaid Spending Statewide FY 2020
4b-Issue Brief - 2021 General Session - Medicaid Consensus Forecasting
Russell Frandsen, Office of the Legislative Fiscal Analyst (LFA), explained the Medicaid Spending Statewide - Issue Brief.
Rep. Judkins asked for more information on Workforce Services and Russell Frandsen responded.
Nathan Checketts, Director, Division of Medicaid and Health Financing, Department of Health (DOH), provided information on the number of people the Department of Workforce Services (DWS) serves.
Russell Frandsen continued with the presentation.
5. 8:30 Medicaid - First Performance Report for New Items Funded in the 2020 General
5a-Medicaid Rate Increase Survey Results
Tonya Hales, Assistant Director, Division of Medicaid and Health Financing, DOH, gave a follow-up on home health care services.
Rep. Ward commented on the need for adequate staff to provide the services Medicare recipients need to receive.
Rep. Judkins asked for additional information about the survey results and comments and Tonya Hales responded.
Rep. Kohler mentioned the need to increase salaries for home health workers.
Tonya Hales responded to Rep. Kohler's suggestion and agreed.
Clare Tobin Lence, LFA, provided additional information about different types of care givers and asked Tonya Hales to give more information.
Sen. Escamilla also gave information about the populations served by different agencies.
Emma Chacon, Assistant Division Director, DOH, provided information on the increase in physical therapy and occupational therapy providers available to Medicaid recipients.
Rep. Judkins asked where the additional providers were located and Emma Chacon said she would get the information.
6. 9:10 Budget Reduction Option - Shift Medicaid Managed Care Dental to State-run Fee-
8-Medicaid Letter
Russell Frandsen discussed budget reduction options.
Nathan Checketts provided information on costs and the utilization of services.
Emma Chacon said only pregnant women and children were involved in managed Medicaid dental care.
Dr. Robert Baird discussed the differences between medical and dental managed care and spoke against managed dental care because the process has become so cumbersome.
Rep. Ray assumed the chair.
Rep. Ward asked if more providers were willing to provide services under the new plan and Emma Chacon responded.
Sen. Anderegg resumed the chair.
Dr. Aaron Christensen spoke in favor of returning the management of dental care to the state rather than the current system of privately managed care.
Dr. Roger Adams responded to the previous comments and defended the current managed care system.
Dr. David Stewart spoke in support of the current managed care system.
Dr. Brant Larson expressed his preference for state managed Medicaid dental care.
Chris Swanker, CEO, Avesis, Inc., one of the two companies managing dental care for the state, spoke in opposition to going away from managed care.
Shannon Turner, MCNA Managed Dental Care, one of the two companies managing dental care for the state, spoke in support of managed dental care.
Dr. Aaron Christensen disputed the accuracy of the picture painted by the companies paid to provide managed care and said his father, former Sen. Allen Christensen, also a dentist, opposed privately managed dental care.
Rep. Petersen asked why the state moved to managed care and Rep. Ray responded.
Russell Frandsen and Nathan Checketts gave information on what it would cost to return management to the state.
Emma Chacon provided additional information on the number of dentists who served Medicaid patients.
Sen. Escamilla expressed concern that this is a policy decision rather than a legislative decision.
Russell Frandsen and Nathan Checketts responded to Sen. Escamilla's question about waivers.
Sen. Kennedy mentioned an email from Rep. Dunnigan supporting managed care.
Rep. Ray said it is this committee's job to review and consider this issue.
Sen. Escamilla clarified her previous comment.
Chair Anderegg added comments to the discussion.
7. 9:00 Status Report on Replacement of Medicaid Management Information System
7-MMIS Annual Report - October 2020
7b-PRISM 2021 Presentation Subcommittee Status Report
Nathan Checketts discussed the replacement of the Medicaid Management Information System.
Jason Stewart, PRISM Project Director, DOH, discussed the scope of use and age of the current system.
Rep. Ray asked when the state began to build PRISM and Jason Stewart responded.
Rep. Ray asked what the original estimated cost was and how much has been spent and Jason Stewart and Nathan Checketts responded.
John Dixon, Senior Vice President, CNSI, explained the various parts of the system and the need for state-specific customization.
Chair Anderegg asked for more information on the costs to develop and run the system and John Dixon, Nathan Checketts, and Jason Stewart responded.
Rep. Judkins asked for a cost accounting of the project and Chair Anderegg tasked Nathan Checketts and Jason Stewart with coming up with the information.
Jason Stewart continued with the presentation.
8. 8:40 Requests for Appropriation - Health (agency only)
6-SSA BB Presentation II
Nathan Checketts discussed the Children's Health Insurance Program.
Emma Chacon continued with the presentation.
Russell Frandsen discussed alternative funding sources.
Rep. Ray assumed the chair.
Russell Frandsen discussed possible motions.
9. 9:35 Review of Department of Health's Medicaid and Health Financing Budget
10. 9:50 Review of Department of Health's Children's Health Insurance Program Budget
9c-UOIG - Annual Report Final - 29-Oct-2020
Russell Frandsen discussed the Office of the Inspector General's report.
11. 10:00 Department of Workforce Services - Operations and Policy - Base Budget
11a-DWS Operations and Policy Expenditure Details
Kimberly Madsen, LFA, discussed motions for the committee to consider.
MOTION: Rep. Ward moved to approve all of the BG and BB motions not previously approved from the sheet entitled "Motions for Consideration." The motion passed with a vote of 11-0-6.
Yeas - 11Nays-0Abs-6
Rep. S. Christiansen
Rep. J. Dailey-Provost
Rep. M. Judkins
Sen. M. Kennedy
Rep. M. Kohler
Rep. M. Petersen
Rep. C. Pierucci
Rep. P. Ray
Sen. D. Thatcher
Rep. R. Ward
Sen. T. Weiler
Sen. J. Adams
Sen. J. Anderegg
Sen. L. Escamilla
Rep. S. Hollins
Sen. J. Johnson
Rep. N. Thurston
MOTION: Rep. Ward moved to approve all DH motions except DH3 for the Operations and Policy line item on the sheet entitled "Motions for Consideration." The motion passed with a vote of 11-0-6.
Yeas - 11Nays-0Abs-6
Rep. S. Christiansen
Rep. J. Dailey-Provost
Rep. M. Judkins
Sen. M. Kennedy
Rep. M. Kohler
Rep. M. Petersen
Rep. C. Pierucci
Rep. P. Ray
Sen. D. Thatcher
Rep. R. Ward
Sen. T. Weiler
Sen. J. Adams
Sen. J. Anderegg
Sen. L. Escamilla
Rep. S. Hollins
Sen. J. Johnson
Rep. N. Thurston
MOTION: Rep. Ward moved to approve motion DZ6 from the ad hoc tab on the sheet entitled "Motions for Subcommittee Consideration." The motion passed with a vote of 11-0-6.
Yeas - 11Nays-0Abs-6
Rep. S. Christiansen
Rep. J. Dailey-Provost
Rep. M. Judkins
Sen. M. Kennedy
Rep. M. Kohler
Rep. M. Petersen
Rep. C. Pierucci
Rep. P. Ray
Sen. D. Thatcher
Rep. R. Ward
Sen. T. Weiler
Sen. J. Adams
Sen. J. Anderegg
Sen. L. Escamilla
Rep. S. Hollins
Sen. J. Johnson
Rep. N. Thurston
Nathan Harrison, Finance Director, DWS, answered Rep. Judkins question about the costs to determine Medicaid eligibility.
Rep. Ward moved to adjourn.
Chair Ray adjourned the meeting at 10:54 a.m.