What Happened at the June 16, 2016 Meeting of the Social Services Appropriations Subcommittee? -
Russell T. Frandsen ( PDF)
Morning Agenda - Call to Order /Approval of Minutes
- Subcommittee Questions from the 2016 General Session (Department of Human Services) - these questions included: 1) Who, besides UTA, provides contracted transportation services to people with disabilities in Utah?; 2) If what you do makes a difference, show us the outcomes for the Marriage Commission and tie it to your trainings?; 3) What is the agency timeline to find a resolution to legal concerns for sharing more client information in the coordination efforts between agencies?; 4) What can we do to keep costs down for high cost clients?; 5) What is the General Fund cost associated with the high cost individuals report?; and 6) What would the funds for the Utah Foster Care Foundation be used for?
- Subcommittee Questions from the 2016 General Session from Non-state Agencies - included the following question: What is the Utah Domestic Violence Coalition doing to help the male perpetrators of domestic violence?
- Funding and Responsibility for Local Medicaid Mental Health Services Match - this topic was reviewed in response to Legislative intent language passed during the 2016 General Session directing it be "studied during the 2016 interim to determine the best solution for funding Medicaid mental health services in an effective ongoing manner and [the responsibility] regarding who and how that should be financially sustained." The Utah Behavioral Healthcare Committee (UBHC) of the Utah Association of Counties requested the Legislature fund $6.4 million ongoing during its 2017 General Session to make the past appropriation ongoing. UBHC also requested the Legislature fund an additional $5.0 million ongoing for increased caseload growth subsequent to the initial $6.4 million request.
- Foster Care Rate Increase - a representative of Foster Families of Utah presented information to the subcommittee regarding the costs associated with a potential rate increase to the three lowest categories of foster care. Costs were shown for potential two, five and ten percent rate increases.
- Public Input on Topics on Today's Agenda - no one signed up.
- Mental Health/Substance Abuse Services - Salt Lake County Behavioral Health, Salt Lake County Sheriff Jim Winder, and Cache County Sheriff Chad Jensen presented an overview of substance abuse and mental health system components and how the various components coordinate with the public safety and criminal justice systems. Presenters also addressed challenges that still exist.
- Tour of Salt Lake County Metro Jail - a tour was taken of the Salt Lake County Metro jail. As part of the tour, a discussion took place regarding a proposal for a forensic mental health pod in the jail. This discussion was in the context of the Utah State Hospital's ongoing forensic mental health inreach efforts.
- Strategies to Address High Cost Clients - presentations were made from: 1) the Intermountain Medical Group on how it addresses the "sickest of the sick"; Salt Lake County on its efforts to address the highest cost clients in its behavioral health system; and the Department of Human Services regarding its efforts to maintain children and youth in least restrictive settings when appropriate.
- Subcommittee Questions from the 2016 General Session (Department of Human Services) - see agenda item number 2 shown above listing all questions.
- Subcommittee Questions from the 2016 General Session (Department of Health)
- Update on Implementation of Health Coverage Improvement Program
- Study of Options to Keep People Out of Nursing Homes - Legislative action recommended by the Departments of Health and Human Services: (1) redirect state-only funding programs in the Division of Services for People with Disabilities' to home and community based waivers; (2) evaluate waiver coverage of housing-related activities, and services for seniors and individuals with disabilities; (3) review the rates for in-home services and determine if there is sufficient access; and (4) establish a mechanism to evaluate the feasibility of limited HCBS as State Plan Services under 1915(i) authority for a targeted population.
- Study of New Home and Community-based Settings Rule - representatives from the Disability Law Center (DLC) presented concerns the DLC has regarding the state's complaince with the new federal Home and Community-based settings rule. States are required to be in compliance with the rule by 2019 or face federal funding penalties.
- Comparison of Social Services Recommendations to Final Action Taken by the Legislature - how the recommendations of the Social Services Appropriations Subcomittee compared to the final action taken by the Legislature.
Afternoon Agenda - Call to Order
- Unfinished Items From the Morning Agenda
- Subcommittee Questions from the 2016 General Session (Department of Health)
- Proposed Performance Measures for Recent Building Blocks - Co-chair Christensen requested the following from the agencies: (1) formally request the missing information for seven building blocks from the Department of Workforce Services by July 31, 2016 and (2) formally request targets for the proposed measures for the Access to Recovery TANF Grant from the Department of Human Services by July 31, 2016.
- Maintenance of Effort Requirements for Federal Grants - the Subcommittee took the following action: (1) the Social Services Appropriations Subcommittee consider sponsoring a joint resolution requesting Utah's congressional delegation to submit federal legislation amending federal block grant maintenance-of-effort (MOE) requirements by adding the following language to each MOE statutory requirement: "In nowise shall the state amount obligated as a maintenance-of-effort calculation exceed the amount of federal funding provided through the grant." and (2) direct those agencies that are currently paying more than the minimum MOE to explore strategies to reduce their MOE to the minimum amount required and report back to the Social Services Appropriations Subcommittee by October 1, 2016.
- Third Party Match for Federal Grants - there were 42 grants over $500,000 in these four agencies totaling $2.7 billion in funding with 24 sources providing $250.6 million in third party match to help draw down these federal funds. Of the match, $25.1 million is General Fund provided to other state agencies and divisions. Another $103 million comes from hospitals for matching in Medicaid for paying higher reimbursement rates. Another $10 million comes from various school districts, cities, and non-profit organizations to match Child Care and Development grants. Staff from the Office of the Legislative Fiscal Analyst have reviewed these submissions and subsequently determined there are no active federal proposals to reduce the use of outside third party match. Although there are no other pending reductions in the use of outside third party match, a number of programs indicated that if these arrangements were disallowed or if the third party matching funding were to go away, both services and/or rates could be reduced in order to respond to such actions.
- Public Input on Topics on Today's Agenda - no one signed up.
- Mental Health/Substance Abuse Services - Salt Lake County Behavioral Health, along with one of its contract providers and a graduate from one of its programs, continued presenting on what it considers "best practices" for treatment services for mentally ill individuals and individuals with a substance use disorder and how Salt Lake County has implemented these practices. The Utah Hospital Association also presented on the process of hospitals caring for an escalating individual with mental illness in a hospital setting. There was also discussion about the need to get a patient stabilized before they are released from a hospital.
- Tour of Host Facility - the subcommittee took a tour of the host facility, Cornerstone Counseling Center. The center is also a contract provider for Salt Lake County Behavioral Health.
- A Performance Audit of USOR's Case Management Controls - the Office of the Legislative Auditor General (OLAG) presented the second of two audits it has performed on the Utah State Office of Rehabilitation (USOR) in the past 18 months. OLAG commented that USOR is very receptive to the audit suggestions and USOR plans to implement all of OLAG's recommendations.
- Subcommittee Questions from the 2016 General Session (Department of Workforce Services) - included the following question: For future Temporary Assistance for Needy Families (TANF) reports, please provide more outcome data for the money spent.
- Report on Coordination of Restricted Funds - the Department of Workforce Services manages 13 restricted accounts that do not require legislative authority for annual expenditures with total balances of $10.6 million as of May 2016. The department provided no recommendations to increase the coordination of resources for these 13 accounts.
- Report on Opioid Pain Medications Dispensed - the Department of Health's report on opioid prescribing practices in Utah indicates (1) am increasing number of prescriptions per patient, total prescriptions, and high-dose prescriptions; (2) females receive more prescriptions than males but males receive more high-dose prescriptions; and (3) individuals 65 and older receive the most prescriptions per capita by age group but individuals between 25 and 64 years receive more high-dose prescriptions. The Department of Health plans to provide another detailed report by October 31, 2016
- New Federal Funding and Laws Regarding Opioid Epidemic
- Report on Allowing a Three Month Supply of Some Medicaid Medications - Beginning July 1, 2016 the Department of Health will provide the option to fill 191 low cost medications for up to a three month supply per dispensing rather than the current one month requirement. This change may or may not result in savings to the State. Savings may be achieved by reducing the number of dispensing fees paid. Costs may be incurred if members discontinue a prescription or lose Medicaid eligibility before using the full three month supply. The Department of Health will report on the financial impact of this change on September 30, 2017
- Increasing Family Practice Residencies and the Future of Family Practice - "Utah is ranked 49th out of 50 for primary care physician (PCPs) saturation in the nation at just 38 [PCPs] per 100,000 people."
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June 2016 Content
( PDF)
Cost to Transfer UACD Employees to Agriculture - Ivan D. Djambov The purpose of this article is to provide background information about the Department of Agricult...
Department of Environmental Quality Fees - Brian WikleUCA 63J-1-504 requires that each fee assessed by an agency be "reasonable, fair, and reflect the co...
Equipment Funding Allocations for the Utah College of Applied Technology - Jill L.Curry The Utah College of Applied Technology (UCAT) receives funding for equipment at its eight colleges...
Funding for Utah's Veterans' Nursing Homes - Steven M. AllredThe State operates four veterans nursing homes located in Salt Lake City, Ogden, Payson, and Ivins....
FY 2017 Capital Improvement Allocations - Angela J. Oh The State of Utah has a statutory requirement to fund capital improvements and it is one of the f...
Market-Based Billing for State Audits - Clare Tobin Lence During the 2014 General Session, the Legislature passed intent language supporting the State Audi...
Revenue Update - Fiscal Highlights - June 2016 - Andrea WilkoUtah's revenue is expected to grow by 3.0 percent between FY 2015 and FY 2016. We anticipate collec...
School Funding Equalization - Ben Leishman Utah is continually ranked as one of the most equalized states in the nation when it comes to fun...
The Price of Gas: More Driving and an Industry Recession - Thomas E. YoungOne of the more transparent price movements in recent years is the drop in the price of gasoline. T...
USHE Enrollment Projections - Spencer C. PrattThe Utah State Board of Regents recently adopted enrollment projections for the eight colleges and ...
What Happened at the June 16, 2016 Meeting of the Social Services Appropriations Subcommittee? - Russell T. FrandsenMorning AgendaCall to Order /Approval of MinutesSubcommittee Questions from the 2016 General Sessio...
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