Compendium of Budget Information for the 2014 General Session
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Line Item: Disease Control and Prevention Function The mission of the Division of Disease Control and Prevention is to promote health and reduce the leading causes of death, disease, and disability in Utah. The Division of Disease Control and Prevention works with and for other state, local, and private entities to:
Statutory Authority The Division of Disease Control and Prevention is governed by the Utah Health Code in Title 26 of the Utah Code.
Intent Language Under Section 63J-1-603 of the Utah Code the Legislature intends that appropriations provided for Disease Control and Prevention in Item 3 of Chapter 14 Laws of Utah 2012 not lapse at the close of Fiscal Year 2013. The use of any nonlapsing funds is limited to the following: $175,000 for replacement computer equipment, software, laboratory equipment, and for facility improvements/expansion for the Office of the Medical Examiner. Under Section 63J-1-603 of the Utah Code the Legislature intends that appropriations provided for Disease Control and Prevention in Item 3 of Chapter 14 Laws of Utah 2012 not lapse at the close of Fiscal Year 2013. The use of any nonlapsing funds is limited to the following: $300,000 for laboratory equipment, computer equipment, software and building improvements for the Unified State Laboratory. Under Section 63J-1-603 of the Utah Code, the Legislature intends that up to $500,000 of Item 3 of Chapter 14 Laws of Utah 2012 for the alcohol, tobacco, and other drug prevention reduction, cessation, and control programs not lapse at the close of Fiscal Year 2013. The use of any nonlapsing funds is limited to alcohol, tobacco, and other drug prevention, reduction, cessation, and control programs. Funding Detail Because of the Department's budget reorganization in FY 2011, some of the detail between FY 2010 and FY 2011 nonlapsing balances do not tie out by line item. For analysis of current budget requests and discussion of issues related to this budget click here.
Program: Laboratory General Administration Function The Division of Disease Control and Prevention provides administration of public health, public health laboratory, and environmental health programs. These programs include Chemical and Environmental Services, Forensic Toxicology, Laboratory Operations, Microbiology, Health Promotion, Office of the Medical Examiner, and Epidemiology. Funding Detail
Function The Bureau of Health Promotion works to reduce premature death and disability due to heart disease, stroke, cancer, diabetes, arthritis, asthma, tobacco, injuries and violence, and lack of prenatal care. The Bureau's mission is to foster a culture of health in Utah, by promoting environments in which the healthy choice is the easy choice. The Bureau's programs coordinate around common functions such as public health surveillance and information management, local health departments and other partner relations, consumer education, outreach, and research. Comprehensive population-based interventions take place at school, work, community and health care settings, and include primary, secondary, and tertiary prevention strategies. Cancer Control Program The mission of the Utah Cancer Control Program is to reduce cancer incidence and mortality in Utah through collaborative efforts that provide services and programs directed toward comprehensive cancer prevention and control through the following:
Healthy Living through Environment, Policy and Improved Clinical Care Program (EPICC) (100% Federally-funded) The Healthy Living through Environment, Policy and Improved Clinical Care Program (EPICC) is a new program resulting from the consolidation of three programs (Diabetes Prevention and Control Program, Heart Disease and Stroke Prevention Program, and the Physical Activity, Nutrition and Obesity Program). The consolidation of the three programs assists in the coordination of activities to ensure a productive, collaborative and efficient program focused on health outcomes. The program aims to reduce the incidence of diabetes, heart disease, and stroke by targeting risk factors including reducing obesity, increasing physical activity and nutritious food consumption, and improving diabetes and hypertension control. This is done through three approaches; Policy and Environment, Health Systems, and Community Clinical Linkages. The primary strategies of the program include:
Arthritis Program (100% Federally-funded) The mission of the Utah Arthritis Program is to improve the quality of life for people affected by arthritis. The program has funding until June 2017 from the Centers for Disease Control and Prevention. The Utah Arthritis Program focuses on:
Evidence-based Interventions: The Utah Arthritis Program works with partners to develop infrastructure and offer evidence based interventions to people with arthritis. Currently there are three categories of Centers for Disease Control and Prevention-approved evidence based interventions:
All reports are available on the Utah Arthritis Program website at http://health.utah.gov/arthritis/. Asthma Program (100% Federally-funded) The Utah Asthma Program was developed in 2002 and is fully funded by the Centers for Disease Control and Prevention to address asthma from a public health perspective. The program works to identify the extent of the asthma problem, implement a statewide plan to reduce the burden of asthma, and partners with other agencies to increase awareness and use of asthma self-management and asthma care resources. Violence and Injury Prevention Program To accomplish its mission, the Violence and Injury Prevention Program collaborates with many partners, including other Health Department programs, State and local agencies, local health departments, private businesses, non-profit community based organizations, health care providers, and others. It is funded primarily through federal money, the exception being the Traumatic Brain Injury Fund and Spinal Cord and Traumatic Brain Injury Rehabilitation Fund which are passed through to 501(c)(3) agencies in the form of contracts. The Violence and Injury Prevention Program conducts and/or provides significant support to the following projects and activities: Teen Motor Vehicle Safety, Motor Vehicle Seat Belt Campaign, Child Safety Seat Campaign, Child Booster Seat Campaign, Domestic Violence Fatality Review, Child Fatality Review Committee, Utah Violent Death Reporting System, Falls Prevention Among Older Adults, Rape and Sexual Assault Prevention Project, Traumatic Brain Injury Surveillance Project, Traumatic Brain Injury Fund and Contracts, Safe Kids Utah, and others. The Violence and Injury Prevention Program contracts with all local health departments, providing funding and technical support for local injury prevention programs that address: teen motor vehicle safety, seat belt, booster seat, child car seat use, bicycle safety, and pedestrian safety. Additionally, the Violence and Injury Prevention Program contracts with non-profit, community-based organizations to provide: (1) primary prevention rape and sexual assault activities in their communities, (2) traumatic brain injury resource facilitation services, education and prevention services, and (3) traumatic spinal cord and brain injury rehabilitation services. Additional information, reports, and data are available at http://health.utah.gov/vipp/. Prescription Pain Medication Management Program The Prescription Pain Medication Management Program's mission is to reduce deaths and other harm from prescription opiates through data collection, surveillance, and partner collaborations that focus on research and public and provider education regarding safe use, disposal, and storage of prescription pain medications. Staff participate on Utah Pharmaceutical Drug Crime Project and Utah Prevention Advisory Council. Health Resource Center The Health Resource Center strives to improve access to critical health information to better the health of families in Utah through outreach programs, telephone hotlines, and education services. The center provides answering service for more than 15 programs including the Children's Health Insurance Program, the Cancer Control Program and the Immunization Program, among others. The Baby Your Baby Program provides a vehicle through which the Health Department can target audiences throughout the State with important health messages. The outreach program establishes public-private partnerships to promote healthy lifestyles, reduce health risks, and increase access to health care. This is accomplished through public service announcements and other television programs, radio and printed materials which address Department goals dealing with early prenatal care, folic acid, vaccine-preventable infections, injury, dental disease, obesity, and other important health issues. Tobacco Prevention and Control Program The Tobacco Prevention and Control Program provides technical expertise and coordination at State and community levels to prevent and reduce tobacco use in Utah. The goals of the Tobacco Prevention and Control Program are to promote quitting among young people and adults, prevent initiation of tobacco use among young people, eliminate nonsmokers' exposure to secondhand smoke, and identify and eliminate disparities in tobacco use among populations groups. Statewide and Community-based Services to Help Tobacco Users Quit Quitting tobacco at any age provides health benefits and increases life expectancy. To help Utah tobacco users quit, the Tobacco Prevention and Control Program offers the following quit services:
Tobacco Prevention and Control Public Awareness Campaign The TRUTH media campaign is multi-pronged, targeting prevention and quitting among mainstream and high-risk youth, adults, pregnant women, ethnic groups, and rural populations through a mix of media including radio, TV, and outdoor advertising. The campaign directly or indirectly impacts most Utah residents. The Tobacco Prevention and Control Program evaluates the reach and impact of the media campaign with annual surveys of 1,200 randomly selected Utah teens, adult smokers, and non-smokers. Some campaign components include:
Prevention Partnerships with Local Health Departments, Schools, and Communities Evidence-based school programs promote strong "no tobacco use" attitudes among students, increase students' knowledge of the dangers of tobacco, and teach students skills to resist peer influences. School programs are most effective when they are part of comprehensive school tobacco policies that include enforcement of rules against tobacco use, tobacco prevention education for students in all grades, access to cessation services, and involvement of families and communities in tobacco prevention. Tobacco Prevention and Control Program prevention services include:
Efforts to Reduce Exposure to Secondhand Smoke:
Youth Access to Tobacco Utah law prohibits tobacco sales to minors under the age of 19. Local health departments collaborate with retailers and law enforcement to ensure compliance with youth access laws through retailer education, retailer recognition, and compliance checks. Coordinated Chronic Disease and Health Promotion Program The Coordinated Chronic Disease and Health Promotion Program ensures that Utah has a strong foundation for chronic disease and health promotion. The program develops leadership and expertise to work collaboratively across chronic disease conditions and risk factors to most effectively meet health needs of the population. The program works to leverage shared basic services such as: data management, communication, health systems changes, and enhanced clinic-community linkages. Community Transformation Program The Community Transformation Grants program supports community-level efforts to reduce chronic diseases such as heart disease, cancer, stroke, and diabetes. The program works closely with local health departments to coordinate and improve community level activities statewide in healthy eating, active living, tobacco-free living, and access to clinical preventive services and screenings. Funding Detail
Function The Bureau of Epidemiology is responsible for: (1) the detection, investigation, and control of communicable and infectious diseases, (2) surveillance and investigation of health effects associated with environmental hazards, (3) coordinating a statewide environmental sanitation program including 15 sanitation rules, (4) supporting treatment of HIV, AIDS, sexually transmitted disease, and tuberculosis, and (5) managing a statewide immunization program and immunization information system. The Bureau operates nine programs: the Communicable Disease Prevention Program, the Treatment and Care Services Program, the Communicable Disease Investigation and Response Program, the Environmental Epidemiology Program, the Environmental Sanitation Program, the Immunization Program, the Communicable Disease Analysis and Reporting Program, the Utah Statewide Immunization Information System, and the Healthcare Associated Infections Prevention and Reporting Program. The programs have adopted the U.S. Healthy People 2020 Goals and Objectives, and activities are established to meet Health Department goals of protecting the public health, improving quality of life, preventing disease and premature death, and promoting healthy lifestyles for the residents of the State. The Bureau also is responsible for developing and operating surveillance systems to detect bioterrorism and for assuring epidemiological preparedness to respond to an incident of bioterrorism or the similar threat of pandemic disease. Funding sources include the Centers for Disease Control and Prevention, Health Resources Services Administration, and the Utah Department of Workforce Services. The Department of Health requires reporting by medical providers of over 20 diseases within 24 hours and over 50 diseases within 72 hours in accordance with UCA 26-6-6. UCA 26-6-31 directs the Department of Health to annually prepare and publicly disclose a report on selected health care associated infection rates. The rates are for the following types of medical facilities: ambulatory surgical facility, general acute hospital, end stage renal disease facility, and specialty hospital. The National Healthcare Safety Network in the Centers for Disease Control and Prevention requires the reporting of certain types of infections. Communicable Disease Prevention Program
Treatment and Care Services Program
Communicable Disease Investigation and Response Program (CDIRP) The Communicable Disease Investigation and Response Program (CDIRP) conducts communicable disease surveillance and management. The responsibilities of the CDIRP include assisting with the identification, investigation, and management of communicable diseases and outbreaks. The program conducts epidemiological investigations in collaboration with local health departments to identify risk factors and implement appropriate control measures and prevention strategies. The program also responds rapidly to suspect and confirmed cases of diseases of public health significance, aiding local health departments, healthcare workers, and the public in implementing control and prevention measures. In addition, the program provides consultation regarding communicable diseases to healthcare professionals, healthcare facilities, and a variety of local, State, and federal agencies, and acts as a liaison to the Centers for Disease Control and Prevention (CDC) for disease investigations in Utah. Communicable Disease Analysis and Reporting Program The Communicable Disease Analysis and Reporting Program conducts regular analyses of surveillance data as well as generating and evaluating daily reports. These reports incorporate statistical methods to interpret disease trends over time to identify clusters of disease that may indicate an outbreak. The program also develops surveillance reports that provide communicable disease trend data to the public, healthcare professionals, and local, State, and federal partners on a regular basis and as requested. The program is responsible for maintaining Utah's National Electronic Database Surveillance System for Surveillance (UT-NEDSS) and providing support to local health departments in using this system to store and manage communicable disease data. The program is also responsible for building, implementing, and maintaining the UT-NEDSS in Utah as part of a national effort to improve mechanisms for disease reporting, public health surveillance, and disease control practices. UT-NEDSS provides a web-based system for storing and managing communicable disease data. UT-NEDSS also allows local and State Health Department staff to simultaneously monitor and evaluate case management functions. The program also is responsible for Utah's participation in the National Notifiable Disease Surveillance System managed by the Centers for Disease Control and Prevention. Environmental Epidemiology Program The Environmental Epidemiology Program addresses environmental hazards and diseases in Utah. The mission of the program is to improve the health of Utah residents through science-based environmental policy and by empowering citizens through knowledge about environmental health risks and concerns. The program works with the Utah Department of Environmental Quality and other state and federal agencies to prevent or reduce the potential for acute and chronic morbidity and mortality associated with environmental and occupational factors, including exposure to toxic substances, reproductive hazards, unsafe work environments, and agents responsible for debilitating diseases. The program conducts epidemiological and toxicological investigations; develops, produces and distributes educational awareness materials about environmental health concerns to the public; cooperates with local, State, and federal agencies in investigating and resolving health concerns related to hazardous substance exposure, and researches environmental and occupational health concerns. Environmental Sanitation Program The Environmental Sanitation Program's goal is to primarily prevent and/or reduce illness, premature death, and disability due to the effects of secondhand smoke, contaminated food, and poor sanitation at public food service establishments, public swimming pools, public lodging, schools, and many other public places. With the focus to decrease illness, premature death, and disability due to contaminated food served to the public, this program provides consultation to food and restaurant inspectors. This program also seeks to establish and maintain a consistent approach statewide to environmental health regulation across the 12 local health departments in Utah through implementing rules and consultation and training aimed at a standardized approach to enforcement. The Immunization Program promotes vaccinations as part of comprehensive health care across the life span: infants, children, adolescents, and adults. It provides services through technical assistance to local health departments (LHD), community health centers (CHC), managed care organizations, schools (public and private), and early childhood programs (licensed day cares, head start, etc.), as well as other providers. The program contracts with LHDs and CHCs to support activities to increase immunization coverage rates for eligible populations. Special emphasis is placed on efforts to improve the immunization coverage of preschool-age children and adolescents, especially those less than two years of age via local coalitions and media campaigns. Additionally, the program monitors required school entry vaccination levels of all school children kindergarten through grade 12 in collaboration with the Utah State Office of Education. The Immunization Program also performs the following functions:
The federally-funded Vaccines for Children Program (VFC) provides vaccines at no cost to eligible children ages 0-18 years that are uninsured, covered by Medicaid, under-insured, or American Indian. The vaccine is provided to over 350 enrolled public and private medical providers statewide. This program provides technical assistance for vaccine management and accountability including: doses administered, quality assurance, assessment, storage and handling, and audits. CHIP uses the VFC distribution system to provide vaccines which provides a substantial cost savings to the CHIP program and provides the same services related to vaccine management and accountability. The federal government also maintains the Vaccine Adverse Event Reports System, which provides for a reporting system for adverse events following receipt of any U.S. licensed vaccine. Utah Statewide Immunization Information System Utah Statewide Immunization Information System is a web-based system that collects, consolidates, and maintains immunization records for Utah residents. Health care providers can use the system to prevent over and under immunization. The system facilitates the introduction of new vaccines, implements changes in medically-recommended vaccine schedules, as well as tracking vaccines during shortages and recalls. The system is also used by public and private schools, daycares and camps to assist with meeting school and childcare immunization rules. The program develops, operates and supports the system, as well as data interfaces to electronic health record systems operated at private practices, public clinics, pharmacies and other collaborating programs. The Health Department uses this data to monitor the overall immunization rates in Utah and to assist with outbreak management. Healthcare Associated Infections Prevention and Reporting Program Healthcare-associated infections (HAIs) are infections that patients acquire during the course of receiving healthcare treatment for other conditions. These infections related to medical care can be devastating and even deadly. The Healthcare Associated Infections Prevention and Reporting Program strives to understand the burden of HAIs within the state, how these infections occur and work collaboratively with healthcare facilities, local public health departments, and other partners toward their reduction and elimination. The program uses HAI data reported by healthcare facilities to the National Healthcare and Safety Network to compile an annual report for public distribution. An annual report is also compiled for public distribution detailing healthcare worker influenza vaccination rates in acute care facilities. The HAI program is responsible for development and revision of R386-705, the Health Care Associated Infection (HAI) Rule, which identifies Utah's reporting requirements related to healthcare associated infections with data sharing requirements for HAI data reported by facilities to the National Healthcare and Safety Network. Performance        Issues/Analysis Here is the November 2013 press release from the Department of Health regarding the increase in gonorrhea cases - http://udohnews.blogspot.com/2013/11/gonorrhea-cases-up-94-percent-in-utah.html. Funding Detail
Function The Bureau of Microbiology provides laboratory testing and consultation services for local health departments; hospitals, clinics, labs, and physicians throughout Utah; the Utah Department of Agriculture; State Mosquito Abatement Districts; the Department of Environmental Quality; the Division of Family Health and Preparedness Services; and the State Medical Examiner. The areas of support include: newborn screening, sexually-transmitted diseases (HIV, syphilis, chlamydia, and gonorrhea), agents of bioterrorism surveillance, respiratory virus surveillance and subtyping, arbovirus surveillance, virology, rabies testing, bacteriology, mycology, mycobacteriology, parasitology, as well as outbreak control (food and waterborne), and communicable disease outbreak support, i.e. - influenza, tuberculosis, and food borne diseases. The Bureau works closely with the Bureau of Epidemiology to provide test data for disease surveillance and statistics across the entire State. The Bureau also works closely with State and federal partners such as health care workers, local public health, fire, Postal Inspection Service, FBI, law enforcement, military, and Indian tribal governments to provide training on safe packaging and shipping of specimens for testing, interpretation of results, emergency preparedness, and other services provided by the Bureau. The Bureau also provides local health departments with specimen collection kits and packaging and shipping materials to send specimens to the laboratory. Performance  Funding Detail
Program: Office of the Medical Examiner Function The Office of the Medical Examiner is responsible for the investigation and certification of sudden and unexpected deaths that occur within the borders of the State. UCA 26-4-7 specifies the specific circumstances surrounding any given death which place it under the jurisdiction of the Medical Examiner, such as:
The Medical Examiner pays for roundtrip transportation of bodies under its jurisdiction. A contracted transportation service is used along the Wasatch Front; funeral homes provide all other transportation. Funding Detail
Program: Chemical and Environmental Services Function The Bureau of Chemical and Environmental Services provides testing of water, soil, and air for toxic contaminants to monitor the environment to assure compliance with health and safety standards, and to respond to emergencies such as chemical spills and contaminated drinking water. The testing and results, requested primarily by the Department of Environmental Quality and the Department of Natural Resources, assist those departments in assessing the safety of the environment. The Bureau also serves private agencies. The United States Environmental Protection Agency certifies the State laboratory as the principal laboratory for water testing. The laboratory program also tests for chemical agents in clinical samples in response to chemical terrorism incidents as a result of federal funding from the Center for Disease Control and Prevention (CDC) for the Public Health Preparedness Program. The laboratory tests and analyzes heavy metals, cyanide, volatile organic chemicals, tetramine, and other toxic chemicals in samples to determine exposure of these chemicals to humans. The Bureau's Chemical Preparedness Program is funded by the Centers for Disease Control and Prevention's Bioterrorism Program. The Environmental Protection Agency (EPA) approved the Bureau to be a member laboratory for EPA's Environmental Response Laboratory Network, and Water Laboratory Alliance program to assist EPA in meeting laboratory testing needs in a national or local emergency situation. Funding Detail
Function The Bureau of Forensic Toxicology provides drug and alcohol analysis for law enforcement agencies to determine driving under the influence violations, including automobile homicides, sexual assaults, and other crimes. In addition, the Bureau provides testing for drug, alcohol, and other poisons in autopsy specimens to assist the Office of the Medical Examiner in determining the cause of death. Additionally, Bureau staff provide expert witness testimony on alcohol and drug impairment in courts statewide. Funding Detail
Program: Certification Programs Function The Bureau of Laboratory Operations sets and enforces standards for those laboratories that perform tests that impact public health. The main function of the operations program is to provide quality assurance assistance, safety training, financial support, and technical services within the Utah Public Health Laboratory. The Bureau provides two types of laboratory certification, clinical and environmental. The Clinical Lab Certification is under the authority and direction of the federal Centers for Medicare and Medicaid Services. The Environmental Lab Certification is under the authority of the Utah Code and the United States Environmental Protection Agency and works closely with the Utah Department of Environmental Quality to maintain adequate certified laboratory capacity. The Bureau is responsible to investigate complaints regarding the quality of the tests performed at certified environmental laboratories. Additionally, the Bureau provides quality assurance assistance, safety training, and technical services within the Utah Public Health Laboratory. Funding Detail
Program: Communicable Disease Control Function The Department combined this program with the Epidemiology Program effective FY 2011. Funding Detail
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COBI contains unaudited data as presented to the Legislature by state agencies at the time of publication. For audited financial data see the State of Utah's Comprehensive Annual Financial Reports.