FY 2016 Appropriation

The Department of Human Services administers a variety of social services programs for the State of Utah. The Department includes the divisions of Executive Director Operations, Substance Abuse and Mental Health, Services for People with Disabilities, Aging and Adult Services, Office of Recovery Services, Child and Family Services, and Juvenile Justice Services (DJJS - formerly Youth Corrections). While DJJS is part of the Department of Human Services, its budget is reviewed in the Executive Offices and Criminal Justice Appropriations Subcommittee. For that reason, the DJJS budget and related issues are not summarized here. The Division of Substance Abuse and Mental Health also oversees the treatment portion of the Drug Courts and the Drug Offender Reform Act (DORA) program. Programs within the divisions of Aging and Adult Services and Substance Abuse and Mental Health are operated at the local county level.

Additional information regarding the Department of Human Services can be found on their official website found at: Utah Department of Human Services

Funding History

Funding Issues

Adult Protective Services Caseworkers

Adult Protective Services Caseload - 3 additional caseworkers, 2 of which will help with increasing field caseloads (particularly in rural areas of the state) and 1 with increasing intake caseloads. Adult Protective Services (APS) is tasked with investigating abuse, neglect, and exploitation, including financial exploitation, of seniors aged 65 and older as well as vulnerable adults, defined as individuals aged 18-64 who have a disability that limits their ability to complete two or more Activities of Daily Living. Each year there are thousands of reports of abuse, neglect, and exploitation of seniors and vulnerable adults in Utah, with a 35% growth in allegations since 2009. This is an increase from the base of 7.5%.

Aging Nutrition

This item was funded $300,000 with one-time funding sources in the 2014 General Session. Area Agencies on Aging (AAAs) requested a $300,000 ongoing amount in the 2015 General Session to address federal sequestration reductions affecting meals to a "vulnerable aging population either at senior centers or through the meals on wheels program." The Governor recommended funding $150,000 one-time for "Meals on Wheels." The Governor also recommended using $150,000 from the DHS federal reserve. The senior nutrition programs consist of Meals on Wheels (Home-delivered Meals) and meals served in senior centers (Congregate Meals). Both programs are designed to provide nutritious meals to seniors who cannot leave their homes or who may lack nutrition in the food they eat. Senior nutrition meals are created to meet seniors' specific nutritional needs and are intended to prevent issues associated with malnutrition and dehydration. Although both programs are currently in place, the demand for senior nutrition, as well as the costs of administering the programs, continues to rise and the request is for an additional General Fund to be provided to the twelve Utah Area Agencies on Aging (AAA) who administer senior nutrition programs across the state. The program requires clients be seniors aged 60 or older.

Children's Mental Health Early Intervention for Children and Youth

Children's mental health promotion/mental illness prevention that was funded $1,500,000 one time during the 2014 General Session. This request is to make that funding ongoing. Counties are also asking that this funding be increased by an additional $1.5 million in order to serve more schools. Children, Youth and their Families who have Serious Emotional Disturbance (SED) or who are at Risk of developing SEDs are the population being served. In the past two years these community based efforts to intervene early, helped 9,744 children, youth, and their families; 3,983 in the first year of funding and 5,761 in the second year of funding. The subcommittee took action to reduce the request to $1.2 million and fund $300,000 one-time with TANF funds.

Contract Monitoring Staff

A recent Pew Charitable Trusts article discussed the challenge states have in monitoring contracts for services. The article indicated that most states lack appropriate contract monitoring tools (i.e. - trained staff, up-to-date contract databases, enforcement of contract penalties) and instead end up 'auditing' programs once problems are realized. The article points out that the 'pay and chase' method via audits comes after the state has provided the funding without receiving the expected services. The article stresses moving the process forward so that contract monitoring is done in 'real time' where corrections can be made in order to receive the expected services and outcomes. Member of the Social Services Appropriations Subcommittee have expressed interest in this 'real time' monitoring concept.

Direct Care Staff Salary Increase

This request would raise the wage of direct care workers providing services for the Division of Services for People with Disabiities (DSPD). The increase would apply to any 'waiver code' where there is a direct care worker. During FY 2014 DSPD had difficulty placing individuals already funded by the Legislature because community providers were unable to staff these placements due to lack of appropriate staff. This difficult is evidenced by DSPD nonlapsing $6.7 million in state funds (meant for services) at the end of FY 2014. The issue meant that families anticipating receiving services already approved had to wait for as long as six months to receive that service. The issue also involves access with regard to the Medicaid waiver and quality of care when appropiate staff cannot be hired.

Disabilities Mandated Additional Needs

There is a Medicaid requirement that the health and safety service needs of individuals receiving waiver services be met. Of the 4,800 covered individuals, 660 or 13.8 % identified last year as having increased health and safety needs. This is an increase from the base of 1.9%. How Measure Success? "Percent of people who are satisfied with their staff, support coordinator, and fiscal agent."

Disabilities Waiting List

The Disability Waiting List was funded in the 2014 General Session with one-time money. Advocates are looking to make this funding ongoing plus any additional funding request in the 2015 General Session. If the Legislature funds approximately 150 individuals currently on the waiting list for services it would cost about $1,000,000 in General Fund and $3,500,000 in total funds. This is an increase from the base of 1.86%. How Measure Success? "Percent of people who are satisfied with their staff, support coordinator, and fiscal agent."

Domestic Violence Shelters

This item was funded $300,000 ongoing and $393,500 one-time in the 2014 General Session. This funding provides $400,000 for Domestic Violence shelters ongoing. The funding will be divided up equally between all 13 non-profit domestic violence shelters in FY 2016. DCFS plans to implement a new funding formula in state FY 2017 and beyond. The funding is intended to provide basic life-saving and protection services of: safe shelter, case management, therapy, and children's services.

Federal Medical Assistance Percentage Change (FMAP)

This increased cost reflects a lower federal medical assistance match rate for FY 2016. The Federal Medical Assistance Percentage (FMAP) represents the federal share of the programmatic costs for Medicaid, Foster Care, and Adoption Assistance. When the federal government's participation rate goes up, the state of Utah's participation goes down in a commensurate manner. The federal government utilizes a formula to determine its annual percent of FMAP based on a rolling three year average of per capita income levels compared to the national average. By law the FMAP rate cannot be lower than 50 percent or higher than 83 percent.

Local Mental Health Medicaid Match

Local Mental Health Medicaid caseload growth has exceeded the growth in available Medicaid match funding sources. During the 2014 General Session the Legislature provided an additional $6.4 million one-time to counties to assist them in paying for Medicaid match. Counties are now looking to the state to: 1) make the $6.4 million ongoing. The Medicaid program requires that state partners (including counties) pay for a portion of Medicaid expenditures called Medicaid match. The total FY 2013 Utah Medicaid match requirement was approximately 30%. Local authority information indicates the increased pressure to fund the Medicaid match affects all counties. Growth in Medicaid enrollment has outpaced funding for Medicaid match. In FY 2013 73% of the match was paid for with State General Fund received by the counties as pass through while 27% was paid using county General Fund sources.

Replace Lost Medicaid Funding

This request results from Medicaid auditors disallowing previous cost allocation methods which lowered the annual Medicaid payments to the State Hospital. Medicaid auditors recommended various changes to the Utah State Hospital (USH) cost allocation methods previously agreed upon by both parties which have now lowered the annual Medicaid payments to the State Hospital. Lowering the Medicaid payments has the effect of increasing the state funding requirement.

Youth Aging Out of DCFS Custody

This request maintains youth with intellectual disabilities on the Medicaid waiver who are aging out of the Division of Child and Family Services (DCFS) custody. DCFS is currently providing the funding until a person reaches age 18 (sometimes up to age 22). This item was funded $455,200 one-time General Fund in 2014 General Session. The underlying dynamics of the program would require an ongoing funding to replace the one-time funding plus any estimate in growth (or decline) of the need. How Measure Success? "Percent of people who are satisfied with their staff, support coordinator, and fiscal agent."
Appropriation Overview

During the 2015 General Session, the Legislature appropriated for Fiscal Year 2016, $898,351,900 from all sources for Human Services. This is a 3.6 percent increase from Fiscal Year 2015 revised estimated amounts from all sources. The total includes $338,889,300 from the General/Education Funds, an increase of 7.6 percent from revised Fiscal Year 2015 estimates.

Appropriation Adjustments

In addition to statewide compensation and internal service fund cost increases, the following appropriation adjustments were made during the 2015 General Session:

DescriptionOngoingOne-Time 2-1-1 Information and Referral System at the United Way$0$550,000
OngoingOne-TimeFinancing Source
$0$550,000General Fund, One-time
Funding is meant to support an information and referral system.
ACA Savings - Local Mental Health/Sub Abuse ($100,000)$0
OngoingOne-TimeFinancing Source
($100,000)$0General Fund
Savings to local mental health and substance abuse systems for both children and adults that have already occurred resulting from passage of federal health care reform (ACA). The amount represents less than four tenths of 1% of state General Fund pass through provided. Savings would involve newly covered groups either on Medicaid or ACA subsidy where local agencies had paying the full amount before (e.g. - children 6-18 below 100% of poverty, etc.).
Adult Protective Services Caseworkers$229,700$0
OngoingOne-TimeFinancing Source
$229,700$0General Fund
Adult Protective Services Caseload - 3 additional caseworkers, 2 of which will help with increasing field caseloads (particularly in rural areas of the state) and 1 with increasing intake caseloads. Adult Protective Services (APS) is tasked with investigating abuse, neglect, and exploitation, including financial exploitation, of seniors aged 65 and older as well as vulnerable adults, defined as individuals aged 18-64 who have a disability that limits their ability to complete two or more Activities of Daily Living. Each year there are thousands of reports of abuse, neglect, and exploitation of seniors and vulnerable adults in Utah, with a 35% growth in allegations since 2009. This is an increase from the base of 7.5%.
Aging Local Caregiver Support$0$250,000
OngoingOne-TimeFinancing Source
$0$250,000General Fund, One-time
This funding will be passed through to the local Area Agencies on Aging to provide additional respite services to the caregivers of seniors.
Aging Nutrition$0$500,000
OngoingOne-TimeFinancing Source
$0$350,000General Fund, One-time
$0$150,000Federal Funds
This item was funded $300,000 with one-time funding sources in the 2014 General Session. Area Agencies on Aging (AAAs) requested a $300,000 ongoing amount in the 2015 General Session to address federal sequestration reductions affecting meals to a "vulnerable aging population either at senior centers or through the meals on wheels program." The Governor recommended funding $150,000 one-time for "Meals on Wheels." The Governor also recommended using $150,000 from the DHS federal reserve. The senior nutrition programs consist of Meals on Wheels (Home-delivered Meals) and meals served in senior centers (Congregate Meals). Both programs are designed to provide nutritious meals to seniors who cannot leave their homes or who may lack nutrition in the food they eat. Senior nutrition meals are created to meet seniors' specific nutritional needs and are intended to prevent issues associated with malnutrition and dehydration. Although both programs are currently in place, the demand for senior nutrition, as well as the costs of administering the programs, continues to rise and the request is for an additional General Fund to be provided to the twelve Utah Area Agencies on Aging (AAA) who administer senior nutrition programs across the state. The program requires clients be seniors aged 60 or older.
Aging Waiver$673,900$0
OngoingOne-TimeFinancing Source
$200,000$0General Fund
$473,900$0Transfers - Medicaid
This item was presented as a request to the Health and Human Services interim standing committee on 9-17-14 asking that the waiting list on the aging waiver be fully funded. Some have suggested funding this item as a cost saving measure to reduce more expensive institutional care. Funding for the Aging Waiver has been flat for a number of years.
Attorney General Dedicated Credit Adjustments$377,000$0
OngoingOne-TimeFinancing Source
$101,800$0General Fund
$275,200$0Federal Funds
This item designates additional funding appropriated to an agency to pay higher costs for Attorney General services, due to statewide and AG-specific compensation increases.
Background Checks/HB 145 Vulnerable Adult Workers$477,000$1,500
OngoingOne-TimeFinancing Source
$299,700$0General Fund
$0$1,500General Fund, One-time
$34,600$0Federal Funds
$142,700$0Transfers - Medicaid
Human Services - Background Checks & HB 145 - Vulnerable Adult Worker Amendments - "to enable background checks of employees working with vulnerable adults."
Child and Family Amendments$11,100$0
OngoingOne-TimeFinancing Source
$11,100$0General Fund
Enactment of this legislation likely will not materially impact state revenue. Assuming about 5 cases annually, enactment of this bill could create total ongoing costs of $25,000 from the General Fund for the following agencies beginning in FY 2016: 1. Courts - $5,300 - for processing hearings, 2. Attorney General - $4,900 - for attorney representation, and 3. Guardian ad Litem (GAL) - $3,700 - for attorney representation, and 4. Division of Child and Family Services (DCFS) - $11,100 - for evaluations.
Children's Mental Health Early Intervention for Children and Youth$1,500,000$0
OngoingOne-TimeFinancing Source
$1,200,000$0General Fund
$300,000$0Federal Funds
Children's mental health promotion/mental illness prevention that was funded $1,500,000 one time during the 2014 General Session. This request is to make that funding ongoing. Counties are also asking that this funding be increased by an additional $1.5 million in order to serve more schools. Children, Youth and their Families who have Serious Emotional Disturbance (SED) or who are at Risk of developing SEDs are the population being served. In the past two years these community based efforts to intervene early, helped 9,744 children, youth, and their families; 3,983 in the first year of funding and 5,761 in the second year of funding. The subcommittee took action to reduce the request to $1.2 million and fund $300,000 one-time with TANF funds.
DCFS Legal Fees$0$28,000
OngoingOne-TimeFinancing Source
$0$28,000General Fund, One-time
DCFS Legal Fees - "to implement a favorable Board of Examiners' recommendation." The Board of Examiners (Governor, Attorney General, State Auditor) sent a letter to the Senate President and Speaker of the House. The letter stated the following: "Pursuant to Utah Code Ann. Section 63G-9-1 0 1 etc. seq. , this letter reports to the Legislature the recommendation of the Board of Examiners for claims filed against the state for which funds have not been provided . . . The Board reviewed the report provided by Doug and Janet McLain for foster care adoption expenses and recommends payment in the amount of $27,568.25."
Direct Care Staff Salary Increase$14,260,400$4,211,600
OngoingOne-TimeFinancing Source
$4,232,500$0General Fund
$0$1,250,000General Fund, One-time
$10,027,900$2,961,600Transfers - Medicaid
This request would raise the wage of direct care workers providing services for the Division of Services for People with Disabiities (DSPD). The increase would apply to any 'waiver code' where there is a direct care worker. During FY 2014 DSPD had difficulty placing individuals already funded by the Legislature because community providers were unable to staff these placements due to lack of appropriate staff. This difficult is evidenced by DSPD nonlapsing $6.7 million in state funds (meant for services) at the end of FY 2014. The issue meant that families anticipating receiving services already approved had to wait for as long as six months to receive that service. The issue also involves access with regard to the Medicaid waiver and quality of care when appropiate staff cannot be hired.
Direct Care Staff Salary Increase - Internal Funding$3,917,500$0
OngoingOne-TimeFinancing Source
$1,162,700$0General Fund
$2,754,800$0Transfers - Medicaid
This request would raise the wage of direct care workers providing services for the Division of Services for People with Disabiities (DSPD). The increase would apply to any 'waiver code' where there is a direct care worker. During FY 2014 DSPD had difficulty placing individuals already funded by the Legislature because community providers were unable to staff these placements due to lack of appropriate staff. This difficult is evidenced by DSPD nonlapsing $6.7 million in state funds (meant for services) at the end of FY 2014. The issue meant that families anticipating receiving services already approved had to wait for as long as six months to receive that service. The issue also involves the issue of access with regard to the Medicaid waiver and quality of care when appropiate staff cannot be hired.
Disabilities - Capital Development Assistance$0$500,000
OngoingOne-TimeFinancing Source
$0$500,000General Fund, One-time
The funding could either be for FY 2015 or FY 2016. The funding will be used to assist individuals with disabilities living in community settings where the services are throughout much of the state.
Disabilities - Inclusive Schools, Communities, Workplaces$0$50,000
OngoingOne-TimeFinancing Source
$0$50,000General Fund, One-time
The funding is to provide assistance for creating inclusive schools, communities, and workplaces for individuals with disabilities.
Disabilities Dental Program$0$200,000
OngoingOne-TimeFinancing Source
$0$200,000General Fund, One-time
Funding is meant to help provide specialized dental services statewide to individuals with disabilities.
Disabilities Mandated Additional Needs$5,157,000 ($3,697,100)
OngoingOne-TimeFinancing Source
$1,530,600$0General Fund
$0 ($1,097,300)General Fund, One-time
$3,626,400 ($2,599,800)Transfers - Medicaid
There is a Medicaid requirement that the health and safety service needs of individuals receiving waiver services be met. Of the 4,800 covered individuals, 660 or 13.8 % identified last year as having increased health and safety needs. This is an increase from the base of 1.9%. How Measure Success? "Percent of people who are satisfied with their staff, support coordinator, and fiscal agent."
Disabilities Transportation$0$508,600
OngoingOne-TimeFinancing Source
$0$150,000General Fund, One-time
$0$358,600Transfers - Medicaid
Increases the rate for transportation services for people with disabilities to get from their homes to day programs, jobs, and other activities. This item was funded with one-time money during the 2014 General Session. Intent language was included to study the issue and provide a report to the LFA (which was done). The report included a number of recommendations almost all of which consisted of increasing the rates in various ways.
Disabilities Waiting List$0$4,211,600
OngoingOne-TimeFinancing Source
$0$1,250,000General Fund, One-time
$0$2,961,600Transfers - Medicaid
The Disability Waiting List was funded in the 2014 General Session with one-time money. Advocates are looking to make this funding ongoing plus any additional funding request in the 2015 General Session. If the Legislature funds approximately 150 individuals currently on the waiting list for services it would cost about $1,000,000 in General Fund and $3,500,000 in total funds. This is an increase from the base of 1.86%. How Measure Success? "Percent of people who are satisfied with their staff, support coordinator, and fiscal agent."
Domestic Violence Shelters$400,000$0
OngoingOne-TimeFinancing Source
$400,000$0General Fund
$0$0General Fund, One-time
This item was funded $300,000 ongoing and $393,500 one-time in the 2014 General Session. This funding provides $400,000 for Domestic Violence shelters ongoing. The funding will be divided up equally between all 13 non-profit domestic violence shelters in FY 2016. DCFS plans to implement a new funding formula in state FY 2017 and beyond. The funding is intended to provide basic life-saving and protection services of: safe shelter, case management, therapy, and children's services.
DSPD Nonlapsing Carryforward$0 ($6,676,200)
OngoingOne-TimeFinancing Source
$0 ($6,676,200)General Fund, One-time
DHS - DSPD Nonlapsing carryforward - the Division of Services for People with Disabilities (DSPD) has a large amount of unspent General Fund it has carried from FY 2014 into FY 2015. DSPD suggests this funding is due to difficulties in placing individuals into services in a timely manner. This funding is one-time. Utah Code (UCA 62A-5-102(7) dictates how nonlapsing funds may be used. DSPD would like to use the one-time funding to provide $5,000 in Respite Services per person to 850 people currently on the DSPD Waiting List ($4,250,000) and to cover: 1) the costs of Mandated Additional Needs for individuals currently receiving Medicaid Waiver Services who experience a loss of natural supports or a deterioration in health or behavior requiring additional supports to ensure their health and safety ($1,530,600); 2) the additional General Fund costs of children aging out of DCFS and DJJS custody who are receiving Medicaid Waiver Services through DSPD ($537,900); and 3) continue, and add to, the one-time transportation rate increase appropriated for FY 2015 ($357,700). The subcommittee may choose to agree with these uses or to use the funding in an alternate manner.
DV Shelters - Lethality Assessment$0$693,500
OngoingOne-TimeFinancing Source
$0$693,500General Fund, One-time
The Lethality Assessment Project (LAP) was developed in Maryland and "has proven to save lives. From 2006 to 2010, Maryland reduced domestic violence homicides by 30%." The LAP will increase the demand for shelter and services by directing high-risk domestic violence victims to the Domestic Violence Nonprofits across the state. These funds will assist in partnering with local law enforcement and accommodate the increase in clients. Based on research by Dr. Jacquelyn Campbell of The Johns Hopkins University School of Nursing, the LAP is designed to prevent domestic violence homicides, serious injury, and re-assault through partnering with law enforcement and encouraging more victims to utilize the support and shelter services of domestic violence programs. The LAP features a research based lethality screening tool and an accompanying protocol referral that provides direction for law enforcement, and domestic violence nonprofits personal to initiate appropriate action based on the results of the screening process. Some statistics relevant to this pilot project include: Only 4% of domestic violence murder victims ever participated in domestic violence service programs. In 50% of domestic violence related homicides, officers had previously responded to the scene. Re-assault of domestic violence victims in high danger was reduced by 60% if they went into shelter.
Employment Program for the Mentally Ill$0$120,000
OngoingOne-TimeFinancing Source
$0$120,000Federal Funds
Funding is to assist individuals with a serious and persistent mental illness the opportunity to build self-confidence and self-esteem through reintregartion into their community through meaningful work, education, safe and affordable housing, and respectful relationships.
Expand Autism Classrooms$0$500,000
OngoingOne-TimeFinancing Source
$0$500,000General Fund, One-time
Funding is meant to expand autism classrooms available throughout the state.
Fed Medical Assistance % Rate Change$29,000$0
OngoingOne-TimeFinancing Source
$537,100$0General Fund
($36,500)$0Federal Funds
($471,600)$0Transfers - Medicaid
The Federal Medical Assistance Percentage (FMAP) represents the federal share of the programmatic costs for Medicaid and federal Title IV-E (of the Social Security Act) programs. Title IV-E funds are used to support foster care and adoption assistance in the Division of Child and Family Services. The federal government utilizes a formula to determine its annual percent of FMAP. The projected FMAP rate for State Fiscal Year 2016 for Utah is 70.32 percent. This represents a 0.185 percent decrease from the State Fiscal Year 2015 FMAP rate. Of the $537,100 total FMAP rate change, $431,200 or 80 percent is within the Division of Services for People with Disabilities.
Forensic Competency Restoration$300,000$0
OngoingOne-TimeFinancing Source
$300,000$0General Fund
County needs for competency evaluations are exceeding the availability of State Hospital forensic beds. The forensic program has 100 beds. Forensic adults are "adults who have been adjudicated and found not competent to stand trial. These patients are held in a secure facility (regardless of the severity of the crime they are accused of committing) until competency can be restored. . . The forensic unit also holds and treats patients who have been adjudicated and been found guilty or not guilty and mentally ill [20%]. . . Forensic patients cost more than civilly committed adult patients. Over the past four fiscal years, the average cost for forensic patients was $475 per patient day. The average cost for a civilly committed adult was $434 per patient day." A review by the Department of Human Services has determined that a less expensive option than adding more State Hospital forensic beds is to hire State Hospital level staff to go directly to county jails and restore competency there. This option allows the use of existing jails to provide the room and board.
Justice Reinvestment Initiative$3,355,000$1,620,000
OngoingOne-TimeFinancing Source
$3,355,000$0General Fund
$0$1,620,000General Fund, One-time
Over the past 18 months, leaders in state government collaborated with the Pew Charitable Trusts Public Safety Performance Project and the U.S. Department of Justice to examine and find solutions to Utah's recidivism rate and growing prison population. The Justice Reinvestment Initiative is the broad project to begin implementation of key recommendations from the study. Funding is provided for the Department of Corrections, Board of Pardons and Parole, Governor's Office (Commission on Criminal and Juvenile Justice); additional funding is provided for the Division of Substance Abuse and Mental Health.
Local Mental Health Medicaid Match$0$6,400,000
OngoingOne-TimeFinancing Source
$0$6,400,000General Fund, One-time
Local Mental Health Medicaid caseload growth has exceeded the growth in available Medicaid match funding sources. During the 2014 General Session the Legislature provided an additional $6.4 million one-time to counties to assist them in paying for Medicaid match. Counties are now looking to the state to: 1) make the $6.4 million ongoing. The Medicaid program requires that state partners (including counties) pay for a portion of Medicaid expenditures called Medicaid match. The total FY 2013 Utah Medicaid match requirement was approximately 30%. Local authority information indicates the increased pressure to fund the Medicaid match affects all counties. Growth in Medicaid enrollment has outpaced funding for Medicaid match. In FY 2013 73% of the match was paid for with State General Fund received by the counties as pass through while 27% was paid using county General Fund sources.
Marriage Commission$0$300,000
OngoingOne-TimeFinancing Source
$0$300,000Federal Funds
This item was funded one-time in the 2014 General Session. The funding continues one-time assistance for the Marriage Commission. The commission is also exploring other options of public funding. The $300,000 maintains existing staff ($100,000) and expands efforts statewide to provide courses locally to help individuals form and sustain healthy and enduring marriages.
Medication Assisted Addiction Treatment$0$500,000
OngoingOne-TimeFinancing Source
$0$500,000General Fund, One-time
Funding provides assistance for medication assisted addiction treatment.
Mental Health Services Rates - DCFS$621,100$0
OngoingOne-TimeFinancing Source
$621,100$0General Fund
DHS - DCFS Mental Health Services Rates - Division of Child and Family Services (DCFS) and Division of Juvenile Justice Services (DJJS) mental health rates are lower than Medicaid rates due to two reductions taken in FY10 and FY11. Medicaid also added the requirement these contract providers use a more complex enrollment and bill directly through the Medicaid payment system (presented in the 2/14/13 Social Services Appropriations Subcommittee meeting). The Legislature funded part of this difference during its 2014 General Session: $559,600 to DCFS ($390,600 General Fund) and $439,600 to DJJS ($306,900 General Fund). How Measure Success? 1. Did children in foster care receive mental health assessments in required time frames (SAFE Measure) 2. Is the child making reasonable progress toward stable and adequate functioning emotionally and behaviorally, at home and at school? (Qualitative Case Review Measure)
Nonlapsing Balance Transfer$0$475,000
OngoingOne-TimeFinancing Source
$0$475,000Beginning Nonlapsing
No Description
Parent and Child Amendments$1,500$0
OngoingOne-TimeFinancing Source
$1,500$0General Fund
Enactment of this legislation likely will not materially impact state revenue. Assuming about 60 shelter and other removal hearings cases, enactment of this bill could create total ongoing costs of about $52,900 from the General Fund for the following agencies beginning in FY 2016: 1. Courts - $32,000 - for processing hearings and judge time; 2. Attorney General - $11,900 - for attorney representation and research; and 3. Guardian ad Litem (GAL) - $9,000 - for attorney representation. Also, assuming about 15 cases of investigating cases of mental abuse, the Department of Human Services may have additional costs of about $1,500 annually for a total General Fund impact of $54,400.
Portability - Transfer IN - DOH to DHS$1,146,900$0
OngoingOne-TimeFinancing Source
$340,400$0General Fund
$806,500$0Transfers - Medicaid
Transfer ongoing General Fund of $1,466,000 for portability and transition programs beginning in FY 2015 from the Department of Health's Medicaid Optional Services to the Department of Human Services' Division of Services for People with Disabilities. The clients associated with the funding have already transferred from Health to Human Services. This adjustment facilitates the funding following the person. Both the Department of Health and the Department of Human Services agree with this transfer.
Replace Lost Medicaid Funding$1,100,000$0
OngoingOne-TimeFinancing Source
$1,100,000$0General Fund
This request results from Medicaid auditors disallowing previous cost allocation methods which lowered the annual Medicaid payments to the State Hospital. Medicaid auditors recommended various changes to the Utah State Hospital (USH) cost allocation methods previously agreed upon by both parties which have now lowered the annual Medicaid payments to the State Hospital. Lowering the Medicaid payments has the effect of increasing the state funding requirement.
State Hospital Savings regarding HB 14 (2012 GS) ($32,500) ($32,500)
OngoingOne-TimeFinancing Source
($32,500)$0General Fund
$0 ($32,500)General Fund, One-time
DHS - State Hospital Savings re H.B. 14 (2012) GS - The original fiscal note anticipated 4 individuals civilly committed to the State Hospital as a result of this bill. There has only been one civil commitment to the State Hospital since enactment of the bill. The State Hospital did hire staff to prepare for the effects of H.B. 14 at an ongoing cost of $167,500 leaving an ongoing surplus of $32,500.
Suicide Prevention Amendments$191,000$210,000
OngoingOne-TimeFinancing Source
$191,000$0General Fund
$0$210,000General Fund, One-time
No Description
Supplemental Federal Funds Adjustment - Human Services$0$6,699,000
OngoingOne-TimeFinancing Source
$0$6,699,000Federal Funds
No Description
Youth Aging Out of DCFS Custody$537,900$0
OngoingOne-TimeFinancing Source
$537,900$0General Fund
This request maintains youth with intellectual disabilities on the Medicaid waiver who are aging out of the Division of Child and Family Services (DCFS) custody. DCFS is currently providing the funding until a person reaches age 18 (sometimes up to age 22). This item was funded $455,200 one-time General Fund in 2014 General Session. The underlying dynamics of the program would require an ongoing funding to replace the one-time funding plus any estimate in growth (or decline) of the need. How Measure Success? "Percent of people who are satisfied with their staff, support coordinator, and fiscal agent."
Staff Analysis

Funding in the Department of Human Services by Major Program Categories

Table of Funding in the Department of Human Services by Major Program Categories

Full-time equivalent staff positions in the Department of Human Services by major program categories

Issue Brief - 2014 General Session - Drug Offender Reform Act or DORA

Issue Brief - 2014 General Session - S.B. 259 Amendments to Disability Waiting List

Social Services Review of Travel Costs

Unused Funds From Lapsing and Nonlapsing Balances

Department of Human Services response to Legislator questions

Issue Brief - 2014 Interim - Federal Block Grants Used to Fund Social Services Program

OLAG In-depth Budget Review of the Department of Human Services

OLAG A Performance Audit of the Division of Services for People with Disabilities

Addressing the Coverage Gap - including a definition of "Medically Vulnerable"

Behavioral Health Workgroup Report to the Health Reform Task Force

Performance measures can be found at the individual program level. In addition, the department has four overarching goals which are:

  • Deliver statewide coordinated early intervention and prevention efforts;
  • Assure the safety of children and youth in their home; Provide care and treatment in the least restrictive, community-based setting that meet personal as well as community safety needs; and
  • Maximize engagement of two parents in support of their children.

And deliver upon each of these goals in the most efficient and effective way -- with responsible use of public resources, respecting self-determination of those whom we serve, and applying evidence-based practices with accountability for demonstrated results.

DHS Performance Measures 1st Quarter Response - October 2014

Statute

The Department of Human Services is established and functions under authority of Title 62A of the Utah Code.

  • UCA 62A-1-102 creates the Department of Human Services and broadly outlines its purposes.
  • UCA 62A-1-107 describes creation and purposes of state boards within the department.
  • UCA 62A-1-111 lists the department's authority.
  • UCA 62A-1-112 and UCA 62A-1-114 outline the department's role as the State agency overseeing federal social service programs.

Intent Language

HB0003: Item 88

The Legislature intends the Department of Human Services and the Department of Human Resource Management provide information to the Office of the Legislative Fiscal Analyst no later than June 1, 2015 regarding the following: 1) a listing of programs throughout the Department of Human Services by agency and by program documenting where drug testing of job applicants is taking place as well as where drug testing of job applicants is not currently taking place and 2) any formal or informal state policies regarding the use or discouragement of drug testing of job applicants.

HB0003: Item 88

The Legislature intends that the Department of Human Services prepare proposed performance measures for all new state funding or TANF federal funds for building blocks and give this information to the Office of the Legislative Fiscal Analyst by June 30, 2015. At a minimum the proposed measures should include those presented to the Subcommittee during the requests for funding. If the same measures are not included, a detailed explanation as to why should be included. The Department of Human Services shall provide its first report on its performance measures to the Office of the Legislative Fiscal Analyst by October 31, 2015. The Office of the Legislative Fiscal Analyst shall give this information to the legislative staff of the Health and Human Services Interim Committee.

HB0003: Item 88

The Legislature intends the departments of Health, Human Services, and Workforce Services and the Utah State Office of Rehabilitation provide to the Office of the Legislative Fiscal Analyst by June 1, 2015 a report outlining how funds are distributed within the state when passed through to local government entities or allocated to various regions and how often these distributions are reviewed and altered to reflect the relevant factors associated with the programs. (1) Is the program considered a statewide program (this would include something that serves all rural areas)? a. Is the implementation of the program really statewide? If not, is there a compelling reason why? (2) Who gets the money (by county)? (3) What is the methodology for distributing the money? a. How does the distribution compare to actual need as expressed by population? i. [If distributions are not reflecting current need (as represented by population), please explain why not?] b. If not done by population, what is the reason? (4) Does statute say anything about distribution and equity for the program?

HB0003: Item 89

Under Section 63J-1-603 of the Utah Code, the Legislature intends that any remaining funds provided by Item 38, Chapter 13, Laws of Utah 2014 for the Drug Courts program within the Department of Human Services' Division of Substance Abuse and Mental Health line item not lapse at the close of Fiscal Year 2015. The use of any non-lapsing funds is limited to "other charges/pass through" expenditures consistent with the requirements found at UCA 63J-1-603(3)(b).

HB0003: Item 89

Under Section 63J-1-603 of the Utah Code, the Legislature intends that any remaining funds provided by Item 38, Chapter 13, Laws of Utah 2014 for State Substance Abuse Services and Local Substance Abuse Services within the Department of Human Services' Division of Substance Abuse and Mental Health line item not lapse at the close of Fiscal Year 2015. The use of any non-lapsing funds is limited to "other charges/pass through" expenditures consistent with the requirements found at UCA 63J-1-603(3)(b).

HB0003: Item 89

Under Section 63J-1-603 of the Utah Code, the Legislature intends that up to $50,000 of appropriations provided for the Department of Human Services' Division of Substance Abuse and Mental Health line item in Item 38, Chapter 13, Laws of Utah 2014 not lapse at the close of Fiscal Year 2015. These funds are to be used for the purchase of computer equipment and software, capital equipment or improvements, equipment, or supplies.

HB0003: Item 92

Under Section 63J-1-603 of the Utah Code, the Legislature intends that any remaining funds provided for the Division of Child and Family Services, in Item 41, Chapter 13, Laws of Utah 2014 not lapse at the close of FY 2015. The Legislature further intends that these non-lapsing funds are to be used for Adoption Assistance, Out of Home Care, Service Delivery, In-Home Services, Special Needs, and SAFE Management Information System modernization consistent with the requirements found at UCA 63J-1-603(3)(b).

HB0003: Item 93

Under Section 63J-1-603 of the Utah Code, the Legislature intends that up to $50,000 of appropriations provided for the Department of Human Services' Division of Aging and Adult Services - Adult Protective Services, in Item 42, Chapter 13, Laws of Utah 2014 not lapse at the close of Fiscal Year 2015. These funds are to be used for the purchase of computer equipment and software, capital equipment or improvements, equipment, or supplies.

HB0003: Item 93

Under Section 63J-1-603 of the Utah Code, the Legislature intends that any remaining funds provided by Item 42, Chapter 13, Laws of Utah 2014 for the Department of Human Services' Division of Aging and Adult Services not lapse at the close of Fiscal Year 2015. It is further the intent of the Legislature that these non-lapsing funds are to be used for client services for the Aging Waiver consistent with the requirements found at UCA 63J-1-603(3)(b).

SB0002: Item 81

The Legislature intends the Department of Human Services (DHS) report to the Office of the Legislative Fiscal Analyst by September 1, 2015 regarding its efforts and progress in addressing each specific recommendation contained in the Office of the Legislative Auditor General's "An In-Depth Budget Review of the Department of Human Services" (No. 2014-09) released in October of 2014. If there are any recommendations DHS is not addressing, the Legislature further intends DHS explain why it is not addressing those recommendations. The Legislature further intends DHS identify specific savings resulting from its process improvement efforts.

SB0002: Item 81

The Legislature intends that the Department of Human Services prepare proposed performance measures for all new state funding or TANF federal funds for building blocks and give this information to the Office of the Legislative Fiscal Analyst by June 30, 2015. At a minimum the proposed measures should include those presented to the Subcommittee during the requests for funding. If the same measures are not included, a detailed explanation as to why should be included. The Department of Human Services shall provide its first report on its performance measures to the Office of the Legislative Fiscal Analyst by October 31, 2015. The Office of the Legislative Fiscal Analyst shall give this information to the legislative staff of the Health and Human Services Interim Committee.

SB0002: Item 81

The Legislature intends the Departments of Workforce Services, Health, Human Services, and the Utah State Office of Rehabilitation provide a report regarding each agency's highest cost individuals and possible efficiencies through coordination, early intervention, and prevention. The Legislature further intends these agencies provide a report to the Office of the Legislative Fiscal Analyst by September 1, 2015. The report shall include the following regarding high cost individuals: 1) a summary, by program, of individuals receiving services in excess of $100,000 total fund annually in any given agency, what percentage of total costs is spent on these individuals, and what the agency is doing to manage these costs in an efficient manner, 2) an assessment of these high cost individuals receiving services from multiple agencies, 3) a description of agency coordination regarding high cost individuals accompanied by a list of areas where agencies specifically coordinate on these high cost individuals, 4) recommendations regarding how best to serve these high cost individuals in least restrictive settings where appropriate and consistent with choice, and 5) recommendation on how agency efforts might better be coordinated across programs.

SB0002: Item 82

The Legislature intends the Department of Workforce Services and the Administrative Offices of the Courts provide a report to the Office of the Legislative Fiscal Analyst no later than September 1, 2015. The report shall include, at a minimum: 1) a summary of efforts to improve coordination between the Drug Court program and DWS' Workforce Development Division in order to improve Drug Court success, 2) data indicating the success of the efforts including the implementation and reporting on measures of post program recidivism, and 3) any identified savings or additional funding of drug court recipients as a result of improved coordination efforts.

SB0002: Item 82

The Legislature intends that the one-time General Fund appropriation of $6,400,000 to the Department of Human Services for Local Authority Mental Health Medicaid Match is provided to assist local mental health authorities for one year until they can find ways to provide their own matching funds in the future. The Legislature further intends the local mental health authorities report their plans to provide their own matching funds in the future to the Office of the Legislative Fiscal Analyst by September 1, 2015.

SB0002: Item 82

The Legislature intends that the $300,000 in federal funds appropriated for Children's Mental Health Early Intervention for Children and Youth in the Department of Human Services in the Division of Substance Abuse and Mental Health line item is dependent upon the availability of and qualification for the Children's Mental Health Early Intervention for Children and Youth for Temporary Assistance for Needy Families federal funds.

SB0002: Item 83

The Legislature intends the Division of Services for People with Disabilities (DSPD) in the Department of Human Services provide to the Office of the Legislative Fiscal Analyst no later than September 1, 2015 a report that includes a(n): 1) response to each specific audit recommendation found in A Performance Audit of the Division of Services for People with Disabilities (October 2014 - Audit No. 2014 - 10), 2) identification of specific efficiencies gained by DSPD through implementing the audit's recommendations, 3) estimate of savings, if any, achieved through implementation of each recommendation, and 4) measures that demonstrate effective implementation of each recommendation. The Legislature further intends the Office of the Legislative Fiscal Analyst provide the report to the Office of the Legislative Auditor General (OLAG) and that OLAG review the report in order to assess: 1) if the measures accurately demonstrate effective implementation of the recommendations and 2) the accuracy of the savings estimates, if any. The Legislature further intends OLAG report its review of the DSPD report to the Social Services Appropriations Subcommittee.

SB0002: Item 83

The Legislature intends that for the building block titled "DSPD - Direct Care Staff Salary Increase," the Division of Services for People with Disabilities (DSPD) shall: 1) Direct funds to increase the salaries of direct care workers; 2) Increase only those rates which include a direct care service component, including respite; 3) Monitor providers to ensure that all funds appropriated are applied to direct care worker wages and that none of the funding goes to administrative functions or provider profits; 4) In conjunction with DSPD community providers, report to the Office of the Legislature Fiscal Analyst no later than September 1, 2015 regarding: 1) the implementation and status of increasing salaries for direct care workers, 2) a detailed explanation with supporting documentation of how DSPD providers are reimbursed, including all accounting codes used and the previous and current rates for each accounting code, and 3) a conceptual explanation of how DSPD community providers realize profit within the closed market of providing DSPD community services.

SB0002: Item 84

The Legislature intends the Office of Recovery Services report to the Office of the Legislative Fiscal Analyst by September 1, 2015 regarding implementation of 2014 General Session fee increases and a detailed listing of the intended uses of the additional fee revenue with associated amounts.

SB0002: Item 85

The Legislature intends the Department of Human Services' Division of Child and Family Services use nonlapsing state funds originally appropriated for Adoption Assistance non-IV-E monthly subsidies for any children that were not initially Title IV-E eligible in foster care, but that now qualify for Title IV-E adoption assistance monthly subsidies under eligibility exception criteria specified in P.L. 112-34 [Social Security Act Section 473(e)]. These funds shall only be used for child welfare services allowable under Title IV-B or Title IV-E of the Social Security Act consistent with the requirements found at UCA 63J-1-603(3)(b).

SB0002: Item 85

The Legislature intends to reinvest non-lapsing state funds originally appropriated for Out of Home Care to enhance Service Delivery or In-Home Services consistent with the requirements found at UCA 63J-1-603(3)(b). The purpose of this reinvestment of funds is to increase capacity to keep children safely at home and reduce the need for foster care, in accordance with Utah's Child Welfare Demonstration Project authorized under Section 1130 of the Social Security Act (Act) (42 U.S.C. 1320a-9), which grants a waiver for certain foster care funding requirements under Title IV-E of the Act. These funds shall only be used for child welfare services allowable under Title IV-B or Title IV-E of the Act.

SB0002: Item 86

The Legislature intends the Department of Human Services' Division of Aging and Adult Services use applicable federal funding reserves to provide one-time funding of $150,000 for Aging Nutrition.

SB0003: Item 129

The $300,000 in federal funds appropriated for the Marriage Commission in the Department of Human Services in the Executive Director Operations line item is dependent upon the availability of and qualification for the Marriage Commission for Temporary Assistance for Needy Families federal funds.

SB0003: Item 129

Under Section 63J-1-603 of the Utah Code the Legislature intends that up to $75,000 funds provided by Item 37, Chapter 13, Laws of Utah 2014 not otherwise designated as nonlapsing to the Department of Human Services - Executive Director Operations line item shall not lapse at the close of Fiscal Year 2015. The use of any nonlapsing funds is for respite care for individuals with disabilities in the Division of Services for People with Disabilities.

SB0003: Item 134

The Legislature intends that the $400,000 in Beginning Nonlapsing provided to respite care for individuals with disabilities in the Division of Services for People with Disabilities is dependent upon up to $400,000 funds not otherwise designated as nonlapsing to the Department of Human Services - Division of Substance Abuse and Mental Health line item being retained as nonlapsing in FY 2015.

SB0003: Item 134

The Legislature intends that the $75,000 in Beginning Nonlapsing provided to respite care for individuals with disabilities in the Division of Services for People with Disabilities is dependent upon up to $75,000 funds not otherwise designated as nonlapsing to the Department of Human Services - Executive Director Operations line item being retained as nonlapsing in FY 2015.

SB0007S01: Item 9

The Legislature intends that the Department of Human Services report on the following performance measures for the Substance Abuse and Mental Health line item: (1) Local Substance Abuse Services - Successful completion rate (Target = 40%), (2) Mental Health Services - Adult Outcomes Questionnaire - Percent of clients stable, improved, or in recovery while in current treatment (Target = 70%), and (3) Mental Health Centers - Youth Outcomes Questionnaire - Percent of clients stable, improved, or in recovery while in current treatment (Target = 70%) by January 1, 2016 to the Social Services Appropriations Subcommittee.

SB0007S01: Item 26

The Legislature intends that the Department of Human Services report on the following performance measures for the Executive Director Operations line item: (1) Corrected department-wide reported fiscal issues - per reporting process and June 30 quarterly report involving Bureaus of Finance and Internal Review and Audit (Target = 70%), (2) Percentage of initial foster care homes licensed within 3 months of training completion (Target = 60%), and (3) double-read (reviewed) Case Process Reviews will be accurate in The Office of Service Review (Target = 90%) by January 1, 2016 to the Social Services Appropriations Subcommittee.

SB0007S01: Item 27

The Legislature intends that the Department of Human Services report on the following performance measures for the Substance Abuse and Mental Health line item: (1) Local Substance Abuse Services - Successful completion rate (Target = 40%), (2) Mental Health Services - Adult Outcomes Questionnaire - Percent of clients stable, improved, or in recovery while in current treatment (Target = 70%), and (3) Mental Health Centers - Youth Outcomes Questionnaire - Percent of clients stable, improved, or in recovery while in current treatment (Target = 70%) by January 1, 2016 to the Social Services Appropriations Subcommittee.

SB0007S01: Item 28

The Legislature intends that the Division of Services for People with Disabilities (DSPD) use Fiscal Year 2016 beginning non-lapsing funds to provide services for individuals needing emergency services, individuals needing additional waiver services, individuals who turn 18 years old and leave state custody from the Divisions of Child and Family services and Juvenile Justice Services, individuals court ordered into DSPD services and to provide increases to providers for direct care staff salaries. The legislature further intends DSPD report to the Office of Legislative Fiscal Analyst on the use of these non-lapsing funds.

SB0007S01: Item 28

The Legislature intends that the Department of Human Services report on the following performance measures for the Services for People with Disabilities line item: (1) Community Supports, Brain Injury, Physical Disability Waivers, Non-waiver Services - % providers meeting fiscal requirements of contract (Target = 100%), (2) Community Supports, Brain Injury, Physical Disability Waivers, Non-waiver Services - % providers meeting non-fiscal requirements of contracts (Target = 100%), and (3) People receive supports in employment settings rather than day programs (National ranking) (Target = #1 nationally) by January 1, 2016 to the Social Services Appropriations Subcommittee.

SB0007S01: Item 29

The Legislature intends that the Department of Human Services report on the following performance measures for the Office of Recovery Services line item: (1) ORS Total Collections (Target = $250 million), (2) Child Support Services Collections (Target = $215 million), and (3) Ratio: ORS Collections to Cost (Target = > 5.9 to 1) by January 1, 2016 to the Social Services Appropriations Subcommittee.

SB0007S01: Item 30

The Legislature intends that the Department of Human Services report on the following performance measures for the Child and Family Services line item: (1) Administrative Performance: Percent satisfactory outcomes on qualitative case reviews/system performance (Target = 85%/85%), (2) Child Protective Services:  Absence of maltreatment recurrence within 6 months (Target = 94.6%), and (3) Out of home services: Percent of children reunified within 12 months (Target = 74.2%) by January 1, 2016 to the Social Services Appropriations Subcommittee.

SB0007S01: Item 31

The Legislature intends that the Department of Human Services report on the following performance measures for the Aging and Adult Services line item: (1) Medicaid Aging Waiver: Average Cost of Client at 15% or less of Nursing Home Cost (Target = 15%), (2) Adult Protective Services: Protective needs resolved positively (Target = 95%), and (3) Meals on Wheels: Total meals served (Target = 10,115) by January 1, 2016 to the Social Services Appropriations Subcommittee.

For analysis of current budget requests and discussion of issues related to budgets covered by this subcommittee click here.

Special Funds

As indicated in the above table, the department also draws funds from several General Fund restricted accounts, some of which are appropriated by the Legislature. These restricted accounts include:

  • Children's Account: UCA 62A-4a-309 - $3 surcharge on birth certificates and private contributions assessed at UCA 26-2-12.5 to provide abuse prevention programs

Children's Account

  • Victims of Domestic Violence Services Account: UCA 51-9-406 - 4.0 percent of surcharges on court fines and penalties to provide domestic violence services

Domestic Violence Services Account

  • Intoxicated Drivers Rehabilitation Account: UCA 62A-15-502, 62A-15-503, and UCA 51-9-407 -- 7.5 percent surcharge on court fines and penalties to provide education, intervention, and treatment of Driving Under the Influence (DUI) drivers

Intoxicated Driver Rehabilitation Account

  • Tobacco Settlement Account: UCA 51-9-201 -- tobacco settlement payments for drug court treatment services

Tobacco Settlement Restricted Account

  • Utah State Developmental Center Land Fund: UCA 63A-5-220 -- sale and lease of real property at Utah State Developmental Center where the interest on the principal may be appropriated to benefit programs at the Center or for disabilities-related programs identified in UCA 62A-5
  • Alzheimer's State Plan Task Force Restricted Account: -- Senate Bill 48 in the 2011 General Session established the Alzheimer's State Plan Task Force within the Division of Aging and Adult Services. S.B. 48 also created the Alzheimer's State Plan Task Force Restricted Account and provided that the task force not go into effect until at least $25,000 had been deposited into the account. The bill also required the task force to complete its duties and submit a report on its finding and recommendations to the Health and Human Services Interim Committee on or before its November 2011 meeting.
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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.