FY 2016 Appropriation

State statute assigns mental health local authority responsibility to each county. Counties may elect to perform their local authority responsibilities singularly or through an interlocal agreement between multiple counties. Currently, there are thirteen (13) local mental health authorities. The Division of Substance Abuse and Mental Health (DSAMH) is the state's public mental health authority. DSAMH has the duty to consult and coordinate with local mental health authorities regarding programs and services. The DSAMH also sets policy for programs funded with state and federal money and accomplishes this objective by establishing rules and minimum standards for local mental health authorities. DSAMH establishes minimum quality standards, funding formulas for distribution of public funds, and other public mental health services with input from various stakeholders.

Funding History

Funding Issues

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.
Appropriation Overview

During the 2015 General Session, the Legislature appropriated for Fiscal Year 2016, $33,978,600 from all sources for Mental Health Centers. This is a 0.1 percent reduction from Fiscal Year 2015 revised estimated amounts from all sources. The total includes $31,735,000 from the General/Education Funds, a reduction of 0.2 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 ACA Savings - Local Mental Health/Sub Abuse ($50,000)$0
OngoingOne-TimeFinancing Source
($50,000)$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.).
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.
Staff Analysis

For the most recent completed fiscal year, the following information represents the purposes for which the money was used:

Mental Health Centers Detailed Purposes

Adult mental health clients stable, improved, or in recovery while in current treatment

Youth mental health clients stable, improved, or in recovery while in current treatment

Following is a list of mental health local authorities, the counties served, and the agency or organization through which services are provided:

  • Interlocal agreement between Box Elder, Cache, and Rich counties known as District 1 Mental Health Authority -- services provided through Bear River Mental Health, a private, not-for-profit entity
  • Interlocal agreement between Carbon, Emery, and Grand counties -- services provided by Four Corners Community Mental Health Center, Inc., a private, not-for-profit entity
  • Interlocal agreement between Juab, Millard, Piute, Sevier, Wayne, and Sanpete counties -- services provided by Central Utah Mental Health/Substance Abuse Center doing business as Central Utah Counseling Center, a governmental entity formed via the interlocal agreement
  • Davis County -- services provided through a contract with Davis Behavioral Health Inc., a private, not-for-profit entity
  • Salt Lake County, Division of Behavioral Health Services -- contracts with OptumHealth Inc. (a subsidiary of United Health Group, a for-profit entity) who sub-contracts with service providers
  • San Juan County -- services provided through San Juan County Substance Abuse/Mental Health Special Service District operating as San Juan Counseling, a service district organized under the Utah Special Services District Act
  • Interlocal agreement between Beaver, Garfield, Iron, Kane, and Washington counties -- services provided by Southwest Behavioral Health Center also known as Southwest Center, a governmental entity formed via the interlocal agreement
  • Summit County -- services provided through a contract with Valley Mental Health, Inc., a private, not-for-profit entity
  • Tooele County -- services provided through a contract with Valley Mental Health, Inc., a private, not-for-profit entity
  • Interlocal agreement between Daggett, Duchesne, and Uintah counties -- services provided by Uintah Basin Tri-County Mental Health and Substance Abuse Local Authority doing business as Northeastern Counseling Center, a governmental entity
  • Wasatch County -- services provided by Wasatch Mental Health Services Special Service District, organized under the Utah Special Services District Act and operating as Wasatch Mental Health
  • Utah County -- services provided by Wasatch Mental Health Services Special Service District, organized under the Utah Special Services District Act and operating as Wasatch Mental Health
  • Interlocal agreement between Morgan and Weber counties -- services provided by Weber Human Services, a governmental entity formed via the interlocal agreement

Intent Language

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.

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.

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 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.

Counties obtain funds from various sources including state General Fund, the federal community mental health block grant, federal Medicaid funds, private pay insurance, and client fees. Counties are required to "match" (i.e. - provide from county resources) no less than twenty percent (20%) of an amount equal to most of the General Fund received from the state division of Substance Abuse and Mental Health [UCA 17-43-301(4)(a)(x)]

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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.