FY 2016 Appropriation

The Division of Family Health and Preparedness assures and improves the quality of the Utah health care system, with an emphasis on care delivered to the most vulnerable populations. This function is fulfilled through the examination, analysis, and regulatory actions to improve service availability, accessibility, safety, continuity, quality, and cost. The Division directs the regulation and oversight of the health care industry. Division-wide improvement strategies include training, certification, licensing, and inspection. The Division also strives to assure that women, infants, children, and their families have access to comprehensive, coordinated, affordable, community-based quality health care. These health care services are available to all citizens of the State according to their ability to pay. Primary clients are low income women, infants, and children who have special health care needs. The Division coordinates efforts, identifies needs, prioritizes programs, and develops resources necessary to reduce illness, disability and death from adverse pregnancy outcomes and disabling conditions.

Funding History

Funding Issues

Baby Watch Early Intervention Caseload

Last year provided one-time funding for ongoing caseload growth.

Health Facility Certification Staffing

Provide ongoing funding for four FTEs to continue more timely inspections of health care facilities to meet state licensing and Medicare/Medicaid certification requirements. The Department of Health internally funded these four extra FTEs for FY 2014. The Department anticipates being able to inspect 100 facilities annually compared to 56 inspections in 2013. The Department indicates the federally-required frequency of inspections is 12.9 months, Utah was at 23 months in 2013. For FY 2014 the State Auditor indicates that the average inspection frequency was 12.9 months with all inspections less than 15.9 months since the last inspection. How Measure Success? (1) Average inspection frequency less than 13 months. (2) No nursing home inspected twice in a 16 month period.

Health Facility State Licensing Staffing

One FTE to perform about 25 inspections and to try and have more timely inspections of state licensed facilities (i.e. - assisted living, personal care agencies, and psychiatric hospitals). The agency indicates that currently state-only facilities are inspected every 4.5 years by 3 FTEs. This appropriation should bring the frequency to every 3.5 years. Health recommends a two year frequency for inspections as ideal. How Measure Success? (1) Facility inspections completed annually. (2) Time between inspections. (3) Class 1 deficiencies per inspection.

New Federal Surplus Property Resale Program

New federal surplus resale program where state agencies can receive dedicated credits from the sale of property/equipment.
Appropriation Overview

During the 2015 General Session, the Legislature appropriated for Fiscal Year 2016, $130,480,900 from all sources for Family Health and Preparedness. This is a 6.4 percent reduction from Fiscal Year 2015 revised estimated amounts from all sources. The total includes $19,952,800 from the General/Education Funds, an increase of 0.3 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 Automatic External Defibrillator Account$0$150,000
OngoingOne-TimeFinancing Source
$0$150,000GFR - Automatic External Defibrillator Account
Provide $150,000 in one-time spending authority to the Department of Health from the General Fund Restricted - Automatic External Defibrillator Account for FY 2015. The money is already in the account from the 2014 General Session.
Baby Watch Early Intervention Caseload$220,000$0
OngoingOne-TimeFinancing Source
$220,000$0General Fund
DOH - Baby Watch Early Intervention Caseload - The Legislature funded ongoing caseload with $220,000 one-time for FY 2015. The $220,000 represents a 0.9% increase in ongoing funding for this program. How Measure Success? (1) the proportion of Moderately and Severely delayed infants/toddlers who are served. (2) the number of families reporting that early intervention services have helped their family effectively communicate their child's needs and help their child develop and learn. (3) development closer to typically developing children in the following ways: Acquisition and use of knowledge and skills Use of appropriate behaviors to meet their needs Positive social and emotional skills. (4) at least 85% of these children will complete the program with improvement. (5) Continue to serve both severely delayed and moderately delayed children rather than having to restrict this program to only the severely delayed.
Child Care Amendments$88,000$12,000
OngoingOne-TimeFinancing Source
$88,000$0General Fund
$0$12,000General Fund, One-time
About 1,000 child care workers in FY 2015 and 7,000 ongoing beginning in FY 2016 who previously paid $15 for a background check to the Department of Public Safety will now pay those fees to the Department of Health. This could result in a shift of revenue of $15,000 in FY 2015 and $105,000 ongoing beginning in FY 2016 from dedicated credits to the Department of Public Safety to a deposit in the General Fund. The Department of Health deposits its child care background check fees into the General Fund. Enactment of this legislation could cost the Department of Health from the General Fund $12,000 in FY 2015 and $88,000 ongoing beginning in FY 2016 for 1.6 FTEs to process 1,000 child care worker background checks in FY 2015 and 7,000 ongoing beginning in FY 2016. The Department of Public Safety will no longer be processing these child care background checks at a dedicated credits cost of $15,000 in FY 2015 and $105,000 ongoing beginning in FY 2016.
Dedicated Credits Increase$4,400$0
OngoingOne-TimeFinancing Source
$4,400$0Dedicated Credits Revenue
(1) An increase of $802,200 in dedicated credits in FY 2016 in the Department of Health's Executive Director's Operations line item for $383,700 for potential sales from five new products from the All Payer Claims Database, $250,000 for contract for implementing the Master Person Index, and $168,500 for increased fees in vital records to offset declines in fee quantities. (2) An increase of $10,002,000 in dedicated credits in FY 2016 in the Department of Health's Medicaid Mandatory Services line item which is just a shift from the Medicaid Optional Services line item, but no overall increases for dedicated credits in Medicaid services. (3) $27,500 in ongoing dedicated credits beginning in FY 2016 for the Department of Health for a new federal surplus resale program where state agencies can receive dedicated credits from the sale of property/equipment. (4) For the Department of Health's Disease and Prevention Control line item as dedicated credits - Health: "Grant from the Association of Public Health Laboratories for $148,100. The purpose of this proposal is to establish molecular testing (Severe Combined Immunodeficiency) within the Utah Public Health Laboratory. Through this mechanism we explore and implement a cross-testing section process to advance Newborn Screening and the Infectious Disease group. The grant finances research and development work to implement a mandated test. All future cost will be covered completely through revenue generated through test fees."
Federal Funds Adjustments$0$7,778,100
OngoingOne-TimeFinancing Source
$0$7,778,100Federal Funds
Annual adjustments of federal funds based on agency submission of grant changes.
Health Facility Certification Staffing$357,700$357,700
OngoingOne-TimeFinancing Source
$56,000$0General Fund
$0$56,000General Fund, One-time
$301,700$301,700Federal Funds
Provide ongoing funding for four FTEs to continue more timely inspections of health care facilities to meet state licensing and Medicare/Medicaid certification requirements. The Department of Health internally funded these four extra FTEs for FY 2014. The Department anticipates being able to inspect 100 facilities annually compared to 56 inspections in 2013. The Department indicates the federally-required frequency of inspections is 12.9 months, Utah was at 23 months in 2013. For FY 2014 the State Auditor indicates that the average inspection frequency was 12.9 months with all inspections less than 15.9 months since the last inspection. How Measure Success? (1) Average inspection frequency less than 13 months. (2) No nursing home inspected twice in a 16 month period.
Health Facility State Licensing Staffing$86,900$0
OngoingOne-TimeFinancing Source
$86,900$0General Fund
One FTE to perform about 25 inspections and to try and have more timely inspections of state licensed facilities (i.e. - assisted living, personal care agencies, and psychiatric hospitals). The agency indicates that currently state-only facilities are inspected every 4.5 years by 3 FTEs. This appropriation should bring the frequency to every 3.5 years. Health recommends a two year frequency for inspections as ideal. How Measure Success? (1) Facility inspections completed annually. (2) Time between inspections. (3) Class 1 deficiencies per inspection.
Maliheh Free Clinic$0$50,000
OngoingOne-TimeFinancing Source
$0$50,000General Fund, One-time
No Description
Nurse Family Partnership$0$1,000,000
OngoingOne-TimeFinancing Source
$0$1,000,000Federal Funds
"Early and intensive interventions in high-risk pregnancies and family situations up to 2 years of age to improve outcomes and decrease short and long-term social services costs."
Primary Care Grants$600,000$1,400,000
OngoingOne-TimeFinancing Source
$600,000$0General Fund
$0$1,400,000General Fund, One-time
"increase access for uninsured."
Transfer Cytomegalovirus Public Health Initiative from Disease Control and Prevention to Family Health and Preparedness$40,000$40,000
OngoingOne-TimeFinancing Source
$40,000$0General Fund
$0$40,000General Fund, One-time
Transfer the $40,000 ongoing General Fund for the item "Additional Funding for HB 81 (2013 General Session, Menlove) Cytomegalovirus Public Health Initiative" from the Department of Health's Disease Control and Prevention line item to the Family Health and Preparedness line item.
Utah Emergency Medical Services System Act Amendments$11,100$57,600
OngoingOne-TimeFinancing Source
$11,100$57,600Dedicated Credits Revenue
The Department of Health will receive an ongoing increase in dedicated credits beginning in FY 2016 of $33,100 with additional one-time increases in FY 2016 and FY 2017 of $84,800. Enactment of this legislation may cost the Department of Public Safety $12,500 for 0.25 FTE from dedicated credits to process background check applications. The Department of Public Safety will have pass through costs from dedicated credits to the Federal Bureau of Investigation for fingerprint background checks of $9,500 ongoing beginning in FY 2016 and one-time costs in FY 2016 and FY 2017 of $27,200. The bill may cost the Department of Health $11,100 ongoing dedicated credits beginning in FY 2016 and one-time costs of $57,600 in FY 2016 and FY 2017 for FTE time to process background check applications and background computer system upgrades and maintenance.
Staff Analysis

Results of Inspections for Child Care and Health Care Providers

In FY 2014 the child care program issued 918 citations and the Bureau of Health Facility Licensing, Certification and Resident Assessment issued 2,220 citations for being in violation of State rules. If cited findings are not corrected, then a civil money penalty is assessed. The amount charged ranges from $100 to $500 per rule violated, mostly for serious violations of harm to residents or putting patients in immediate jeopardy of harm. In FY 2014 the child care program collected $4,700 in civil money penalties, while all others collected $141,800. These monies are used to fund training activities.

Results of Criminal Background Checks for Child Care and Health Care Providers

In FY 2014, the Division processed 30,516 criminal background checks on child care providers and applicants to provide direct care to patients in health care facilities as well as emergency medical technicians. Of these checks, 732 or 2% did not pass the background screening. Individuals who do not pass the background screening are prohibited from being employed in a State-licensed child care or health care facility or being an emergency medical technician. Persons providing direct care to patients in health care facilities can appeal a failed background screening. Through the appeals process 164 or 22% of those originally denied were cleared to work in the health care field.

The following are performance measures tracked within this organization.

Statute

The Division of Family Health and Preparedness is governed by the Utah Health Code in Title 26 of the Utah Code.

  • UCA 26-6a sets up criteria for testing and workers' compensation for emergency medical services providers who are exposed to various diseases.
  • UCA 26-7 authorizes the Department to create programs to promote good health practices and reduce major risk factors that contribute to injury, sickness, death, and disability.
  • UCA 26-8a creates the State Emergency Medical Services Committee, establishes the Statewide Trauma System, and outlines the criteria for emergency medical service personnel.
  • UCA 26-9 outlines the Health Department's efforts in relation to primary health care services in rural areas of the State.
  • UCA 26-9-5 establishes the Rural County Health Care Special Service District Retirement Grant Program.
  • UCA 26-9f creates the Utah Digital Health Services Commission which deals with telehealth issues.
  • UCA 26-10 establishes "Family Health Services" including the hearing testing as well as metabolic, endocrine, pulse oximetry, and hematologic testing of newborns.
  • UCA 26-10b "Access to Health Care" outlines the criteria for the Department to make grants to public and nonprofit entities for the cost of operation of providing primary health care services to medically underserved populations.
  • UCA 26-10-1 defines maternal and child health and also services for children with disabilities.
  • UCA 26-10-10 directs the Department to do public education regarding cytomegalovirus. This section also requires medical practitioners to test newborns who fail hearing tests for cytomegalovirus.
  • UCA 26-21 and UCA 26-21a outline the necessary requirements for State licensing of various health care facilities. It also details the direct patient care workers who must have a background check.
  • UCA 26-39 details the licensing requirements for child care providers.
  • UCA 26-47-103 creates the Assistance to Persons with Bleeding Disorders Program. It outlines the criteria for granting awards for assistance with the cost of obtaining hemophilia services or the cost of insurance premiums for coverage of hemophilia services.
  • UCA 26-52 creates the Autism Treatment Account to provide services for treating autism for those children not already covered by Medicaid.

The Division includes the Director's Office and the following seven programs: (1) Health Facility Licensing and Certification, (2) Emergency Medical Services (EMS), (3) Child Development, (4) Public Health and Preparedness Grants, (5) Children with Special Health Care Needs, (6) Primary Care, and (7) Maternal and Child Health. The Division also supports the Patient Safety Initiative, the Primary Care Grants Program, the American Indian/Alaska Native Health Program, the Office of Health Disparities Reduction, and the Assistance to Persons with Bleeding Disorders Program. Additionally the Division (through the Resident Assessment program) provides pre-admission screenings for all Utah Medicaid recipients seeking nursing home or institutional care and promoting primary care services to underserved populations.

Intent Language

HB0003: Item 76

Under Section 63J-1-603 of the Utah Code, the Legislature intends that up to $50,000 of Item 21 of Chapter 13, Laws of Utah 2014, funds appropriated for the Department of Health's Assistance for People with Bleeding Disorders Program shall not lapse at the close of Fiscal Year 2015. The use of any nonlapsing funds is limited to services to eligible clients.

HB0003: Item 76

Under Section 63J-1-603 of the Utah Code, the Legislature intends that up to $250,000 of Item 21 of Chapter 13, Laws of Utah 2014 for the Department of Health's Emergency Medical Services shall not lapse at the close of Fiscal Year 2015. The use of any nonlapsing funds is limited to testing, certifications, background screenings, replacement testing equipment and testing supplies.

HB0003: Item 76

Under Section 63J-1-603 of the Utah Code, the Legislature intends that civil money penalties collected for the Department of Health's Child Care Licensing and Health Care Licensing in Item 21 of Chapter 13, Laws of Utah 2014 from childcare and health care provider violations shall not lapse at the close of Fiscal Year 2015. The use of any nonlapsing funds is limited to trainings for providers and staff, as well as upgrades to the Child Care Licensing database.

HB0003: Item 76

Under Section 63J-1-603 of the Utah Code, the Legislature intends that up to $245,000 of Item 21 of Chapter 13, Laws of Utah 2014 for the Department of Health's Family Health and Preparedness line item not lapse at the close of Fiscal Year 2015. The use of any nonlapsing funds is limited to health facility licensure and certification activities.

HB0003: Item 76

Under Section 63J-1-603 of the Utah Code, the Legislature intends that up to $210,000 of Item 21 of Chapter 13, Laws of Utah 2014 from fees collected for the purpose of plan reviews by the Department of Health's Bureau of Health Facility Licensure, Certification and Resident Assessment shall not lapse at the close of Fiscal Year 2015. The use of any nonlapsing funds is limited to plan review activities.

HB0003: Item 76

Under Section 63J-1-603 of the Utah Code, the Legislature intends that criminal fines and forfeiture money collected for the Department of Health's Emergency Medical Services in Item 21 of Chapter 13, Laws of Utah 2014 shall not lapse at the close of Fiscal Year 2015. The use of any nonlapsing funds is limited to purposes outlined in Section 26-8a-207(2).

SB0003: Item 113

The $1,000,000 in federal funds appropriated for the Nurse Family Partnership in the Department of Health in the Family Health and Preparedness line item is dependent upon the availability of and qualification for the Nurse Family Partnership for Temporary Assistance for Needy Families federal funds.

SB0007S01: Item 1

The Legislature intends that the Department of Health report on the following performance measures for the Family Health and Preparedness line item: (1) The percent of children who demonstrated improvement in social-emotional skills, including social relationships (Goal = 70% or more), (2) The percent of children who demonstrated improvement in their rate of growth in acquisition and use of knowledge and skills, including early language/communication and early literacy (Goal = 75% or more), (3) The percent of children who demonstrated improvement in their rate of growth in the use of appropriate behaviors to meet their needs (Goal = 75% or more) by January 1, 2016 to the Social Services Appropriations Subcommittee.

SB0007S01: Item 11

The Legislature intends that the Department of Health report on the following performance measures for the Family Health and Preparedness line item: (1) The percent of children who demonstrated improvement in social-emotional skills, including social relationships (Goal = 70% or more), (2) The percent of children who demonstrated improvement in their rate of growth in acquisition and use of knowledge and skills, including early language/communication and early literacy (Goal = 75% or more), (3) The percent of children who demonstrated improvement in their rate of growth in the use of appropriate behaviors to meet their needs (Goal = 75% or more) by January 1, 2016 to the Social Services Appropriations Subcommittee.

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.

During the 2013 General Session the Legislature moved $100,000 of beginning nonlapsing from Medicaid Sanctions to Family Health and Preparedness for FY 2013.

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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.