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MINUTES OF THE

JOINT HEALTH AND HUMAN SERVICES APPROPRIATION SUBCOMMITTEE

February 10, 1999, 2:00 P.M.

Room 403, State Capitol Building



Members Present:        Sen. Robert Muhlestein, Committee Co-Chair
    Rep. Bill Wright, Committee Co-Chair
    Sen. Edgar Allen
    Sen. Steve Poulton
    Rep. Loretta Baca
        Rep. Trisha Beck
    Rep. David L. Hogue
    Rep. Bryan D. Holladay     Rep. Matt Throckmorton
    
Members Absent:     Rep. J.W. "Bill" Hickman

Staff Present:    Spencer Pratt, Legislative Fiscal Analyst
    Thor Nilsen, Legislative Fiscal Analyst
    Bonnie Brinton, Secretary

Others Present:        Robin Arnold-Williams, Executive Director, Department of Human Services
        Helen Goddard, Director, Division of Aging and Adult Services
        Suzanne Lundy, Consumer, Ombudsman Program
        Carol Bloswick, State Long-Term Care Ombudsman Program
        Ted Livingston, Mountainlands Association of Government AAA
        Mary Hillier, Program Participant, Meals on Wheels
        Darlene Russell, Participant, Aging and Adult Services
        Amanda Jones, Program Manager, Salt Lake County Aging Transportation
        Shauna O'Neil, Salt Lake County AAA
        Marvin James, Case Worker, Salt Lake County Aging Services
        Dan Hull, Utah Association of Home health Agencies
        Carol Page, Commissioner, Davis County, Chair of Utah Association of Counties
        Mark Shurtleff, Commissioner, Salt Lake County
        Jack Tanner, Executive Director, Utah Behavioral Health Network
        Dr. David Dangerfield, Valley Mental health
        Maureen Womack, Pres/CEO, Davis Mental Health
                Cathy Chambless, Executive Director, Governor's Council for People with Disabilities
        Patricia Worthington, Director, Foster Care Citizen's Review Board

List of Others Present on File.

    Committee Co-Chair Wright called the meeting to order at 2:18 p.m. and welcomed Sen Muhlestein to the     meeting.

1..     Budget Hearing: Division of Aging and Adult Services

     Fiscal Analyst - Thor Nilsen

        Mr. Nilsen presented an overview of the Division of Aging and Adult Services which coordinates all State activities related to the Older Americans Act of 1965. It advocates for the elderly, contracts for services, and administers State and federal programs for the elderly. The Division is also responsible for the protection of abused, neglected and exploited adults. Programs funded through the Older Americans Act must be distributed to the State's 12 local Area Agencies on Aging (AAAs) through an approved funding formula.

        For FY 2000, the Analyst recommends an appropriation for DAAS totaling $17,568,300, including $10,533,800 from the General Fund. Most of the balance comes from federal sources. About 80 percent of the Division's budget is passed through to local AAAs.

     Division of Aging and Adult Services

        Robin Arnold-Williams
introduced Helen Goddard, Director of the Division of Aging and Adult Services, who presented information on the organization and purposes of the Division and the local government units. She stated that Malcolm Beck, Chairman of the State Board for Aging and Adult Services, was not able to attend this meeting. The State Board, consisting of seven members, has been touring the State visiting the local government unit sites to review the facilities and services offered.

     Other Testimony:

        Suzanne Lundy
, citizen, spoke in support of current budget requests for the Long-Term Care Ombudsman Program.

        Carol Bloswick, State Long-Term Care Ombudsman Program, responded to questions from committee members.

        Area Agencies on Aging (AAAs):
            
            Mary Hillier
, Program Participant, Meals on Wheels, spoke in support of funding Meals on Wheels and transportation budgets.

            Darlene Russell, Participant, Aging and Adult Services, urged support for funding State Alternatives/Care Giver Respite programs and the waiting list.

            Melodie Holz, Citizen Care Giver, spoke in support of funding for the State Alternatives/Care Giver Respite program.

    Co-Chair Sen. Muhlestein assumed the Chair.

            Amanda Jones, Program Manager, Salt Lake County Aging, read a letter from Marcee Cazier, Director, Cache County Senior Citizen Center, regarding concerns about rural elderly transportation. Ms. Jones stated that there is a desperate need to fund transportation for seniors.

            Marvin Jones, Case Worker, Salt Lake County Aging Services, spoke of the Outreach Program which assesses the needs of the elderly and attempts to provide services at little or no cost.

            Ted Livingston, Mountainlands Association of Governments AAA, stated that the mission of the Area Agencies on Aging is to provide support to families giving care to the elderly and to provide support to the individual who has no family to give care to them. Mr. Livingston requested budget enhancements for the AAAs.

    Rep. Hogue encouraged the State divisions to work together to save money in every area possible to provide more funding for services to the elderly.

        Shauna O'Neil, Salt Lake County AAA, stated her funding concerns for case workers who can assess people who have applied to go to nursing homes and apprize them of the in-home services alternatives. She also spoke for funding the waiting lists.

    Rep. Hogue requested a report of all waiting lists for committee members to study.

    Dan Hull, Utah Association of Home Health Agencies (UAHHA) reported that Utah Home Health agencies number of visits have been cut in half by the loss of venipuncture coverage, new aggregate cost limits, fraud investigations and pressure of physicians due to Medicare fines. He stated that the majority of the decrease in service has been in the home health aide area. He stated the need for more funding for personal care services in aging and Medicaid waiver programs.

3.    Utah Association of Counties (UAC)

    Carol Page
, Commissioner, Davis County, Chair of UAC, presented the role of the UAC and its partnership with the State. She explained the funds matching requirements and that the counties are overmatching because of the lack of State funding. Ms. Page stated that funding for compensation adjustments is a high priority for the UAC. Challenges faced by this association are the cost of services and the increasing number of people requiring services.

     Utah Behavioral Health Network (UBHN):

        Jack Tanner,
Executive Director, UBHN, and Dr. David Dangerfield, Valley Mental Health, explained the organization of Utah's partnership system for mental health and substance abuse services, which consists of the State authority and the local mental health/substance abuse authorities. Mr. Tanner illustrated with a handout the trends affecting mental health and substance abuse growth and funding, average health care costs and treatment results. Dr. Dangerfield explained the Safe Haven Development, which is a partnership with private investors. Requests for funding are in three areas: Mental Health and Substance Abuse compensation adjustment - $575,892; Mental Health, Institutional Alternative, two PACT teams - $1,171,588; and Substance Abuse, Treatment of Meth Addiction - $700,000 and Drug Courts - $800,000.

    Sen. Poulton assumed the Chair.

        Maureen Womack, President/CEO, Davis County Mental Health, discussed services provided for children at this facility.

        Mark Shurtleff, Commissioner, Salt Lake County, summarized the background, services, challenges and requests of the Utah Association of Counties. The requests were in five areas: compensation adjustments, "hospital without walls," Drug Courts, keeping the aged population in their homes, and promoting health by preventing the spread of disease.

4. Budget Hearing: Executive Director Operations

    
Fiscal Analyst - Thor Nilsen

    The Analyst recommends a total FY 2000 appropriation for Executive Director Operations of $18,368,400. This includes $8,192,800 from the General Fund, with most of the balance coming from federal sources. Mr. Nilsen referred to the Intent Language regarding the Department of Human Services, Executive Director Operations, resulting in the FACT meeting, outcome measures and public money not being used by the Governor's Council for People with Disabilities to develop, train for, or promote legislative lobbying efforts.

    Rep. Beck stated her concern that the intent language referring to the Governor's Council for People with Disabilities conflicts with federal mandates. The Analyst informed committee members that this intent language can be eliminated this year by failing to reinstate it for FY 2000.

    The Analyst presented information on the Internal Service Funds budget. The Department of Human Services

operates two internal service funds that provide shared services to the divisions and bureaus of the Department.

    The Analyst recommends an FY 2000 appropriation of $3,565,900 from collection of dedicated credits/intergovernmental revenues.

    Robin Arnold-Williams summarized the Executive Director Operations budget by speaking of funding building blocks recommended by the Governor but not by the Analyst. She encouraged funding at the Governor's level for multi-need youth. She requested that the Department funding be across agency lines and be converted to a single line item to Human Services. This flexibility could streamline overhead costs and could help save money; also, administrative efficiencies could be obtained. It would impact lapsing funds in a positive way. The Department of Human Services would still provide detailed accounting of the funds. Ms. Williams stated that Youth Corrections would create an accommodation problem.

    Co-Chair Sen. Muhlestein assumed the Chair.

     Others:

        Cathy Chambless
, Executive Director, Governor's Council for People with Disabilities, reiterated the concern Rep. Beck had regarding the intent language not allowing public funds to be used by GCPD for lobbying or training. Intent language is left out unless it is reinstated, and the committee has the option of not reinstating this intent language for FY 2000. Ms. Chambless explained the makeup of the Council and its purpose, which is to advocate, not deliver services. She felt there was a misunderstanding when this intent language was written. She pointed out that no State money goes to support Council education and advocay efforts, only federal funds.

    Rep. Holladay cautioned committee members to be aware of how critical intent language can be and to be certain it is drafted correctly.

        Patricia Worthington, Director, Foster Care Citizens Review Board, requested that the committee recommend providing funds for leased facilities for this board to conduct their reviews. She explained the problems with not having a regular, unchanging place for the reviews and the need to locate near the area where most of their participants live. The amount requested is in the Analyst's budget and Ms. Worthington urged the support of the committee in funding this amount.

    MOTION: Sen. Allen moved to adjourn the meeting. The motion passed with Sen. Poulton and Reps. Baca, Throckmorton and Wright absent at the time of voting.

Committee Co-Chair Muhlestein adjourned the meeting at 5:10 p.m.

Minutes were reported by Bonnie Brinton, Secretary.






Sen. Robert Muhlestein, Co-Chair



Rep. Bill Wright, Co-Chair