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MINUTES OF THE
JOINT HEALTH AND HUMAN SERVICES APPROPRIATION SUBCOMMITTEE
Friday, January 19, 2001

Room 403, State Capitol Building


Members Present:    Sen. David H. Steele, Committee Co-Chair
        Rep. Jack A. Seitz, Committee Co-Chair
        Sen. D. Edgar Allen
        Rep. Trisha Beck
        Rep. David L. Hogue
        Rep. David Litvack
        Rep. Carl R. Sanders

Members Excused:    Sen. L. Steven Poulton
        Rep. Rebecca Lockhart

Members Absent:    Sen. Curtis Bramble
        Rep. Matt Throckmorton

Staff Present:    Thor Nilsen, Legislative Fiscal Analyst
        Spencer C. Pratt Legislative Fiscal Analyst         Norda Shepard, Secretary

Public Speakers Present:        Rod Betit, Executive Director, Department of Health
        Ken Patterson, Director, Division of Child and Family Services
        Robin Arnold-Williams, Executive Director, Department of Human Services
        Jana Mather, Dean, U of U Graduate School of Social Work
        Mark Duke, Utah Adoption Council
        Kit Hansen, President, Utah Foster Family Association
        E. Jerome Battle, Board Member, Utah Foster Care Foundation
        Kelcie Lewis, Staff Member, Utah Foster Care Foundation
        Patricia Berckman, Salt Lake County Youth Services
        Diane Stuart, Utah Domestic Violence Advisory Council
        Erik Bjorklund, Utah Youth Care Providers Association
        Michael Deily, Director, Division of Health Care Financing
        Jim Anderson, Consultant to the Christmas Box House Foundation
        Ros McGee, Utah Children
        Dr. Jayne Wolfe, Salt Lake Family Support Center
        Julie Brown, Valley Mental Health Youth Program Director
        Jack Green, Director of Finance and Information Systems, DCFS

List of Visitors on File


Co-Chair Seitz called the meeting to order at 2:04 p.m.

1.     Budget Overview - Department of Health

    Analyst Spencer Pratt stated that the analyst's office is there to help both sides of the legislature and encouraged committee members to call for help when needed. He explained the format of the Budget Analyst Book for the Department of Health, stating that each tap in the Budget Book represents a line item and behind each tab is Section One which summaries that line item, Section Two where the analyst brings up issues of concern, Section Three containing the recommendations for programs within the line items and Section Four giving the historical perspective of the line items.

    He explained that the Executive Appropriations Committee directed the Legislative Fiscal Analyst's Office to build the FY 2002 budget based on the FY 2001 appropriated amount plus an additional $77 million and that $77 million was to replace one time funding and capital expenditures, including the Centennial Highway Fund. Mr. Pratt explained that the Executive Appropriations Committee has requested that subcommittees hear each of the department's requests for additional funding and then prioritize those funding requests.
     Pages 11 through 15 contain additional information and a glossary of health related terms and acronyms for reference during these meetings.

    Rod Betit, Executive Director, Department of Health, introduced department staff members Dr. Richard Melton, Deputy Director; Dr. Scott Williams, Deputy Director; John Williams, Project Director for the Veteran's Nursing Home; Doug Springmeyer, Chief Legal Council; Sheri Watkins, Chief Financial Officer; Michael Deily, Director of Health Care Financing; Chad Westover, Director of Children's Health Insurance Program; Dr. George Delavan, Director of Division of Community and Family Health Services; Dr. Charles Brokopp, Director of Division of Epidemiology and Laboratory Services; Iona Thraen, Division of Health Systems Improvement and Dr. Bob Rolfs, Director of Public Health Assessment.

    Mr. Betit distributed the Utah Public Health Outcome Measures Report, the department's FY2002 Budget Increase Request and a pie chart showing the department's distribution of funds from the FY 2001 authorized budget. He stated he would touch on these items in this meeting: The cost vs administrative services budget; items not on the analysts recommended list including Primary Care, Restoration of UMAP and the UMAP study; the major issues of moving the Veteran's Nursing Home; Olympic funding implications for the future and the effect of S.B. 15. He commended Analyst Pratt for his efforts on behalf of the department.

2.     Approval of Minutes

     MOTION: Rep. Hogue moved to approve the minutes for the meeting held 1-17-01.

    The motion passed unanimously.

3.     Budget Hearing - Division of Child and Family Services

    
Analyst Thor Nilsen stated that state statue defines the primary purpose of the Division of Child and Family     services as providing for child welfare. The analyst is recommending a budget of $119,593,00 with
$61,140,500 coming from General Fund, most of the rest coming from various federal sources. Mr. Nilsen
    highlighted some aspects of the division budget. He stated the adoption assistance program audit should be reviewed as it becomes available. He explained the TANF transfers, Child Welfare MIS Funding and the Christmas Box House. He stated it was not known at this time just what the impact on the division the Federal Title IV-E Rule changes would have.

    Robin-Arnold Williams, Executive Director, Department of Human Services, distributed the requested list of the Department of Human Services staff members. Ken Patterson, Division Director, Child and Family Services, distributed and explained a number of graphs showing various aspects of the division services. He also distributed "DCFS by the Numbers" which answers many of the frequently asked questions for fiscal year 2000. He thanked the committee and asked for their support for the requested building blocks for foster care providers and support programs. He introduced some of the partners from the community who work with the division.

    Jana Mather, Dean of the U of U Graduate School of Social Work, spoke about the program model that is being implemented by the Division of Child and Family Services. She stated it is a family oriented model and needs involvement of the whole community. It's purpose is to increase the involvement of the family in

placing the child either with a family member or back into the home. She stated the model program is working very well. She invited committee members to visit any DCFS office and witness first hand the kinds of service and hard work that is being done.     She commented that if committee members need any data to call the School of Social Work and they would help find it.

    Mark Duke, Utah Adoption Council, spoke in support of the building block for foster care. He gave examples of a foster care child and his special needs. He stated resources are needed to help make the adoption of these special needs children successful.

    Kit Hansen, President, Utah Foster Family Association, stated that foster parents take these children into their homes and nurture them, love them and teach them many basic things. They also teach the parents how to be parents. She said the majority of the foster care parents don't do it for money but because of willingness to be of service. They are on the job twenty-four hours a day, seven days a week. She urged the committee to support the proposal for a rate increase for foster parents.

    Kelcie Lewis, Recruitment Director, Utah Foster Care Foundation, stated the foundation has been charged with the task of increasing the number of licensed foster families in the state. When they began there were 944 licensed foster care families in the state. During the past sixteen months, the foundation has requited over l,000 new families. The foundation also tries to increase public awareness of the needs of foster children.

             Jerome Battle, Board Member, Utah Foster Care Foundation, stated he was concerned that if adoptive parents do not receive adequate support, the children are often returned to foster care, requiring more expenditures.
    He stated we need to provide consistent support and services to our most vulnerable children and the families that care for them.

    Patricia Berckman, Salt Lake County Youth Services, distributed "Christmas Box House Fast Facts" to the committee and urged additional funding. The Christmas Box House has contracted with DCSF to provide shelter and services to abused and neglected children. Actual operating costs have been higher than original estimates and that is why they are urging committee support of the requested additional dollars. She states the great advantage of the Christmas Box House is that children can enter any hour of the day and can remain with their siblings, helping to make the trauma less stressful.

    Diane Stuart, Utah Domestic Violence Advisory Council, stated there are two main reasons why domestic violence continues. It works for the perpetrator and we let it continue. What is helping to reduce domestic violence is a coordinated community effort, a system of services responding and working together.
    She stated that 65% of children who witness domestic violence will grow up to be abusive if there is no intervention by the community. She indicated her purpose for being here was to ask for support to provide funding for domestic shelters. These shelters provide shelter, clothing and those kinds of things, but also provide 24-hour crisis lines, crisis intervention, educational counseling, support groups and other services which help to stem domestic violence. She emphasized that funding for domestic shelters does make a difference.

    Eric Bjorklund from the Utah Youth Care Providers Association distributed a paper showing employee data for their front line employees. He explained that the wages shown for these people, who take care of kids who are too difficult for foster care, was lower than McDonalds. He also distributed a formal recommendation from the Utah Youth Village that asks for support for cost of living adjustments for DCFS providers of an amount equal to whatever adjustment is given to state employees and to support the DCFS consumer evaluation process. He also spoke in support of the increase in rates for foster care parents.


    Rep. Hogue asked to make a statement concerning some problems with foster care. He has been a foster parent and explained some of the problems in this process. He stated that the reason some people want to leave the foster care program is they don't get the assistance they need. Sometimes the program is so structured that parents can't make decisions or do things a parent should do. He told of a foster family who was willing to adopt and the difficulties encountered with a breakdown of communications with the department. He brought a doll, Destiny, to the meeting that had been delivered to him before the session to be his "foster child." He stated that for "Destiny" and other foster children to receive the best care, we need to make it easier for the foster parents. Just sending in money won't solve these problems. He said reforms in policy and communications would help.

    Mr. Patterson responded that they are working to try and change policy to be more helpful in putting relationships first and to create higher consumer and foster care satisfaction. Michael Deily, Director, Division of Health Care Financing, answered committee questions concerning medicaid coverage for foster children.

4.     Jim Anderson, Consultant to Christmas Box Foundation

    Mr. Anderson, Board Member, Foster Care Foundation, stated the building block for foster care should be funded wholeheartedly. He said the Christmas Box Houses in Moab and Salt Lake City were fully completed, operational and paid for and applauded the community for their support. Another house is planned for the Ogden area. He stated that in order to fulfill the community responsibility to take care of dependent children, we must act by providing the means to make things happen. He said that legislators are partners to the community in doing this

5.     Roz McGee, Utah Children

    Ms. McGee explained that she is the Executive Director of Utah Children, an independent, statewide organization engaged in research, education and policy advocacy on behalf of the children of Utah whose parents are not able to nurture and protect them. She distributed a printed letter to committee members outlining their issues of concern. She stated she was disappointed that the analyst did not recommend a rate increase for foster care parents and asked committee members to support that building block. She said legislators were Class A stock holders in running the most challenging business in Utah, that of taking care of children.

6.     Dr. Jayne Wolfe, Executive Director, Salt Lake Family Support Center

    Dr. Wolfe explained that she was not here to speak in support of any particular program but to ask for support of funding the DCFS budget to the fullest extent possible in any year. She said that any increase or decrease in the DCFS budget impacts all in the private sector who contract with DCFS to provide services. They are the ones who do much of the work with our kids.

7.     Public Testimony

    Julie Brown, Youth Client and Program Manager at Valley Mental Health, said she really represents the kids in our care. She said she has listened to the meeting today and heard about programs, financing, subsidies, carving in and carving out, but that is not what the kids care about. What they care about is consistency and adults that care about them. She stated she was also here in support of the staff who works with the kids. They are very committed. They don't make much. She said she drives to work and passes an Arctic Circle and it is discouraging to note that the managers at Arctic Circle make more than a house counselor with a bachelor degree who works with kids whose lives are at risk. She said she was an advocate for the staff, an

advocate for the kids and would appreciate anything the legislature could do to support the needs of our youth.

8.     Other Committee Business

    Rep. Hogue asked for an explanation of the Child Welfare Management Information System. Mr. Patterson explained that the state is required to send certain information to the federal government about how were are serving children, how we are serving families and how we are spending federal dollars. States were offered the opportunity in the early 90's of developing statewide automated child welfare information systems and the federal government paid 75% of the development if you got in the first four years. The federal government has since changed the amount of support. Jack Green, Director of Finance and Information Systems, Division of Child and Family Services, explained that the federal government initially indicated that when the system was operational there would still be a 50% match. There is still some confusion among several states as to where that lies but the information from the Denver regional office is that we get 50% of the percentage of children that are IV-E eligible, which is 36%. We get half of that for operating the program which drops
    us down to 18%.

     MOTION: Rep. Hogue moved to adjourn.

Co-Chair Seitz adjourned the meeting at 4:55 p.m.

Minutes reported by Norda Shepard, Secretary.









Sen. David Steele
Committee Co-Chair



Rep. Jack A. Seitz
Committee Co-Chair