H.B. 154

1

IN-HOME AND COMMUNITY BASED SUPPORT
2 SERVICES FOR ADULTS WITH LONG-TERM
3 CARE NEEDS
4 2006 GENERAL SESSION
5 STATE OF UTAH
6 Chief Sponsor: Eric K. Hutchings
7 Senate Sponsor: ____________
8
9 LONG TITLE
10 General Description:
11 This bill amends the state Medical Assistance Act and the Budgetary Procedures Act to
12 require the Department of Health to prioritize, and the governor to consider prioritizing
13 funding for programs to support in-home and community based support services for
14 adults with long-term care needs.
15 Highlighted Provisions:
16 This bill:
17 . makes legislative findings;
18 . directs the Department of Health, within appropriation from the Legislature, to
19 prioritize spending on long-term care needs of adults for in-home and community
20 based support services; and
21 . amends the Budgetary Procedures Act to require the governor to consider
22 prioritizing state spending on long-term care needs of adults for in-home and
23 community based support services.
24 Monies Appropriated in this Bill:
25 None
26 Other Special Clauses:
27 None

28 Utah Code Sections Affected:
29 AMENDS:
30 63-38-2, as last amended by Chapters 326 and 352, Laws of Utah 2004
31 ENACTS:
32 26-18-403, Utah Code Annotated 1953
33
34 Be it enacted by the Legislature of the state of Utah:
35 Section 1. Section 26-18-403 is enacted to read:
36 26-18-403. In-home and community based support services for adults with
37 long-term care needs.
38 (1) The Legislature finds that:
39 (a) in-home and community based support services have not been sufficiently available
40 for many adults with long-term care needs;
41 (b) many adults with long-term care needs are at risk of being or already have been
42 placed in institutional settings, because in-home and community based support services or
43 funds to pay for those services have not been available to them; and
44 (c) a variety of agencies, facilities, and individuals should be encouraged to provide
45 in-home and community based support services to adults with long-term care needs.
46 (2) Within appropriations from the Legislature, the department shall prioritize funding
47 for in-home and community based support services for long-term care needs of adults.
48 (3) The department shall, subject to available funding, establish and administer
49 programs of in-home and community based support services for adults with long-term care
50 needs, by itself or in cooperation with the federal government, local governments, or private
51 providers of in-home and community based support services.
52 Section 2. Section 63-38-2 is amended to read:
53 63-38-2. Governor to submit budget to Legislature -- Contents -- Preparation --
54 Appropriations based on current tax laws and not to exceed estimated revenues.
55 (1) (a) The governor shall, within three days after the convening of the Legislature in
56 the annual general session, submit a budget for the ensuing fiscal year by delivering it to the
57 presiding officer of each house of the Legislature together with a schedule for all of the
58 proposed appropriations of the budget, clearly itemized and classified.

59 (b) The budget message shall include:
60 (i) a projection of estimated revenues and expenditures for the next fiscal year; and
61 (ii) the source of all direct, indirect, or in-kind matching funds for all federal grants or
62 assistance programs included in the budget.
63 (2) At least 34 days before the submission of any budget, the governor shall deliver a
64 confidential draft copy of his proposed budget recommendations to the Office of the
65 Legislative Fiscal Analyst.
66 (3) (a) The budget shall contain a complete plan of proposed expenditures and
67 estimated revenues for the next fiscal year based upon the current fiscal year state tax laws and
68 rates.
69 (b) The budget may be accompanied by a separate document showing proposed
70 expenditures and estimated revenues based on changes in state tax laws or rates.
71 (4) The budget shall be accompanied by a statement showing:
72 (a) the revenues and expenditures for the last fiscal year;
73 (b) the current assets, liabilities, and reserves, surplus or deficit, and the debts and
74 funds of the state;
75 (c) an estimate of the state's financial condition as of the beginning and the end of the
76 period covered by the budget;
77 (d) a complete analysis of lease with an option to purchase arrangements entered into
78 by state agencies;
79 (e) the recommendations for each state agency for new full-time employees for the next
80 fiscal year; which recommendation should be provided also to the State Building Board under
81 Subsection 63A-5-103 (2);
82 (f) any explanation the governor may desire to make as to the important features of the
83 budget and any suggestion as to methods for the reduction of expenditures or increase of the
84 state's revenue; and
85 (g) the information detailing certain regulatory fee increases required by Section
86 63-38-3.2 .
87 (5) The budget shall include an itemized estimate of the appropriations for:
88 (a) the Legislative Department as certified to the governor by the president of the
89 Senate and the speaker of the House;

90 (b) the Executive Department;
91 (c) the Judicial Department as certified to the governor by the state court administrator;
92 (d) payment and discharge of the principal and interest of the indebtedness of the state;
93 (e) the salaries payable by the state under the Utah Constitution or under law for the
94 lease agreements planned for the next fiscal year;
95 (f) other purposes that are set forth in the Utah Constitution or under law; and
96 (g) all other appropriations.
97 (6) Deficits or anticipated deficits shall be included in the budget.
98 (7) (a) (i) For the purpose of preparing and reporting the budget, the governor shall
99 require from the proper state officials, including public and higher education officials, all heads
100 of executive and administrative departments and state institutions, bureaus, boards,
101 commissions, and agencies expending or supervising the expenditure of the state moneys, and
102 all institutions applying for state moneys and appropriations, itemized estimates of revenues
103 and expenditures.
104 (ii) (A) The governor may also require other information under these guidelines and at
105 times as the governor may direct.
106 (B) These guidelines may include a requirement for program productivity and
107 performance measures, where appropriate, with emphasis on outcome indicators.
108 (b) The estimate for the Legislative Department as certified by the presiding officers of
109 both houses shall be included in the budget without revision by the governor.
110 (c) The estimate for the Judicial Department, as certified by the state court
111 administrator, shall also be included in the budget without revision, but the governor may make
112 separate recommendations on it.
113 (d) The governor may require the attendance at budget meetings of representatives of
114 public and higher education, state departments and institutions, and other institutions or
115 individuals applying for state appropriations.
116 (e) The governor may revise all estimates, except those relating to the Legislative
117 Department, the Judicial Department, and those providing for the payment of principal and
118 interest to the state debt and for the salaries and expenditures specified by the Utah
119 Constitution or under the laws of the state.
120 (8) The total appropriations requested for expenditures authorized by the budget may

121 not exceed the estimated revenues from taxes, fees, and all other sources for the next ensuing
122 fiscal year.
123 (9) If any item of the budget as enacted is held invalid upon any ground, the invalidity
124 does not affect the budget itself or any other item in it.
125 (10) (a) In submitting the budgets for the Departments of Health and Human Services
126 and the Office of the Attorney General, the governor shall consider a separate recommendation
127 in his budget for funds to be:
128 (i) contracted to:
129 [(i)] (A) local mental health authorities under Section 62A-15-110 ;
130 [(ii)] (B) local substance abuse authorities under Section 62A-15-110 ;
131 [(iii)] (C) area agencies under Section 62A-3-104.2 ;
132 [(iv)] (D) programs administered directly by and for operation of the Divisions of
133 Substance Abuse and Mental Health and Aging and Adult Services;
134 [(v)] (E) local health departments under Title 26A, Chapter 1, Local Health
135 Departments; and
136 [(vi)] (F) counties for the operation of Children's Justice Centers under Section
137 67-5b-102 [.]; and
138 (ii) prioritized for spending on in-home and community based support services for
139 adults with long-term care needs.
140 (b) In his budget recommendations under Subsections (10)(a)(i)[, (ii), and (iii)] (A),
141 (B), and (C), the governor shall consider an amount sufficient to grant local health departments,
142 local mental health authorities, local substance abuse authorities, and area agencies the same
143 percentage increase for wages and benefits that he includes in his budget for persons employed
144 by the state.
145 (c) If the governor does not include in his budget an amount sufficient to grant the
146 increase described in Subsection (10)(b), he shall include a message to the Legislature
147 regarding his reason for not including that amount.
148 (d) If the governor does not prioritize spending for in-home and community based
149 support services described in Subsection (10)(a)(ii), the governor shall include a message to the
150 Legislature regarding his reason for not prioritizing the funding.
151 (11) (a) In submitting the budget for the Division of Services for People with

152 Disabilities, the Division of Child and Family Services, and the Division of Juvenile Justice
153 Services within the Department of Human Services, the governor shall consider an amount
154 sufficient to grant employees of corporations that provide direct services under contract with
155 those divisions, the same percentage increase for cost-of-living that he includes in his budget
156 for persons employed by the state.
157 (b) If the governor does not include in his budget an amount sufficient to grant the
158 increase described in Subsection (11)(a), he shall include a message to the Legislature
159 regarding his reason for not including that amount.
160 (12) (a) The Families, Agencies, and Communities Together Council may propose to
161 the governor under Subsection 63-75-4 (4)(e) a budget recommendation for collaborative
162 service delivery systems operated under Section 63-75-6.5 .
163 (b) The Legislature may, through a specific program schedule, designate funds
164 appropriated for collaborative service delivery systems operated under Section 63-75-6.5 .
165 (13) The governor shall include in his budget the state's portion of the budget for the
166 Utah Communications Agency Network established in Title 63C, Chapter 7, Utah
167 Communications Agency Network Act.
168 (14) (a) The governor shall include a separate recommendation in the governor's
169 budget for funds to maintain the operation and administration of the Utah Comprehensive
170 Health Insurance Pool.
171 (b) In making the recommendation the governor may consider:
172 (i) actuarial analysis of growth or decline in enrollment projected over a period of at
173 least three years;
174 (ii) actuarial analysis of the medical and pharmacy claims costs projected over a period
175 of at least three years;
176 (iii) the annual Medical Care Consumer Price Index;
177 (iv) the annual base budget for the pool established by the Commerce and Revenue
178 Appropriations Subcommittee for each fiscal year;
179 (v) the growth or decline in insurance premium taxes and fees collected by the tax
180 commission and the insurance department; and
181 (vi) the availability of surplus General Fund revenue under Section 63-38-2.5 and
182 Subsection 59-14-204 (5)(b).

183 (15) In adopting a budget for each fiscal year, the Legislature shall consider an amount
184 sufficient to grant local health departments, local mental health authorities, local substance
185 abuse authorities, and area agencies on aging the same percentage increase for wages and
186 benefits that is included in the budget for persons employed by the state.
187 (16) (a) In adopting a budget each year for the Utah Comprehensive Health Insurance
188 Pool, the Legislature shall determine an amount that is sufficient to fund the pool for each
189 fiscal year.
190 (b) When making a determination under Subsection (16)(a), the Legislature shall
191 consider factors it determines are appropriate, which may include:
192 (i) actuarial analysis of growth or decline in enrollment projected over a period of at
193 least three years;
194 (ii) actuarial analysis of the medical and pharmacy claims costs projected over a period
195 of at least three years;
196 (iii) the annual Medical Care Consumer Price Index;
197 (iv) the annual base budget for the pool established by the Commerce and Revenue
198 Appropriations Subcommittee for each fiscal year;
199 (v) the growth or decline in insurance premium taxes and fees collected by the tax
200 commission and the insurance department from the previous fiscal year; and
201 (vi) the availability of surplus General Fund revenue under Section 63-38-2.5 and
202 Subsection 59-14-204 (5)(b).
203 (c) The funds appropriated by the Legislature to fund the Utah Comprehensive Health
204 Insurance Pool as determined under Subsection (16)(a):
205 (i) shall be deposited into the enterprise fund established by Section 31A-29-120 ; and
206 (ii) are restricted and are to be used to maintain the operation, administration, and
207 management of the Utah Comprehensive Health Insurance Pool created by Section
208 31A-29-104 .
209 (17) In considering the factors in Subsections (14)(b)(i), (ii), and (iii) and Subsections
210 (16)(b)(i), (ii), and (iii), the governor and the Legislature may consider the actuarial data and
211 projections prepared for the board of the Utah Comprehensive Health Insurance Pool as it
212 develops its financial statements and projections for each fiscal year.

Legislative Review Note
as of 1-19-06 8:54 AM

Based on a limited legal review, this legislation has not been determined to have a high
probability of being held unconstitutional.

Office of Legislative Research and General Counsel