Senator Sheldon Killpack
Co-Chair of the Health and Human Services Appropriations SubcommitteeSenator Lyle Hillyard
Co-Chair of Executive Appropriations
In the course of the 2006 Legislative Session, the Health and Human Services Appropriations Subcommittee heard countless requests for the funding available. They spent long, sometimes heartbreaking hours carefully prioritizing competing requests. Medicaid dental didn’t even make the list.
Now, somehow, it’s on the special session agenda.
Utah is unique in the fact that every legislator has the opportunity to sit on an appropriation sub-committee. Some legislators have the distinct opportunity to sit on the Health and Human Services Sub-Appropriation Committee. Many will argue that this is by far the most difficult committee on which to serve because you will simply never be able to meet everyone's needs.
Because human needs are so desperate and the resources are limited, the PROCESS becomes key in deciding what is funded and what is not funded.
Prior to the past legislative session we learned that – due to inflation, case load growth, changes in Federal funding, and utilization - we needed over sixty million dollars to keep programs whole as they already existed. During the session we learned that the Feds were going to deliver twenty million less
than we anticipated for the 2007 fiscal year and 10 million less for the 2006 fiscal year for the Department of Human Services.
The committee spent several meetings listening to testimony from department heads, advocacy groups, industry leaders, and state and local leaders (not to mention six hours of public testimony). What resulted was a prioritized list of needs that was passed along to the Executive Appropriations Committee.
To their credit our priorities were funded pretty much in the order the committee placed them.
However, many of our priorities were not funded at the level we hoped and some items were not funded at all.
Many worthy programs compete for the same funding. The following state needs were all prioritized ABOVE the Medicaid optional dental program:
Which one of these programs are less important than Medicaid dental?
- Mental Health funding,
- Ongoing additional funding for the medical examiners office,
- Utah Birth Defects Network,
- Additional DCFS caseload workers,
There certainly needs to be some rationale we can explain to advocates of other programs as to why they should not all try to short circuit the legislative process.
In some areas the very basics of the Medicaid program are in trouble. Providers are becoming leery of giving assistance to Medicaid patients because the reimbursement rates are so low. Increasing payment to providers was a priority to the committee - a higher priority than dental - but it was not funded.Weighing and comparing competing priorities is incredibly important.
There is a line a mile long of other optional Medicaid programs that did not get funded. It is bad policy and bad precedence to circumvent this process.
This would have been a bit more palatable had the Governor’s office given us any indication that this was important to them during the legislative session.
This move must be incredibly frustrating to those who play by the rules.