February 2, 2024
Nate Crippes / Public Affairs Supervising Attorney
ncrippes@disabilitylawcenter.org
Andrew Riggle / Public Policy Advocate
ariggle@disabilitylawcenter.org
(801) 363-1347 / (800) 662-9080
disabilitylawcenter.org
Dear President Adams, Speaker Schultz, and Executive Appropriations Committee Members,
The Disability Law Center (DLC) hopes the following list of items, along with a brief explanation of their importance from our perspective, is useful as you discuss where they may fall in your ranking this week.
We support funding of the following:
Education
- $5,000,000 one-time for Rep. Judkins’ HB 458. A co-teaching pilot program will help students with disabilities be in the general education classroom and fulfill the promises of the IDEA and ADA of an integrated and inclusive society for people with disabilities. If we continue to separate kids with disabilities from their nondisabled peers in schools, we will likely perpetuate the stigma and discrimination that has led to the exclusion of people with disabilities in employment, housing, and other opportunities that allow them to lead independent, self-directed lives.
Mental Health
- #34 on SSA’s list, Representative Eliason’s critical request for $8,000,000 to cover the gap in local mental health authorities’ required Medicaid match. If the gap is not filled, an already struggling community-based system will have even fewer resources to meet the needs of unhoused persons and other at-risk individuals or implement potential recommendations from the proposed Behavioral Health Commission. This is also why we and others continue to advocate that behavioral health be included in the Medicaid consensus process.
- #43 on SSA’s list, Representative Eliason’s $1,043,000 request to create parity in foster care and JJYS Medicaid. These youth need access to mental health care, just like anyone else. Federal law requires comparability of services for all those on Medicaid. Failure to fund this item could result in noncompliance with the State’s obligations under Medicaid.
- SSA’s recommendation at #46, of $5,439,200 for one rural receiving center and up to 4 mobile crisis outreach teams. Utahns off the Wasatch Front experiencing a crisis deserve the chance to stabilize in a less costly alternative to the ER, the hospital, or jail. At the same time, we have heard MCOTs are a less effective resource than they could be because of an inability to respond in a timely fashion due to a lack of capacity.
- HB 139, Rep, Judkins’ Mental Health Treatment Study, which complements the Behavioral Health Master Plan. While the master plan takes a 30,000-foot view, this study looks at the particular needs and gaps faced by Utahns with serious mental illness, from community supports to crisis response, hospitalization, and incarceration. It will give the legislature specific recommendations, based on best practices from around the country, for filling them over the next decade. It is likely the $500,000 one-time fiscal note can be at least partially matched or supplanted by federal Medicaid administrative dollars.
Long-term Services and Supports
- SSA’s #1 ranking for the Division of Services for People with Disabilities waiting list, although we prefer the governor’s recommendation of $4,476,000 to bring 272 individuals into services. We would also like to see his recommendation of $1,067,600, currently #29 on SSA’s list, for the limited supports waiver and bringing those who have been waiting 20 years or more into services.
- #4 on SSA’s one-time list, $1,200,000 for Rep. Ballard’s Katie Beckett waiver. The bill would give kids with complex medical needs access to Medicaid. Some families have said medical and behavioral healthcare would delay or prevent their need for more intensive DSPD services. Likewise, we know it is a big swing, but we encourage you to seriously consider Rep. Dailey-Provost’s HB 393 to use the interest from a trust fund created with $400 million from the Transportation Fund as a perpetual funding source for the waiting list. However, none of this is possible unless DSPD providers and support coordinators can maintain and increase their capacity with SSA’s #22 item of $6,600,000 for a rate increase.
- SSA’s ranking of $3,800,000 for New Choices Waiver rates #14 to keep individuals out of more costly care. Similarly, we are grateful the committee put the governor’s recommendation of $2,895,400 to increase rates for Home and Community-based Services recipients, including the Aging waiver and Employment-related Personal Assistant Services at #10. For example, one of our staff has had agency attendant coverage, and only in the morning, for just 6 weeks in the last year and a half. They could hire their own staff but would have to subsidize at least $7 an hour out-of-pocket to attract and retain someone in today’s market.
- Millner’s $220,000 request to increase the personal needs allowance to $60 a month at #12 on SSA’s list, the $5 million request for a nursing home rate increase at #15, and support more staff are a part of the answer to quality concerns in residential and long-term care facilities. Our recent report highlighting the consequences of a lack of oversight and enforcement demonstrates the need for the governor’s #45 and #11 requests respectively of $753,800 for 6 facility licensing staff and $434,800 for 3 additional Adult Protective Services and 1.5 Office of Public Guardian positions.
- In addition to these items, we spent the summer seeking a plan to provide critical services to individuals on the Technology Dependent Waiver, as they cannot access DSPD’s Community Supports Waiver due to their need of a trach. But for this need, they would have access to the broader array of supports available through the CSW. We worked with DHHS to come up with a solution, but, unfortunately, the governor did not include it among his recommendations. Even so, we urge you to consider providing funding for another waiver to serve these individuals.
Criminal and Juvenile Justice
- SSA’s #35 priority, the governor’s request for $838,600 to implement an expected Medicaid waiver providing physical and mental healthcare, along with case management to offenders preparing to re-enter the community. The 30-day post-release medication coverage is especially important for offenders with mental health needs.
- The governor’s recommendation of $6,223,900 for SSA’s #4 priority of DCFS and JJYS high acuity placements to keep kids out of even more costly settings or secure care. For the same reason, we want non-Medicaid eligible DCFS and JJYS youth to have access to high-quality mental healthcare. Therefore, we support the governor’s recommendation of $4,048,000 for the committee’s #3
Housing
- While we are grateful for the governor’s recommendation of $15 million for deeply affordable housing, the $10 million for the Olene Walker Housing Loan fund at #50 on SSA list, should be the absolute minimum. Inexplicably, the governor’s $5,000,000 recommendation for deeply affordable housing stabilization grants was not ranked by the committee.
- We urge you to revisit Rep. Carol Moss’ HB 141, which would use 25% of Liquor Control Fund profits as an ongoing source for the Olene Walker Housing Loan Fund. The solution to homelessness is housing.
Finally, we oppose funding the following:
- #3 on SSA’s one-time list, Sen. Weiler’s $8,800,000 request for a serious mental illness step-down facility in Davis County. Combining substantial commitments to peer supports, case management, wraparound services, and deeply affordable housing is a more efficient and effective way to provide integrated, scattered-site permanent supportive housing for individuals with SMI.
As always, thank you for your time and considering our priorities. Please feel free to contact us with questions or for more information.