2024 Public Comment / SSA Priorities

Updated: 2 months ago
Public Policy

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 Chairs Ward, Balderree, and Social Services Appropriations Committee Members,

We hope the following list of items, along with a brief explanation of their importance from the Disability Law Center’s perspective is useful as you discuss where they may fall in your ranking today and Monday.

Mental Health

  • We fully support Representative Eliason’s critical request for $8 million 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.
  • We also support 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 on Medicaid. Federal Medicaid law requires comparability of services for all those on Medicaid, so a failure to fund this item could result in noncompliance with the State’s obligations under Medicaid.
  • We support the governor’s recommendation of $2,856,600 for one rural receiving center and up to 4 mobile crisis outreach teams. Utahns off the Wasatch Front experiencing a crisis also 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.
  • We oppose the $8 million request for a serious mental illness step-down facility. 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.
  • We oppose the governor’s recommendation of $10 million for a 5-year pilot of HOME Court. We are concerned neither the parameters of the proposal nor the target population are well defined. Community-based civil commitment follow-up is hit or miss. Data on assisted outpatient treatment’s “black robe” effect is mixed at best. Deeply affordable housing is nearly nonexistent. Rather, we suggest using the money to strengthen the systems we have and then decide if something more is necessary.

Long-term Services and Supports

  • Not surprisingly, we support the governor’s recommendation of $4,476,000 to bring 272 individuals off the Division of Services for People with Disabilities waiting list. We are also grateful for his request to you to consider ways to support individuals toward the end of the list, such as automatically bringing those who have been waiting 20 years or more into services. Likewise, we know it is a big swing, but we urge you to seriously consider Representative Dailey-Provost’s proposal to use the interest from a trust fund created with $400 million of the income tax set aside for children and Utahns with disabilities as a perpetual funding source for the waiting list. However, we know none of this is possible unless DSPD providers and support coordinators can maintain and increase their capacity with a $6 million rate increase.
  • For similar reasons, we support the governor’s recommendation of $2,895,400 to increase rates for Home and Community-based Services recipients, including the Aging and New Choices waivers, as well as Employment-related Personal Assistant Services. 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.
  • While we absolutely endorse senator Millner’s $220,000 request to increase the personal needs allowance to $60 a month, appreciate the $5 million request for a nursing home rate increase, and support more staff as 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 requests of $753,800 for 6 facility licensing staff, as well as $434,800 for 3 additional Adult Protective Services and 1.5 Office of Public Guardian positions.
  • We spent the summer seeking a plan to provide critical services to individuals on the Technology Dependent Waiver, as individuals on that waiver cannot access the DSPD Waiver due to their need of a trach. But for this need, they would have access to the DSPD waiver. 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

  • We fully support 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.

Housing

  • While we are grateful for the governor’s recommendation of $15 million for deeply affordable housing in the form of grants, please push for more. The solution to homelessness is housing.

As always, thank you for your time and considering our priorities. Please feel free to contact us if you have questions or would like more information.

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