The Utah Legislature is considering how to align the priorities of local county health departments in the state with state and federal government funding and regulations.
At a meeting of the Provisional Committee on Health and Social Services on June 15the legislature discussed ways to improve local, state, and federal funding processes for local health departments.
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Seth Anderson, Legislative Policy Analyst, Legislative Research and General Council, explained how local health departments are funded.
Local health departments have 3 main sources of funding: local, state, and federal dollars. Local funds are determined by county commissioners and are subject to local taxes.
Anderson said counties don’t have minimums to pay local health departments, but they do have a maximum. This means counties can choose not to fund their health departments with local taxes. Jill Parker, executive director of the Utah Association of Local Health Departments (LHD), said funding often changes as new county officials are elected with different priorities.
“There is no floor. There is a ceiling but no bottom for local dollars,” Parker said. “The stability of local funds depends on election cycles.”
Brian Hatch, director of health for the Davis County Department of Health, said most counties work well with their commissioners, but local departments representing multiple counties can find it difficult to coordinate.
Public funds are determined according to the state’s Minimum Operational Funding, which is a formula that calculates how much a local health department will need for “naked” operations, Parker said. The Legislature recently increased the minimum activity funding for all counties from $2.1 million to $6.13 million, effective July 1, 2022.
Parker said an increase in the minimum performance funding would help the state move away from dependence on federal funds, but policies are still needed to allow local departments the flexibility to use funds in a way that best suits their community.
Federal funding controlled through Utah Management Committeewhich is a group of representatives from the Utah Department of Health (DOH) and the local health department to process and distribute federal grant funds. However, because of the caveats, Parker said, federal funds often come with directives that don’t reflect the local priorities of each health department.
Recent audit conducted by the Office of the Legislative Auditor General in Utah found that the committee lacked transparency. There was also a need for closer collaboration between the Ministry of Health and local departments to determine the needs of each local health department.
The auditors, Parker and Tracey Gruber, executive director of the future Department of Health and Human Services (DHHS), recommend systematizing best practices for the committee and giving local health departments more flexibility to spend funds that will have the best impact. their communities.
Gina Voten, senior vice president of the Utah Association of Counties, stressed the need for local health departments to come to the negotiating table earlier in funding discussions so that counties can have more say in how their funding is used.
“We don’t often feel like we have a say in what we do,” Woten said. “It would be helpful to give counties more say so that health departments would be held accountable.”