Utah interim committee hears testimony on ways to more efficiently fund local health departments

The Utah Legislature is thinking of ways to align the priorities of local county health departments in the state with the funding and stipulations of the state and federal governments.

At the Health and Human Services Interim Committee meeting on June 15th, the legislature discussed ways to improve the processes around local health department funding through local, state, and federal means. 

 

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Seth Anderson, Legislative Policy Analyst with the Legislative Research and General Council, gave background into how local health departments are funded. 

Local health departments have 3 main sources of funding: local, state, and federal dollars. The local funds are determined by the county commissioners and are affected by local taxes.

Anderson said counties do not have minimum amounts to pay local health departments, but do have a maximum. This means that counties can choose to not give local tax funding to their health departments. Jill Parker, Executive Director of the Utah Association of Local Health Departments (LHD), said funding is often changed with the election of new county officials with different priorities.

“There is no floor. There is a ceiling, but there is not a floor for local dollars,” Parker said. “The stability of local funds is subject to election cycles.” 

Brian Hatch, Director of Health for the Davis County Health Department, said most counties do well working with their commissioners, but in local departments that represent multiple counties, it can get challenging to coordinate. 

State funds are determined by the State Minimum Performance Funding, which is a formula that calculates how much a local health department would need for “bare bones” operation, Parker said. The legislature recently increased the minimum performance funding for all counties from $2.1 million to $6.13 million, which will go into effect July 1st, 2022. 

Parker said the increase in the minimum performance funding will help the state wean off of reliance on federal funds, but policy is still needed to allow local departments flexibility to use the funds in a way that best suits their community. 

Federal funding is controlled through Utah’s Governance Committee, which is a group of Utah Department of Health (DOH) and local health department representatives to process and allocate federal grant funds. However, due to stipulations, Parker said federal funds often come with directives that do not represent the local priorities of each health department. 

A recent audit conducted by the Office of the Legislative Auditor General in Utah found the committee to lack transparency. It also found a need for stronger collaborations between DOH and local departments to decipher the needs of each local health department. 

The auditors, Parker, and Tracy Gruber, Executive Director of the soon-to-be Department of Health and Human Services (DHHS), recommend codifying best practices for the committee and giving local health departments more flexibility to spend on items that will best impact their communities. 

Gina Wothen, First Vice President with the Utah Association of Counties, emphasized the need for local health departments to be at the table earlier in the funding conversation to allow counties to have more say on how their funding is used. 

“We don’t feel often that we have a lot of say in what we do,” Wothen said. “Allowing counties to have more of a say would be helpful so that there is an ownership from the health departments.”