Utah Governor Spencer Cox released his Fiscal Year (FY) 2023 $28.5 billion budget recommendations on Dec. 7.
For DHHS, Cox calls for funding expansions in Medicaid eligibility and enrollment, informational technology (IT) databases, and workforce loan repayment programs. He also emphasizes his continuing commitment to fund the implementation of a value-based payment model through the recently announced Utah Sustainable Health Collaborative.
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Nate Talley, deputy director and chief economist at the Governor’s Office of Planning and Budget (GOPB), says 9% of $1.16 billion new, ongoing state revenue is going to social services. This revenue contains the new General Fund (GF) and Education Fund (ED) dollars acquired in FY 2022 through income and sales taxes.
Other sources, like federal funding from the American Rescue Plan Act (ARPA), are contributing to the DHHS recommended budget. FY 2023’s DHHS budget is around $200 million less than FY 2022’s final budget for health and human services.
For Medicaid, the budget allocates $68 million in ongoing GF dollars—$186 million overall—towards supporting enrollment, caseload changes, and inflationary changes. This accounts for 470,000 people in Utah, which represents a 14% caseload increase from FY 2022. Talley says this funding is dependent on when the public health emergency ends and triggers an anticipated drop in Medicaid enrollment.
“Over the course of the pandemic, estimates have been relying on a number of different assumptions, and as those assumptions change, especially with the continuation of the public health emergency, that has material impacts on what we expect needs to be funded there.”
The budget also allocates $1.1 million for 12-month continuous Medicaid eligibility for children aged 0-18 so that “no child experiences a lapse in access to health care.” The governor’s office says this is a response to the expected end of continuous federal government eligibility in 2022.
The budget proposal also allocates $2.15 million one-time funding and $1 million in ongoing funding to the new Utah Sustainable Health Collaborative. This health collaborative will “bring together key public and private stakeholders to transform Utah’s health care system, prioritizing patient health outcomes, and reducing the cost of health care.”
Talley says the collaborative aims to use this funding for staffing, conduct research, and conduct surveys.
“You bring in several experts from a variety of different perspectives and then they will come up with recommendations. So, the first part is staffing that, but the second part is being able to pull that together and execute it in a way that is responsive to any research requirements, [and] to be able to continue to push forward that initiative such that it gains traction.”
Cox also directs $1.7 million in ongoing GF to health care workforce financial assistance programs like the Rural Physician Loan Repayment Program, the Health Care Worker Financial Assistance Program, and the Behavioral Health Workforce Loan Repayment Program. The proposal reads:
“These programs leverage state funding by requiring provider matching to give qualified health providers educational loan assistance in exchange for serving in rural and underserved Health Professional Shortage Areas throughout the state.”
The funding will increase total available funding for health workers, streamline the grant admission process, and connect more health care professionals to this support.
The governor also allocates $37.4 million in ARPA funds for DHHS to modernize its technology, which includes over 20 databases and software platforms supporting vital records and child care licensing applications. The budget says these updates will improve access to appropriate data while enhancing IT processes.