Q&A: Utah House District 24 Rep. Jen Dailey-Provost

Rep. Jen Dailey-Provost represents Utah’s House District 24 and has a strong background in public health as a non-profit executive. Dailey-Provost serves on several committees including the House Health and Human Services Committee and the Social Services Appropriations Subcommittee. In this Q&A, she discusses the health care budget cuts that are threatening three of Utah’s state health clinics and future bills she wants to pass for reproductive freedoms.

 

 

Haley Donwerth: In regards to House Bill 65 related to abortions due to rape, can you explain more about the bill and why you sponsored it?

Rep. Jen Dailey-Provost: “Basically every bill idea I have comes from someone else, either a news story, or advocates that I work with, or people in my community who point out injustices… and this one in particular was brought to me by a young college student. She pointed out to me that in the State of Utah one of the few exceptions for accessing abortion after the legal gestational stage is rape, but in order for that rape to be considered valid, it has to be reported to police. It seems very inappropriate to me. Even when rapes are reported, they are rarely investigated and even more rarely prosecuted. We also know that some women don’t feel comfortable going to the police. Rape is a deeply traumatizing experience and too often having to go through that reporting process just adds to the trauma of that terrible experience. When it comes right down to it, the biggest issue is a report to a police officer does not make a rape a rape. And that is basically what we are saying as a society, that it didn’t actually happen and it wasn’t actually a bad thing until you reported it to police. The intent behind the bill was that rape should still be a reason that a woman can access an abortion for her unwanted pregnancy, but while we want to make police reporting as accessible and as easy as possible, it sometimes puts the woman at risk if it’s an intimate partner or a known person. Reporting to police sometimes adds to the risk of harm for the woman. It’s too high of a bar and shouldn’t be a requirement in order to access that health care.”

HD: Since the bill did not pass during this session, do you plan on continuing with it in future sessions?

JDP: “It’s not off the table. If we see a dramatic difference in the makeup of our legislature in the 2020 election, it might be worth reopening the discussion… The political reality is we have a legislature that is very hostile to reproductive freedoms and while I still care really deeply about reproductive freedom, right now I need to focus on things that I think are going to be more beneficial and more likely to pass in helping women with their reproductive needs. One bill in particular that I’ll be running again is creating funding for better access to contraception services for inmates. Preventing pregnancy is the number one way to prevent the need for abortion. With finite resources and especially in the COVID pandemic where our budgets are being harmed, I’ve got to be a little more focused about where I put my time and energy.”

HD: What are you hoping to focus on during the upcoming session?

JDP: “Like I mentioned, I’ve got my contraception access for inmates bill. I do have a bill idea I am considering that would open up Medicaid as an insurer for people to purchase low-cost health insurance. It’s like a Medicaid Bill of Rights, but I think that’s really useful because one of the things we need and would help Medicaid in general is a broader risk pool. By nature when you serve lower income people demographically you tend to have people with higher health care needs because of delayed care, because it’s a population that has not typically had consistent health care throughout their lives. If we can get some paying customers who want that access to low-cost insurance and the provider pool that is part and parcel to Medicaid, I feel like we can drive the cost of Medicaid down because we would be able to improve the risk pool by having healthier people in that risk pool. More patients and lower costs means better reimbursement rates for providers, and with better reimbursements rates for providers you get more providers. There’s a lot of potential.”

HD: Can you speak to the use of telehealth in your district in terms of bandwidth access?

JDP: “I do have my digital opportunity access amendment, which is ensuring universal access to high-speed internet. I think this is a social justice issue because so much of our society hinges on the ability to get online, especially now during this pandemic when we have to try to socially distance  as much as possible. Watching how many low income students across our state are falling behind because they don’t have access to the internet, so that was actually something that I started working on before the pandemic, the need for which has become even more obvious and telehealth is a huge part of that. I don’t know if I can speak broadly for my district, but I can certainly offer some personal perspective. I’ve personally participated in some telehealth interactions with my providers since the pandemic, and I have absolutely loved it. I could see taking advantage of telehealth appointments with my providers going forward wherever it’s feasible. But, as people see the benefit and convenience of telehealth, we need to be really careful about watching for delayed care for certain screenings… we need to make sure we don’t lose sight of the necessity and benefit in those annual screenings that can’t be done via telehealth.

I think our legislature was very wise at the last minute in the 2020 session to make sure that we made access and payment for telehealth more robust right before the session adjourned, recognizing how critical it was going to be in the months following the session. That has turned out to be a really wise move, and I will credit Maryann Martindale with Utah Academy of Family Physicians for really pushing that conversation. Whenever we come out of this pandemic it will have changed the way health care is delivered. It’s just going to be part of the new normal and if people really see the benefit that’s great, but we also need to be really careful about keeping our providers whole because telehealth doesn’t always fit neatly into the fee-for-service model and we’ve got to stay really diligent about having conversations and paying for value in the value that health care providers provide to the community. We’re seeing a lot of primary health care officers struggle to stay solvent and if our primary health care system collapses, our entire health care system and our economy will follow.”

HD: Can you speak to current COVID-19 budget cuts causing closures of health clinics around the state?

JDP: “As a member of social services appropriations, which partially funds the state’s community health centers, the $2.5 million cut looks like it’s going to close three of our clinics that serve tens of thousands of our state’s most vulnerable populations who are already at risk of falling through the cracks in our health care system. I was blindsided because in May and June our legislative leadership tasked all of our appropriations committees with coming to the table and making a list of proposed cuts that would cut their budget by 2%, 5%, and 10%. It wasn’t an actual cut, it was just saying ‘If we were forced to cut X dollars out of our state budget, what items from your budget would be the least painful’. In social services, everything is extremely painful. So we went through this exercise, and we started the conversation with ‘We’re in the middle of a public health pandemic, we shouldn’t be cutting social services at all. But, if you want us to have the conversation, here is the list starting with things that are least painful and getting down to the bottom of the 10% list to things that are really going to hurt people.’ Also, any cut in social services is not actually cost saving, it’s a delayed cost that will be even more expensive down the road.

As somebody who comes from a public health background and has worked in primary care for a long time, and was really involved in examining the social services appropriations budget before I served in the legislature… I never saw that proposal for the $2.5 million cut to the community health centers. To my memory it was never discussed, it wasn’t on the list. If it was on the list and I had seen it, I would have raised some really significant alarms. After that whole process, executive appropriations and legislative leadership made an announcement that not only were they not going to cut social services or education, social services would remain completely intact, education funding would be increased, and all the budget cuts that needed to be made would come out of other portions of the budget, which we celebrated as a huge success. When it came out that the health center’s funding had been cut, I was really blindsided and I’m still trying to figure out where that even came from. My Democratic house caucus had a meeting with the speaker of the house a couple of days ago and several of us implored him to ask leadership how to figure out how to fix that $2.5 million funding… this is not a savings to the state, it will just mean more expensive care for people in other places.”

HD: Are there any other pressing health care or health policy concerns you are looking into as a legislator?

JDP: “I am really nervous as we see schools coming back into sessions. I received a video from a friend of mine who is a teacher in the Granite School District who’s back to work this week, not teaching yet but preparing, and she sent me a video of her classroom set up in preparation for “COVID-19 learning environment”. It’s just a regular classroom. It’s got 40 desks, they’re all lined up one right behind another. They’ve given her a face shield to put on and put some hand sanitizer on a desk at the front of the classroom. I’m concerned that as communities still have these vicious, visceral fights about face masks, that we’re going to see a second wave this fall and it’s going to be even worse than the first. We’re not prepared for what’s yet to come with COVID-19.

I’ve also got a lot of renters in my district who are facing eviction and are not able to make ends meet because unemployment benefits are being cut or eliminated. As we hear the Trump Administration make comments about states having to pick up portions of unemployment coverage, I’m really alarmed because as far as I can tell that translates into needing $20-25 million in funding to keep people’s unemployment benefits at the rate that they’ve been at. The State of Utah does not have $20-25 million in extra funding to put toward that right now.”

This interview has been edited for length and clarity.