Opening Keynote: Utah DHHS Deputy Director Nate Checketts discusses departmental challenges, legislative outcomes


Maddie McCarthy, Alex Nelson


Utah Department of Health and Human Services (DHHS) Deputy Director Nate Checketts discussed the department’s challenges, successes, and priorities during the 2024 Utah State of Reform Health Policy Conference in March. 

In the past four years, DHHS has seen many significant changes and challenges, Checketts said. In 2020, the department implemented Medicaid expansion and dealt with the COVID-19 pandemic. DHHS was created in 2021 and 2022 when the Department of Health and the Department of Human Services merged. In 2023, DHHS adopted a new IT system, and began Medicaid redeterminations after the federal public health emergency ended, and pandemic-era continuous enrollment stopped. 

“My hope is, as we focus on the vision and work through this goal of seeking to deliver services to all Utahns, that we can work through these different opposing forces.”

— Checketts

Checketts discussed a few legislative initiatives affecting DHHS, including House Bill 261, sponsored by Rep. Katy Hall (R-Davis County).

“[The bill] prohibited the state government and other government entities from having offices based on certain identity characteristics. It prohibited training on certain practices. It prohibited policies that promote differential treatment based on certain identity characteristics. And it prohibited certain submissions of statements related to employment.”

— Checketts

Many people saw that bill as the state devaluing diversity, Checketts said, so DHHS sent a message to its team to ensure they knew the department valued its diversity. And so workers understood the bill and how the department would proceed. Checketts said DHHS will be able to follow the law and still continue to provide everyone with the care they need.

“The bill does not stop our important work of serving the public and meeting the goal that all Utahns will have fair and equitable opportunities to live safe and healthy lives. We will continue striving forward toward making this the safe and supportive workplace it needs to be. It’s OK to disagree, but we cannot do that with hatred, animosity, or abusive language.”

— Checketts

Checketts discussed HB 463, which outlined cuts that would be made to the Medicaid program if a Medicaid shortfall were to happen. The bill, sponsored by Rep. Brady Brammer (R-Utah County), did not pass.

“At its core, HB 463 said, ‘If things go bad, what is the state going to do to respond?’ And in that sense, it was on the right track. What did HB 463 get wrong? In part it didn’t include the community in helping decide what those [cuts] would be. What are the specific triggers that decide what is going on? What are the ways to remedy those? What are the things the state will do if one of these situations happens? 

So we think there is an opportunity to continue that discussion. It just needed to happen in a different way. We’re happy that the bill didn’t pass and we have an opportunity to continue discussing that.”

— Checketts

Checketts also highlighted Senate Bill 27, sponsored by Sen. Evan Vickers (R-Beaver County), which created the Utah Behavioral Health Commission.

“[The commission] will be an important opportunity for citizens across the state to weigh in on where the state is going to be going related to behavioral health … A predominant number of members are supposed to represent consumers rather than providers of the service and many of the councils that are already in existence in the state are being brought into that environment so we can have a single place.”

— Checketts

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