5 Things Utah: Local health departments, Adolescent behavioral health, DHHS implementation - State of Reform

5 Things Utah: Local health departments, Adolescent behavioral health, DHHS implementation – State of Reform

This is the final newsletter before Utah has a new, combined health agency; the Department of Health and Human Services is set to operationalize on July 1st.

Read more about the impending merge below, as well as a push for local health department’s to have more say in how their funding is allocated, a conversation with the CEO of Valley Behavioral Health, and new data about adolescent mental health in Utah.

Thanks, as always, for reading!

Eli Kirshbaum
State of Reform

1. Local health department leaders call for more financial independence

Local health departments need more say in how local, state, and federal money is used to fund their operations, according to numerous local health leaders. At a recent Health and Human Services Interim Committee meeting, advocates urged legislators to reform the way in which local health departments are funded so each jurisdiction can manage their funding based on their specific needs.

Locally-derived funding is governed by county commissioners and thereby subject to change based on elections. Stakeholders say this funding structure also gets complicated under health departments that oversee more than one county. An audit of Utah’s Governance Committee—which manages the federal funding Utah receives—found it to lack transparency and recommended increased collaboration with UDOH and local health departments. “We don’t often feel that we have a lot of say in what we do,” said Gina Wothen, First Vice President of the Utah Association of Counties.

2. Q&A: Valley Behavioral Health CEO on the state of the BH workforce

Perhaps unsurprisingly, the number one issue facing behavioral health care in Utah today is an insufficient workforce, according to Jared Sanford, President and CEO of Valley Behavioral Health. In this Q&A, Sanford discusses how the BH workforce shortage is particularly challenging to manage in the midst of an increased need for BH services following the pandemic.

Sanford says this has forced his facility to turn away a lot of patients. “You never want to see people fall through the cracks, but I worry that people who need care might not find it quickly and just give up,” he said. Although he believes there’s no “silver bullet” for solving the issue, Sanford says potential solutions include higher wages and better benefits for BH providers, dedicated time off for self care, and a stronger BH provider recruitment pipeline.

3. What They’re Watching: Stephen Foxley, Regence BlueCross BlueShield of Utah

The end of the public health emergency (PHE) presents risk to those who received Medicaid coverage throughout the pandemic, but might not be eligible when redeterminations begin again. Stephen Foxley, Government Affairs Director of Regence BlueCross BlueShield of Utah, sat down with us to discuss Regence’s efforts to create a seamless transition for Medicaid members who may no longer be eligible for the marketplace or insurance from their employer.

Foxley said Regence is working to coordinate with key stakeholders in the health plan and coverage space to share meaningful data and get a head start on redeterminations to ensure a smooth transition off of Medicaid. “There is still quite a bit of work to do, but I think we will want to make sure we are coordinating with the Department of Health—soon to be the Department of Health and Human Services—other ACOs, and provider partners to make sure that [conversations around coordinating the redetermination effort] take place,” Foxley said.

4. Utah will have a new DHHS next week

Utah is approaching what is perhaps the most anticipated health policy development in the state: the merge of the Department of Health and the Department of Human Services, set to be finalized on July 1st. Joe Dougherty, Communications Director for the new Department of Health and Human Services, said the remaining work mostly consists of solidifying intrapartmental operational efficiency and ensuring the department is “legally and fully operational.”

Dougherty also said leadership is finalizing the DHHS’s new website and the new employees’ intranet, as well as ensuring that all accounts and payrolls are combined under the new consolidated department. The DHHS Transition Plan notes that work will remain after the July 1st implementation date, including developing a combined IT system, employee culture training, and performance metrics for the new department.

5. Adolescent BH needs increased, substance use decreased in 2021

UDOH, DHS, and the State Board of Education recently partnered to release a report on the behavioral health status of Utah adolescents, which revealed notable upticks in behavioral health needs among the population in 2021. The report, which uses data from SHARP’s recent Prevention Needs Assessment Survey, showed adolescents in the state had a 6% higher rate of “psychological distress” and a 5% higher rate of feelings of sadness or hopelessness, compared to 2019 levels.

Along with these concerning statistics, the report also revealed a decrease in substance use among Utah adolescents last year. The number of adolescents reporting using vape products more than anything else, 7.8%, represents a 5% decrease from 2019. Adolescents who binge drink (3.1% in 2021) decreased by nearly 2% since 2019. Marijuana use, use of medicines that weren ‘t prescribed, and cigarette smoking also decreased in 2021.

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