Few Utah Department of Health (UDOH) programs would be left untouched if the state's base budget recommendations -- which call for a 7.5 percent cut in fiscal year 2009 and a 15 percent cut in fiscal year 2010 -- are adopted.

"This is really our best effort to have a starting point (for cuts) and that's really what it is," said Russell Frandsen, a state fiscal analyst who presented the numbers Monday at a Health and Human Services Appropriations Subcommittee meeting at the Capitol.

His base budget does not tap into Rainy Day Funds or bonds. Frandsen's first stab at shrinking Department of Health numbers means 24.8 full-time employees would lose their jobs, while another 8.8 positions would be left unfilled.

The cuts would eliminate some of the state's testing capabilities, such as scans for E. Coli in water and mercury in fish and other wild game. Testing for radioactive agents would cease.

The ability to detect, analyze and respond to major health events would also be reduced. The state would eliminate $12,500 to each of Utah's 12 local health departments, funds that have supported enforcement of environmental sanitation regulations, including at day care facilities, restaurants and swimming pools.

Specimen processing at the State Lab would be slower, and tests that provide specific levels of illegal substances for the State Medical Examiner and law enforcement would only determine the presence of a substance -- not the level.

Tobacco cessation programs would take a hit, with a reduction in contracts to organizations for education and quitting services, and an end to large-scale media outreach to reduce tobacco usage.

Public and provider education outreach efforts for cervical cancer would also end.

Utah's Medicaid program, which makes up a large portion of the department's budget, would eliminate coverage for 660 breast and cervical cancer patients. It would also reduce the eligibility level for the aged, blind and disabled to those who earn an income at 75 percent of the federal poverty level, down from 100 percent, affecting about 5,800 people.

And an estimated 13,800 people who "spend down" to get into Medicaid would have to spend an additional $485 monthly to continue to qualify.

Providers would also feel the sting: their payment rates would be rolled back to July 1, 2008-levels, potentially impacting the number of health care workers willing to see Medicaid enrollees.

Enrollment in the Primary Care Network (PCN), a basic insurance plan, would also be closed and families enrolled in the Children's Health Insurance Program (CHIP) would get slapped with $15 late fees for quarterly premiums that are not paid on time.

The incentive for medical workers to work in underserved areas would also disappear: the state would no longer help them pay back education loans.

The state's economists generate revenue estimates that serve as a target for appropriations. A 2008 revenue update resulted in a projected $350 million shortfall. And Health and Human Services, which includes the Utah Department of Health, has the second largest budget behind education.

At the same time, DHS also is facing new spending pressures: Utah's Medicaid program, for instance, is facing growing costs from caseload growth and inflation, and may lose millions of dollars in federal funding being challenged by the Centers for Medicare and Medicaid Services (CMS.)

lrosetta@sltrib.com