An attempt to combine two major state agencies — the departments of health and human services — is progressing through the Legislature with support from Utah’s new governor.
“We feel the best way to be more efficient and effective as we deliver services to the public is to combine these two agencies together and try to break down those silos and get communication going,” said Rep. Paul Ray, who’s sponsoring legislation to set this merger in motion. “So that people aren’t going to two, three, four different places to get services.”
His bill, HB365, calls for consolidating the two agencies into the new Utah Department of Health and Human Services by July 2022 and lays out a transition process. Rather than bringing in a third party to spearhead the consolidation, Ray, R-Clearfield, says agency members will lead that effort.
By Dec. 1, the two agencies will have to prepare a written plan that lists all the tasks that need to be accomplished as part of the merger and presents a proposed organizational structure. The document should also include a plan for using office space and detail any worksite or service site changes that should happen during the consolidation.
Richard Saunders, executive director of the state health department, said he knows the proposal has created consternation among those who suspect public health will lose stature if it doesn’t have its own agency.
“We can assure people that that is well-known, that we need to be very well aware of that and that public health does retain a proper, balanced voice in all of this,” he said. “Because community prevention is key to population health.”
But Saunders argues that there are advantages to integrating physical and behavioral health services into a single agency — such as creating a better environment for collaboration and information sharing. Tracy Gruber, who heads the state’s human services department, noted that clients who have behavioral health needs are often also dealing with physical health needs.
Under Ray’s bill, the heads of both the health department and human services agency would be in charge of overseeing the transition process. The measure would also set aside $1.6 million in state money for any expenses that crop up during the merger, but Ray said he anticipates some of those funds would be left over at the end.
The House Health and Human Services Committee on Thursday passed the legislation, which will now advance to the full House.
Though the bill received unanimous committee approval, Rep. Marsha Judkins expressed some discomfort that the agencies want to handle the entire process in-house, comparing the consolidation to a marriage involving partners who assume they’ll work together seamlessly.
“And they get married and they realize, wait, I didn’t know that you wanted to share my bank account,” the Provo Republican said. “And it just seems to me that this big of a process and this important of a process needs maybe some expertise in process.”
Ray said Gov. Spencer Cox and he will be keeping close watch on the transition and can tap into the set-aside funds if it becomes clear the state needs to call in reinforcements from the outside.
Todd Losser, executive director of the Utah Public Employees Association, said representatives from his group have met with Cox and have been given reassurances that the consolidation won’t lead to job cuts. State agencies are already highly efficient, Losser said, adding that his association wants to help “ensure a smooth transition for public employees and to continue the gold standard we have established.”
Courtney Bullard with the Utah Health Policy Project said her group agrees that the state could improve coordination between the health and human services agencies but shared “concerns over how this merger will actually improve efficiency and the potential for unintended consequences.”
Bullard also shared reservations about the bill’s proposal to shift certain Medicaid eligibility functions from the health department to the Utah Department of Workforce Services.
The timing of the proposal, which is coming as health agencies are grappling with the COVID-19 pandemic, could also be problematic, said Bullard, who suggested that lawmakers study the merger during the interim rather than proceeding right now.
“We just do not think that now is the time to implement a big change,” she said.