SALT LAKE CITY — Salt Lake County's reliance on fund balances to pay for substance use disorder prevention and treatment programs has reached a brink, Mayor Ben McAdams says.
Unless the Utah Legislature addresses Medicaid expansion in special session this summer, Salt Lake County faces cutting prevention and treatment programs by 12 percent by Jan. 1, 2015, McAdams said. The cuts would affect 3,200 people, among them 570 clients receiving treatment services.
McAdams said he is "pessimistic" that the Utah Legislature will take up the issue this summer.
"It's real people Salt Lake County will not be able to provide services for on Jan. 1, 2015," the mayor said, addressing the Salt Lake County Council on Tuesday afternoon.
Pat Fleming, Salt Lake County's director of behavioral health services, said the growing demand for services coupled with the Legislature's inaction on Medicaid expansion has left the county with no other option but to cut funding to contract providers.
"We have no rabbit to pull out of the hat out there. This is all we can do," he said.
Fleming said the county is giving contract providers six months notice so they can plan for the cuts.
McAdams said the situation has reached the point that "there is urgency (for lawmakers) to make a decision."
"There will be fairly deep cuts if our state leaders fail to take action," he said.
The Salt Lake County Council voted unanimously Tuesday to send a letter to legislative leaders, urging them to act on Medicaid expansion this summer. A draft of the letter endorses Gov. Gary Herbert's Healthy Utah alternative to full Medicaid expansion offered under the Affordable Care Act, describing it as a "good Utah-style solution."
"Healthy Utah is not a one-size-fits-all approach but allows Utah to craft a plan for coverage that meets the unique needs of Utah families. It allows for cost containment, is fiscally sound, requires cost sharing for those that can, allows family members to be on the same plan, and uses a private, market-based approach to coverage. All of this and it keeps Utah tax dollars here in Utah rather than being sent to the federal government or other states," the draft states.
The letter expresses concerns about Utahns in the "coverage gap," some 110,000 low-income Utahns who may not have access to any insurance coverage.
However, it also speaks to the county sheriff's statutory responsibility of operating a jail.
"We are concerned with the revolving door of people cycling in and out of our jails and prisons. Healthy Utah would give us one of the best opportunities to stop the cycle by getting effective substance abuse and mental health treatment to many of the at-risk individuals coming out of our jails and prisons. With proper treatment, these individuals have a chance at successfully reintegrating back into our communities and becoming productive members of society," the draft states.
Several council members noted that the issue was "not partisan" given the real-life and financial implications for low-income people in the "coverage gap" and the costs that are passed on to individuals who have coverage and employers that provide it.
Council Chairman Mike Jensen said the council has an obligation to address the well-being of all county residents. Herbert's approach is balanced, and the governor has come up with a good compromise, he said.
"I don’t think it's a stretch for any party for anybody to look at the human side of it and say, 'This is a toll we’re not willing to take,'" Jensen said.
Herbert's proposal, announced in late February, joined competing proposals from Republicans in the Utah Senate and House of Representatives.
The 11-member legislative Health Reform Task Force will continue to to study the issue. Its next meeting is Thursday morning.