Local health officials predict a decline in the general health of Utahns if the tax initiatives pass in November.

The initiatives would add insult to an already injured Medicaid program, hospital administrators say, and the Utah Medical Assistance and Medically Needy programs could be eliminated.These programs serve Utahns who fall into two categories: Those who have catastrophic medical expenses (such as liver transplants), and those who have life-threatening or acute illnesses but are not eligible for any other type of financial assistance for medical care.

"Many of these persons would fail to receive needed care if these programs were not available," said Dr. Suzanne Dandoy, executive director, Utah Department of Health, which administers the two programs.

Greg Beesley, of the Utah Tax Limitation Coalition, says the health officials are using scare tactics to defeat the initiatives on the November ballot.

"As a tax limitation coalition, we have absolutely no say as to where the cuts will be made," he said. "Besides, the initiatives have nothing to do with program cuts; they have to do with tax cuts only.

"Anyone in any department who tells you they are going to have to cut so much out of their budget is blowing smoke. It's only the Legislature that can say where the cuts will be made," he said. "The governor doesn't even have that privilege."

Health officials agree they're only speculating about what will happen if the initiatives pass. Dandoy speculates that the Department of Health would have to reduce its expenditures of state funds by about 10 percent.

The result, she said, would be devastating to the health of the people of Utah.

The executive director said the Perinatal Program that provides prenatal and infant care for low-income women and their babies would be reduced. The air-quality program or the radiation-control program would be eliminated.

Simply put, that means there would be no state activity in the monitoring or remediation of air-pollution problems or monitoring radiation sources.

Passage of the tax initiatives could also mean elimination of the Smoke Free Utah Program, the cancer-screening program, and the state's contribution to the Cancer Registry, one of the programs that helps in early identification of cancer, Dandoy said.

There would also be fee increases, Dandoy said.

She said immunization fees would be increased to offset the loss of state money to purchase vaccines.

"This may decrease the number of children immunized against preventable diseases, such as whooping cough, tetanus, measles and polio, thereby increasing the numbers of cases of these diseases in the state," she said.

Kent H. Fitzgerald, deputy director of the Salt Lake City-County Health Department, predicts that fees charged for child health conferences and sexually transmitted disease testing will also be increased.

The county health department, Fitzgerald said, stands to lose $2.1 million if the initiatives pass. This could mean a significant reduction in personnel - 62-75 from the 225 people currently employed.

"These aren't administrative positions; these people provide services to the public," he said. "Our total administrative costs are only 7.5 percent of our total budget."

Passage of the initiatives potentially could have this effect on other county health department programs:

***Satellite offices could be closed, making services less accessible.

***Inspections of water systems, swimming pools, restaurants could be conducted less frequently.

***Staffing could be limited to respond to occupational health and general nuisance complaints, such as unsanitary housing conditions, hazardous waste and garbage in people's yards.

***School inspections would likely be done only on a complaint basis.

***Inspections of licensed nursing homes, preschools and day care centers could be curtailed.

Fitzgerald emphasized these are preliminary estimates. More detailed documents will be prepared to assess the possible effect of the initiatives.