While advocates for human service programs described the 1991 legislative session with words ranging from "awful" to "unrealistic," the department director was heaving a sigh of "almost-relief."

Not joy. But it wasn't as painful as it might have been, he said."We survived," Norman G. Angus, Human Services director, said. "That is, we survived in every area except public assistance caseload and foster care."

Survival, he said, meant there wasn't much improvement.

"There was very little increase for aging - programs like Meals on Wheels and Alternatives. There was very little increase for family support and respite in Handicapped Services," he said.

"The governor did approve a caseload increase, but when he was putting his budget together, caseload was on a kind-of flat plateau. After that, it started climbing."

Caseload in public assistance has increased by 16,000 cases from a year ago. "Workers are about at the breaking point, and we may have to cut programs to buy more workers."

Human Services got a boost with passage of a 31/2 cent tax on cigarettes. That is expected to bring in $600,000 for programs for "at-risk" youth, $300,000 in tobacco-prevention education and $1.9 million for youth substance abuse treatment.

Legislation supported by the department did very well. "In fact, we did great on bills," Angus said. "But this wasn't a big bill year for us."

Legislation included upgrading security staff at the Utah State Hospital, providing procedures for dealing with mentally retarded offenders, amendments to the crime victims reparations act and authorization to fingerprint youth treatment program providers.

"Foster care's a real problem. You've gotta provide foster care, so we have to rob from preventive programs and . . . it just kills us."

Advocates were more harsh in their assessment.

"I'd just call it awful," said Bill Walsh, director of Utah Issues. "July 1, I think we'll feel the impact of these decisions. What hurts most is the potential cut in welfare grants."

Walsh said that 3,000 people who qualify for Aid to Families with Dependent Children but chose not to accept it may be forced to in order to get medical assistance.

"They're entitled to both right now, but they're not taking the grant. They'll have three choices: no health care, accept charity care or take welfare, which they don't want. We appreciate the funding put into human services. But overall, I wish poor people got a better shake up here. I think the hammer comes down in July."

"Human service needs just aren't met," said Carola Zitzmann, Legislative Coalition for People with Disabilities. "Providers aren't getting an increase, so we may lose providers."

Funding for low-income medical programs was mixed. Federal mandates were funded, said Rod Betit, Division of Health Care Financing. By putting $1.5 million into long-term care rate rebasing, a costly lawsuit was avoided. And new rates were set for home health services, pharmacies, hospitals, doctors and long-term care. But 3,000 people will lose access to the Medically Needy program, some organ transplants for adults were curtailed and the Utah Medical Assistance Program will be denied anyone with an income over $289 a month.

"Still, the cuts could have been broader and deeper," Betit said. "And they cleaned up some potential legal snafus. I think we're going to see a good discussion of the importance of medical assistance and underfunding in the future. We need a long-term strategy."