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Is 1 better than 2? Advocates have questions as Utah merges departments of health, human services

Utah Department of Human Services Executive Director Tracy Gruber answers questions in virtual Q&A session about the merger of her department and the Department of Health.

Utah Department of Human Services Executive Director Tracy Gruber answers questions in virtual Q&A session about the merger of her department and the Department of Health. (Department of Human Services)



Estimated read time: 5-6 minutes

SALT LAKE CITY — Questions and concerns from some groups continue as the merger between Utah's Department of Health and the Department of Human Services has entered its transition planning phase.

The Utah Legislature passed a bill, HB365, joining the two agencies into a Department of Health and Human Services in March 2021. The process has entered a transition planning phase which has opened the agencies up to questions from the public in virtual Q&A sessions.

The merger's intention was to streamline processes for those who rely on the services from the two agencies and to reduce redundancy.

But some organizations have questions about how the process of consolidation would affect the agencies amid their COVID-19 pandemic response.

"We've been asking our state agencies or local health departments to do a tremendous amount of work in their COVID-19 response and they've been doing a tremendous amount of work and really should be celebrated for the work that they're doing," said Jessie Mandle, senior policy analyst at Voices for Utah Children. "But the merger is also a huge undertaking as well."

Mandle pointed to how under-resourced and overburdened groups were disproportionately affected by the pandemic throughout 2020.

"I think as an advocate, I think it's just questions for us to continue to ask — how that's happening and to get more details around to how they're managing both at the same time and how are we continuing to meet their needs as this project takes place?" Mandle said.

Similar concerns were raised before HB365 was officially passed.

But those involved in the merger are confident that it can be done competently and without disruption of services. The agencies addressed the concern in a statement on a website outlining the plan for the merger:

"We are moving in a positive direction in our efforts to address the pandemic, and we look forward to the day when it is no longer our main concern. We recognize, however, that the needs of our underserved communities will not go away. Delivery of vital services and programs has not stopped, and we have the opportunity to address needs moving forward."

The Health and Human Services Consolidation Steering Committee also emphasized in a statement that throughout the process "significant stakeholder outreach would be conducted by the leadership of the departments to address outstanding stakeholder concerns, ensuring the success of the new agency and that the preferred template is adopted."

But Utah Health Policy Project education and collaborations director Courtney Bullard said her concerns expressed in public testimony during the legislative session persist.

"Our biggest push during the merger as we're evaluating these organizations is to consider moving Medicaid eligibility and enrollment back to the Department of Health from Department of Workforce Services because we feel like Medicaid is a health program and it really should be administered by the health agency, not a workforce agency," Bullard said.

Bullard recognized that the program had some inefficiencies but that those inefficiencies weren't as large when it was administered by the Department of Health. She also expressed concern about the lack of participation in public meetings by representatives of Workforce Services.

"It's not really clear why they're merging some things and not other things and what they're evaluating and why they're not evaluating everything. And we've noticed a lot of participation from the Department of Health and from the Department of Human Services throughout this merger, but then part of Workforce Services is very much a part of the merger as well."

Department of Human Services communications director Heather Barnum said that the committee is following the directive outlined in the bill. She added that the Workforce Services part of the consolidation is smaller than the two other agencies. The committee's statement also noted that only the economic eligibility components of Medicaid are being moved to Workforce Services and oversight from the Department of Heath and Human Services will continue.

The merger's transition planning phase is scheduled to last until Dec. 1 before moving into an implementation phase through March 2022.

Bullard and Mandle maintain that the planned structure of these agencies will create a big impact on communities throughout Utah.

"It's hard sometimes to tie the direct impact from some wonky long policy like this one into how communities are going to be impacted, but sometimes these are the most influential policies. How social services are administered and who administers them and what is the culture of each of these agencies," Bullard said. "I think that if people understood that these policies have direct impact on that process, then it might be a little bit closer to home."

The official start date of the Department of Health and Human Services is scheduled for July 1, 2022. Until then, Bullard and Mandle reiterated the importance of being involved and watching the process.

"I'm not raising concerns at this point but questions. I'm asking that we continue to ask these questions as residents of Utah, as advocates, all of us together. Making sure that the agencies are getting the support they need during this time," Mandle said. "We're staying engaged and staying involved in this project."

You can find more information regarding the proposed structure or how to attend a virtual public session here.

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