The Utah State Legislature’s 2022 general session, which adjourned on March 4, saw bipartisan support for most of its priorities. Governor Spencer Cox and the Legislature were generally aligned and accomplished their objectives of a tax cut – giving $193 million back to Utahns – and funding long-term building projects. However, lawmakers did wrestle over how to spend the state’s $25+ billion budget.
Other issues also dominated considerable discussion during the session, such as water conservation and affordable housing.
Utah lawmakers approved a massive $25+ billion budget, the largest in state history, taking advantage of federal stimulus dollars and Utah’s economic boom to fund some big priorities.
Although Governor Cox proposed a $160 million grocery tax credit in his budget recommendation, lawmakers opted for a $193 million tax cut, with $163 million for an across-the-board income tax rate cut for all Utahns. That cut, which dropped Utah’s income tax rate from 4.95% to 4.85%, was accompanied by a $16 million non-refundable earned income tax credit and a $15 million expansion of the state’s Social Security tax credit.
Healthcare Workforce Initiative
Lawmakers approved $2 million in an ongoing general appropriation to provide increased educational opportunities for incoming healthcare professionals in higher education programs. This request was promoted by MountainStar in the beginning of the session. It will fund programs aimed at training more nurses and healthcare workers in the state to accelerate solutions to the rising job demand in Utah’s healthcare industry. This is a first step and there will be more work done on this in the upcoming legislative sessions.
Legislators allocated about $35 million in additional Medicaid funding for hospitals (3% rate increase), plus $3 million for Gov. Cox’s Utah Sustainable Health Collaborative, which was formed late last year to reduce healthcare costs and improve health outcomes.
Several healthcare-related bills now await the governor’s signature, including:
Department of Health and Human Services
Two state agencies, the Department of Health and the Department of Human Services, were combined by SB 45 into a single entity: the Department of Health and Human Services.
Medicaid Waiver for Medically Complex Children
HB 200 will amend application, eligibility, treatment, and evaluation provisions of the Medicaid program for children with complex medical conditions that meet the definition of a disability. The legislation includes a child’s behavioral health needs as a factor for prioritizing entrance into the program.
Medical CANDOR Act
Legislators passed HB 344, which amends Utah court rules of procedure and evidence in a medical malpractice case. This legislation will, for the first time in Utah, allow hospitals and providers to discuss medical injuries with patients and that information will not be admitted in a court case if future litigation ensues. CANDOR is an acronym for the “Communication and Optimal Resolution” process.
Healthcare Worker Protection
HB 32 imposes a Class A misdemeanor for assault or threat of violence against a health facility employee, increasing the penalty to a third-degree felony if the attack is intentional and causes substantial bodily injury. State code already applies those penalties to cover emergency room workers, and this bill extends the same protections to all health workers.
HB 295 creates grant programs for new or expanded residency programs, including a one-time appropriation of $3 million and an ongoing appropriation of over $2 million. HB 176, the Utah Health Workforce Act, creates an advisory council to provide information on policies which affect the healthcare workforce. It also creates an information center to conduct research and analyze workforce data. SB 101, the Nurse Apprentice Licensing Act, creates a new path for those wishing to enter the healthcare nursing field by allowing students to be licensed as nurses sooner.
Legislators passed several bills related to behavioral healthcare. HB 236, Behavioral Health Amendments, establishes a collaborative care grant program to award grants to small primary practices to integrate physical and behavioral healthcare. In addition, HB 363, Modifications To Civil Commitment, clarifies civil commitment processes for adult patients. SB 171, the Behavioral Health Curriculum Program, directs the Huntsman Mental Health Institute (within the University of Utah) to develop a youth curriculum on behavioral health.
SB 41 requires the state Department of Health (potentially soon to be merged into a new Department of Health and Human Services) to award a grant to a local mental health authority to implement or expand an integrated behavioral health program and develop a proposal to allow the state Medicaid program to reimburse a local mental health authority for behavioral health services in an integrated behavioral healthcare setting.
SB 121 requires the Physician Licensing Board to license, qualify and regulate anesthesiology assistants in Utah. Concerns have been raised as to whether it would help fill shortages or serve as an anticompetitive measure for nurse anesthetists, who receive more training, though currently anesthesiology assistants are licensed to work in 17 other states.
HB 225, Access To Medical Records Amendments, requires the Department of Health and Human Services to create (by end of 2022) a new standard statewide HIPAA release form for all healthcare providers to use for patients to access records.
SB 236, Pharmacy Practice Amendments, prevents an insurer or pharmacy benefit manager from inquiring how payment for prescription was made by the pharmacy or patient (except when to ensure compliance with state and federal law).
COVID-19 Related Legislation
Utah’s COVID-19 case count declined as the session progressed, leading Gov. Cox to announce the state’s transition from “an emergency posture and into a manageable risk model.”
Early in the session, lawmakers passed a joint resolution to terminate all public health orders that mandated facemask usage except in certain circumstances. They also passed SB 194, Medical Rationing Amendments, to keep the Legislature informed about medical rationing of scarce resources and to develop a process for determining when medical rationing would occur.
Lawmakers passed HB 63, which would clarify that “natural immunity” satisfies the requirements under a vaccine mandate and allows employees who have had COVID-19 to obtain a letter from a physician exempting them from a vaccine requirement by certain employers.
Finally, HB 316, Medical Assistant Amendments, allows medical assistants to administer vaccinations under the general supervision of a physician.
The last 20 years have been Utah’s driest on record, and lawmakers reacted to the shrinking Great Salt Lake by directing hundreds of millions to water-related issues. HB 410 provides $40 million to a water trust tasked with identifying conservation and sustainability projects, while HB 429 allocates $5 million to close data gaps, develop an overall water budget for the lake, and look for opportunities in the watershed to improve water management. The bills received widespread support from the House and Senate, and they now await Governor Cox’s signature.
Lawmakers also approved $250 million to meter secondary water connections statewide by 2030, as well as $5 million for the nation’s first statewide turf buy-back program and $20 million for making agricultural watering more efficient. They also approved a requirement that state-owned buildings constructed after May 2022 have no more than 20% turf.
The Legislature appropriated $70 million for homelessness and housing this year, including $55 million for deeply affordable housing competitive grants and $15 million for housing preservation. Lawmakers also passed HB 462, which requires cities with public transit hubs to develop plans for moderate- and low-income housing within a one-mile radius of those locations.
Lawmakers will increase per-pupil education funding by 6%, while all teachers will receive bonuses as a thank you for extra work during the omicron surge of COVID-19. The total cost to the state is $10 million, although the amount each teacher will receive has not been determined.
The Legislature also established a new committee to study the contributions of ethnic minorities and recommend how to incorporate them into K-12 core standards. The committee will be made up of five House members, five senators, and two other members appointed by the governor.