S.B. 158 Recreational Therapy Program Amendments: transcript

Thank you. Grab my computer before I leave it here and wonder where it's tomorrow. By the way, I think I have a pain medication bill coming up on your agenda. And I'm gonna pull that, I'm gonna ask that one to be pulled from the agenda. At the request of the stakeholder I'm working with. Is this, um, while you're there, is this, um, we've got a number. Is this SER five? Concurrent resolution? PEHP? Yeah. Yes. Okay. So I'm gonna ask That one To not, so those in the public, those online, we're going to not listen to item agenda item number seven today at the request of the sponsor. Okay. Again, SB 1 58, Senator Weiler 1 58. Okay, I'm finally there.

This bill, um, adds to the list of recreational therapy facilities or programs that may be reimbursed for recreational therapy under the Medicaid program. Um, what we're adding is a licensed residential support program that is accredited by the American Camp Association. And this would authorize the Department of Health and Human Services to apply for any necessary waivers to implement the change. And, um, you'll notice on line 39 that we define residential support program to mean the same as that term is already defined in section 26 B dash two dash 1 0 1 of the code. And, um, and then the only other change in the bill is line 65. The department may, may seek approval from CMS for any waiver amendment or an existing waiver or state plan amendment necessary to implement this section. Uh, this bill would take effect in May. Um, it has, uh, an ongoing, uh, fiscal note that is large, that is probably gonna have a hard time getting funded, but I think it's the right policy. And I, I believe that this is language that DHHS gave to us to kind of help, um, um, with Camp K, which some of you are, uh, maybe familiar with here in Salt Lake County. So with that, I'd be happy to, uh, take any questions, Mr. Chair.

Um, camp K is a 70-year-old facility that where people with severely disabled, um, adults or children can drop them off. Um, and it's a summer camp for them, but it's also a respite for their family. So maybe the rest of them can go to Disneyland. And then they have horses. They have, they have swimming pools, they have a splash pad. Now they have, um, ropes courses. These, um, uh, disabled individuals, they have the time of their life and they're with their peers, but it's also, they have to have skilled nursing facility staffed 24 7. It's an expensive facility, but, um, it, it really, they're, I believe they're doing God's work, uh, at Camp K. So, couldn't speak higher about them.

Uh, thank you Mr. Chair. I would like to recommend that we move forward Senate bill 1 58 favorably to the full body of the Senate.

Uh, waive back To the make of the motion.

Thank you, Mr. Chair. Um, this bill is designed to help, um, programs like camp, um, k, which provide care for individuals with severe disabilities in a summer camp style set residential setting. And currently receiv only a fraction of the cost of the care they provide. So, um, camp K for the last several years, uh, maybe even a decade or more has been operated under a, uh, a code recognized by Medicaid that that gives them like $12 an hour. And they're, they have, uh, specialized nurses on staff, their, uh, tending, uh, children and adults with, um, who are severely disabled and re require 24 7 care. Uh, they're, they're putting them on horse backs to ride horses. They're have swimming pools, a splash pad. They have hor um, they have a ropes course that they hoist them up on. They take 'em outta the wheelchair and hoist 'em up then. And so the, the $12 an hour, especially with the specialized nursing care, uh, they're, they're losing money on every hour. And so, um, their, their true cost is more than double that. Um, there was a rate study done last year statewide that we brought in. The Department of Health and Human Services brought in a, uh, consultant and they recommended a, a much higher rate, uh, for Camp K when they studied and understood what they were doing. They're one of the only places in the country that does what they do. And by the way, the, the, the, the, the wonderful thing about Camp K is, is the disabled person can get a wonderful, uh, camp like experience with their peer, with peers, uh, like them. And the families can, their families that drop them off can go and have a Disneyland vacation or something with their other children who may not be disabled. So it's a win-win, uh, type of situation. And those are equally important, I think, sometimes for the family to have that respite and, and a chance to get away and not have everything focused on one child. Um, and so, uh, what this bill does, and, and it has a fiscal note that is, um, high. And so the, whether you recommend it or not, the fiscal note may determine its outcome. But this adds to the list, to the list of rec recreational, the therapy facilities or programs, I'm sorry, this is my first time speaking in English. Uh, that may be reimbursed for recreational therapy under the Medicaid program. So it's adding the licensed residential support program that is accredited by the American Camp Association. And, and if this bill passes, it authorizes, uh, DHHS to apply for any necessary waivers to implement the change. Um, so this is, this bill is designed to get them a higher hourly rate that I believe accurately reflects what they've been doing for years. This, this camp has been here since, uh, 50 since, uh, for, for over 50 years. And it's really, I think, a pearl in our community. Um, so it's, I I, you know, anyways, I'll conclude my presentation with that and, and, uh, camp Kay asked if they needed to be here for this, and I, I told them it's okay. I, I can, I can present it, so thank you.

Uh, I'm sorry, I'm just hogging all the questions. Hog away. So in Social Services appropriations, we did also talk about a couple of different requests from Camp K. Yeah. Um, and there was a, a request which was, I thought, prioritized fairly well by the committee at 500,000 ongoing. Yeah. And then there was a separate one time request of 700 that ultimately wa was at first for more, but ultimately was moved to 750,001 time. Yeah. Does this, does this bill and its fiscal note relate to those two? Or this is a separate issue than those two?

This is a separate issue. And, and, and gosh, I, I'm gonna cross my fingers that all three of those requests will get funded, but I, I know the realities. Um, so the one time they, they're building a new lodge, which is gonna cost like 15 million. Is that, that was the one time the 500,000 is they, um, they had a crippling setback financially during COVID and they're still gasping for error, partially because, um, although I've been working with them for three years, I haven't gotten their hourly rate increased yet. Um, this is really the long term plan. I've told Camp K, the legislature's not gonna make an appropriation to you every year. And their first appropriation was just like a year or two ago, ever in their 50 year history. This is the solution, this is what they need so that they don't have to come back every year with their handout.

Thank you Mr. Chair. I am just wondering, is there any connection we have the people who get the DSPD, right? Yes. And then we have the people who go to Camp K. Is there overlap between those or

Sorry. I just don't have that clear in my mind.

So I think almost everyone who is on DSPD services would also qualify for Medicaid because they're disabled. So they would be on Medicaid, but in general, Medicaid covers medical services. And so the DSPD services then are like a day program or, or a place for them to live. So DSPD covers different kinds of things that aren't normally considered medicine, but that the person does need to live live because they're so disabled. This kind of goes back to Medicaid and says Medicaid will for, for this specific kind of service, in this case, getting care at a camp, in a camp setting, that Medicaid will cover this kind of service.

And, and if I could add to that briefly, 'cause I think it's an excellent question. So the problem that Camp K has had is they are providing everything I just said, I'm not gonna repeat it, but the specialized nursing program, and they're getting paid as if they were just a babysitter. Um, that's the problem is they, they, they have these wonderful facilities, they're doing magic really. And they're getting paid as if they're someone that just comes and sits with somebody while they're sleeping or something, which is not what they're doing. Thank you. And, um, chair Hall.

Thank you Mr. Chair. I, I, you actually answered my question. I think what kind of specialized people are are working there and about how many? So they have a nursing station. I know it's manned, I think 24 7. And I, I do believe a lot of their nurses are actually retired and volun volunteer their time. Uh, but I I, I know that every one of their patients has like a specialized re regime where they have to, they have all their medications and sometimes they're receiving shots. A lot of them have seizures on a regular basis. So I know that they have to have people. And you would know more about nursing than I would, uh, representative, but I know they have to have people that can accommodate that type of, um, care. Yeah.

And, and I guess I ha I haven't been out there yet. I wanna go. Is it, is it a living facility

Thank you Mr. Chair. I'd like to make a motion. We favorably recommend this legislation out of the committee and onto the full body of the house.

I'll waive. Alright. Um, to the bail sponsor, Uh, I'll waive. Thank you.

Thank you, Mr. Vice Chair. Um, I just wanna say to the sponsor, I appreciate what you're doing. I think Camp K's a wonderful program. Um, I am gonna vote no on this motion just for process purposes. I, I just want you and Camp Kay to know that it's absolutely not about the services they provide. They do an amazing job. Um, back to the maker of the motion. Uh, no appre. I appreciate the good discussion that, uh, we've had today.

motion. Adjourn. Motion to adjourn.

Thank you Mr. President. This bill, um, is, is, I'll be transparent. This bill is basically, uh, designed to help Camp K. Uh, it adds to the list of recreational therapy programs or facilities that can be reimbursed for recreational therapy under the Medicaid program for licensed residential support programs that's accredited by the American Camp Association, it would authorize the Department of Health and Human Services to apply for any necessary waivers to implement the change. Um, right now, um, despite the fact that there was a rate study last summer that, uh, uh, proposed, uh, a big increase for Camp K that was not funded in the governor's budget. And right now we're paying, uh, just a fraction. Uh, they're, they're getting just a fraction of the cost. We're providing the care that they provide for the disabled severely disabled individuals that they care for in a summer camp environment. Um, that's the bill and I'll yield to any questions. Looking for questions. Seeing none to you for a motion. Uh, I would move that Senate Bill 1 58. Be read for a third time. Thank

Thank you. Uh, Mr. President. This adds to the list of recreational therapy facilities or programs that may be in reimbursed for recreational therapy under the Medicaid program. So we're adding a licensed residential support program that that is accredited by the American Camp Association. With that, I would yield to any questions, Don't see any questions, uh, going to you for a motion, Um, I would move that Senate Bill 1 58. Be read for a third time and pass.

Call vote. Senator Vickers Baldy Lewin, can we just finish the Brammer Gilmore Esia Fillmore Grover Harper Kins Ipson Johnson k Juab McKay Mikel Milner Mussman Owens pitcher Plum Rebe Sandal Stevenson Stratton Vickers. Weiler Aye. Wilson Wilson Winterton. President Adams, Did we finish here? Great.

Thank you Mr. Speaker. This bill expands Medicaid reimbursement for recreational therapy. Currently, Utah Medicaid covers recreational therapy in specific SE settings, but this adds, um, therapy by an American Camp Association accredited institution. The bill ensures that that recreational programs meet high national standards for safety staffing programming. But I just wanna be clear that recreational therapy is not just play, it's a clinical intervention. It requires a referral from a licensed health therapist, um, and it also does a lot to improve physical, cognitive and emotional wellbeing. The fiscal impact on this is 420,000 from the general fund. Um, it's expected to draw down roughly 824,000, um, after the federal waiver. And I'm open to questions.