The Social Services Appropriations Subcommittee on Oct. 14, 2025, reviewed the public health prevention and epidemiology budget and approved two formal requests for reports on tuberculosis services, while also directing follow-up on immunization funding and the state's Baby Your Baby prenatal outreach campaign.

Russell Fransen, finance officer with the Office of the Legislative Fiscal Analyst, framed three recommendations tied to the review: exploring whether private health care should take responsibility for treating people with latent tuberculosis identified through employment or school screenings; researching alternatives to paying $81,000 a year to reserve two inpatient beds for non-compliant active tuberculosis patients at the University of Utah Hospital; and stopping or regularizing new fees the department had begun charging health plans for access to the state immunization registry without explicit legislative approval.

On the tuberculosis recommendations, the committee approved motions asking DHHS to study options and report back. The committee passed, by voice vote, motions supporting Recommendation 1 (explore options to have private health care treat latent tuberculosis cases identified through employment or school screenings) and Recommendation 2 (report on alternatives to the $81,000 bed reservation and feasibility of serving compliant active tuberculosis patients with other providers). Both motions were approved by voice vote during the meeting and recorded as passed by the committee.

The immunization discussion focused on a policy choice the department had made to replace a voluntary contribution system with a new tiered fee schedule for health-plan access to the Utah State Immunization Information System. Health-plan tiers described during the presentation included fees to access up to 100,000 records ($10,000), up to 200,000 records ($15,000), unlimited access ($20,000), a $150,000 level for unlimited access plus customization, and a $12 per-record request fee. Department staff said they implemented the schedule to stabilize revenue after several years of unreliable voluntary contributions (the agency reported $190,000 raised by voluntary contributions in 2025 and an estimated $245,000 with the new fees). Committee members raised concerns about statutory authority for charging fees without legislative approval and the potential impact on smaller providers.

After debate, the subcommittee adopted a substitute motion directing staff to request and review detailed historical spending information and to consider reallocation of the ongoing $681,600 general fund for the immunization state program. The approved substitute motion directed DHHS to report how much has been spent on each vaccine over the past 10 years from all funding sources and to consider reallocation of that $681,600 during the 2026 general session.

Separately, the committee voted unanimously to add the Baby Your Baby prenatal outreach campaign to a list of programs to be evaluated for potential reallocation. Committee members said they wanted more data on the program's reach and effectiveness and whether media buys tied to a single television station remain the best approach to reach pregnant people.

Quotes from department staff included: "This was funding related to responding to COVID-19, for the epi and lab capacity," said Janae Duncan, division director for population health, describing the ELC grants. "We're currently doing a deep dive analysis of these fees," said Mykia Saracino, senior accountant at DHHS, about the immunization-fee schedule.

Votes at a glance:
- Motion to adopt Recommendation 1 (explore shifting latent-TB treatment to private health care) — outcome: approved (voice vote; recorded as passed).
- Motion to adopt Recommendation 2 (report on alternatives to $81,000 reservation of two beds and feasibility study for compliant active-TB care) — outcome: approved (voice vote; recorded as passed).
- Motion to request detailed immunization spending for the past 10 years and to consider reallocation of the $681,600 ongoing immunization general-fund allocation — outcome: approved (substitute motion; unanimous voice vote).
- Motion to evaluate the Baby Your Baby outreach program for possible reallocation and invite public comment on effectiveness — outcome: approved (unanimous voice vote).

Ending: The department supported the committee's requests and agreed to provide the detailed reports requested by the committee, including vaccine-specific expenditure histories and the tuberculosis feasibility reports. The committee will review those reports before making final budget decisions in the 2026 general session.