A successful Utah program with broad support that reduces homelessness, lowers recidivism and saves taxpayer dollars is at risk of being eliminated. We join together as a group of bipartisan elected officials — representing the state legislature and local governments from both urban and rural Utah — and bring attention to the risks of a federal agency discontinuing a homegrown solution.
The program at risk of being discontinued, Targeted Adult Medicaid (TAM), has a decade-long history of delivering results in Utah and we fear the consequences if it were to close.
TAM provides 12 months of uninterrupted evidence-based health care and wraparound services to a narrow group of Utah citizens — extremely low-income adults experiencing chronic homelessness, facing addiction or exiting jail or prison. This continuity of care is unique to TAM and was specifically included to help people in crisis transition into stability by providing access to basic health care, mental health services and substance use treatment. The safety net can be either quicksand, keeping individuals and families stuck, or it can act like a trampoline, helping someone to bounce back.
After 10 years of implementation, we can observe what TAM has been able to accomplish. The program has been fiscally responsible by reducing reliance on costly emergency room visits and providing continuity for individuals to complete their treatment. The program has aligned perfectly with public safety goals. For example, in Sanpete County, the sheriff’s office has seen a 61% reduction in recidivism by using TAM as a resource to connect people to help and support during reentry.
Along with reducing recidivism, it’s saving counties money and giving thousands of Utahns a second chance to rebuild their lives. Because local governments, law enforcement leaders and service providers have seen all these benefits firsthand, a broad coalition of sheriffs, police chiefs, homeless service organizations, elected officials and community leaders has come together to support renewing the program.
As elected leaders, we have a primary obligation to ensure the public safety of our communities, and we are concerned this shortsighted decision made by the Centers for Medicare and Medicaid Services (CMS) will shut the door on a program which has yielded such positive results. The decision is particularly difficult to understand because TAM advances goals that policymakers across the political spectrum share: improving health outcomes, reducing pressure on emergency rooms and jails, and helping vulnerable individuals move toward stability and self-sufficiency.
Our perspective comes from on-the-ground experience and a deep connection to our local communities. We have worked directly with people whose lives have been changed by targeted investments in health care and social services. By quickly accessing health care during a crisis, more expensive and disruptive interventions later can be prevented. We have seen individuals experiencing mental health crises find help through Mobile Crisis Outreach Teams. We have seen young men and women come out of prison, seek training and certification, and secure long-term employment because they had the security to take a risk without losing their continuity of services. We know individuals who gained enough stability that they no longer use any government benefits whatsoever.
This is because eliminating TAM will not eliminate the challenges it was created to address, but it will shift the costs and burden elsewhere.
Utah has long taken seriously its responsibility to safeguard taxpayer dollars, prevent fraud and ensure public programs deliver measurable results. During our time in public office, we worked to expand access to health care while maintaining a commitment to fiscal responsibility.
Cutting this program will simply lead to a drain on resources for police officers, healthcare providers and emergency rooms. This is because eliminating TAM will not eliminate the challenges it was created to address, but it will shift the costs and burden elsewhere. With fewer tools to address underlying needs effectively, burnout will hit all those who serve the most vulnerable among us.
Federal agencies should provide states with flexibility, especially if we are meeting our shared objectives while maintaining fiscal integrity. TAM has clearly demonstrated that it can improve lives, strengthen communities and reduce long-term costs. We urge Dr. Mehmet Oz and his team at CMS to reconsider its position and allow Utah to continue Targeted Adult Medicaid.