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Salt Lake County officials have come up with a plan to stretch their human-services programs until, they hope, Utah legislators accept some form of Medicaid expansion.

It won't come without some human pain, however. About 3,200 recipients of substance abuse and mental health services will have their treatments trimmed back over the last half of 2014.

That service reduction will free up about $750,000, which the county can use as a match to acquire about $2.4 million in Medicaid funding from the federal government. Those funds will underwrite numerous Human Services programs, most notably one that provides substance abuse treatment to low-income women and their children, through July 1, 2015.

If the Legislature hasn't accepted expanded Medicaid through the Affordable Care Act or Gov. Gary Herbert's alternative "Healthy Utah" plan by then, said county Mayor Ben McAdams "people will be hurting.

"In the absence of the Legislature adopting the Healthy Utah plan, this is the least bad option we have," he told the council Tuesday. "We don't have good options in front of us."

The Republican-majority council shares Democrat McAdams' concerns about legislative inaction on the Medicaid front because Salt Lake County is the biggest provider of services to the individuals who would be covered by expanded Medicaid — often young singles and people released from the county jail.

Council Chairman Michael Jensen emphasized those concerns, speaking directly to Sen. Wayne Harper, R-Taylorsville, who attended the council meeting for a different matter.

"We're nervous about our Medicaid population, our underprivileged people drastically affected without federal dollars," said the Republican councilman from Magna. "We wanted you to hear how big of an effect, across the board in Salt Lake County, this [failure to act] was going to have on our various divisions — the jail, mental health, substance abuse, public safety, but especially the human services department."

"We need you to lobby your colleagues," added Councilman Sam Granato.

Harper had little response, noting only that resistance to Medicaid expansion was primarily a House issue. Many House Republicans worry that accepting an expansion of Medicaid will zap state resources in the future.

County behavioral health director Tim Whalen acknowledged that the county's money juggling now could leave its most needy in an especially vulnerable place if legislators do not act in time to get expanded Medicaid money rolling into the county by July 1, 2015.

But this approach "is the right thing to do," he added. "It will cover a lot of the expenses we need covered. …It will really help the women with dependent children."

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