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Second Substitute H.B. 170

Representative Matt Throckmorton proposes to substitute the following bill:


             1     
PRESCRIBING PSYCHIATRIC DRUGS OR

             2     
MEDICATION

             3     
2001 GENERAL SESSION

             4     
STATE OF UTAH

             5     
Sponsor: Matt Throckmorton

             6      This act modifies the Human Services Code. The act amends the definition of substantiated
             7      child abuse to exclude the failure to administer prescribed medication or course of treatment
             8      if the parent or legal guardian has not been notified of the opportunity to obtain a physical
             9      examination of the minor by a health care professional. The act authorizes the Division of
             10      Child and Family Services to report an individual to the appropriate licensing authority if
             11      the division has reason to believe the individual exceeded the individual's scope of practice
             12      by recommending medication for a minor. This act contains a coordination clause.
             13      This act affects sections of Utah Code Annotated 1953 as follows:
             14      AMENDS:
             15          62A-4a-116, as last amended by Chapters 304 and 321, Laws of Utah 2000
             16      Be it enacted by the Legislature of the state of Utah:
             17          Section 1. Section 62A-4a-116 is amended to read:
             18           62A-4a-116. Management information system -- Requirements.
             19          (1) The division shall develop and implement a management information system that
             20      meets the requirements of this section and the requirements of federal law and regulation.
             21          (2) With regard to all child welfare cases, the management information system shall:
             22          (a) provide each caseworker with a complete history of each child in his caseload,
             23      including:
             24          (i) all past action taken by the division with regard to that child and his siblings, the
             25      complete case history and all reports and information in the control or keeping of the division


             26      regarding that child and his siblings;
             27          (ii) the number of times the child has been in foster care;
             28          (iii) the cumulative period of time the child has been in foster care;
             29          (iv) all reports of abuse or neglect received by the division with regard to that child's parent
             30      or parents, including documentation regarding whether each report was substantiated,
             31      unsubstantiated, or without merit;
             32          (v) the number of times the child's parent or parents have failed any treatment plan; and
             33          (vi) the number of different caseworkers who have been assigned to that child in the past;
             34          (b) contain all key elements of each family's current treatment plan, including the dates and
             35      number of times the plan has been administratively or judicially reviewed, the number of times the
             36      parent or parents have failed that treatment plan, and the exact length of time that treatment plan
             37      has been in effect;
             38          (c) alert caseworkers regarding deadlines for completion of and compliance with treatment
             39      plans; and
             40          (d) unless the executive director determines that there is good cause for keeping the report
             41      on the system based on standards established by rule, delete any reference to:
             42          (i) a report that is without merit if no subsequent report involving the same alleged
             43      perpetrator has occurred within one year; or
             44          (ii) a report that is unsubstantiated if no subsequent report involving the same alleged
             45      perpetrator has occurred within ten years.
             46          (3) With regard to all child protective services cases, the management information system
             47      shall, in addition to the information required in Subsection (2), monitor compliance with the policy
             48      of the division, the laws of this state, and federal law and regulation.
             49          (4) With regard to all child welfare and protective services cases, the age and date of birth
             50      of the alleged perpetrator, at the time the abuse or neglect is alleged to have occurred, shall be
             51      included in the management information system.
             52          (5) (a) The division shall develop and maintain a part of the information management
             53      system for licensing purposes, which shall be:
             54          (i) limited to:
             55          (A) substantiated findings of child abuse or neglect since January 1, 1988, after notice and
             56      an opportunity to challenge has been provided under Section 62A-4a-116.5 ;


             57          (B) the name of a person who was not sent a notice of agency action under Section
             58      62A-4a-116.5 because his location was not available on the management information system or
             59      who was sent a notice of agency action that was returned to the division as undelivered for the sole
             60      purpose of alerting the division of the need to afford the person an opportunity to challenge the
             61      finding of child abuse or neglect under Section 62A-4a-116.5 before any adverse action, beyond
             62      delaying the person's licensing application to provide an opportunity for challenge, may be taken;
             63          (C) an adjudication of child abuse or neglect by a court of competent jurisdiction if
             64      Subsection 62A-4a-116.5 (5) has been met; and
             65          (D) any criminal conviction or guilty plea related to neglect, physical abuse, or sexual
             66      abuse of any person; and
             67          (ii) accessible by:
             68          (A) the Office of Licensing for licensing purposes only;
             69          (B) the division:
             70          (I) to screen a person at the request of the Office of the Guardian Ad Litem Director,
             71      created by Section 78-3a-912 , at the time the person seeks a paid or voluntary position with the
             72      Office of the Guardian Ad Litem and each year thereafter that the person remains with the office;
             73      and
             74          (II) to respond to a request for information from the person who is identified as a
             75      perpetrator in the report, after advising the person of the screening prohibition in Subsection
             76      (4)(d)(iii);
             77          (C) subject to the provisions of Subsection (5)(c), the Bureau of Health Facility Licensure
             78      within the Department of Health only for the purpose of licensing a child care program or provider,
             79      or for determining whether a person associated with a covered health care facility, as defined by
             80      the Department of Health by rule, who provides direct care to a child has a substantiated finding
             81      of child abuse or neglect; and
             82          (D) the department as provided in Subsection (6) and Section 62A-1-118 .
             83          (b) For the purpose of Subsection (5)(a), "substantiated":
             84          (i) means a finding that there is a reasonable basis to conclude that:
             85          (A) a person 18 years of age or older committed one or more of the following types of
             86      child abuse or neglect:
             87          (I) physical abuse;


             88          (II) sexual abuse;
             89          (III) sexual exploitation;
             90          (IV) abandonment;
             91          (V) medical neglect resulting in death, disability, or serious illness; or
             92          (VI) chronic or severe neglect; and
             93          (B) a person under the age of 18:
             94          (I) caused serious physical injury, as defined in Subsection 76-5-109 (1)(d), to another child
             95      which indicates a significant risk to other children; or
             96          (II) engaged in sexual behavior with or upon another child which indicates a significant
             97      risk to other children; and
             98          (ii) does not include:
             99          (A) the use of reasonable and necessary physical restraint or force by an educator in
             100      accordance with Subsection 53A-11-802 (2) or Section 76-2-401 ; [or]
             101          (B) a person's conduct that:
             102          (I) is justified under Section 76-2-401 ; or
             103          (II) constituted the use of reasonable and necessary physical restraint or force in
             104      self-defense or otherwise appropriate to the circumstances to obtain possession of a weapon or
             105      other dangerous object in the possession or under the control of a child or to protect the child or
             106      another person from physical injury[.]; or
             107          (C) (I) failure to administer prescribed or recommended medication or to follow a course
             108      of treatment prescribed or recommended by a health care provider as defined in Section 78-14-3,
             109      if the division has not provided the legal guardian or parent notice of the opportunity to obtain, at
             110      the parent's or guardian's expense, a physical examination of the minor by a health care
             111      professional licensed under title 58, Chapter 67, Utah Medical Practice Act, to determine if the
             112      course of treatment chosen by the legal guardian or parent is a medically acceptable alternative and
             113      is in the best interest of the minor under the circumstances;
             114          (II) Subsection (5)(b)(ii)(C)(I) does not apply in circumstances where a delay in the
             115      prescribed or recommended medical treatment may result in imminent death or serious disability
             116      of the minor; and
             117          (III) for purposes of this Subsection (5)(b)(ii)(C), if the division has reason to believe that
             118      an individual is making medical recommendations concerning the administration of medication,


             119      and the individual is not licensed as a health care provider, as defined in Section 78-14-3 , the
             120      division may report that individual to the appropriate licensing authority.
             121          (iii) (A) For purposes of Subsection (5)(b)(i)(B), "significant risk" shall be determined in
             122      accordance with risk assessment tools and policies established by the division that focus on age,
             123      social factors, emotional factors, sexual factors, intellectual factors, family risk factors, and other
             124      related considerations.
             125          (B) The division shall train its child protection workers to apply the risk assessment tools
             126      and policies established under Subsection (5)(b)(iii)(A).
             127          (c) (i) The Department of Health shall:
             128          (A) designate two persons within the Department of Health to access the licensing part of
             129      the management information system; and
             130          (B) adopt measures to:
             131          (I) protect the security of the licensing part of the management information system; and
             132          (II) strictly limit access to the licensing part of the management information system to
             133      those designated under Subsection (5)(c)(i)(A).
             134          (ii) Those designated under Subsection (5)(c)(i)(A) shall receive training from the
             135      department with respect to:
             136          (A) accessing the licensing part of the management information system;
             137          (B) maintaining strict security; and
             138          (C) the criminal provisions in Section 62A-4a-412 for the improper release of information.
             139          (iii) Those designated under Subsection (5)(c)(i)(A):
             140          (A) are the only ones in the Department of Health with the authority to access the licensing
             141      part of the management information system; and
             142          (B) may only access the licensing part of the management information system in
             143      accordance with the provisions of Subsection (5)(a)(ii).
             144          (iv) The Department of Health may obtain information in the possession of the division
             145      that relates to a substantiated finding of abuse or neglect of a person screened under this
             146      Subsection (5)(c).
             147          (d) (i) Information in the licensing part of the management information system is
             148      confidential and may only be used or disclosed as specifically provided in this section, Section
             149      62A-2-121 , and Section 62A-4a-116.5 .


             150          (ii) No person, unless listed in Subsection (5)(a)(ii), may request another person to obtain
             151      or release a report or any other information in the possession of the division obtained as a result
             152      of the report that is available under Subsection (5)(a)(ii)(A)(III) to screen for potential perpetrators
             153      of child abuse or neglect.
             154          (iii) A person who requests information knowing that it is a violation of Subsection
             155      (5)(d)(ii) to do so is subject to the criminal penalty in Section 62A-4a-412 .
             156          (6) All information contained in the management information system shall be available
             157      to the department upon the approval of the executive director, on a need-to-know basis.
             158          (7) (a) The division may allow its contract providers to have limited access to the
             159      management information system. The division shall limit that access to information about persons
             160      who are currently receiving services from the specific contract provider.
             161          (b) Each contract provider shall:
             162          (i) take all necessary precautions to safeguard the security of the information contained in
             163      the management information system;
             164          (ii) train its employees regarding requirements for confidentiality and the criminal
             165      penalties under Sections 62A-4a-412 and 63-2-801 for improper release of information; and
             166          (iii) monitor its employees to ensure that they comply with the confidentiality requirements
             167      related to the management information system.
             168          (c) The division shall take reasonable precautions to ensure that its contract providers are
             169      complying with Subsection (7)(b).
             170          (8) The division shall take all necessary precautions, including password protection and
             171      other appropriate technological techniques, to prevent unauthorized access to the information
             172      contained in the management information system.
             173          (9) (a) The division shall send a certified letter to a person who submitted a report of child
             174      abuse or neglect that is put onto any part of the management information system if the division
             175      determines, at the conclusion of its investigation, that:
             176          (i) the report is false;
             177          (ii) it is more likely than not that the person knew that the report was false at the time the
             178      person submitted the report; and
             179          (iii) the person's address is known or reasonably available.
             180          (b) The letter shall inform the person of:


             181          (i) the determination made under Subsection (9)(a);
             182          (ii) the penalty for submitting false information under Section 76-8-506 and other
             183      applicable laws;
             184          (iii) the obligation of the division to inform law enforcement and the alleged perpetrator:
             185          (A) in the present instance if an immediate referral is justified by the facts; or
             186          (B) if the person submits a subsequent false report involving the same alleged perpetrator
             187      or victim.
             188          (c) (i) The division may inform law enforcement and the alleged perpetrator of a report for
             189      which a letter is required to be sent under Subsection (9)(a) if an immediate referral is justified by
             190      the facts.
             191          (ii) The division shall inform law enforcement and the alleged perpetrator of a report for
             192      which a letter is required to be sent under Subsection (9)(a) if this is the second letter sent to the
             193      person involving the same alleged perpetrator or victim.
             194          (iii) The division shall determine, in consultation with law enforcement:
             195          (A) the information to be given to an alleged perpetrator about a false claim; and
             196          (B) whether good cause exists, as defined by rule, for not informing an alleged perpetrator
             197      about a false claim.
             198          (d) Nothing in this Subsection (9) may be construed as requiring the division to conduct
             199      an investigation, beyond what is required in Subsection (9)(a), to determine whether or not a report
             200      is false.
             201          Section 2. Coordination clause.
             202          If this bill and H.B. 387, Narrowing Grounds for Removal of a Child from the Home, both
             203      pass, it is the intent of the Legislature that in preparing the Utah Code database for publication, the
             204      Office of Legislative Research and General Counsel shall:
             205          (1) amend the language of Subsection 62A-4a-409 (3)(b) in H.B. 387 to read:
             206          "(b) If an investigation by the division shows that the incident reported was not abuse but
             207      was the result of the reasonable exercise of discipline by a parent or guardian as defined in
             208      Subsection 62A-4a-101 (1)(b), the investigation will proceed no further and the report shall be
             209      classified as without merit."; and
             210          (2) Subsection 62A-4a-116 (2) in this bill shall be amended by adding a new Subsection
             211      (e) which shall read as follows:


             212          "(e) for purposes of Subsection (2)(d)(i), "without merit" shall include a report that is
             213      determined to be the reasonable exercise of discipline as defined in Subsection 62A-4a-101(1)(b).".


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