1     
REPEAL OF HEALTH AND HUMAN SERVICES REPORTS

2     
2017 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Evan J. Vickers

5     
House Sponsor: Brad M. Daw

6     

7     LONG TITLE
8     General Description:
9          This bill repeals and amends Utah Code provisions that require reports to the Health
10     and Human Services Interim Committee.
11     Highlighted Provisions:
12          This bill:
13          ▸     repeals and amends provisions that require reports to the Health and Human
14     Services Interim Committee.
15     Money Appropriated in this Bill:
16          None
17     Other Special Clauses:
18          None
19     Utah Code Sections Affected:
20     AMENDS:
21          26-2-3, as last amended by Laws of Utah 2015, Chapter 183
22          26-18-2.6, as last amended by Laws of Utah 2013, Chapter 278
23          26-18-407, as last amended by Laws of Utah 2014, Chapter 302
24          26-18-408, as last amended by Laws of Utah 2015, Chapter 246
25          26-56-103, as last amended by Laws of Utah 2016, Chapter 89
26          49-20-106, as enacted by Laws of Utah 2016, Chapter 119
27          62A-15-1102, as enacted by Laws of Utah 2016, Chapter 164
28          62A-17-103, as enacted by Laws of Utah 2013, Chapter 24
29     


30     Be it enacted by the Legislature of the state of Utah:
31          Section 1. Section 26-2-3 is amended to read:
32          26-2-3. Department duties and authority.
33          (1) As used in this section:
34          (a) "Compact" means the Compact for Interstate Sharing of Putative Father Registry
35     Information created in Section 78B-6-121.5, effective on May 10, 2016.
36          (b) "Putative father":
37          (i) means the same as that term is as defined in Section 78B-6-121.5; and
38          (ii) includes an unmarried biological father.
39          (c) "State registrar" means the state registrar of vital records appointed under
40     Subsection (2)(e).
41          (d) "Unmarried biological father" means the same as that term is defined in Section
42     78B-6-103.
43          (2) The department shall:
44          (a) provide offices properly equipped for the preservation of vital records made or
45     received under this chapter;
46          (b) establish a statewide vital records system for the registration, collection,
47     preservation, amendment, and certification of vital records and other similar documents
48     required by this chapter and activities related to them, including the tabulation, analysis, and
49     publication of vital statistics;
50          (c) prescribe forms for certificates, certification, reports, and other documents and
51     records necessary to establish and maintain a statewide system of vital records;
52          (d) prepare an annual compilation, analysis, and publication of statistics derived from
53     vital records; and
54          (e) appoint a state registrar to direct the statewide system of vital records.
55          (3) The department may:
56          (a) divide the state from time to time into registration districts; and
57          (b) appoint local registrars for registration districts who under the direction and

58     supervision of the state registrar shall perform all duties required of them by this chapter and
59     department rules.
60          (4) The state registrar appointed under Subsection (2)(e) shall[: (a)], with the input of
61     Utah stakeholders and the Uniform Law Commission, study the following items for the state's
62     implementation of the compact:
63          [(i)] (a) the feasibility of using systems developed by the National Association for
64     Public Health Statistics and Information Systems, including the State and Territorial Exchange
65     of Vital Events (STEVE) system and the Electronic Verification of Vital Events (EVVE)
66     system, or similar systems, to exchange putative father registry information with states that are
67     parties to the compact;
68          [(ii)] (b) procedures necessary to share putative father information, located in the
69     confidential registry maintained by the state registrar, upon request from the state registrar of
70     another state that is a party to the compact;
71          [(iii)] (c) procedures necessary for the state registrar to access putative father
72     information located in a state that is a party to the compact, and share that information with
73     persons who request a certificate from the state registrar;
74          [(iv)] (d) procedures necessary to ensure that the name of the mother of the child who
75     is the subject of a putative father's notice of commencement, filed pursuant to Section
76     78B-6-121, is kept confidential when a state that is a party to the compact accesses this state's
77     confidential registry through the state registrar; and
78          [(v)] (e) procedures necessary to ensure that a putative father's registration with a state
79     that is a party to the compact is given the same effect as a putative father's notice of
80     commencement filed pursuant to Section 78B-6-121[; and].
81          [(b) report to the Health and Human Services Interim Committee before November 1,
82     2015, on the study items described in Subsection (4)(a).]
83          Section 2. Section 26-18-2.6 is amended to read:
84          26-18-2.6. Dental benefits.
85          (1) (a) Except as provided in Subsection (8), the division shall establish a competitive

86     bid process to bid out Medicaid dental benefits under this chapter.
87          (b) The division may bid out the Medicaid dental benefits separately from other
88     program benefits.
89          (2) The division shall use the following criteria to evaluate dental bids:
90          (a) ability to manage dental expenses;
91          (b) proven ability to handle dental insurance;
92          (c) efficiency of claim paying procedures;
93          (d) provider contracting, discounts, and adequacy of network; and
94          (e) other criteria established by the department.
95          (3) The division shall request bids for the program's benefits:
96          (a) in 2011; and
97          (b) at least once every five years thereafter.
98          (4) The division's contract with dental plans for the program's benefits shall include
99     risk sharing provisions in which the dental plan must accept 100% of the risk for any difference
100     between the division's premium payments per client and actual dental expenditures.
101          (5) The division may not award contracts to:
102          (a) more than three responsive bidders under this section; or
103          (b) an insurer that does not have a current license in the state.
104          (6) (a) The division may cancel the request for proposals if:
105          (i) there are no responsive bidders; or
106          (ii) the division determines that accepting the bids would increase the program's costs.
107          (b) If the division cancels the request for proposals under Subsection (6)(a), the
108     division shall report to the Health and Human Services Interim Committee regarding the
109     reasons for the decision.
110          (7) Title 63G, Chapter 6a, Utah Procurement Code, shall apply to this section.
111          (8) (a) The division may:
112          (i) establish a dental health care delivery system and payment reform pilot program for
113     Medicaid dental benefits to increase access to cost effective and quality dental health care by

114     increasing the number of dentists available for Medicaid dental services; and
115          (ii) target specific Medicaid populations or geographic areas in the state.
116          (b) The pilot program shall establish compensation models for dentists and dental
117     hygienists that:
118          (i) increase access to quality, cost effective dental care; and
119          (ii) use funds from the Division of Family Health and Preparedness that are available to
120     reimburse dentists for educational loans in exchange for the dentist agreeing to serve Medicaid
121     and under-served populations.
122          (c) The division may amend the state plan and apply to the Secretary of Health and
123     Human Services for waivers or pilot programs if necessary to establish the new dental care
124     delivery and payment reform model. The division shall evaluate the pilot program's effect on
125     the cost of dental care and access to dental care for the targeted Medicaid populations. [The
126     division shall report to the Legislature's Health and Human Services Interim Committee by
127     November 30th of each year that the pilot project is in effect.]
128          Section 3. Section 26-18-407 is amended to read:
129          26-18-407. Medicaid waiver for autism spectrum disorder.
130          (1) As used in this section:
131          (a) "Autism spectrum disorder" is as defined by the most recent edition of the
132     Diagnostic and Statistical Manual on Mental Disorders or a recent edition of a professionally
133     accepted diagnostic manual.
134          (b) "Program" means the autism spectrum disorder program created in Subsection (3).
135          (c) "Qualified child" means a child who is:
136          (i) at least two years of age but less than seven years of age; and
137          (ii) diagnosed with an autism spectrum disorder by a qualified professional.
138          (2) The department shall apply for a Medicaid waiver with the Centers for Medicare
139     and Medicaid Services within the United States Department of Health and Human Services to
140     implement, within the state Medicaid program, the program described in Subsection (3).
141          (3) The department shall offer an autism spectrum disorder program that:

142          (a) as funding permits, provides treatment for autism spectrum disorders to qualified
143     children; and
144          (b) accepts applications for the program during periods of open enrollment.
145          (4) The department shall:
146          (a) convene a public process with the Department of Human Services to determine the
147     benefits and services the program shall offer qualified children that considers, in addition to
148     any other relevant factor:
149          (i) demonstrated effective treatments;
150          (ii) methods to engage family members in the treatment process; and
151          (iii) outreach to qualified children in rural and underserved areas of the state; and
152          (b) evaluate the ongoing results, cost, and effectiveness of the program.
153          [(5) The department shall annually report to the Legislature's Health and Human
154     Services Interim Committee before each November 30 while the waiver is in effect regarding:]
155          [(a) the number of qualified children served under the waiver;]
156          [(b) success involving families in supporting treatment plans for autistic children;]
157          [(c) the cost of the program; and]
158          [(d) the results and effectiveness of the program.]
159          Section 4. Section 26-18-408 is amended to read:
160          26-18-408. Incentives to appropriately use emergency department services.
161          (1) (a) This section applies to the Medicaid program and to the Utah Children's Health
162     Insurance Program created in Chapter 40, Utah Children's Health Insurance Act.
163          (b) For purposes of this section:
164          (i) "Accountable care organization" means a Medicaid or Children's Health Insurance
165     Program administrator that contracts with the Medicaid program or the Children's Health
166     Insurance Program to deliver health care through an accountable care plan.
167          (ii) "Accountable care plan" means a risk based delivery service model authorized by
168     Section 26-18-405 and administered by an accountable care organization.
169          (iii) "Nonemergent care":

170          (A) means use of the emergency department to receive health care that is nonemergent
171     as defined by the department by administrative rule adopted in accordance with Title 63G,
172     Chapter 3, Utah Administrative Rulemaking Act, and the Emergency Medical Treatment and
173     Active Labor Act; and
174          (B) does not mean the medical services provided to a recipient required by the
175     Emergency Medical Treatment and Active Labor Act, including services to conduct a medical
176     screening examination to determine if the recipient has an emergent or nonemergent condition.
177          (iv) "Professional compensation" means payment made for services rendered to a
178     Medicaid recipient by an individual licensed to provide health care services.
179          (v) "Super-utilizer" means a Medicaid recipient who has been identified by the
180     recipient's accountable care organization as a person who uses the emergency department
181     excessively, as defined by the accountable care organization.
182          (2) (a) An accountable care organization may, in accordance with Subsections (2)(b)
183     and (c):
184          (i) audit emergency department services provided to a recipient enrolled in the
185     accountable care plan to determine if nonemergent care was provided to the recipient; and
186          (ii) establish differential payment for emergent and nonemergent care provided in an
187     emergency department.
188          (b) (i) The differential payments under Subsection (2)(a)(ii) do not apply to
189     professional compensation for services rendered in an emergency department.
190          (ii) Except in cases of suspected fraud, waste, and abuse, an accountable care
191     organization's audit of payment under Subsection (2)(a)(i) is limited to the 18-month period of
192     time after the date on which the medical services were provided to the recipient. If fraud,
193     waste, or abuse is alleged, the accountable care organization's audit of payment under
194     Subsection (2)(a)(i) is limited to three years after the date on which the medical services were
195     provided to the recipient.
196          (c) The audits and differential payments under Subsections (2)(a) and (b) apply to
197     services provided to a recipient on or after July 1, 2015.

198          (3) An accountable care organization shall:
199          (a) use the savings under Subsection (2) to maintain and improve access to primary
200     care and urgent care services for all of the recipients enrolled in the accountable care plan;
201          (b) provide viable alternatives for increasing primary care provider reimbursement
202     rates to incentivize after hours primary care access for recipients; and
203          (c) report to the department on how the accountable care organization complied with
204     this Subsection (3).
205          (4) The department shall:
206          (a) through administrative rule adopted by the department, develop quality
207     measurements that evaluate an accountable care organization's delivery of:
208          (i) appropriate emergency department services to recipients enrolled in the accountable
209     care plan;
210          (ii) expanded primary care and urgent care for recipients enrolled in the accountable
211     care plan, with consideration of the accountable care organization's:
212          (A) delivery of primary care, urgent care, and after hours care through means other than
213     the emergency department;
214          (B) recipient access to primary care providers and community health centers including
215     evening and weekend access; and
216          (C) other innovations for expanding access to primary care; and
217          (iii) quality of care for the accountable care plan members;
218          (b) compare the quality measures developed under Subsection (4)(a) for each
219     accountable care organization and share the data and quality measures developed under
220     Subsection (4)(a) with the Health Data Committee created in Chapter 33a, Utah Health Data
221     Authority Act;
222          (c) apply for a Medicaid waiver and a Children's Health Insurance Program waiver
223     with the Centers for Medicare and Medicaid Services within the United States Department of
224     Health and Human Services, to:
225          (i) allow the program to charge recipients who are enrolled in an accountable care plan

226     a higher copayment for emergency department services; and
227          (ii) develop, by administrative rule, an algorithm to determine assignment of new,
228     unassigned recipients to specific accountable care plans based on the plan's performance in
229     relation to the quality measures developed pursuant to Subsection (4)(a); and
230          (d) before July 1, 2015, convene representatives from the accountable care
231     organizations, pre-paid mental health plans, an organization representing hospitals, an
232     organization representing physicians, and a county mental health and substance abuse authority
233     to discuss alternatives to emergency department care, including:
234          (i) creating increased access to primary care services;
235          (ii) alternative care settings for super-utilizers and individuals with behavioral health or
236     substance abuse issues;
237          (iii) primary care medical and health homes that can be created and supported through
238     enhanced federal match rates, a state plan amendment for integrated care models, or other
239     Medicaid waivers;
240          (iv) case management programs that can:
241          (A) schedule prompt visits with primary care providers within 72 to 96 hours of an
242     emergency department visit;
243          (B) help super-utilizers with behavioral health or substance abuse issues to obtain care
244     in appropriate care settings; and
245          (C) assist with transportation to primary care visits if transportation is a barrier to
246     appropriate care for the recipient; and
247          (v) sharing of medical records between health care providers and emergency
248     departments for Medicaid recipients.
249          (5) The Health Data Committee may publish data in accordance with Chapter 33a,
250     Utah Health Data Authority Act, which compares the quality measures for the accountable care
251     plans.
252          (6) The department shall report to the Legislature's Health and Human Services Interim
253     Committee [on or before October 1, 2016,] every two years regarding implementation of this

254     section.
255          Section 5. Section 26-56-103 is amended to read:
256          26-56-103. Hemp extract registration card -- Application -- Fees -- Database.
257          (1) The department shall issue a hemp extract registration card to an individual who:
258          (a) is at least 18 years of age;
259          (b) is a Utah resident;
260          (c) provides the department with a statement signed by a neurologist that:
261          (i) indicates that the individual:
262          (A) suffers from intractable epilepsy; and
263          (B) may benefit from treatment with hemp extract; and
264          (ii) is consistent with a record from the neurologist, concerning the individual,
265     contained in the database described in Subsection (8);
266          (d) pays the department a fee in an amount established by the department under
267     Subsection (5); and
268          (e) submits an application to the department, on a form created by the department, that
269     contains:
270          (i) the individual's name and address;
271          (ii) a copy of the individual's valid photo identification; and
272          (iii) any other information the department considers necessary to implement this
273     chapter.
274          (2) The department shall issue a hemp extract registration card to a parent who:
275          (a) is at least 18 years of age;
276          (b) is a Utah resident;
277          (c) provides the department with a statement signed by a neurologist that:
278          (i) indicates that a minor in the parent's care:
279          (A) suffers from intractable epilepsy; and
280          (B) may benefit from treatment with hemp extract; and
281          (ii) is consistent with a record from the neurologist, concerning the minor, contained in

282     the database described in Subsection (8);
283          (d) pays the department a fee in an amount established by the department under
284     Subsection (5); and
285          (e) submits an application to the department, on a form created by the department, that
286     contains:
287          (i) the parent's name and address;
288          (ii) the minor's name;
289          (iii) a copy of the parent's valid photo identification; and
290          (iv) any other information the department considers necessary to implement this
291     chapter.
292          (3) The department shall maintain a record of:
293          (a) the name of each registrant; and
294          (b) the name of each minor receiving care from a registrant.
295          (4) The department shall make rules in accordance with Title 63G, Chapter 3, Utah
296     Administrative Rulemaking Act, to:
297          (a) establish the information an applicant is required to provide to the department under
298     Subsections (1)(e)(iii) and (2)(e)(iv); and
299          (b) establish, in accordance with recommendations from the Department of Public
300     Safety, the form and content of the hemp extract registration card.
301          (5) The department shall establish fees in accordance with Section 63J-1-504 that are
302     no greater than the amount necessary to cover the cost the department incurs to implement this
303     chapter.
304          (6) The registration cards issued under Subsections (1) and (2) are:
305          (a) valid for one year; and
306          (b) renewable, if, at the time of renewal, the registrant meets the requirements of either
307     Subsection (1) or (2).
308          (7) The neurologist who signs the statement described in Subsection (1)(c) or (2)(c)
309     shall:

310          (a) keep a record of the neurologist's evaluation and observation of a patient who is a
311     registrant or minor under a registrant's care, including the patient's response to hemp extract;
312     and
313          (b) transmit the record described in Subsection (7)(a) to the department.
314          (8) The department shall:
315          (a) maintain a database of the records described in Subsection (7);
316          (b) treat the records as identifiable health data, as defined in Section 26-3-1; and
317          (c) establish a procedure for ensuring that neurologists transmit the records described
318     in Subsection (7).
319          (9) (a) The department shall prepare a de-identified set of data based on records
320     described in Subsection (8) and make the set of data available to researchers at a higher
321     education institution for the purpose of studying hemp extract.
322          (b) No later than July 1, 2016, the department shall, in accordance with Title 63G,
323     Chapter 6a, Utah Procurement Code, request proposals to conduct a study of hemp extract.
324          (c) The study of hemp extract shall include at least the following:
325          (i) analysis of data from the records of patients who have held hemp extract registration
326     cards for one year or more;
327          (ii) the effect of hemp extract on the patient's seizure control; and
328          (iii) any adverse effects or other effects on the patient that may be attributable to the
329     patient's use of hemp extract.
330          (d) The department shall report to the Health and Human Services Interim Committee
331     [of the Legislature on or before the November 2016 interim meeting] by November 30 of each
332     year until November 30, 2019, on the study of hemp extract.
333          Section 6. Section 49-20-106 is amended to read:
334          49-20-106. Obesity report.
335          (1) The Public Employees' Health Plan shall report to the Health and Human Services
336     Interim Committee every two years by no later than the Health and Human Services Interim
337     Committee's November [2016] interim meeting regarding the analysis required by Subsection

338     (2).
339          (2) For purposes of the report required by Subsection (1), the Public Employees' Health
340     Plan shall:
341          (a) estimate the costs and benefits to the Public Employees' Health Plan associated with
342     providing insurance coverage for anti-obesity treatment, including:
343          (i) counseling;
344          (ii) medication; and
345          (iii) surgery;
346          (b) compare the costs and benefits estimated under Subsection (2)(a) with the costs and
347     benefits to the Public Employees' Health Plan associated with treating diseases caused by or
348     linked to obesity, including:
349          (i) diabetes;
350          (ii) hypertension;
351          (iii) heart disease; and
352          (iv) other diseases; and
353          (c) analyze whether there would be cost savings by providing the insurance coverage
354     described in Subsection (2)(a).
355          (3) The Public Employees' Health Plan may work with other insurers or other
356     interested persons in developing the report required by this section.
357          Section 7. Section 62A-15-1102 is amended to read:
358          62A-15-1102. Study on gun use -- Report.
359          (1) As used in this section:
360          (a) "Coordinator" means the state suicide prevention coordinator described in Section
361     62A-15-1101.
362          (b) "Legal intervention" means an incident in which an individual is shot by another
363     individual who has legal authority to use deadly force.
364          (c) "Shooter" means an individual who uses a gun in an act that results in the death of
365     the actor or another individual, whether the act was a suicide, homicide, legal intervention, act

366     of self-defense, or accident.
367          (2) The coordinator shall, by October 30, 2018, conduct a study on use of guns in the
368     state and on an ongoing basis report on the progress and findings of the study to the Health and
369     Human Services Interim Committee.
370          [(3) By October 30, 2016, the coordinator shall:]
371          [(a) determine what information, and from which state, local, and federal agencies, will
372     be necessary to complete the study;]
373          [(b) determine how much the study will cost;]
374          [(c) make recommendations for legislation, if any, that will be necessary to facilitate
375     information-sharing between local, state, federal, and private entities and the coordinator; and]
376          [(d) report the findings described in Subsections (3)(a) through (c) to the Health and
377     Human Services Interim Committee.]
378          [(4)] (3) The study described in Subsection (2) shall investigate:
379          (a) the number of deaths in the state that involved a gun, including deaths from suicide,
380     homicide including gang-related violence, legal intervention, self-defense, and accidents;
381          (b) where and how a gun that was involved in a death described in Subsection [(4)]
382     (3)(a) was procured, and whether that procurement was legal;
383          (c) demographic information on the shooter and, where applicable, a victim of a death
384     described in Subsection [(4)] (3)(a), including gender, race, age, criminal history, and gang
385     affiliation, if any;
386          (d) the total estimated number of gun owners in the state;
387          (e) information on the shooter, including whether the shooter has a history of:
388          (i) mental illness; or
389          (ii) domestic violence; and
390          (f) whether gun deaths are seasonal.
391          (5) The coordinator shall ensure that the study described in Subsection (2) is conducted
392     in an unbiased manner, with no preconceived conclusions about potential results.
393          (6) The coordinator may contract with another state agency, private entity, or research

394     institution to assist the coordinator and office with the study required by Subsection (2).
395          (7) (a) The coordinator shall submit a final report on the study described in Subsection
396     (2), including proposed legislation and recommendations, to the Health and Human Services
397     Interim Committee before November 30, 2018.
398          (b) The final report shall include references to all sources of information and data used
399     in the report and study.
400          Section 8. Section 62A-17-103 is amended to read:
401          62A-17-103. Designated approved 211 service provider -- Department
402     responsibilities.
403          (1) The department shall designate an approved 211 service provider to provide
404     information to Utah citizens about health and human services available in the citizen's
405     community.
406          (2) Only a service provider approved by the department may provide 211 telephone
407     services in this state.
408          (3) The department shall approve a 211 service provider after considering the
409     following:
410          (a) the ability of the proposed 211 service provider to meet the national 211 standards
411     recommended by the Alliance of Information and Referral Systems;
412          (b) the financial stability of the proposed 211 service provider;
413          (c) the community support for the proposed 211 service provider;
414          (d) the relationship between the proposed 211 service provider and other information
415     and referral services; and
416          (e) other criteria as the department considers appropriate.
417          (4) The department shall coordinate with the approved 211 service provider and[: (a)]
418     other state and local agencies to ensure the joint development and maintenance of a statewide
419     information database for use by the approved 211 service provider[; and].
420          [(b) other interested parties, including public, private, and non-profit transportation
421     operators, who shall form a work group and issue a report to the Health and Human Services

422     Interim Committee by November 15, 2013 that addresses the following issues:]
423          [(i) an assessment of transportation needs for individuals with disabilities, the elderly,
424     and other receiving services from the department;]
425          [(ii) an assessment of available services and current transportation providers
426     throughout Utah;]
427          [(iii) identification of opportunities to achieve efficiency in service delivery, including
428     the viability of a single dispatch system; and]
429          [(iv) priorities for implementation of efficiency, based on resources and feasibility.]