Download Zipped Introduced WP 6.1 HB0272S1.ZIP 43,178 Bytes
[Status][Bill Documents][Fiscal Note][Bills Directory]

First Substitute H.B. 272





Sponsor: Mary Carlson

9    This act affects sections of Utah Code Annotated 1953 as follows:
10    AMENDS:
11         26-18-3.7, as last amended by Chapter 250, Laws of Utah 1996
12         26-21-1, as last amended by Chapter 114, Laws of Utah 1990
13         26-21-2, as last amended by Chapter 79, Laws of Utah 1996
14         26-21-2.1, as enacted by Chapter 114, Laws of Utah 1990
15         26-21-3, as last amended by Chapter 243, Laws of Utah 1996
16         26-21-5, as last amended by Chapter 28, Laws of Utah 1995
17         26-21-6, as last amended by Chapters 4 and 234, Laws of Utah 1993
18         26-21-8, as last amended by Chapter 201, Laws of Utah 1993
19         26-21-11, as last amended by Chapter 114, Laws of Utah 1990
20         26-21-12, as last amended by Chapter 114, Laws of Utah 1990
21         26-21-16, as last amended by Chapter 241, Laws of Utah 1991
22         26-21-20, as last amended by Chapter 114, Laws of Utah 1990
23         26-35-103, as enacted by Chapter 170, Laws of Utah 1992
24         26-36-104, as last amended by Chapter 209, Laws of Utah 1995
25         59-12-102, as last amended by Chapters 126, 170, 232, 274, 287 and 342, Laws of Utah 1996
26         62A-3-202, as last amended by Chapter 176, Laws of Utah 1993
27         78-30-4.13, as enacted by Chapter 168, Laws of Utah 1995

2         26-21-10, as last amended by Chapter 114, Laws of Utah 1990
3    Be it enacted by the Legislature of the state of Utah:
4        Section 1. Section 26-18-3.7 is amended to read:
5         26-18-3.7. Prepaid health care delivery systems.
6        (1) (a) Before July 1, 1996, the division shall submit to the Health Care Financing
7    Administration within the United States Department of Health and Human Services, an
8    amendment to the state's freedom of choice waiver. That amendment shall provide that the
9    following persons who are eligible for services under the state plan for medical assistance, who
10    reside in Salt Lake, Utah, Davis, or Weber counties, shall enroll in the recipient's choice of a health
11    care delivery system that meets the requirements of Subsection (2):
12        (i) by July 1, 1994, 40% of eligible persons;
13        (ii) by July 1, 1995, 65% of eligible persons; and
14        (iii) by July 1, 1996, 100% of eligible persons.
15        (b) The division may not enter into any agreements with mental health providers that
16    establish a prepaid capitated delivery system for mental health services that were not in existence
17    prior to July 1, 1993, until the application of the Utah Medicaid Hospital Provider Temporary
18    Assessment Act with regard to a specialty hospital as defined in [Subsection 26-21-2(19)] Section
19    26-21-2 that may be engaged exclusively in rendering psychiatric or other mental health treatment
20    is repealed.
21        (c) The following are exempt from the requirements of Subsection (a):
22        (i) persons who:
23        (A) receive medical assistance for the first time after July 1, 1996;
24        (B) have a mental illness, as that term is defined in Section 62A-12-202; and
25        (C) are receiving treatment for that mental illness. The division, when appropriate, shall
26    enroll these persons in a health care delivery system that meets the requirements of this section;
27        (ii) persons who are institutionalized in a facility designated by the division as a nursing
28    facility or an intermediate care facility for the mentally retarded; or
29        (iii) persons with a health condition that requires specialized medical treatment that is not
30    available from a health care delivery system that meets the requirements of this section.
31        (2) In submitting the amendment to the state's freedom of choice waiver under Subsection

- 2 -

1    (1), the division shall ensure that the proposed health care delivery systems have at least the
2    following characteristics, so that the system:
3        (a) is financially at risk, for a specified continuum of health care services, for a defined
4    population, and has incentives to balance the patient's need for care against the need for cost
5    control;
6        (b) follows utilization and quality controls developed by the department;
7        (c) is encouraged to promote the health of patients through primary and preventive care;
8        (d) coordinates care to avoid unnecessary duplication and services;
9        (e) conserves health care resources; and
10        (f) if permissible under the waiver, utilizes private insurance plans including health
11    maintenance organizations and other private health care delivery organizations.
12        (3) Subsection (2) does not prevent the division from contracting with other health care
13    delivery organizations if the division determines that it is advantageous to do so.
14        (4) Health care delivery systems that meet the requirements of this section may provide
15    all services otherwise available under the state plan for medical assistance, except prescribed
16    drugs.
17        (5) The division shall periodically report to the Legislative Health and Environment and
18    Human Services Interim Committees regarding the development and implementation of the
19    amendment to the state's freedom of choice waiver required under this section.
20        Section 2. Section 26-21-1 is amended to read:
21         26-21-1. Title.
22        This chapter is known as the "Health Care Facility [Licensure] Licensing and Inspection
23    Act."
24        Section 3. Section 26-21-2 is amended to read:
25         26-21-2. Definitions.
26        As used in this chapter:
27        (1) "Abortion clinic" means a facility, other than a general acute or specialty hospital, that
28    performs abortions and provides abortion services during the second trimester of pregnancy.
29        (2) "Activities of daily living" means essential activities including:
30        (a) dressing;
31         (b) eating;

- 3 -

1         (c) grooming;
2         (d) bathing;
3         (e) toileting;
4         (f) ambulation;
5        (g) transferring; and
6        (h) self-administration of medication.
7        [(2)] (3) "Ambulatory surgical facility" means a freestanding facility, which provides
8    surgical services to patients not requiring hospitalization.
9        (4) "Assistance with activities of daily living" means providing of or arranging for the
10    provision of assistance with activities of daily living.
11        [(3)] (5) "Assisted living facility" means a residential facility with a home-like setting that
12    provides an array of coordinated supportive personal and health care services, available 24 hours
13    per day, to residents who have been assessed under division rule to need any of these services.
14    Each resident shall have a service plan based on the assessment, which may include:
15        (a) specified services of intermittent nursing care;
16        (b) administration of medication; and
17        (c) support services promoting residents' independence and self sufficiency.
18        [(4)] (6) "Birthing center" means a freestanding facility, receiving maternal clients and
19    providing care during pregnancy, delivery, and immediately after delivery.
20        [(5)] (7) "Committee" means the Health Facility Committee created in Section 26-1-7.
21        [(6)] (8) "Consumer" means any person not primarily engaged in the provision of health
22    care to individuals or in the administration of facilities or institutions in which such care is
23    provided and who does not hold a fiduciary position, or have a fiduciary interest in any entity
24    involved in the provision of health care, and does not receive, either directly or through his spouse,
25    more than 1/10 of his gross income from any entity or activity relating to health care.
26        [(7)] (9) "End stage renal disease facility" means a facility which furnishes staff-assisted
27    kidney dialysis services, self-dialysis services, or home-dialysis services on an outpatient basis.
28        [(8)] (10) "Freestanding" means existing independently or physically separated from
29    another health care facility by fire walls and doors and administrated by separate staff with
30    separate records.
31        [(9)] (11) "General acute hospital" means a facility which provides diagnostic, therapeutic,

- 4 -

1    and rehabilitative services to both inpatients and outpatients by or under the supervision of
2    physicians.
3        [(10)] (12) "Governmental unit" means the state, or any county, municipality, or other
4    political subdivision or any department, division, board, or agency of the state, a county,
5    municipality, or other political subdivision.
6        [(11)] (13) (a) "Health care facility" means general acute hospitals, specialty hospitals,
7    home health agencies, hospices, nursing care facilities, residential [health care facilities,] assisted
8    living facilities, birthing centers, ambulatory surgical facilities, small health care facilities, abortion
9    clinics, facilities owned or operated by health maintenance organizations, end stage renal disease
10    facilities, and any other health care facility which the committee designates by rule.
11        (b) "Health care facility" does not include the offices of private physicians or dentists,
12    whether for individual or group practice.
13        [(12)] (14) "Health maintenance organization" means an organization, organized under the
14    laws of any state which:
15        (a) is a qualified health maintenance organization under Section 1310 (d) of the Public
16    Health Service Act; or
17        (b) (i) provides or otherwise makes available to enrolled participants at least the following
18    basic health care services: usual physician services, hospitalization, laboratory, x-ray, emergency,
19    and preventive services and out-of-area coverage;
20        (ii) is compensated, [(]except for copayments[)], for the provision of the basic health
21    services listed in Subsection [(12)] (14)(b)(i) to enrolled participants by a payment which is paid
22    on a periodic basis without regard to the date the health services are provided and which is fixed
23    without regard to the frequency, extent, or kind of health services actually provided; and
24        (iii) provides physicians' services primarily directly through physicians who are either
25    employees or partners of such organizations, or through arrangements with individual physicians
26    or one or more groups of physicians organized on a group practice or individual practice basis.
27        [(13)] (15) (a) "Home health agency" means an agency, organization, or facility or a
28    subdivision of an agency, organization, or facility [employing] which employs two or more direct
29    care staff persons [which provides] who provide licensed nursing services, therapeutic services [(]
30    of physical therapy, speech therapy, occupational therapy, medical social services, or home health
31    aide services[), or both,] on a visiting basis.

- 5 -

1        (b) "Home health agency" does not [include] mean an individual who provides services
2    under the authority of a private license.
3        [(14)] (16) "Hospice" means a program of care for the terminally ill and their families
4    which occurs in a home or in a health care facility and which provides medical, palliative,
5    psychological, spiritual, and supportive care and treatment.
6        [(15)] (17) "Nursing care facility" means a health care facility, other than a general acute
7    or specialty hospital, constructed, licensed, and operated to provide patient living accommodations,
8    24-hour staff availability, and at least two of the following patient services:
9        (a) a selection of patient care services, under the direction and supervision of a registered
10    nurse, ranging from continuous medical, skilled nursing, psychological, or other professional
11    therapies to intermittent health-related or paraprofessional personal care services;
12        (b) a structured, supportive social living environment based on a professionally designed
13    and supervised treatment plan, oriented to the individual's habilitation or rehabilitation needs; or
14        (c) a supervised living environment that provides support, training, or assistance with
15    individual activities of daily living.
16        [(16)] (18) "Person" means any individual, firm, partnership, corporation, company,
17    association, or joint stock association, and the legal successor thereof.
18        (19) "Resident" means a person 21 years of age or older who:
19        (a) as a result of physical or mental limitations or age requires or requests services
20    provided in a residential health care facility or assisted living facility; and
21        (b) does not require intensive medical or nursing services as provided in a hospital or
22    nursing care facility.
23        [(17)] (20) "Residential health care facility" means a facility providing assistance with
24    activities of daily living and social care to two or more residents who require protected living
25    arrangements.
26        [(18)] (21) "Small health care facility" means a four to sixteen bed facility that provides
27    licensed health care programs and services to residents who generally do not need continuous
28    nursing care or supervision.
29        [(19)] (22) "Specialty hospital" means a facility which provides specialized diagnostic,
30    therapeutic, or rehabilitative services in the recognized specialty or specialties for which the
31    hospital is licensed.

- 6 -

1        (23) "Substantial compliance" means in a department survey of a licensee, the department
2    determines there is an absence of deficiencies which would harm the physical health, mental
3    health, safety, or welfare of patients or residents of a licensee.
4        Section 4. Section 26-21-2.1 is amended to read:
5         26-21-2.1. Services.
6        (1) General acute hospitals and specialty hospitals shall remain open and be continuously
7    ready to receive patients 24 hours of every day in a year and have an attending medical staff
8    consisting of one or more physicians licensed to practice medicine and surgery under Title 58,
9    Chapter [12] 67, Utah Medical Practice Act, or Title 58, Chapter 68, Utah Osteopathic [Medicine
10    Licensing] Medical Practice Act.
11        (2) A specialty hospital shall provide on-site all basic services required of a general acute
12    hospital that are needed for the diagnosis, therapy, or rehabilitation offered to or required by
13    patients admitted to or cared for in the facility.
14        (3) (a) A home health agency shall provide at least licensed nursing services or therapeutic
15    services directly through the agency employees.
16        (b) A home health agency may provide additional services itself or under arrangements
17    with another agency, organization, facility, or individual.
18        Section 5. Section 26-21-3 is amended to read:
19         26-21-3. Health Facility Committee -- Members -- Terms -- Organization --
20     Meetings.
21        (1) The Health Facility Committee created by Section 26-1-7 [shall consist] consists of
22    13 members appointed by the governor with the consent of the senate. No more than seven
23    members [shall] may be from the same political party. The appointed members shall be
24    knowledgeable about health care facilities and issues. The membership of the committee [shall
25    be composed of] is:
26        (a) one physician, licensed to practice medicine and surgery under Title 58, Chapter [12]
27    67, Utah Medical Practice Act, or Title 58, Chapter 68, Utah Osteopathic [Medicine Licensing]
28    Medical Practice Act, who is a graduate of a regularly chartered medical school;
29        (b) one hospital administrator;
30        (c) one hospital trustee;
31        (d) one representative of the nursing care facility industry;

- 7 -

1        (e) one [licensed] registered nurse, licensed to practice under Title 58, Chapter 31, Nurse
2    Practice Act;
3        (f) one professional in the field of mental retardation not affiliated with a nursing care
4    facility;
5        (g) one licensed architect or engineer with expertise in health care facilities;
6        (h) two representatives of health care facilities, other than nursing care facilities or
7    hospitals, licensed under this chapter; and
8        (i) four consumers, one of whom [shall have] has an interest in or expertise in geriatric
9    care.
10        (2) (a) Except as required by Subsection (b), members shall be appointed for a term of four
11    years.
12        (b) Notwithstanding the requirements of Subsection (a), the governor shall, at the time of
13    appointment or reappointment, adjust the length of terms to ensure that the terms of committee
14    members are staggered so that approximately half of the committee is appointed every two years.
15        (c) When a vacancy occurs in the membership for any reason, the replacement shall be
16    appointed for the unexpired term by the governor, giving consideration to recommendations made
17    by the committee, with the consent of the Senate.
18        (d) [No] A member [shall] may not serve more than two consecutive full terms or ten
19    consecutive years, whichever is less. However, a member may continue to serve as a member until
20    he is replaced.
21        (e) The committee shall annually elect from its membership a chair and vice chair [during
22    the second quarter of each year].
23        (f) The committee shall meet at least quarterly, or more frequently as determined by the
24    chair or five members of the committee.
25        (g) Seven members constitute a quorum. A vote of the majority of the members present
26    constitutes action of the committee.
27        Section 6. Section 26-21-5 is amended to read:
28         26-21-5. Duties of committee.
29        [(1)] The committee shall:
30        [(a)] (1) make rules in accordance with Title 63, Chapter 46a, Utah Administrative
31    Rulemaking Act:

- 8 -

1        [(i)] (a) for the licensing [and revoking licenses for] of health-care facilities; and
2        [(ii) governing the entry of agents of the department into health-care facilities for
3    inspections;]
4        [(iii) governing public hearings conducted under this chapter;]
5        [(iv) governing appeals related to licensure decisions of the department; and]
6        [(v)] (b) requiring the submission of architectural plans and specifications for any
7    proposed new health-care facility or renovation to the department for review;
8        [(b) define] (2) approve the information [that must be submitted to the department with
9    an application] for applications for [a license] licensure pursuant to Section 26-21-9;
10        [(c) establish fees for licenses issued to health-care facilities under this chapter in
11    accordance with Section 63-38-3.2;]
12        [(d)] (3) advise the department as requested concerning the interpretation and enforcement
13    of the rules established under this chapter; and
14        [(e) conduct hearings on appeals from enforcement actions of the department as provided
15    in this chapter;]
16        [(f) compel the attendance of witnesses and the production of documents and evidence,
17    administer oaths, and take testimony concerning appeals as provided in this chapter;]
18        [(g) appoint a hearings officer who is empowered to act in its behalf in hearings and
19    appeals as provided in this chapter; an appointed hearings officer has the same powers as the
20    committee in the conduct of the hearings; and]
21        [(h)] (4) advise, consult, cooperate with, and provide technical assistance to other agencies
22    of the state and federal government, and other states and affected groups or persons in carrying out
23    the purposes of this chapter.
24        [(2) Rules made by the committee under Subsection (1)(a)(v) are subject to Utah Fire
25    Prevention Board rules governing residential health-care facilities made under Section 53-7-204.]
26        Section 7. Section 26-21-6 is amended to read:
27         26-21-6. Duties of department.
28        (1) The department shall:
29        (a) enforce rules established [by the committee] pursuant to this chapter;
30        (b) authorize an agent of the department to conduct inspections of health-care facilities
31    pursuant to [rules of the committee] this chapter;

- 9 -

1        (c) collect information authorized by the committee that may be necessary to ensure that
2    adequate health-care facilities are available to the public;
3        (d) collect and credit fees for licenses as free revenue;
4        (e) collect and credit fees for conducting plan reviews as dedicated credits;
5        (f) designate an executive secretary from within the department to assist the committee in
6    carrying out its powers and responsibilities; and
7        (g) provide necessary administrative and staff support to the committee[;].
8        (2) The department may:
9        [(h)] (a) exercise all incidental powers necessary to carry out the purposes of this chapter;
10    [and]
11        [(i)] (b) review architectural plans and specifications of proposed health-care facilities or
12    renovations of health-care facilities to ensure that the plans and specifications conform to rules
13    established by the committee[.]; and
14        (c) make rules as necessary to implement the provisions of this chapter, except as authority
15    is specifically delegated to the committee.
16        [(2) The rules established by the committee under Subsection (1)(i) are subject to the rules
17    of the Utah Fire Prevention Board made pursuant to Section 53-7-204.]
18        Section 8. Section 26-21-8 is amended to read:
19         26-21-8. License required -- Not assignable or transferable -- Posting -- Expiration
20     and renewal -- Time for compliance by operating facilities.
21        (1) (a) A person or governmental unit acting severally or jointly with any other person or
22    governmental unit, may not establish, conduct, or maintain a health care facility in this state
23    without receiving a license from the department as provided by this chapter and the rules of the
24    committee.
25        (b) This subsection does not apply to those facilities exempted under Section 26-21-7.
26        (2) A license issued under this chapter is not assignable or transferable.
27        (3) The current license shall at all times be posted in each health care facility in a place
28    readily visible and accessible to the public.
29        (4) (a) Each license expires at midnight on the last day of the month, 12 months from date
30    of issuance, unless previously revoked by the department.
31        (b) The license shall be renewed annually upon completion of the application

- 10 -

1    requirements, unless the department finds the health care facility has not complied with the
2    provisions of this chapter or the rules adopted pursuant to [Section 26-21-5] this chapter.
3        (5) A license may be issued under this section only for the operation of a specific facility
4    at a specific site by a specific person.
5        (6) Any health care facility in operation at the time of adoption of any applicable rules as
6    provided under this chapter shall be given a reasonable time for compliance as determined by the
7    committee.
8        Section 9. Section 26-21-11 is amended to read:
9         26-21-11. Violations -- Denial or revocation of license -- Restricting or prohibiting
10     new admissions -- Monitor.
11        If the department finds a violation [is found under Section 26-21-10] of this chapter or any
12    rules adopted pursuant to this chapter the department may take one or more of the following
13    actions:
14        (1) [Serve] serve a written statement of violation requiring corrective action, which shall
15    include time frames for correction of all violations[.];
16        (2) [Deny, suspend,] deny or revoke a license if it finds [that]:
17        (a) there has been a failure to comply with the rules established [by the committee; or, it
18    finds] pursuant to this chapter;
19        (b) evidence of aiding, abetting, or permitting the commission of any illegal act[,]; or [it
20    finds]
21        (c) conduct adverse to the public health, morals, welfare, and safety of the people of the
22    state[.];
23        (3) [Restrict] restrict or prohibit new admissions to a health care facility or revoke [or
24    suspend] the license of a health care facility for:
25        (a) violation of any rule adopted under this chapter; or
26        (b) permitting, aiding, or abetting the commission of any illegal act in the health care
27    facility[.];
28        (4) [Place] place a department representative as a monitor in the facility until [such time
29    as] corrective action is completed[.];
30        (5) [Assess] assess to the facility the cost incurred by the department in placing [the] a
31    monitor[.];

- 11 -

1        (6) assess an administrative penalty as allowed by Subsection 26-23-6(1)(a); or
2        (7) issue a cease and desist order to the facility.
3        Section 10. Section 26-21-12 is amended to read:
4         26-21-12. Issuance of new license after revocation -- Restoration.
5        (1) If a license is revoked, [a new license may be issued only after the department verifies
6    by inspection that the conditions upon which revocation was based have been corrected] the
7    department may issue a new license only after it determines by inspection that the facility has
8    corrected the conditions that were the basis of revocation and that the facility complies with all
9    provisions of this chapter and applicable rules.
10        [(2) Suspension of a license may be for a definite or indefinite period. The Department
11    shall completely or partially restore a suspended license upon a determination that the conditions
12    upon which suspension was based have been completely or partially corrected and that the interests
13    of the public will not be jeopardized by restoration of the license. ]
14        [(3) If a license is not renewed] (2) If the department does not renew a license because of
15    noncompliance with the provisions of this chapter or the rules adopted under [Section 26-21-5, a
16    new license may be issued] this chapter, the department may issue a new license only after the
17    facility complies with all renewal requirements and the department determines that the interests
18    of the public will not be jeopardized.
19        Section 11. Section 26-21-16 is amended to read:
20         26-21-16. Operating facility in violation of chapter or rules a misdemeanor.
21        (1) Any person owning, establishing, conducting, maintaining, managing, or operating a
22    health care facility in violation of this chapter or rules of the committee is guilty of a class [B] A
23    misdemeanor.
24        (2) This section takes precedence over Section 26-23-6.
25        Section 12. Section 26-21-20 is amended to read:
26         26-21-20. Requirement for hospitals to provide statements of itemized charges to
27     patients.
28        (1) Each hospital, as defined in [Subsections 26-21-2 (8) and (18)] Section 26-21-2, shall
29    provide a statement of itemized charges to any patient receiving medical care or other services
30    from that hospital.
31        (2) The statement shall be provided to the patient or his personal representative or agent

- 12 -

1    at the hospital's expense, either personally or by mail, at the time any statement is provided to any
2    person or entity for billing purposes. If the statement is not provided to a third party, it shall be
3    provided to the patient as soon as possible and practicable.
4        (3) The statement shall itemize each of the charges actually provided by the hospital to the
5    patient.
6        (4) The statement may not include charges of physicians who bill separately.
7        (5) The requirements of this section do not apply to patients who receive services from a
8    hospital under Title XIX of the Social Security Act.
9        (6) A statement of charges to be paid by a third party and related information provided to
10    a patient pursuant to this section shall be marked in bold: "DUPLICATE: DO NOT PAY" or other
11    appropriate language.
12        Section 13. Section 26-35-103 is amended to read:
13         26-35-103. Definitions.
14        As used in this chapter:
15        (1) (a) "Nursing facility" means a health care facility described in [Subsection
16    26-21-2(14)] Section 26-21-2 or an intermediate care facility for the mentally retarded that is
17    licensed under Section 26-21-13.5.
18        (b) "Nursing facility" does not include the Utah State Developmental Center or the Utah
19    State Hospital.
20        (2) "Patient day" means each calendar day in which an individual patient is admitted to
21    the nursing facility during a calendar month, even if on a temporary leave of absence from the
22    facility.
23        Section 14. Section 26-36-104 is amended to read:
24         26-36-104. Definitions.
25        As used in this chapter:
26        (1) "Adjusted inpatient days" for any hospital during a particular measuring period means
27    the number of inpatient days for a hospital during a measuring period times a fraction, the
28    numerator of which is the total patient revenue of the hospital during a measuring period and the
29    denominator of which is the total inpatient revenue of the hospital during a measuring period.
30        (2) "Assessment" means the Medicaid hospital provider temporary assessment established
31    by this chapter.

- 13 -

1        (3) "Federal act" means the Medicaid Voluntary Contribution and Provider-Specific Tax
2    Amendments of 1991, Public Law 102-234, enacted December 12, 1991.
3        (4) "Freestanding ambulatory surgical facility" means an urban or rural nonhospital based
4    or nonhospital affiliated licensed facility as defined in [Subsection 26-21-2(2)] Section 26-21-2
5    as an ambulatory surgical facility, with an organized professional staff that provides surgical
6    services to patients who do not require an inpatient bed.
7        (5) "Gross revenue" for any hospital during a particular measuring period means standard,
8    nondiscounted charges for all services rendered to patients by the hospital during a measuring
9    period.
10        (6) "Hospital" means:
11        (a) any general acute hospital operating in the state of Utah as defined in [Subsection
12    26-21-2(9)] Section 26-21-2.
13        (b) "Hospital" does not include residential care or treatment facilities as defined in
14    Subsections 62A-2-101(17), (18), and (20), Health Maintenance Organization owned service
15    facilities, the Utah State Hospital or any rural hospital that operates outside of a metropolitan
16    statistical area, a metropolitan area, or an urbanized area as designated by the U.S. Bureau of
17    Census, or any specialty hospital operating in this state as defined in [Subsection 26-21-2(19)]
18    Section 26-21-2 that may be engaged exclusively in rendering psychiatric or other mental health
19    treatment.
20        (7) "Hospital-based ambulatory surgical facility" means an urban or rural on hospital
21    campus or hospital affiliated licensed facility with an organized professional staff that provides
22    surgical services to patients who do not require an inpatient bed.
23        (8) "Inpatient" means a patient of a hospital who is admitted on an overnight basis.
24        (9) "Inpatient day" means, with respect to each hospital patient excluding patients in the
25    nursery, skilled nursing and labor room, each 24-hour period during which a patient is an inpatient
26    of the hospital.
27        (10) "Inpatient services" means all services rendered by a hospital to an inpatient.
28        (11) "Outpatient" means any patient of a hospital other than an inpatient.
29        (12) "Outpatient services" means all services rendered by a hospital other than inpatient
30    services.
31        (13) "Patient encounter" as applied to any freestanding ambulatory surgical facility or

- 14 -

1    hospital-based ambulatory surgical facility means one or more outpatient surgery procedures
2    performed on one outpatient during the course of one outpatient visit for which a charge is
3    incurred. The patient encounter as defined in this act includes ancillary services incident to the
4    surgical procedures performed during the surgical visit.
5        (14) "Total inpatient revenue" for any hospital during a particular measuring period means
6    total gross revenue derived by the hospital from inpatient services rendered during a measuring
7    period.
8        (15) "Total outpatient revenue" for any hospital during a particular measuring period
9    means total gross revenue derived by the hospital from all outpatient services rendered, minus
10    those revenues derived from a hospital-based ambulatory surgical facility, during a measuring
11    period.
12        (16) "Total patient revenue" means the sum of total inpatient revenue and total outpatient
13    revenue.
14        Section 15. Section 59-12-102 is amended to read:
15         59-12-102. Definitions.
16        As used in this chapter:
17        (1) (a) "Admission or user fees" includes season passes.
18        (b) "Admission or user fees" does not include annual membership dues to private
19    organizations.
20        (2) "Authorized carrier" means:
21        (a) in the case of vehicles operated over public highways, the holder of credentials
22    indicating that the vehicle is or will be operated pursuant to both the International Registration
23    Plan (IRP) and the International Fuel Tax Agreement (IFTA);
24        (b) in the case of aircraft, the holder of a Federal Aviation Administration (FAA) operating
25    certificate or air carrier's operating certificate; or
26        (c) in the case of locomotives, freight cars, railroad work equipment, or other rolling stock,
27    the holder of a certificate issued by the United States Interstate Commerce Commission.
28        (3) (a) For purposes of Subsection 59-12-104(44), "coin-operated amusement device"
29    means:
30        (i) a coin-operated amusement, skill, or ride device;
31        (ii) that is not controlled through vendor-assisted, over-the-counter, sales of tokens; and

- 15 -

1        (iii) includes a music machine, pinball machine, billiard machine, video game machine,
2    arcade machine, and a mechanical or electronic skill game or ride.
3        (b) For purposes of Subsection 59-12-104(44), "coin-operated amusement device" does
4    not mean a coin-operated amusement device possessing a coinage mechanism that:
5        (i) accepts and registers multiple denominations of coins; and
6        (ii) allows the vendor to collect the sales and use tax at the time an amusement device is
7    activated and operated by a person inserting coins into the device.
8        (4) "Commercial use" means the use of gas, electricity, heat, coal, fuel oil, or other fuels
9    that does not constitute industrial use under Subsection (10) or residential use under Subsection
10    (16).
11        (5) "Common carrier" means a person engaged in or transacting the business of
12    transporting passengers, freight, merchandise, or other property for hire within this state.
13        (6) "Component part" includes:
14        (a) poultry, dairy, and other livestock feed, and their components;
15        (b) baling ties and twine used in the baling of hay and straw;
16        (c) fuel used for providing temperature control of orchards and commercial greenhouses
17    doing a majority of their business in wholesale sales, and for providing power for off-highway type
18    farm machinery; and
19        (d) feed, seeds, and seedlings.
20        (7) "Construction materials" means any tangible personal property that will be converted
21    into real property.
22        (8) (a) "Fundraising sales" means sales:
23        (i) (A) made by a public or private elementary or secondary school; or
24        (B) made by a public or private elementary or secondary school student, grades
25    kindergarten through 12;
26        (ii) that are for the purpose of raising funds for the school to purchase equipment,
27    materials, or provide transportation; and
28        (iii) that are part of an officially sanctioned school activity.
29        (b) For purposes of Subsection (8)(a)(iii), "officially sanctioned school activity" means
30    a school activity:
31        (i) that is conducted in accordance with a formal policy adopted by the school or school

- 16 -

1    district governing the authorization and supervision of fundraising activities;
2        (ii) that does not directly or indirectly compensate an individual teacher or other
3    educational personnel by direct payment, commissions, or payment in kind; and
4        (iii) the net or gross revenues from which are deposited in a dedicated account controlled
5    by the school or school district.
6        (9) (a) "Home medical equipment and supplies" means equipment and supplies that:
7        (i) a licensed physician prescribes or authorizes in writing as necessary for the treatment
8    of a medical illness or injury or as necessary to mitigate an impairment resulting from illness or
9    injury;
10        (ii) are used exclusively by the person for whom they are prescribed to serve a medical
11    purpose; and
12        (iii) are listed as eligible for payment under Title 18 of the federal Social Security Act or
13    under the state plan for medical assistance under Title 19 of the federal Social Security Act.
14        (b) "Home medical equipment and supplies" does not include:
15        (i) equipment and supplies purchased by, for, or on behalf of any health care facility, as
16    defined in Subsection (9)(c), doctor, nurse, or other health care provider for use in their
17    professional practice;
18        (ii) eyeglasses, contact lenses, or equipment to correct impaired vision; or
19        (iii) hearing aids or hearing aid accessories.
20        (c) For purposes of Subsection (9)(b)(i), "health care facility" includes:
21        (i) a clinic;
22        (ii) a doctor's office; and
23        (iii) a health care facility as defined in [Subsection 26-21-2(11)(a)] Section 26-21-2.
24        (10) "Industrial use" means the use of natural gas, electricity, heat, coal, fuel oil, or other
25    fuels in:
26        (a) mining or extraction of minerals;
27        (b) agricultural operations to produce an agricultural product up to the time of harvest or
28    placing the agricultural product into a storage facility, including:
29        (i) commercial greenhouses;
30        (ii) irrigation pumps;
31        (iii) farm machinery;

- 17 -

1        (iv) implements of husbandry as defined in Subsection 41-1a-102(23) that are not
2    registered under Title 41, Chapter 1a, Part 2, Registration; and
3        (v) other farming activities; and
4        (c) manufacturing tangible personal property at an establishment described in SIC Codes
5    2000 to 3999 of the 1987 Standard Industrial Classification Manual of the federal Executive Office
6    of the President, Office of Management and Budget.
7        (11) "Manufactured home" means any manufactured home or mobile home as defined in
8    Title 58, Chapter 56, Utah Uniform Building Standards Act.
9        (12) (a) "Medicine" means:
10        (i) insulin, syringes, and any medicine prescribed for the treatment of human ailments by
11    a person authorized to prescribe treatments and dispensed on prescription filled by a registered
12    pharmacist, or supplied to patients by a physician, surgeon, or podiatric physician;
13        (ii) any medicine dispensed to patients in a county or other licensed hospital if prescribed
14    for that patient and dispensed by a registered pharmacist or administered under the direction of a
15    physician; and
16        (iii) any oxygen or stoma supplies prescribed by a physician or administered under the
17    direction of a physician or paramedic.
18        (b) "Medicine" does not include:
19        (i) any auditory, prosthetic, ophthalmic, or ocular device or appliance; or
20        (ii) any alcoholic beverage.
21        (13) (a) "Other fuels" means products that burn independently to produce heat or energy.
22        (b) "Other fuels" includes oxygen when it is used in the manufacturing of tangible personal
23    property.
24        (14) "Person" includes any individual, firm, partnership, joint venture, association,
25    corporation, estate, trust, business trust, receiver, syndicate, this state, any county, city,
26    municipality, district, or other local governmental entity of the state, or any group or combination
27    acting as a unit.
28        (15) "Purchase price" means the amount paid or charged for tangible personal property or
29    any other taxable item or service under Subsection 59-12-103(1), excluding only cash discounts
30    taken or any excise tax imposed on the purchase price by the federal government.
31        (16) "Residential use" means the use in or around a home, apartment building, sleeping

- 18 -

1    quarters, and similar facilities or accommodations.
2        (17) (a) "Retail sale" means any sale within the state of tangible personal property or any
3    other taxable item or service under Subsection 59-12-103(1), other than resale of such property,
4    item, or service by a retailer or wholesaler to a user or consumer.
5        (b) "Retail sale" includes sales by any farmer or other agricultural producer of poultry,
6    eggs, or dairy products to consumers if the sales have an average monthly sales value of $125 or
7    more.
8        (c) "Retail sale" does not include, and no additional sales or use tax shall be assessed
9    against, those transactions where a purchaser of tangible personal property pays applicable sales
10    or use taxes on its initial nonexempt purchases of property and then enters into a sale-leaseback
11    transaction by which title to such property is transferred by the purchaser-lessee to a lessor for
12    consideration, provided:
13        (i) the transaction is intended as a form of financing for the property to the
14    purchaser-lessee; and
15        (ii) pursuant to generally accepted accounting principles, the purchaser-lessee is required
16    to capitalize the subject property for financial reporting purposes, and account for the lease
17    payments as payments made under a financing arrangement.
18        (18) (a) "Retailer" means any person engaged in a regularly organized retail business in
19    tangible personal property or any other taxable item or service under Subsection 59-12-103(1), and
20    who is selling to the user or consumer and not for resale.
21        (b) "Retailer" includes commission merchants, auctioneers, and any person regularly
22    engaged in the business of selling to users or consumers within the state.
23        (c) "Retailer" includes any person who engages in regular or systematic solicitation of a
24    consumer market in this state by the distribution of catalogs, periodicals, advertising flyers, or
25    other advertising, or by means of print, radio or television media, by mail, telegraphy, telephone,
26    computer data base, cable, optic, microwave, or other communication system.
27        (d) "Retailer" does not include farmers, gardeners, stockmen, poultrymen, or other growers
28    or agricultural producers producing and doing business on their own premises, except those who
29    are regularly engaged in the business of buying or selling for a profit.
30        (e) For purposes of this chapter the commission may regard as retailers the following if
31    they determine it is necessary for the efficient administration of this chapter: salesmen,

- 19 -

1    representatives, peddlers, or canvassers as the agents of the dealers, distributors, supervisors, or
2    employers under whom they operate or from whom they obtain the tangible personal property sold
3    by them, irrespective of whether they are making sales on their own behalf or on behalf of these
4    dealers, distributors, supervisors, or employers, except that:
5        (i) a printer's facility with which a retailer has contracted for printing shall not be
6    considered to be a salesman, representative, peddler, canvasser, or agent of the retailer; and
7        (ii) the ownership of property that is located at the premises of a printer's facility with
8    which the retailer has contracted for printing and that consists of the final printed product, property
9    that becomes a part of the final printed product, or copy from which the printed product is
10    produced, shall not result in the retailer being deemed to have or maintain an office, distribution
11    house, sales house, warehouse, service enterprise, or other place of business, or to maintain a stock
12    of goods, within this state.
13        (19) "Sale" means any transfer of title, exchange, or barter, conditional or otherwise, in
14    any manner, of tangible personal property or any other taxable item or service under Subsection
15    59-12-103(1), for a consideration. It includes:
16        (a) installment and credit sales;
17        (b) any closed transaction constituting a sale;
18        (c) any sale of electrical energy, gas, services, or entertainment taxable under this chapter;
19        (d) any transaction if the possession of property is transferred but the seller retains the title
20    as security for the payment of the price; and
21        (e) any transaction under which right to possession, operation, or use of any article of
22    tangible personal property is granted under a lease or contract and the transfer of possession would
23    be taxable if an outright sale were made.
24        (20) (a) "Sales relating to schools" means sales by a public school district or public or
25    private elementary or secondary school, grades kindergarten through 12, that are directly related
26    to the school's or school district's educational functions or activities and include:
27        (i) the sale of textbooks, textbook fees, laboratory fees, laboratory supplies, and safety
28    equipment;
29        (ii) the sale of clothing that:
30        (A) a student is specifically required to wear as a condition of participation in a
31    school-related event or activity; and

- 20 -

1        (B) is not readily adaptable to general or continued usage to the extent that it takes the
2    place of ordinary clothing;
3        (iii) sales of food if the net or gross revenues generated by the food sales are deposited into
4    a school district fund or school fund dedicated to school meals; and
5        (iv) transportation charges for official school activities.
6        (b) "Sales relating to schools" does not include:
7        (i) gate receipts;
8        (ii) special event admission fees;
9        (iii) bookstore sales of items that are not educational materials or supplies; and
10        (iv) except as provided in Subsection (20)(a)(ii), clothing.
11        (21) "State" means the state of Utah, its departments, and agencies.
12        (22) "Storage" means any keeping or retention of tangible personal property or any other
13    taxable item or service under Subsection 59-12-103(1), in this state for any purpose except sale
14    in the regular course of business.
15        (23) (a) "Tangible personal property" means:
16        (i) all goods, wares, merchandise, produce, and commodities;
17        (ii) all tangible or corporeal things and substances which are dealt in or capable of being
18    possessed or exchanged;
19        (iii) water in bottles, tanks, or other containers; and
20        (iv) all other physically existing articles or things, including property severed from real
21    estate.
22        (b) "Tangible personal property" does not include:
23        (i) real estate or any interest or improvements in real estate;
24        (ii) bank accounts, stocks, bonds, mortgages, notes, and other evidence of debt;
25        (iii) insurance certificates or policies;
26        (iv) personal or governmental licenses;
27        (v) water in pipes, conduits, ditches, or reservoirs;
28        (vi) currency and coinage constituting legal tender of the United States or of a foreign
29    nation; and
30        (vii) all gold, silver, or platinum ingots, bars, medallions, or decorative coins, not
31    constituting legal tender of any nation, with a gold, silver, or platinum content of not less than

- 21 -

1    80%.
2        (24) (a) "Use" means the exercise of any right or power over tangible personal property
3    under Subsection 59-12-103(1), incident to the ownership or the leasing of that property, item, or
4    service.
5        (b) "Use" does not include the sale, display, demonstration, or trial of that property in the
6    regular course of business and held for resale.
7        (25) "Vehicle" means any aircraft, as defined in Section 2-1-1; any vehicle, as defined in
8    Section 41-1a-102; any off-highway vehicle, as defined in Section 41-22-2; and any vessel, as
9    defined in Section 41-1a-102; that is required to be titled, registered, or both. "Vehicle" for
10    purposes of Subsection 59-12-104(37) only, also includes any locomotive, freight car, railroad
11    work equipment, or other railroad rolling stock.
12        (26) "Vehicle dealer" means a person engaged in the business of buying, selling, or
13    exchanging vehicles as defined in Subsection (25).
14        (27) (a) "Vendor" means:
15        (i) any person receiving any payment or consideration upon a sale of tangible personal
16    property or any other taxable item or service under Subsection 59-12-103(1), or to whom such
17    payment or consideration is payable; and
18        (ii) any person who engages in regular or systematic solicitation of a consumer market in
19    this state by the distribution of catalogs, periodicals, advertising flyers, or other advertising, or by
20    means of print, radio or television media, by mail, telegraphy, telephone, computer data base,
21    cable, optic, microwave, or other communication system.
22        (b) "Vendor" does not mean a printer's facility described in Subsection (18)(e).
23        Section 16. Section 62A-3-202 is amended to read:
24         62A-3-202. Definitions.
25        As used in this part:
26        (1) "Elderly resident" means an adult 60 years of age or older who because of physical,
27    economic, social, or emotional problems cannot function normally on an independent basis, and
28    who resides in a long-term care facility.
29        (2) "Government agency" means any department, division, office, bureau, board,
30    commission, authority, or any other agency or instrumentality created by the state, or to which the
31    state is a party, or created by any county or municipality, which is responsible for the regulation,

- 22 -

1    visitation, inspection, or supervision of facilities, or which provides services to patients, residents,
2    or clients of facilities.
3        (3) "Long-term care facility" means any skilled nursing facility, intermediate care facility,
4    nursing home, residential health care facility, assisted living facility, adult foster care home, or any
5    living arrangement in the community through which room and personal care services are provided
6    for elderly residents.
7        (4) "Ombudsman" means the administrator of the long-term care ombudsman program,
8    created pursuant to Section 62A-3-203.
9        Section 17. Section 78-30-4.13 is amended to read:
10         78-30-4.13. Notice of adoption proceedings.
11        (1) An unmarried biological father, by virtue of the fact that he has engaged in a sexual
12    relationship with a woman, is deemed to be on notice that a pregnancy and an adoption proceeding
13    regarding that child may occur, and has a duty to protect his own rights and interests. He is
14    therefore entitled to actual notice of a birth or an adoption proceeding with regard to that child only
15    as provided in this section.
16        (2) Notice of an adoption proceeding shall be served on each of the following persons:
17        (a) any person or agency whose consent or relinquishment is required under Section
18    78-30-4.14 unless that right has been terminated by waiver, relinquishment, consent, or judicial
19    action;
20        (b) any person who has initiated a paternity proceeding and filed notice of that action with
21    the state registrar of vital statistics within the Department of Health, in accordance with Subsection
22    (3);
23        (c) any legally appointed custodian or guardian of the adoptee;
24        (d) the petitioner's spouse, if any, only if he has not joined in the petition;
25        (e) the adoptee's spouse, if any;
26        (f) any person who is recorded on the birth certificate as the child's father, with the
27    knowledge and consent of the mother;
28        (g) any person who is openly living in the same household with the child at the time the
29    consent is executed or relinquishment made, and who is holding himself out to be the child's
30    father; and
31        (h) any person who is married to the child's mother at the time she executes her consent

- 23 -

1    to the adoption or relinquishes the child for adoption.
2        (3) (a) In order to preserve any right to notice and consent, an unmarried biological father
3    may initiate proceedings to establish paternity under Title 78, Chapter 45a, Uniform Act on
4    Paternity, and file a notice of the initiation of those proceedings with the state registrar of vital
5    statistics within the Department of Health prior to the mother's execution of consent or her
6    relinquishment to an agency. That action and notice may also be filed prior to the child's birth.
7        (b) The Department of Health shall provide forms for the purpose of filing the notice
8    described in Subsection (a), and make those forms available in the office of the county clerk in
9    each county, every health care facility, as defined in [Subsection 26-21-2(11)] Section 26-21-2,
10    and licensed child-placing agency.
11        (4) Notice provided in accordance with this section need not disclose the name of the
12    mother of the child who is the subject of an adoption proceeding.
13        (5) The notice required by this section may be served immediately after relinquishment
14    or execution of consent, but shall be served at least 30 days prior to the final dispositional hearing.
15    The notice shall specifically state that the person served must respond to the petition within 30
16    days of service if he intends to intervene in or contest the adoption.
17        (6) (a) Any person who has been served with notice of an adoption proceeding and who
18    wishes to contest the adoption shall file a motion in the adoption proceeding within 30 days after
19    service. The motion shall set forth specific relief sought and be accompanied by a memorandum
20    specifying the factual and legal grounds upon which the motion is based.
21        (b) Any person who fails to file a motion for relief within 30 days after service of notice
22    waives any right to further notice in connection with the adoption, forfeits all rights in relation to
23    the adoptee, and is barred from thereafter bringing or maintaining any action to assert any interest
24    in the adoptee.
25        (7) Service of notice under this section shall be made as follows:
26        (a) With regard to a person whose consent is necessary under Section 78-30-4.14, service
27    shall be in accordance with the provisions of the Utah Rules of Civil Procedure. If service is by
28    publication, the court shall designate the content of the notice regarding the identity of the parties.
29    The notice may not include the name of the person or persons seeking to adopt the adoptee.
30        (b) As to any other person for whom notice is required under this section, service by
31    certified mail, return receipt requested, is sufficient. If that service cannot be completed after two

- 24 -

1    attempts, the court may issue an order providing for service by publication, posting, or by any
2    other manner of service.
3        (c) Notice to a person who has initiated a paternity proceeding and filed notice of that
4    action with the state registrar of vital statistics in the Department of Health in accordance with the
5    requirements of Subsection (3), shall be served by certified mail, return receipt requested, at the
6    last address filed with the registrar.
7        (8) The notice required by this section may be waived in writing by the person entitled to
8    receive notice.
9        (9) Proof of service of notice on all persons for whom notice is required by this section
10    shall be filed with the court before the final dispositional hearing on the adoption.
11        (10) Notwithstanding any other provision of law, neither the notice of an adoption
12    proceeding nor any process in that proceeding is required to contain the name of the person or
13    persons seeking to adopt the adoptee.
14        (11) Except as to those persons whose consent to an adoption is required under Section
15    78-30-4.14, the sole purpose of notice under this section is to enable the person served to intervene
16    in the adoption and present evidence to the court relevant to the best interest of the child.
17        Section 18. Repealer.
18        This act repeals:
19        Section 26-21-10, Violations -- Committee review.

- 25 -

[Bill Documents][Bills Directory]