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S.B. 6 Enrolled






Chief Sponsor: Allen M. Christensen

House Sponsor: Bradley G. Last

             8      LONG TITLE
             9      General Description:
             10          This bill removes the sunset provisions for certain programs in the Department of
             11      Health and the Department of Human Services and reduces some reporting
             12      requirements to the Health and Human Services Interim Committee.
             13      Highlighted Provisions:
             14          This bill:
             15          .    amends the Department of Health's annual reporting requirement to the Health and
             16      Human Services Interim Committee for AIDS testing data, abortion informed
             17      consent data, and the Utah Medical Assistance Program;
             18          .    removes the following programs from the legislative sunset act:
             19              .    Family Health Services;
             20              .    Utah Medical Examiner Act;
             21              .    Department of Health Organization; and
             22              .    Safe Relinquishment of Newborn Child;
             23          .    requires the Department of Health to report to the Legislative Executive
             24      Appropriations Committee or the Health and Human Services Appropriations
             25      Subcommittee if the department initiates an amendment to an existing Medicaid
             26      waiver;
             27          .    repeals statutes regarding the 1996 Medicaid freedom of choice waiver and the 1995
             28      Section 1315 Medicaid waiver; and
             29          .    makes conforming and technical amendments.

             30      Monies Appropriated in this Bill:
             31          None
             32      Other Special Clauses:
             33          None
             34      Utah Code Sections Affected:
             35      AMENDS:
             36          26-6-3.5, as last amended by Chapter 13, Laws of Utah 1998
             37          26-18-3, as last amended by Chapters 321 and 324, Laws of Utah 2003
             38          26-18-305, as last amended by Chapter 13, Laws of Utah 1998
             39          62A-4a-902, as enacted by Chapter 115, Laws of Utah 2001
             40          63-55-226, as last amended by Chapter 86, Laws of Utah 2005
             41          63-55-262, as last amended by Chapter 134, Laws of Utah 2001
             42          76-7-305.5, as last amended by Chapter 13, Laws of Utah 1998
             43      REPEALS:
             44          26-18-3.7, as last amended by Chapters 8 and 18, Laws of Utah 2002, Fifth Special
             45      Session
             46          26-18-401, as last amended by Chapter 53, Laws of Utah 2001
             48      Be it enacted by the Legislature of the state of Utah:
             49          Section 1. Section 26-6-3.5 is amended to read:
             50           26-6-3.5. Reporting AIDS and HIV infection -- Anonymous testing.
             51          (1) Because of the nature and consequences of Acquired Immunodeficiency Syndrome
             52      and Human Immunodeficiency Virus infection, the department shall:
             53          (a) require reporting of those conditions; and
             54          (b) utilize contact tracing and other methods for "partner" identification and
             55      notification. The department shall, by rule, define individuals who are considered "partners" for
             56      purposes of this section.
             57          (2) (a) The requirements of Subsection (1) do not apply to seroprevalence and other

             58      epidemiological studies conducted by the department.
             59          (b) The requirements of Subsection (1) do not apply to, and anonymity shall be
             60      provided in, research studies conducted by universities or hospitals, under the authority of
             61      institutional review boards if those studies are funded in whole or in part by research grants and
             62      if anonymity is required in order to obtain the research grant or to carry out the research.
             63          (3) For all purposes of this chapter, Acquired Immunodeficiency Syndrome and Human
             64      Immunodeficiency Virus infection are considered communicable and infectious diseases.
             65          (4) The department may establish or allow one site or agency within the state to
             66      provide anonymous testing.
             67          (a) The site or agency that provides anonymous testing shall maintain accurate records
             68      regarding:
             69          (i) the number of HIV positive individuals that it is able to contact or inform of their
             70      condition;
             71          (ii) the number of HIV positive individuals who receive extensive counseling;
             72          (iii) how many HIV positive individuals provide verifiable information for partner
             73      notification; and
             74          (iv) how many cases in which partner notification is carried through.
             75          [(b) A statistical report of the information maintained under Subsection (4)(a) shall be
             76      presented to the Health and Human Services Interim Committee on an annual basis. The
             77      information collected under Subsection (4)(a) and the reports required by this subsection shall
             78      be maintained and presented in such a way that no individual is identifiable.]
             79          [(c)] (b) If the information [and reports indicate] maintained under Subsection (4)(a)
             80      indicates anonymous testing is not resulting in partner notification, the department shall phase
             81      out the anonymous testing program allowed by this Subsection (4).
             82          Section 2. Section 26-18-3 is amended to read:
             83           26-18-3. Administration of Medicaid program by department -- Disciplinary
             84      measures and sanctions -- Funds collected.
             85          (1) The department shall be the single state agency responsible for the administration

             86      of the Medicaid program in connection with the United States Department of Health and
             87      Human Services pursuant to Title XIX of the Social Security Act.
             88          (2) (a) The department shall implement the Medicaid program through administrative
             89      rules in conformity with this chapter, Title 63, Chapter 46a, Utah Administrative Rulemaking
             90      Act, the requirements of Title XIX, and applicable federal regulations.
             91          (b) (i) The rules adopted under Subsection (2)(a) shall include, in addition to other
             92      rules necessary to implement the program, the standards used by the department for
             93      determining eligibility for Medicaid services, the services and benefits to be covered by the
             94      Medicaid program, and reimbursement methodologies for providers under the Medicaid
             95      program.
             96          (ii) If the department implements a change in the Medicaid State Plan, initiates a new
             97      Medicaid waiver, [submits] initiates an amendment to an existing Medicaid waiver, or initiates
             98      a rate change requiring public notice under state or federal law, the department shall, prior to
             99      adopting the change, report to either the Legislative Executive Appropriations Committee or
             100      the Legislative Health and Human Services Appropriations Subcommittee and include in the
             101      report:
             102          (A) the proposed change in services or reimbursement;
             103          (B) the effect of an increase or decrease in services or benefits on individuals and
             104      families;
             105          (C) the degree to which any proposed cut may result in cost-shifting to more expensive
             106      services in health or human service programs; and
             107          (D) the effect of any proposed increase of benefits or reimbursement on current and
             108      future appropriations from the Legislature to the department.
             109          (iii) Any rules adopted by the department under this Subsection (2) are subject to
             110      review and reauthorization by the Legislature in accordance with Section 63-46a-11.5 .
             111          (3) The department may, in its discretion, contract with the Department of Human
             112      Services or other qualified agencies for services in connection with the administration of the
             113      Medicaid program, including but not limited to the determination of the eligibility of

             114      individuals for the program, recovery of overpayments, and enforcement of fraud and abuse
             115      laws, consistent with Section 26-20-13 , to the extent permitted by law and quality control
             116      services.
             117          (4) The department shall provide, by rule, disciplinary measures and sanctions for
             118      Medicaid providers who fail to comply with the rules and procedures of the program, provided
             119      that sanctions imposed administratively may not extend beyond:
             120          (a) termination from the program;
             121          (b) recovery of claim reimbursements incorrectly paid; and
             122          (c) those specified in Section 1919 of Title XIX of the federal Social Security Act.
             123          (5) Funds collected as a result of a sanction imposed under Section 1919 of Title XIX
             124      of the federal Social Security Act shall be deposited in the General Fund as nonlapsing
             125      dedicated credits to be used by the division in accordance with the requirements of that section.
             126          (6) (a) In determining whether an applicant or recipient is eligible for a service or
             127      benefit under this part or Chapter 40, Utah Children's Health Insurance Act, the department
             128      shall, if Subsection (6)(b) is satisfied, exclude from consideration one passenger vehicle
             129      designated by the applicant or recipient.
             130          (b) Before Subsection (6)(a) may be applied:
             131          (i) the federal government must:
             132          (A) determine that Subsection (6)(a) may be implemented within the state's existing
             133      public assistance-related waivers as of January 1, 1999;
             134          (B) extend a waiver to the state permitting the implementation of Subsection (6)(a); or
             135          (C) determine that the state's waivers that permit dual eligibility determinations for
             136      cash assistance and Medicaid are no longer valid; and
             137          (ii) the department must determine that Subsection (6)(a) can be implemented within
             138      existing funding.
             139          (7) (a) For purposes of this Subsection (7):
             140          (i) "aged, blind, or disabled" shall be defined by administrative rule; and
             141          (ii) "spend down" means an amount of income in excess of the allowable income

             142      standard that must be paid in cash to the department or incurred through the medical services
             143      not paid by Medicaid.
             144          (b) In determining whether an applicant or recipient who is aged, blind, or disabled is
             145      eligible for a service or benefit under this chapter, the department shall use 100% of the federal
             146      poverty level as:
             147          (i) the allowable income standard for eligibility for services or benefits; and
             148          (ii) the allowable income standard for eligibility as a result of spend down.
             149          Section 3. Section 26-18-305 is amended to read:
             150           26-18-305. Report on implementation.
             151          The department shall report to the Health and Human Services Interim Committee by
             152      November 1, 1994, and every year thereafter on the implementation of the grant program for
             153      primary care services. The report shall include a description of the scope and level of coverage
             154      provided to low-income persons by primary care grant programs [and by the medical assistance
             155      program established in Section 26-18-10 . The report shall also include recommendations to
             156      minimize the loss of revenue by hospitals that serve a disproportionate share of persons under
             157      Section 26-18-10 ].
             158          Section 4. Section 62A-4a-902 is amended to read:
             159           62A-4a-902. Definitions.
             160          (1) (a) "Adoption assistance" means direct financial subsidies and support to adoptive
             161      parents of a child with special needs or whose need or condition has created a barrier that
             162      would prevent a successful adoption.
             163          (b) "Adoption assistance" may include state medical assistance, reimbursement of
             164      nonrecurring adoption expenses, or monthly subsidies.
             165          (2) "Child who has a special need" means a child who cannot or should not be returned
             166      to the home of his biological parents and who meets at least one of the following conditions:
             167          (a) the child is five years of age or older;
             168          (b) the child is under the age of 18 with a physical, emotional, or mental disability; or
             169          (c) the child is a member of a sibling group placed together for adoption.

             170          (3) "Monthly subsidy" means financial support to assist with the costs of adopting and
             171      caring for a child who has a special need.
             172          (4) "Nonrecurring adoption expenses" means reasonably necessary adoption fees, court
             173      costs, attorney's fees, and other expenses which are directly related to the legal adoption of a
             174      child who has a special need.
             175          (5) "State medical assistance" means the Medicaid program and medical assistance as
             176      defined in Subsections 26-18-2 (4) and (5)[, not limited to a prepaid health care delivery system
             177      as defined in Section 26-18-3.7 ].
             178          (6) "Supplemental adoption assistance" means financial support for extraordinary,
             179      infrequent, or uncommon documented needs not otherwise covered by a monthly subsidy, state
             180      medical assistance, or other public benefits for which a child who has a special need is eligible.
             181          Section 5. Section 63-55-226 is amended to read:
             182           63-55-226. Repeal dates, Title 26.
             183          [(1) Title 26, Chapter 1, Department of Health Organization, is repealed July 1, 2006.]
             184          [(2) Title 26, Chapter 4, Utah Medical Examiner Act, is repealed July 1, 2010.]
             185          [(3)] (1) Title 26, Chapter 9f, Utah Digital Health Service Commission Act, is repealed
             186      July 1, 2015.
             187          [(4) Title 26, Chapter 10, Family Health Services, is repealed July 1, 2010.]
             188          [(5)] (2) Title 26, Chapter 23b, Detection of Public Health Emergencies Act, is
             189      repealed July 1, 2009.
             190          [(6)] (3) Title 26, Chapter 33a, Utah Health Data Authority Act, is repealed July 1,
             191      2014.
             192          Section 6. Section 63-55-262 is amended to read:
             193           63-55-262. Repeal dates, Title 62A.
             194          [(1) Section 62A-4a-202.7 , Pilot Program for Differentiated Responses to Child Abuse
             195      and Neglect Reports, is repealed July 1, 2005.]
             196          [(2) Title 62A, Chapter 4a, Part 8, Safe Relinquishment of a Newborn Child, is
             197      repealed July 1, 2006.]

             198          Section 7. Section 76-7-305.5 is amended to read:
             199           76-7-305.5. Requirements for printed materials and informational video --
             200      Annual report of Department of Health.
             201          (1) In order to insure that a woman's consent to an abortion is truly an informed
             202      consent, the Department of Health shall publish printed materials and produce an informational
             203      video in accordance with the requirements of this section. The department and each local
             204      health department shall make those materials and a viewing of the video available at no cost to
             205      any person. The printed material and the informational video shall be comprehensible and
             206      contain all of the following:
             207          (a) geographically indexed materials informing the woman of public and private
             208      services and agencies available to assist her, financially and otherwise, through pregnancy, at
             209      childbirth, and while the child is dependent, including services and supports available under
             210      Section 35A-3-308 . Those materials shall contain a description of available adoption services,
             211      including a comprehensive list of the names, addresses, and telephone numbers of public and
             212      private agencies and private attorneys whose practice includes adoption, and explanations of
             213      possible available financial aid during the adoption process. The information regarding
             214      adoption services shall include the fact that private adoption is legal, and that the law permits
             215      adoptive parents to pay the costs of prenatal care, childbirth, and neonatal care. The printed
             216      information and video shall present adoption as a preferred and positive choice and alternative
             217      to abortion. The department may, at its option, include printed materials that describe the
             218      availability of a toll-free 24-hour telephone number that may be called in order to obtain,
             219      orally, the list and description of services, agencies, and adoption attorneys in the locality of the
             220      caller;
             221          (b) truthful and nonmisleading descriptions of the probable anatomical and
             222      physiological characteristics of the unborn child at two-week gestational increments from
             223      fertilization to full term, accompanied by pictures or video segments representing the
             224      development of an unborn child at those gestational increments. The descriptions shall include
             225      information about brain and heart function and the presence of external members and internal

             226      organs during the applicable stages of development. Any pictures used shall contain the
             227      dimensions of the fetus and shall be realistic and appropriate for that woman's stage of
             228      pregnancy. The materials shall be designed to convey accurate scientific information about an
             229      unborn child at the various gestational ages, and to convey the state's preference for childbirth
             230      over abortion;
             231          (c) truthful, nonmisleading descriptions of abortion procedures used in current medical
             232      practice at the various stages of growth of the unborn child, the medical risks commonly
             233      associated with each procedure, including those related to subsequent childbearing, the
             234      consequences of each procedure to the fetus at various stages of fetal development, the possible
             235      detrimental psychological effects of abortion, and the medical risks associated with carrying a
             236      child to term;
             237          (d) any relevant information on the possibility of an unborn child's survival at the
             238      two-week gestational increments described in Subsection (1)(b);
             239          (e) information on the availability of medical assistance benefits for prenatal care,
             240      childbirth, and neonatal care;
             241          (f) a statement conveying that it is unlawful for any person to coerce a woman to
             242      undergo an abortion;
             243          (g) a statement conveying that any physician who performs an abortion without
             244      obtaining the woman's informed consent or without according her a private medical
             245      consultation in accordance with the requirements of this section, may be liable to her for
             246      damages in a civil action at law;
             247          (h) a statement conveying that the state [of Utah] prefers childbirth over abortion; and
             248          (i) information regarding the legal responsibility of the father to assist in child support,
             249      even in instances where he has agreed to pay for an abortion, including a description of the
             250      services available through the Office of Recovery Services, within the Department of Human
             251      Services, to establish and collect that support.
             252          (2) (a) The materials described in Subsection (1) shall be produced and printed in a
             253      way that conveys the state's preference for childbirth over abortion.

             254          (b) The printed material described in Subsection (1) shall be printed in a typeface large
             255      enough to be clearly legible.
             256          (3) Every facility in which abortions are performed shall immediately provide the
             257      printed informed consent materials and a viewing of or a copy of the informational video
             258      described in Subsection (1) to any patient or potential patient prior to the performance of an
             259      abortion, unless the patient's attending or referring physician certifies in writing that he
             260      reasonably believes that provision of the materials or video to that patient would result in a
             261      severely adverse effect on her physical or mental health.
             262          (4) The Department of Health shall produce a standardized videotape that may be used
             263      statewide, containing all of the information described in Subsection (1), in accordance with the
             264      requirements of that subsection and Subsection (2). In preparing the video, the department may
             265      summarize and make reference to the printed comprehensive list of geographically indexed
             266      names and services described in Subsection (1)(a). The videotape shall, in addition to the
             267      information described in Subsection (1), show an ultrasound of the heart beat of an unborn
             268      child at three weeks gestational age, at six to eight weeks gestational age, and each month
             269      thereafter, until 14 weeks gestational age. That information shall be presented in a truthful,
             270      nonmisleading manner designed to convey accurate scientific information, the state's
             271      preference for childbirth over abortion, and the positive aspects of adoption.
             272          (5) The Department of Health and local health departments shall provide ultrasounds in
             273      accordance with the provisions of Subsection 76-7-305 (1)(b), at no expense to the pregnant
             274      woman.
             275          (6) The Department of Health shall compile and report the following information
             276      annually, preserving physician and patient anonymity:
             277          (a) the total amount of informed consent material described in Subsection (1) that was
             278      distributed;
             279          (b) the number of women who obtained abortions in this state without receiving those
             280      materials;
             281          (c) the number of statements signed by attending physicians certifying to his opinion

             282      regarding adverse effects on the patient under Subsection (3); and
             283          (d) any other information pertaining to protecting the informed consent of women
             284      seeking abortions.
             285          [(7) The Department of Health shall annually report to the Health and Human Services
             286      Interim Committee regarding the information described in Subsection (6), and provide a copy
             287      of the printed materials and the videotape produced in accordance with this section to that
             288      committee.]
             289          Section 8. Repealer.
             290          This bill repeals:
             291          Section 26-18-3.7, Prepaid health care delivery systems.
             292          Section 26-18-401, Medicaid waiver.

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