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S.B. 207 Enrolled

             1     

REPEAL OF HEALTH AND HUMAN SERVICES REPORTS

             2     
AND EXPIRED OR DISCONTINUED PROGRAMS

             3     
2013 GENERAL SESSION

             4     
STATE OF UTAH

             5     
Chief Sponsor: Allen M. Christensen

             6     
House Sponsor: Paul Ray

             7     
             8      LONG TITLE
             9      General Description:
             10          This bill repeals Utah Code provisions requiring reports, primarily to various entities of
             11      the Utah Legislature, on health and human services issues, and repeals expired or
             12      discontinued programs.
             13      Highlighted Provisions:
             14          This bill:
             15          .    repeals and amends provisions requiring reports, primarily to various entities of the
             16      Utah Legislature, on health and human services issues, including expired reporting
             17      provisions;
             18          .    repeals the Utah Comprehensive Health Insurance Pool's expired pilot program for
             19      hemophilia and bleeding disorders;
             20          .    repeals the Families, Agencies, and Communities Together for Children and Youth
             21      At Risk Act (FACT); and
             22          .    makes conforming amendments.
             23      Money Appropriated in this Bill:
             24          None
             25      Other Special Clauses:
             26          None
             27      Utah Code Sections Affected:
             28      AMENDS:
             29          4-3-14, as last amended by Laws of Utah 2009, Chapter 183


             30          26-1-4, as last amended by Laws of Utah 2012, Chapter 242
             31          26-1-36, as last amended by Laws of Utah 2010, Chapter 287
             32          26-1-37, as last amended by Laws of Utah 2010, Chapter 68
             33          26-1-38, as last amended by Laws of Utah 2012, Chapter 242
             34          26-4-28, as enacted by Laws of Utah 2007, Chapter 205
             35          26-18-3, as last amended by Laws of Utah 2012, Chapters 28 and 242
             36          26-18-4, as last amended by Laws of Utah 2012, Chapter 369
             37          26-18-10, as last amended by Laws of Utah 2012, Chapter 369
             38          26-18-103, as last amended by Laws of Utah 2008, Chapter 382
             39          26-18-406, as enacted by Laws of Utah 2011, Chapter 166
             40          26-18-604, as enacted by Laws of Utah 2011, Chapter 362
             41          26-18a-3, as last amended by Laws of Utah 2012, Chapter 242
             42          26-18b-101, as last amended by Laws of Utah 2012, Chapter 242
             43          26-33a-104, as last amended by Laws of Utah 2011, Chapter 297
             44          26-40-103, as last amended by Laws of Utah 2012, Chapters 28 and 369
             45          26-40-109, as last amended by Laws of Utah 2001, Chapter 53
             46          26-47-102, as last amended by Laws of Utah 2012, Chapter 242
             47          26-47-103, as last amended by Laws of Utah 2012, Chapter 242
             48          31A-22-626, as last amended by Laws of Utah 2001, Chapter 116
             49          31A-22-633, as last amended by Laws of Utah 2005, Chapter 123
             50          35A-3-207, as last amended by Laws of Utah 2008, Chapter 382
             51          51-9-201, as last amended by Laws of Utah 2012, Chapters 90 and 242
             52          53A-15-205, as last amended by Laws of Utah 2011, Chapter 366
             53          58-37f-801, as renumbered and amended by Laws of Utah 2010, Chapter 287
             54          58-77-201, as last amended by Laws of Utah 2008, Chapter 365
             55          62A-3-110, as last amended by Laws of Utah 2012, Chapter 242
             56          62A-5-105, as last amended by Laws of Utah 2009, Chapter 75
             57          62A-5a-104, as last amended by Laws of Utah 2008, Chapter 382


             58          62A-15-103, as last amended by Laws of Utah 2012, Chapter 242
             59          62A-15-712, as last amended by Laws of Utah 2003, Chapter 78
             60          63C-8-106, as last amended by Laws of Utah 2008, Chapter 382
             61          63I-1-263 (Effective 05/01/13), as last amended by Laws of Utah 2012, Chapters 126,
             62      206, 347, 369, and 395
             63          63J-1-201, as last amended by Laws of Utah 2012, Chapters 242 and 341
             64      REPEALS:
             65          26-10b-105, as renumbered and amended by Laws of Utah 2010, Chapter 340
             66          26-18-3.3, as enacted by Laws of Utah 2011, Chapter 162
             67          31A-29-113.5, as last amended by Laws of Utah 2012, Chapter 242
             68          63M-9-101, as renumbered and amended by Laws of Utah 2008, Chapter 382
             69          63M-9-102, as renumbered and amended by Laws of Utah 2008, Chapter 382
             70          63M-9-103, as last amended by Laws of Utah 2011, Chapter 366
             71          63M-9-104, as renumbered and amended by Laws of Utah 2008, Chapter 382
             72          63M-9-201, as last amended by Laws of Utah 2010, Chapter 286
             73          63M-9-202, as last amended by Laws of Utah 2010, Chapter 286
             74          63M-9-203, as renumbered and amended by Laws of Utah 2008, Chapter 382
             75          63M-9-301, as last amended by Laws of Utah 2010, Chapter 324
             76          63M-9-401, as last amended by Laws of Utah 2008, Chapter 3 and renumbered and
             77      amended by Laws of Utah 2008, Chapter 382
             78          63M-9-402, as renumbered and amended by Laws of Utah 2008, Chapter 382
             79          63M-9-501, as renumbered and amended by Laws of Utah 2008, Chapter 382
             80     
             81      Be it enacted by the Legislature of the state of Utah:
             82          Section 1. Section 4-3-14 is amended to read:
             83           4-3-14. Sale of raw milk -- Suspension of producer's permit -- Severability not
             84      permitted.
             85          (1) As used in this section:


             86          (a) "Batch" means all the milk emptied from one bulk tank and bottled in a single day.
             87          (b) "Self-owned retail store" means a retail store:
             88          (i) of which the producer owns at least 51% of the value of the real property and
             89      tangible personal property used in the operations of the retail store; or
             90          (ii) for which the producer has the power to vote at least 51% of any class of voting
             91      shares or ownership interest in the business entity that operates the retail store.
             92          (2) Raw milk may be sold if:
             93          (a) the producer obtains a permit from the department to produce milk under
             94      Subsection 4-3-8 (5);
             95          (b) the sale and delivery of the milk is made upon the premises where the milk is
             96      produced, except as provided by Subsection (3);
             97          (c) it is sold to consumers for household use and not for resale;
             98          (d) it is bottled or packaged under sanitary conditions and in sanitary containers on the
             99      premises where the milk is produced;
             100          (e) it is labeled "raw milk" and meets the labeling requirements under 21 C.F.R. Parts
             101      101 and 131 and rules established by the department;
             102          (f) it is:
             103          (i) cooled to 50 degrees Fahrenheit or a lower temperature within one hour after being
             104      drawn from the animal;
             105          (ii) further cooled to 41 degrees Fahrenheit within two hours of being drawn from the
             106      animal; and
             107          (iii) maintained at 41 degrees Fahrenheit or a lower temperature until it is delivered to
             108      the consumer;
             109          (g) the bacterial count of the milk does not exceed 20,000 colony forming units per
             110      milliliter;
             111          (h) the bacterial plate count and the coliform count of the milk meet the bacterial and
             112      coliform enforcement standards for grade A pasteurized milk;
             113          (i) the production of the milk conforms to departmental rules for the production of


             114      grade A milk;
             115          (j) all dairy animals on the premises are:
             116          (i) permanently and individually identifiable; and
             117          (ii) free of tuberculosis, brucellosis, and other diseases carried through milk; and
             118          (k) any person on the premises performing any work in connection with the production,
             119      bottling, handling, or sale of the milk is free from communicable disease.
             120          (3) A producer may sell raw whole milk at a self-owned retail store, which is properly
             121      staffed, if, in addition to the requirements of Subsection (2), the producer:
             122          (a) transports the milk from the premises where the milk is produced to the self-owned
             123      retail store in a refrigerated truck where the milk is maintained at 41 degrees Fahrenheit or a
             124      lower temperature;
             125          (b) retains ownership of the milk until it is sold to the final consumer, including
             126      transporting the milk from the premises where the milk is produced to the self-owned retail
             127      store without any:
             128          (i) intervening storage;
             129          (ii) change of ownership; or
             130          (iii) loss of physical control;
             131          (c) stores the milk at 41 degrees Fahrenheit or a lower temperature in a display case
             132      equipped with a properly calibrated thermometer at the self-owned retail store;
             133          (d) places a sign above the display case at the self-owned retail store that reads, "Raw
             134      Unpasteurized Milk";
             135          (e) labels the milk with:
             136          (i) a date, no more than nine days after the milk is produced, by which the milk should
             137      be sold;
             138          (ii) the statement "Raw milk, no matter how carefully produced, may be unsafe.";
             139          (iii) handling instructions to preserve quality and avoid contamination or spoilage; and
             140          (iv) any other information required by rule;
             141          (f) refrains from offering the milk for sale until:


             142          (i) each batch of milk is tested for standard plate count and coliform count from an
             143      official sample taken at the self-owned retail store and tested by a third party certified by the
             144      department; and
             145          (ii) the test results meet the minimum standards established for those tests;
             146          (g) (i) maintains a database of the milk sales; and
             147          (ii) makes the database available to the Department of Health during the self-owned
             148      retail store's business hours for purposes of epidemiological investigation;
             149          (h) refrains from offering any pasteurized milk at the self-owned retail store;
             150          (i) ensures that the plant and retail store complies with Title 4, Chapter 5, Utah
             151      Wholesome Food Act, and the rules governing food establishments enacted under Section
             152      4-5-9 ;
             153          (j) participates in a hazard analysis critical control point system as established by the
             154      United States Food and Drug Administration;
             155          (k) conducts monthly tests on a sample taken from a batch of milk for:
             156          (i) Listeria monocytogenes;
             157          (ii) Salmonella typhimurium;
             158          (iii) Salmonella dublin;
             159          (iv) Campylobacter jejuni; and
             160          (v) E. Coli 0157:H7; and
             161          (l) complies with all applicable rules adopted as authorized by this chapter.
             162          (4) The person conducting the tests required by Subsection (3) shall send a copy of the
             163      test results to the department as soon as the test results are available.
             164          (5) (a) The department shall adopt rules, as authorized by Section 4-3-2 , governing the
             165      sale of raw whole milk at a self-owned retail store.
             166          (b) The rules adopted by the department shall include rules regarding:
             167          (i) permits;
             168          (ii) building and premises requirements;
             169          (iii) sanitation and operating requirements, including bulk milk tanks requirements;


             170          (iv) additional tests, including a test for pathogens;
             171          (v) frequency of inspections, including random cooler checks;
             172          (vi) recordkeeping; and
             173          (vii) packaging and labeling.
             174          (c) (i) The department shall establish a fee for the tests and inspections required by this
             175      section and by rule by following the procedures and requirements of Section 63J-1-504 .
             176          (ii) Notwithstanding Section 63J-1-504 , the department shall retain the fees as
             177      dedicated credits and may only use the fees to administer and enforce this section.
             178          (6) (a) The department shall suspend a permit issued under Section 4-3-8 if a producer
             179      violates any provision of this section or any rules adopted as authorized by this section.
             180          (b) The department may reissue a permit that has been suspended under Subsection
             181      (6)(a) if the producer has complied with all of the requirements of this section and rules
             182      adopted as authorized by this section.
             183          (7) For [2008 and 2009] 2014 and 2015, the Department of Health and the Department
             184      of Agriculture and Food shall report on or before November 30th to the Natural Resources,
             185      Agriculture, and Environment Interim Committee [and the Health and Human Services Interim
             186      Committee] on any health problems resulting from the sale of raw whole milk at self-owned
             187      retail stores.
             188          (8) (a) If any subsection of this section or the application of any subsection to any
             189      person or circumstance is held invalid by a final decision of a court of competent jurisdiction,
             190      the remainder of the section may not be given effect without the invalid subsection or
             191      application.
             192          (b) The provisions of this section may not be severed.
             193          Section 2. Section 26-1-4 is amended to read:
             194           26-1-4. Department of Health created -- Policymaking responsibilities --
             195      Consultation with local health departments -- Committee to evaluate health policies and
             196      to review federal grants -- Committee responsibilities.
             197          (1) There is created the Department of Health, which has all of the policymaking


             198      functions, regulatory and enforcement powers, rights, duties, and responsibilities of the
             199      Division of Health, the Board of Health, the State Health Planning Development Agency, and
             200      the Office of Health Care Financing. Unless otherwise specifically provided, when reference is
             201      made in any statute of this state to the Board of Health, the Division of Health, the State Health
             202      Planning Development Agency, or the Office of Health Care Financing, it refers to the
             203      department. The department shall assume all of the policymaking functions, powers, rights,
             204      duties, and responsibilities over the division, agency, and office previously vested in the
             205      Department of Human Services and its executive director.
             206          (2) In establishing public health policy, the department shall consult with the local
             207      health departments established under Title 26A, Chapter 1, Local Health Departments.
             208          (3) (a) As used in this Subsection (3):
             209          (i) "Committee" means the committee established under Subsection (3)(b).
             210          (ii) "Exempt application" means an application for a federal grant that meets the
             211      criteria established under Subsection (3)(c)(iii).
             212          (iii) "Expedited application" means an application for a federal grant that meets the
             213      criteria established under Subsection (3)(c)(iv).
             214          (iv) "Federal grant" means a grant from the federal government that could provide
             215      funds for local health departments to help them fulfill their duties and responsibilities.
             216          (v) "Reviewable application" means an application for a federal grant that is not an
             217      exempt application.
             218          (b) The department shall establish a committee consisting of:
             219          (i) the executive director, or the executive director's designee;
             220          (ii) two representatives of the department, appointed by the executive director; and
             221          (iii) three representatives of local health departments, appointed by all local health
             222      departments.
             223          (c) The committee shall:
             224          (i) evaluate:
             225          (A) the allocation of public health resources between the department and local health


             226      departments; and
             227          (B) policies that affect local health departments;
             228          (ii) consider policy changes proposed by the department or local health departments;
             229          (iii) establish criteria by which an application for a federal grant may be judged to
             230      determine whether it should be exempt from the requirements under Subsection (3)(d); and
             231          (iv) establish criteria by which an application for a federal grant may be judged to
             232      determine whether committee review under Subsection (3)(d)(i) should be delayed until after
             233      the application is submitted because the application is required to be submitted under a
             234      timetable that makes committee review before it is submitted impracticable if the submission
             235      deadline is to be met.
             236          (d) (i) The committee shall review the goals and budget for each reviewable
             237      application:
             238          (A) before the application is submitted, except for an expedited application; and
             239          (B) for an expedited application, after the application is submitted but before funds
             240      from the federal grant for which the application was submitted are disbursed or encumbered.
             241          (ii) Funds from a federal grant pursuant to a reviewable application may not be
             242      disbursed or encumbered before the goals and budget for the federal grant are established by:
             243          (A) a two-thirds vote of the committee, following the committee review under
             244      Subsection (3)(d)(i); or
             245          (B) if two-thirds of the committee cannot agree on the goals and budget, the chair of
             246      the health advisory council, after consultation with the committee in a manner that the
             247      committee determines.
             248          (e) An exempt application is exempt from the requirements of Subsection (3)(d).
             249          [(f) The committee shall report to the Legislature's Social Services Appropriations
             250      Subcommittee and Political Subdivisions Interim Committee by November 30 of each year
             251      regarding implementation of this Subsection (3).]
             252          [(g)] (f) The department may use money from a federal grant to pay administrative
             253      costs incurred in implementing this Subsection (3).


             254          Section 3. Section 26-1-36 is amended to read:
             255           26-1-36. Duty to establish program to reduce deaths and other harm from
             256      prescription opiates used for chronic noncancer pain.
             257          (1) As used in this section, "opiate" means any drug or other substance having an
             258      addiction-forming or addiction-sustaining liability similar to morphine or being capable of
             259      conversion into a drug having addiction-forming or addiction-sustaining liability.
             260          (2) In addition to the duties listed in Section 26-1-30 , the department shall develop and
             261      implement a two-year program in coordination with the Division of Professional Licensing, the
             262      Utah Labor Commission, and the Utah attorney general, to:
             263          (a) investigate the causes of and risk factors for death and nonfatal complications of
             264      prescription opiate use and misuse in Utah for chronic pain by utilizing the Utah Controlled
             265      Substance Database created in Section 58-37f-201 ;
             266          (b) study the risks, warning signs, and solutions to the risks associated with
             267      prescription opiate medications for chronic pain, including risks and prevention of misuse and
             268      diversion of those medications;
             269          (c) provide education to health care providers, patients, insurers, and the general public
             270      on the appropriate management of chronic pain, including the effective use of medical
             271      treatment and quality care guidelines that are scientifically based and peer reviewed; and
             272          (d) educate the public regarding:
             273          (i) the purpose of the Controlled Substance Database established in Section
             274      58-37f-201 ; and
             275          (ii) the requirement that a person's name and prescription information be recorded on
             276      the database when the person fills a prescription for a schedule II, III, IV, or V controlled
             277      substance.
             278          [(3) The department shall report on the development and implementation of the
             279      program required in Subsection (2) to the legislative Health and Human Services Interim
             280      Committee and the legislative Business and Labor Interim Committee no later than the
             281      November interim meetings in 2008 and 2009. Each report shall include:]


             282          [(a) recommendations on:]
             283          [(i) use of the Utah Controlled Substance Database created in Section 58-37f-201 to
             284      identify and prevent:]
             285          [(A) misuse of opiates;]
             286          [(B) inappropriate prescribing; and]
             287          [(C) adverse outcomes of prescription opiate medications;]
             288          [(ii) interventions to prevent the diversion of prescription opiate medications; and]
             289          [(iii) medical treatment and quality care guidelines that are:]
             290          [(A) scientifically based; and]
             291          [(B) peer reviewed; and]
             292          [(b) (i) a measure of results against expectations under the program as of the date of the
             293      report; and]
             294          [(ii) an analysis of the application of the program, use of the appropriated funds, and
             295      the impact and results of the use of the funds.]
             296          [(4) The report provided under Subsection (3) for the 2008 interim shall also provide a
             297      final cumulative analysis of the measurable effectiveness of the program implemented under
             298      this section.]
             299          Section 4. Section 26-1-37 is amended to read:
             300           26-1-37. Duty to establish standards for the electronic exchange of clinical health
             301      information.
             302          (1) For purposes of this section:
             303          (a) "Affiliate" means an organization that directly or indirectly through one or more
             304      intermediaries controls, is controlled by, or is under common control with another
             305      organization.
             306          (b) "Clinical health information" shall be defined by the department by administrative
             307      rule adopted in accordance with Subsection (2).
             308          (c) "Electronic exchange":
             309          (i) includes:


             310          (A) the electronic transmission of clinical health data via Internet or extranet; and
             311          (B) physically moving clinical health information from one location to another using
             312      magnetic tape, disk, or compact disc media; and
             313          (ii) does not include exchange of information by telephone or fax.
             314          (d) "Health care provider" means a licensing classification that is either:
             315          (i) licensed under Title 58, Occupations and Professions, to provide health care; or
             316          (ii) licensed under Chapter 21, Health Care Facility Licensing and Inspection Act.
             317          (e) "Health care system" shall include:
             318          (i) affiliated health care providers;
             319          (ii) affiliated third party payers; and
             320          (iii) other arrangement between organizations or providers as described by the
             321      department by administrative rule.
             322          (f) "Qualified network" means an entity that:
             323          (i) is a non-profit organization;
             324          (ii) is accredited by the Electronic Healthcare Network Accreditation Commission, or
             325      another national accrediting organization recognized by the department; and
             326          (iii) performs the electronic exchange of clinical health information among multiple
             327      health care providers not under common control, multiple third party payers not under common
             328      control, the department, and local health departments.
             329          (g) "Third party payer" means:
             330          (i) all insurers offering health insurance who are subject to Section 31A-22-614.5 ; and
             331          (ii) the state Medicaid program.
             332          (2) (a) In addition to the duties listed in Section 26-1-30 , the department shall, in
             333      accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act:
             334          (i) define:
             335          (A) "clinical health information" subject to this section; and
             336          (B) "health system arrangements between providers or organizations" as described in
             337      Subsection (1)(e)(iii); and


             338          (ii) adopt standards for the electronic exchange of clinical health information between
             339      health care providers and third party payers that are for treatment, payment, health care
             340      operations, or public health reporting, as provided for in 45 C.F.R. Parts 160, 162, and 164,
             341      Health Insurance Reform: Security Standards.
             342          (b) The department shall coordinate its rule making authority under the provisions of
             343      this section with the rule making authority of the Insurance Department under Section
             344      31A-22-614.5 . The department shall establish procedures for developing the rules adopted
             345      under this section, which ensure that the Insurance Department is given the opportunity to
             346      comment on proposed rules.
             347          (3) (a) Except as provided in Subsection (3)(e), a health care provider or third party
             348      payer in Utah is required to use the standards adopted by the department under the provisions
             349      of Subsection (2) if the health care provider or third party payer elects to engage in an
             350      electronic exchange of clinical health information with another health care provider or third
             351      party payer.
             352          (b) A health care provider or third party payer may disclose information to the
             353      department or a local health department, by electronic exchange of clinical health information,
             354      as permitted by Subsection 45 C.F.R. 164.512(b).
             355          (c) When functioning in its capacity as a health care provider or payer, the department
             356      or a local health department may disclose clinical health information by electronic exchange to
             357      another health care provider or third party payer.
             358          (d) An electronic exchange of clinical health information by a health care provider, a
             359      third party payer, the department, or a local health department is a disclosure for treatment,
             360      payment, or health care operations if it complies with Subsection (3)(a) or (c) and is for
             361      treatment, payment, or health care operations, as those terms are defined in 45 C.F.R. Parts
             362      160, 162, and 164.
             363          (e) A health care provider or third party payer is not required to use the standards
             364      adopted by the department under the provisions of Subsection (2) if the health care provider or
             365      third party payer engage in the electronic exchange of clinical health information within a


             366      particular health care system.
             367          (4) Nothing in this section shall limit the number of networks eligible to engage in the
             368      electronic data interchange of clinical health information using the standards adopted by the
             369      department under Subsection (2)(a)(ii).
             370          (5) The department, a local health department, a health care provider, a third party
             371      payer, or a qualified network is not subject to civil liability for a disclosure of clinical health
             372      information if the disclosure is in accordance both with Subsection (3)(a) and with Subsection
             373      (3)(b), (3)(c), or (3)(d).
             374          (6) Within a qualified network, information generated or disclosed in the electronic
             375      exchange of clinical health information is not subject to discovery, use, or receipt in evidence
             376      in any legal proceeding of any kind or character.
             377          [(7) The department shall report on the use of the standards for the electronic exchange
             378      of clinical health information to the legislative Health and Human Services Interim Committee
             379      no later than October 15 of each year. The report shall include publicly available information
             380      concerning the costs and savings for the department, third party payers, and health care
             381      providers associated with the standards for the electronic exchange of clinical health records.]
             382          Section 5. Section 26-1-38 is amended to read:
             383           26-1-38. Local health emergency assistance program.
             384          (1) As used in this section:
             385          (a) "Local health department" has the same meaning as defined in Section 26A-1-102 .
             386          (b) "Local health emergency" means an unusual event or series of events causing or
             387      resulting in a substantial risk or substantial potential risk to the health of a significant portion
             388      of the population within the boundary of a local health department.
             389          (c) "Program" means the local health emergency assistance program that the
             390      department is required to establish under this section.
             391          (d) "Program fund" means money that the Legislature appropriates to the department
             392      for use in the program and other money otherwise made available for use in the program.
             393          (2) The department shall establish, to the extent of funds appropriated by the


             394      Legislature or otherwise made available to the program fund, a local health emergency
             395      assistance program.
             396          (3) Under the program, the department shall:
             397          (a) provide a method for a local health department to seek reimbursement from the
             398      program fund for local health department expenses incurred in responding to a local health
             399      emergency;
             400          (b) require matching funds from any local health department seeking reimbursement
             401      from the program fund;
             402          (c) establish a method for apportioning money in the program fund to multiple local
             403      health departments when the total amount of concurrent requests for reimbursement by
             404      multiple local health departments exceeds the balance in the program fund; and
             405          (d) establish by rule other provisions that the department considers necessary or
             406      advisable to implement the program.
             407          [(4) Each September the department shall:]
             408          [(a) submit to the Health and Human Services Interim Committee of the Legislature a
             409      written report summarizing program activity, including:]
             410          [(i) a description of the requests for reimbursement from local health departments
             411      during the preceding 12 months;]
             412          [(ii) the amount of each reimbursement made from the program fund to local health
             413      departments; and]
             414          [(iii) the current balance of the program fund; and]
             415          [(b) submit a copy of the report required under Subsection (4)(a) to the Social Services
             416      Appropriations Subcommittee.]
             417          [(5)] (4) (a) (i) Subject to Subsection [(5)] (4)(a)(ii), the department shall use money in
             418      the program fund exclusively for purposes of the program.
             419          (ii) The department may use money in the program fund to cover its costs of
             420      administering the program.
             421          (b) Money that the Legislature appropriates to the program fund is nonlapsing.


             422          (c) Any interest earned on money in the program fund shall be deposited to the General
             423      Fund.
             424          Section 6. Section 26-4-28 is amended to read:
             425           26-4-28. Testing for suspected suicides -- Maintaining information -- Report to
             426      the Health and Human Services Interim Committee -- Compensation to deputy medical
             427      examiners.
             428          (1) In all cases where it is suspected that a death resulted from suicide, including
             429      assisted suicide, the medical examiner shall endeavor to have the following tests conducted
             430      upon samples taken from the body of the deceased:
             431          (a) a test that detects all of the substances included in the volatiles panel of the Bureau
             432      of Forensic Toxicology within the Department of Health;
             433          (b) a test that detects all of the substances included in the drugs of abuse panel of the
             434      Bureau of Forensic Toxicology within the Department of Health; and
             435          (c) a test that detects all of the substances included in the prescription drug panel of the
             436      Bureau of Forensic Toxicology within the Department of Health.
             437          (2) The medical examiner shall maintain information regarding the types of substances
             438      found present in the samples taken from the body of a person who is suspected to have died as
             439      a result of suicide or assisted suicide.
             440          [(3) (a) Beginning in 2008, on or before November 30 of each year, the Department of
             441      Health shall present a report on the information described in Subsection (2) to the Health and
             442      Human Services Interim Committee.]
             443          [(b) The information described in Subsection (3)(a) may not contain any identifying
             444      information regarding any person to whom the information described in Subsection (2) relates.]
             445          [(4)] (3) Within funds appropriated by the Legislature for this purpose, the medical
             446      examiner shall provide compensation, at a standard rate determined by the medical examiner,
             447      to a deputy medical examiner who collects samples for the purposes described in Subsection
             448      (1).
             449          Section 7. Section 26-18-3 is amended to read:


             450           26-18-3. Administration of Medicaid program by department -- Reporting to the
             451      Legislature -- Disciplinary measures and sanctions -- Funds collected -- Eligibility
             452      standards -- Internal audits -- Studies -- Health opportunity accounts.
             453          (1) The department shall be the single state agency responsible for the administration
             454      of the Medicaid program in connection with the United States Department of Health and
             455      Human Services pursuant to Title XIX of the Social Security Act.
             456          (2) (a) The department shall implement the Medicaid program through administrative
             457      rules in conformity with this chapter, Title 63G, Chapter 3, Utah Administrative Rulemaking
             458      Act, the requirements of Title XIX, and applicable federal regulations.
             459          (b) The rules adopted under Subsection (2)(a) shall include, in addition to other rules
             460      necessary to implement the program:
             461          (i) the standards used by the department for determining eligibility for Medicaid
             462      services;
             463          (ii) the services and benefits to be covered by the Medicaid program;
             464          (iii) reimbursement methodologies for providers under the Medicaid program; and
             465          (iv) a requirement that:
             466          (A) a person receiving Medicaid services shall participate in the electronic exchange of
             467      clinical health records established in accordance with Section 26-1-37 unless the individual
             468      opts out of participation;
             469          (B) prior to enrollment in the electronic exchange of clinical health records the enrollee
             470      shall receive notice of enrollment in the electronic exchange of clinical health records and the
             471      right to opt out of participation at any time; and
             472          (C) beginning July 1, 2012, when the program sends enrollment or renewal information
             473      to the enrollee and when the enrollee logs onto the program's website, the enrollee shall receive
             474      notice of the right to opt out of the electronic exchange of clinical health records.
             475          (3) (a) The department shall, in accordance with Subsection (3)(b), report to the Social
             476      Services Appropriations Subcommittee when the department:
             477          (i) implements a change in the Medicaid State Plan;


             478          (ii) initiates a new Medicaid waiver;
             479          (iii) initiates an amendment to an existing Medicaid waiver;
             480          (iv) applies for an extension of an application for a waiver or an existing Medicaid
             481      waiver; or
             482          (v) initiates a rate change that requires public notice under state or federal law.
             483          (b) The report required by Subsection (3)(a) shall:
             484          (i) be submitted to the Social Services Appropriations Subcommittee prior to the
             485      department implementing the proposed change; and
             486          (ii) include:
             487          (A) a description of the department's current practice or policy that the department is
             488      proposing to change;
             489          (B) an explanation of why the department is proposing the change;
             490          (C) the proposed change in services or reimbursement, including a description of the
             491      effect of the change;
             492          (D) the effect of an increase or decrease in services or benefits on individuals and
             493      families;
             494          (E) the degree to which any proposed cut may result in cost-shifting to more expensive
             495      services in health or human service programs; and
             496          (F) the fiscal impact of the proposed change, including:
             497          (I) the effect of the proposed change on current or future appropriations from the
             498      Legislature to the department;
             499          (II) the effect the proposed change may have on federal matching dollars received by
             500      the state Medicaid program;
             501          (III) any cost shifting or cost savings within the department's budget that may result
             502      from the proposed change; and
             503          (IV) identification of the funds that will be used for the proposed change, including any
             504      transfer of funds within the department's budget.
             505          [(4) (a) The Department of Human Services shall report to the Legislative Social


             506      Services Appropriations Subcommittee no later than December 31, 2010 in accordance with
             507      Subsection (4)(b).]
             508          [(b) The report required by Subsection (4)(a) shall include:]
             509          [(i) changes made by the division or the department beginning July 1, 2010, that effect
             510      the Medicaid program, a waiver under the Medicaid program, or an interpretation of Medicaid
             511      services or funding, that relate to care for children and youth in the custody of the Division of
             512      Child and Family Services or the Division of Juvenile Justice Services;]
             513          [(ii) the history and impact of the changes under Subsection (4)(b)(i);]
             514          [(iii) the Department of Human Service's plans for addressing the impact of the
             515      changes under Subsection (4)(b)(i); and]
             516          [(iv) ways to consolidate administrative functions within the Department of Human
             517      Services, the Department of Health, the Division of Child and Family Services, and the
             518      Division of Juvenile Justice Services to more efficiently meet the needs of children and youth
             519      with mental health and substance disorder treatment needs.]
             520          [(5)] (4) Any rules adopted by the department under Subsection (2) are subject to
             521      review and reauthorization by the Legislature in accordance with Section 63G-3-502 .
             522          [(6)] (5) The department may, in its discretion, contract with the Department of Human
             523      Services or other qualified agencies for services in connection with the administration of the
             524      Medicaid program, including:
             525          (a) the determination of the eligibility of individuals for the program;
             526          (b) recovery of overpayments; and
             527          (c) consistent with Section 26-20-13 , and to the extent permitted by law and quality
             528      control services, enforcement of fraud and abuse laws.
             529          [(7)] (6) The department shall provide, by rule, disciplinary measures and sanctions for
             530      Medicaid providers who fail to comply with the rules and procedures of the program, provided
             531      that sanctions imposed administratively may not extend beyond:
             532          (a) termination from the program;
             533          (b) recovery of claim reimbursements incorrectly paid; and


             534          (c) those specified in Section 1919 of Title XIX of the federal Social Security Act.
             535          [(8)] (7) Funds collected as a result of a sanction imposed under Section 1919 of Title
             536      XIX of the federal Social Security Act shall be deposited in the General Fund as dedicated
             537      credits to be used by the division in accordance with the requirements of Section 1919 of Title
             538      XIX of the federal Social Security Act.
             539          [(9)] (8) (a) In determining whether an applicant or recipient is eligible for a service or
             540      benefit under this part or Chapter 40, Utah Children's Health Insurance Act, the department
             541      shall, if Subsection [(9)] (8)(b) is satisfied, exclude from consideration one passenger vehicle
             542      designated by the applicant or recipient.
             543          (b) Before Subsection [(9)] (8)(a) may be applied:
             544          (i) the federal government shall:
             545          (A) determine that Subsection [(9)] (8)(a) may be implemented within the state's
             546      existing public assistance-related waivers as of January 1, 1999;
             547          (B) extend a waiver to the state permitting the implementation of Subsection [(9)]
             548      (8)(a); or
             549          (C) determine that the state's waivers that permit dual eligibility determinations for
             550      cash assistance and Medicaid are no longer valid; and
             551          (ii) the department shall determine that Subsection [(9)] (8)(a) can be implemented
             552      within existing funding.
             553          [(10)] (9) (a) For purposes of this Subsection [(10)] (9):
             554          (i) "aged, blind, or has a disability" means an aged, blind, or disabled individual, as
             555      defined in 42 U.S.C. 1382c(a)(1); and
             556          (ii) "spend down" means an amount of income in excess of the allowable income
             557      standard that shall be paid in cash to the department or incurred through the medical services
             558      not paid by Medicaid.
             559          (b) In determining whether an applicant or recipient who is aged, blind, or has a
             560      disability is eligible for a service or benefit under this chapter, the department shall use 100%
             561      of the federal poverty level as:


             562          (i) the allowable income standard for eligibility for services or benefits; and
             563          (ii) the allowable income standard for eligibility as a result of spend down.
             564          [(11)] (10) The department shall conduct internal audits of the Medicaid program.
             565          [(12)] (11) In order to determine the feasibility of contracting for direct Medicaid
             566      providers for primary care services, the department shall:
             567          (a) issue a request for information for direct contracting for primary services that shall
             568      provide that a provider shall exclusively serve all Medicaid clients:
             569          (i) in a geographic area;
             570          (ii) for a defined range of primary care services; and
             571          (iii) for a predetermined total contracted amount; and
             572          (b) by February 1, 2011, report to the Social Services Appropriations Subcommittee on
             573      the response to the request for information under Subsection [(12)] (11)(a).
             574          [(13)] (12) (a) By December 31, 2010, the department shall:
             575          (i) determine the feasibility of implementing a three year patient-centered medical
             576      home demonstration project in an area of the state using existing budget funds; and
             577          (ii) report the department's findings and recommendations under Subsection [(13)]
             578      (12)(a)(i) to the Social Services Appropriations Subcommittee.
             579          (b) If the department determines that the medical home demonstration project
             580      described in Subsection [(13)] (12)(a) is feasible, and the Social Services Appropriations
             581      Subcommittee recommends that the demonstration project be implemented, the department
             582      shall:
             583          (i) implement the demonstration project; and
             584          (ii) by December 1, 2012, make recommendations to the Social Services
             585      Appropriations Subcommittee regarding the:
             586          (A) continuation of the demonstration project;
             587          (B) expansion of the demonstration project to other areas of the state; and
             588          (C) cost savings incurred by the implementation of the demonstration project.
             589          [(14)] (13) (a) The department may apply for and, if approved, implement a


             590      demonstration program for health opportunity accounts, as provided for in 42 U.S.C. Sec.
             591      1396u-8.
             592          (b) A health opportunity account established under Subsection [(14)] (13)(a) shall be
             593      an alternative to the existing benefits received by an individual eligible to receive Medicaid
             594      under this chapter.
             595          (c) Subsection [(14)] (13)(a) is not intended to expand the coverage of the Medicaid
             596      program.
             597          Section 8. Section 26-18-4 is amended to read:
             598           26-18-4. Department standards for eligibility under Medicaid -- Funds for
             599      abortions.
             600          (1) The department may develop standards and administer policies relating to
             601      eligibility under the Medicaid program as long as they are consistent with Subsection
             602      26-18-3 [(9)](8). An applicant receiving Medicaid assistance may be limited to particular types
             603      of care or services or to payment of part or all costs of care determined to be medically
             604      necessary.
             605          (2) The department may not provide any funds for medical, hospital, or other medical
             606      expenditures or medical services to otherwise eligible persons where the purpose of the
             607      assistance is to perform an abortion, unless the life of the mother would be endangered if an
             608      abortion were not performed.
             609          (3) Any employee of the department who authorizes payment for an abortion contrary
             610      to the provisions of this section is guilty of a class B misdemeanor and subject to forfeiture of
             611      office.
             612          (4) Any person or organization that, under the guise of other medical treatment,
             613      provides an abortion under auspices of the Medicaid program is guilty of a third degree felony
             614      and subject to forfeiture of license to practice medicine or authority to provide medical services
             615      and treatment.
             616          Section 9. Section 26-18-10 is amended to read:
             617           26-18-10. Utah Medical Assistance Program -- Policies and standards.


             618          (1) The division shall develop a medical assistance program, which shall be known as
             619      the Utah Medical Assistance Program, for low income persons who are not eligible under the
             620      state plan for Medicaid under Title XIX of the Social Security Act or Medicare under Title
             621      XVIII of that act.
             622          (2) Persons in the custody of prisons, jails, halfway houses, and other nonmedical
             623      government institutions are not eligible for services provided under this section.
             624          (3) The department shall develop standards and administer policies relating to
             625      eligibility requirements, consistent with Subsection 26-18-3 [(9)](8), for participation in the
             626      program, and for payment of medical claims for eligible persons.
             627          (4) The program shall be a payor of last resort. Before assistance is rendered the
             628      division shall investigate the availability of the resources of the spouse, father, mother, and
             629      adult children of the person making application.
             630          (5) The department shall determine what medically necessary care or services are
             631      covered under the program, including duration of care, and method of payment, which may be
             632      partial or in full.
             633          (6) The department may not provide public assistance for medical, hospital, or other
             634      medical expenditures or medical services to otherwise eligible persons where the purpose of
             635      the assistance is for the performance of an abortion, unless the life of the mother would be
             636      endangered if an abortion were not performed.
             637          (7) The department may establish rules to carry out the provisions of this section.
             638          Section 10. Section 26-18-103 is amended to read:
             639           26-18-103. DUR Board -- Responsibilities.
             640          The board shall:
             641          (1) develop rules necessary to carry out its responsibilities as defined in this part;
             642          (2) oversee the implementation of a Medicaid retrospective and prospective DUR
             643      program in accordance with this part, including responsibility for approving provisions of
             644      contractual agreements between the Medicaid program and any other entity that will process
             645      and review Medicaid drug claims and profiles for the DUR program in accordance with this


             646      part;
             647          (3) develop and apply predetermined criteria and standards to be used in retrospective
             648      and prospective DUR, ensuring that the criteria and standards are based on the compendia, and
             649      that they are developed with professional input, in a consensus fashion, with provisions for
             650      timely revision and assessment as necessary. The DUR standards developed by the board shall
             651      reflect the local practices of physicians in order to monitor:
             652          (a) therapeutic appropriateness;
             653          (b) overutilization or underutilization;
             654          (c) therapeutic duplication;
             655          (d) drug-disease contraindications;
             656          (e) drug-drug interactions;
             657          (f) incorrect drug dosage or duration of drug treatment; and
             658          (g) clinical abuse and misuse;
             659          (4) develop, select, apply, and assess interventions and remedial strategies for
             660      physicians, pharmacists, and recipients that are educational and not punitive in nature, in order
             661      to improve the quality of care;
             662          (5) disseminate information to physicians and pharmacists to ensure that they are aware
             663      of the board's duties and powers;
             664          (6) provide written, oral, or electronic reminders of patient-specific or drug-specific
             665      information, designed to ensure recipient, physician, and pharmacist confidentiality, and
             666      suggest changes in prescribing or dispensing practices designed to improve the quality of care;
             667          (7) utilize face-to-face discussions between experts in drug therapy and the prescriber
             668      or pharmacist who has been targeted for educational intervention;
             669          (8) conduct intensified reviews or monitoring of selected prescribers or pharmacists;
             670          (9) create an educational program using data provided through DUR to provide active
             671      and ongoing educational outreach programs to improve prescribing and dispensing practices,
             672      either directly or by contract with other governmental or private entities;
             673          (10) provide a timely evaluation of intervention to determine if those interventions


             674      have improved the quality of care;
             675          (11) publish an annual report, subject to public comment prior to its issuance, and
             676      submit that report to the United States Department of Health and Human Services by
             677      December 1 of each year. That report shall also be submitted to [legislative leadership,] the
             678      executive director, the president of the Utah Pharmaceutical Association, and the president of
             679      the Utah Medical Association by December 1 of each year. The report shall include:
             680          (a) an overview of the activities of the board and the DUR program;
             681          (b) a description of interventions used and their effectiveness, specifying whether the
             682      intervention was a result of underutilization or overutilization of drugs, without disclosing the
             683      identities of individual physicians, pharmacists, or recipients;
             684          (c) the costs of administering the DUR program;
             685          (d) any fiscal savings resulting from the DUR program;
             686          (e) an overview of the fiscal impact of the DUR program to other areas of the Medicaid
             687      program such as hospitalization or long-term care costs;
             688          (f) a quantifiable assessment of whether DUR has improved the recipient's quality of
             689      care;
             690          (g) a review of the total number of prescriptions, by drug therapeutic class;
             691          (h) an assessment of the impact of educational programs or interventions on
             692      prescribing or dispensing practices; and
             693          (i) recommendations for DUR program improvement;
             694          (12) develop a working agreement with related boards or agencies, including the State
             695      Board of Pharmacy, Physicians' Licensing Board, and SURS staff within the division, in order
             696      to clarify areas of responsibility for each, where those areas may overlap;
             697          (13) establish a grievance process for physicians and pharmacists under this part, in
             698      accordance with Title 63G, Chapter 4, Administrative Procedures Act;
             699          (14) publish and disseminate educational information to physicians and pharmacists
             700      concerning the board and the DUR program, including information regarding:
             701          (a) identification and reduction of the frequency of patterns of fraud, abuse, gross


             702      overuse, inappropriate, or medically unnecessary care among physicians, pharmacists, and
             703      recipients;
             704          (b) potential or actual severe or adverse reactions to drugs;
             705          (c) therapeutic appropriateness;
             706          (d) overutilization or underutilization;
             707          (e) appropriate use of generics;
             708          (f) therapeutic duplication;
             709          (g) drug-disease contraindications;
             710          (h) drug-drug interactions;
             711          (i) incorrect drug dosage and duration of drug treatment;
             712          (j) drug allergy interactions; and
             713          (k) clinical abuse and misuse;
             714          (15) develop and publish, with the input of the State Board of Pharmacy, guidelines
             715      and standards to be used by pharmacists in counseling Medicaid recipients in accordance with
             716      this part. The guidelines shall ensure that the recipient may refuse counseling and that the
             717      refusal is to be documented by the pharmacist. Items to be discussed as part of that counseling
             718      include:
             719          (a) the name and description of the medication;
             720          (b) administration, form, and duration of therapy;
             721          (c) special directions and precautions for use;
             722          (d) common severe side effects or interactions, and therapeutic interactions, and how to
             723      avoid those occurrences;
             724          (e) techniques for self-monitoring drug therapy;
             725          (f) proper storage;
             726          (g) prescription refill information; and
             727          (h) action to be taken in the event of a missed dose; and
             728          (16) establish procedures in cooperation with the State Board of Pharmacy for
             729      pharmacists to record information to be collected under this part. The recorded information


             730      shall include:
             731          (a) the name, address, age, and gender of the recipient;
             732          (b) individual history of the recipient where significant, including disease state, known
             733      allergies and drug reactions, and a comprehensive list of medications and relevant devices;
             734          (c) the pharmacist's comments on the individual's drug therapy;
             735          (d) name of prescriber; and
             736          (e) name of drug, dose, duration of therapy, and directions for use.
             737          Section 11. Section 26-18-406 is amended to read:
             738           26-18-406. Medicaid waiver for community service pilot program.
             739          (1) For purposes of this section, "community service pilot program" is a program in
             740      which the department:
             741          (a) identifies less than 100 Medicaid recipients who are capable of providing
             742      community services to others;
             743          (b) exempts a Medicaid recipient who is not capable of providing community services
             744      from the requirements of the community service pilot program;
             745          (c) identifies community services that the department will recognize for purposes of the
             746      pilot program; and
             747          (d) requires an individual identified under Subsection (1)(a) who is receiving Medicaid
             748      services to perform a certain number of hours of community service as a condition of receiving
             749      Medicaid benefits.
             750          (2) [(a)] The department shall develop a proposal to amend the state Medicaid plan to
             751      include a community service pilot program.
             752          [(b) The department shall present the proposal for the community service pilot program
             753      to the Legislative Health and Human Services Interim Committee on or before November 30,
             754      2011.]
             755          (3) The department shall, by January 1, 2012, apply for a Medicaid waiver with the
             756      Centers for Medicare and Medicaid Services within the United States Department of Health
             757      and Human Services to implement a community service pilot program within the state


             758      Medicaid plan.
             759          Section 12. Section 26-18-604 is amended to read:
             760           26-18-604. Division duties -- Reporting.
             761          (1) The division shall:
             762          (a) develop and implement procedures relating to Medicaid funds and medical or
             763      hospital assistance funds to ensure that providers do not receive:
             764          (i) duplicate payments for the same goods or services;
             765          (ii) payment for goods or services by resubmitting a claim for which:
             766          (A) payment has been disallowed on the grounds that payment would be a violation of
             767      federal or state law, administrative rule, or the state plan; and
             768          (B) the decision to disallow the payment has become final;
             769          (iii) payment for goods or services provided after a recipient's death, including payment
             770      for pharmaceuticals or long-term care; or
             771          (iv) payment for transporting an unborn infant;
             772          (b) consult with the Centers for Medicaid and Medicare Services, other states, and the
             773      Office of Inspector General for Medicaid Services, if one is created by statute, to determine and
             774      implement best practices for discovering and eliminating fraud, waste, and abuse of Medicaid
             775      funds and medical or hospital assistance funds;
             776          (c) actively seek repayment from providers for improperly used or paid:
             777          (i) Medicaid funds; and
             778          (ii) medical or hospital assistance funds;
             779          (d) coordinate, track, and keep records of all division efforts to obtain repayment of the
             780      funds described in Subsection (1)(c), and the results of those efforts;
             781          (e) keep Medicaid pharmaceutical costs as low as possible by actively seeking to obtain
             782      pharmaceuticals at the lowest price possible, including, on a quarterly basis for the
             783      pharmaceuticals that represent the highest 45% of state Medicaid expenditures for
             784      pharmaceuticals and on an annual basis for the remaining pharmaceuticals:
             785          (i) tracking changes in the price of pharmaceuticals;


             786          (ii) checking the availability and price of generic drugs;
             787          (iii) reviewing and updating the state's maximum allowable cost list; and
             788          (iv) comparing pharmaceutical costs of the state Medicaid program to available
             789      pharmacy price lists; and
             790          (f) provide training, on an annual basis, to the employees of the division who make
             791      decisions on billing codes, or who are in the best position to observe and identify upcoding, in
             792      order to avoid and detect upcoding.
             793          [(2) At the October 2011 interim meeting of the Health and Human Services Interim
             794      Committee, the division shall report on the measures taken by the division to correct the
             795      problems identified in, and to implement the recommendations made in, the December 2010
             796      Performance Audit of Utah Medicaid Provider Cost Control published by the Office of
             797      Legislative Auditor General.]
             798          [(3) Beginning in 2012, the division shall annually, before September 1, report to and
             799      provide the Health and Human Services Interim Committee with information, including
             800      statistical information, for the preceding fiscal year, regarding:]
             801          (2) Each year, the division shall report the following to the Social Services
             802      Appropriations Subcommittee:
             803          (a) incidents of improperly used or paid Medicaid funds and medical or hospital
             804      assistance funds;
             805          (b) division efforts to obtain repayment from providers of the funds described in
             806      Subsection [(3)] (2)(a);
             807          (c) all repayments made of funds described in Subsection [(3)] (2)(a), including the
             808      total amount recovered; and
             809          (d) the division's compliance with the recommendations made in the December 2010
             810      Performance Audit of Utah Medicaid Provider Cost Control published by the Office of
             811      Legislative Auditor General.
             812          Section 13. Section 26-18a-3 is amended to read:
             813           26-18a-3. Purpose of committee.


             814          (1) The committee shall work to:
             815          (a) provide financial assistance for initial medical expenses of children who need organ
             816      transplants;
             817          (b) obtain the assistance of volunteer and public service organizations; and
             818          (c) fund activities as the committee designates for the purpose of educating the public
             819      about the need for organ donors.
             820          (2) (a) The committee is responsible for awarding financial assistance funded by the
             821      restricted account.
             822          (b) The financial assistance awarded by the committee under Subsection (1)(a) shall be
             823      in the form of interest free loans. The committee may establish terms for repayment of the
             824      loans, including a waiver of the requirement to repay any awards if, in the committee's
             825      judgment, repayment of the loan would impose an undue financial burden on the recipient.
             826          (c) In making financial awards under Subsection (1)(a), the committee shall consider:
             827          (i) need;
             828          (ii) coordination with or enhancement of existing services or financial assistance,
             829      including availability of insurance or other state aid;
             830          (iii) the success rate of the particular organ transplant procedure needed by the child;
             831      and
             832          (iv) the extent of the threat to the child's life without the organ transplant.
             833          (3) The committee may only provide the assistance described in this section to children
             834      who have resided in Utah, or whose legal guardians have resided in Utah for at least six months
             835      prior to the date of assistance under this section.
             836          (4) (a) The committee may expend up to 5% of its annual appropriation for
             837      administrative costs associated with the allocation of funds from the restricted account.
             838          (b) The administrative costs shall be used for the costs associated with staffing the
             839      committee and for State Tax Commission costs in implementing Section 59-10-1308 .
             840          [(5) The committee shall make an annual report to the Social Services Appropriations
             841      Subcommittee regarding the programs and services funded by contributions to the restricted


             842      account.]
             843          Section 14. Section 26-18b-101 is amended to read:
             844           26-18b-101. Organ Donation Contribution Fund created.
             845          (1) (a) There is created a restricted special revenue fund known as the Organ Donation
             846      Contribution Fund.
             847          (b) The Organ Donation Contribution Fund shall consist of:
             848          (i) private contributions;
             849          (ii) donations or grants from public or private entities;
             850          (iii) voluntary donations collected under Sections 41-1a-230.5 and 53-3-214.7 ; and
             851          (iv) interest and earnings on fund money.
             852          (c) The cost of administering the Organ Donation Contribution Fund shall be paid from
             853      money in the fund.
             854          (2) The Department of Health shall:
             855          (a) administer the funds deposited in the Organ Donation Contribution Fund; and
             856          (b) select qualified organizations and distribute the funds in the Organ Donation
             857      Contribution Fund in accordance with Subsection (3)[; and].
             858          [(c) make an annual report on the fund to the Social Services Appropriations
             859      Subcommittee.]
             860          (3) (a) The funds in the Organ Donation Contribution Fund may be distributed to a
             861      selected organization that:
             862          (i) promotes and supports organ donation;
             863          (ii) assists in maintaining and operating a statewide organ donation registry; and
             864          (iii) provides donor awareness education.
             865          (b) An organization that meets the criteria of Subsections (3)(a)(i) through (iii) may
             866      apply to the Department of Health, in a manner prescribed by the department, to receive a
             867      portion of the money contained in the Organ Donation Contribution Fund.
             868          Section 15. Section 26-33a-104 is amended to read:
             869           26-33a-104. Purpose, powers, and duties of the committee.


             870          (1) The purpose of the committee is to direct a statewide effort to collect, analyze, and
             871      distribute health care data to facilitate the promotion and accessibility of quality and
             872      cost-effective health care and also to facilitate interaction among those with concern for health
             873      care issues.
             874          (2) The committee shall:
             875          (a) develop and adopt by rule, following public hearing and comment, a health data
             876      plan that shall among its elements:
             877          (i) identify the key health care issues, questions, and problems amenable to resolution
             878      or improvement through better data, more extensive or careful analysis, or improved
             879      dissemination of health data;
             880          (ii) document existing health data activities in the state to collect, organize, or make
             881      available types of data pertinent to the needs identified in Subsection (2)(a)(i);
             882          (iii) describe and prioritize the actions suitable for the committee to take in response to
             883      the needs identified in Subsection (2)(a)(i) in order to obtain or to facilitate the obtaining of
             884      needed data, and to encourage improvements in existing data collection, interpretation, and
             885      reporting activities, and indicate how those actions relate to the activities identified under
             886      Subsection (2)(a)(ii);
             887          (iv) detail the types of data needed for the committee's work, the intended data
             888      suppliers, and the form in which such data are to be supplied, noting the consideration given to
             889      the potential alternative sources and forms of such data and to the estimated cost to the
             890      individual suppliers as well as to the department of acquiring these data in the proposed
             891      manner; the plan shall reasonably demonstrate that the committee has attempted to maximize
             892      cost-effectiveness in the data acquisition approaches selected;
             893          (v) describe the types and methods of validation to be performed to assure data validity
             894      and reliability;
             895          (vi) explain the intended uses of and expected benefits to be derived from the data
             896      specified in Subsection (2)(a)(iv), including the contemplated tabulation formats and analysis
             897      methods; the benefits described shall demonstrably relate to one or more of the following:


             898          (A) promoting quality health care;
             899          (B) managing health care costs; or
             900          (C) improving access to health care services;
             901          (vii) describe the expected processes for interpretation and analysis of the data flowing
             902      to the committee; noting specifically the types of expertise and participation to be sought in
             903      those processes; and
             904          (viii) describe the types of reports to be made available by the committee and the
             905      intended audiences and uses;
             906          (b) have the authority to collect, validate, analyze, and present health data in
             907      accordance with the plan while protecting individual privacy through the use of a control
             908      number as the health data identifier;
             909          (c) evaluate existing identification coding methods and, if necessary, require by rule
             910      that health data suppliers use a uniform system for identification of patients, health care
             911      facilities, and health care providers on health data they submit under this chapter; and
             912          [(d) report biennially to the governor and the Legislature on how the committee is
             913      meeting its responsibilities under this chapter; and]
             914          [(e)] (d) advise, consult, contract, and cooperate with any corporation, association, or
             915      other entity for the collection, analysis, processing, or reporting of health data identified by
             916      control number only in accordance with the plan.
             917          (3) The committee may adopt rules to carry out the provisions of this chapter in
             918      accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
             919          (4) Except for data collection, analysis, and validation functions described in this
             920      section, nothing in this chapter shall be construed to authorize or permit the committee to
             921      perform regulatory functions which are delegated by law to other agencies of the state or
             922      federal governments or to perform quality assurance or medical record audit functions that
             923      health care facilities, health care providers, or third party payors are required to conduct to
             924      comply with federal or state law. The committee may not recommend or determine whether a
             925      health care provider, health care facility, third party payor, or self-funded employer is in


             926      compliance with federal or state laws including federal or state licensure, insurance,
             927      reimbursement, tax, malpractice, or quality assurance statutes or common law.
             928          (5) Nothing in this chapter shall be construed to require a data supplier to supply health
             929      data identifying a patient by name or describing detail on a patient beyond that needed to
             930      achieve the approved purposes included in the plan.
             931          (6) No request for health data shall be made of health care providers and other data
             932      suppliers until a plan for the use of such health data has been adopted.
             933          (7) If a proposed request for health data imposes unreasonable costs on a data supplier,
             934      due consideration shall be given by the committee to altering the request. If the request is not
             935      altered, the committee shall pay the costs incurred by the data supplier associated with
             936      satisfying the request that are demonstrated by the data supplier to be unreasonable.
             937          (8) After a plan is adopted as provided in Section 26-33a-106.1 , the committee may
             938      require any data supplier to submit fee schedules, maximum allowable costs, area prevailing
             939      costs, terms of contracts, discounts, fixed reimbursement arrangements, capitations, or other
             940      specific arrangements for reimbursement to a health care provider.
             941          (9) The committee may not publish any health data collected under Subsection (8) that
             942      would disclose specific terms of contracts, discounts, or fixed reimbursement arrangements, or
             943      other specific reimbursement arrangements between an individual provider and a specific
             944      payer.
             945          (10) Nothing in Subsection (8) shall prevent the committee from requiring the
             946      submission of health data on the reimbursements actually made to health care providers from
             947      any source of payment, including consumers.
             948          Section 16. Section 26-40-103 is amended to read:
             949           26-40-103. Creation and administration of the Utah Children's Health Insurance
             950      Program.
             951          (1) There is created the Utah Children's Health Insurance Program to be administered
             952      by the department in accordance with the provisions of:
             953          (a) this chapter; and


             954          (b) the State Children's Health Insurance Program, 42 U.S.C. Sec. 1397aa et seq.
             955          (2) The department shall:
             956          (a) prepare and submit the state's children's health insurance plan before May 1, 1998,
             957      and any amendments to the federal Department of Health and Human Services in accordance
             958      with 42 U.S.C. Sec. 1397ff; and
             959          (b) make rules in accordance with Title 63G, Chapter 3, Utah Administrative
             960      Rulemaking Act regarding:
             961          (i) eligibility requirements consistent with Subsection 26-18-3 [(9)](8);
             962          (ii) program benefits;
             963          (iii) the level of coverage for each program benefit;
             964          (iv) cost-sharing requirements for enrollees, which may not:
             965          (A) exceed the guidelines set forth in 42 U.S.C. Sec. 1397ee; or
             966          (B) impose deductible, copayment, or coinsurance requirements on an enrollee for
             967      well-child, well-baby, and immunizations;
             968          (v) the administration of the program; and
             969          (vi) a requirement that:
             970          (A) enrollees in the program shall participate in the electronic exchange of clinical
             971      health records established in accordance with Section 26-1-37 unless the enrollee opts out of
             972      participation;
             973          (B) prior to enrollment in the electronic exchange of clinical health records the enrollee
             974      shall receive notice of the enrollment in the electronic exchange of clinical health records and
             975      the right to opt out of participation at any time; and
             976          (C) beginning July 1, 2012, when the program sends enrollment or renewal information
             977      to the enrollee and when the enrollee logs onto the program's website, the enrollee shall receive
             978      notice of the right to opt out of the electronic exchange of clinical health records.
             979          Section 17. Section 26-40-109 is amended to read:
             980           26-40-109. Evaluation.
             981          [(1)] The department shall develop performance measures and annually evaluate the


             982      program's performance.
             983          [(2) The department shall report annually on its evaluation to the Health and Human
             984      Services Interim Committee of the Legislature before November 1.]
             985          Section 18. Section 26-47-102 is amended to read:
             986           26-47-102. Prescription Drug Assistance Program.
             987          (1) No later than October 1, 2003, the department shall implement a Prescription Drug
             988      Assistance Program. The program shall assist persons seeking information about how to obtain
             989      prescription drugs at a reduced price or no cost. The program shall:
             990          (a) collect eligibility and enrollment information about programs that make
             991      prescription drugs available to consumers at a reduced price or no cost;
             992          (b) provide information collected under Subsection (1)(a) to consumers upon request
             993      via a toll-free phone line, the Internet, and mail;
             994          (c) inform pharmacists and other health care providers of the Prescription Drug
             995      Assistance Program; and
             996          (d) assist consumers in completing applications to participate in programs identified
             997      under Subsection (1)(a).
             998          (2) Any pharmaceutical manufacturer, distributor, or wholesaler operating in the state
             999      shall:
             1000          (a) notify the department of any program operated by it to provide prescription drugs to
             1001      consumers at a reduced price or no cost; and
             1002          (b) provide the department with information about eligibility, enrollment, and benefits.
             1003          (3) Pharmacies, as defined in Title 58, Chapter 17b, Pharmacy Practice Act, shall
             1004      notify their patients of the Prescription Drug Assistance Program. This notification shall
             1005      include displaying the program's toll-free number, and may include distributing a brochure or
             1006      oral communication.
             1007          (4) The department may accept grants, gifts, and donations of money or property for
             1008      use by the Prescription Drug Assistance Program.
             1009          [(5) The department shall report to the Health and Human Services Interim Committee


             1010      and the Social Services Appropriations Subcommittee on the performance of the Prescription
             1011      Drug Assistance Program prior to the 2004 and 2005 Annual General Sessions of the
             1012      Legislature.]
             1013          Section 19. Section 26-47-103 is amended to read:
             1014           26-47-103. Department to award grants for assistance to persons with bleeding
             1015      disorders.
             1016          (1) For purposes of this section:
             1017          (a) "Hemophilia services" means a program for medical care, including the costs of
             1018      blood transfusions, and the use of blood derivatives and blood clotting factors.
             1019          (b) "Person with a bleeding disorder" means a person:
             1020          (i) who is medically diagnosed with hemophilia or a bleeding disorder;
             1021          (ii) who is not eligible for Medicaid or the Children's Health Insurance Program; and
             1022          (iii) who has either:
             1023          (A) insurance coverage that excludes coverage for hemophilia services;
             1024          (B) exceeded the person's insurance plan's annual maximum benefits;
             1025          (C) exceeded the person's annual or lifetime maximum benefits payable under Title
             1026      31A, Chapter 29, Comprehensive Health Insurance Pool Act; or
             1027          (D) insurance coverage available under either private health insurance, Title 31A,
             1028      Chapter 29, Comprehensive Health Insurance Pool Act, Utah mini COBRA coverage under
             1029      Section 31A-22-722 , or federal COBRA coverage, but the premiums for that coverage are
             1030      greater than a percentage of the person's annual adjusted gross income as established by the
             1031      department by administrative rule.
             1032          (2) (a) Within appropriations specified by the Legislature for this purpose, the
             1033      department shall make grants to public and nonprofit entities who assist persons with bleeding
             1034      disorders with the cost of obtaining hemophilia services or the cost of insurance premiums for
             1035      coverage of hemophilia services.
             1036          (b) Applicants for grants under this section:
             1037          (i) shall be submitted to the department in writing; and


             1038          (ii) shall comply with Subsection (3).
             1039          (3) Applications for grants under this section shall include:
             1040          (a) a statement of specific, measurable objectives, and the methods to be used to assess
             1041      the achievement of those objectives;
             1042          (b) a description of the personnel responsible for carrying out the activities of the grant
             1043      along with a statement justifying the use of any grant funds for the personnel;
             1044          (c) letters and other forms of evidence showing that efforts have been made to secure
             1045      financial and professional assistance and support for the services to be provided under the
             1046      grant;
             1047          (d) a list of services to be provided by the applicant;
             1048          (e) the schedule of fees to be charged by the applicant; and
             1049          (f) other provisions as determined by the department.
             1050          (4) The department may accept grants, gifts, and donations of money or property for
             1051      use by the grant program.
             1052          (5) [(a)] The department shall establish rules in accordance with Title 63G, Chapter 3,
             1053      Utah Administrative Rulemaking Act, governing the application form, process, and criteria it
             1054      will use in awarding grants under this section.
             1055          [(b) The department shall submit an annual report on the implementation of the grant
             1056      program:]
             1057          [(i) by no later than November 1; and]
             1058          [(ii) to the Health and Human Services Interim Committee and the Social Services
             1059      Appropriations Subcommittee.]
             1060          Section 20. Section 31A-22-626 is amended to read:
             1061           31A-22-626. Coverage of diabetes.
             1062          (1) As used in this section, "diabetes" includes individuals with:
             1063          (a) complete insulin deficiency or type 1 diabetes;
             1064          (b) insulin resistant with partial insulin deficiency or type 2 diabetes; and
             1065          (c) elevated blood glucose levels induced by pregnancy or gestational diabetes.


             1066          (2) The commissioner shall establish, by rule, minimum standards of coverage for
             1067      diabetes for accident and health insurance policies that provide a health insurance benefit
             1068      before July 1, 2000.
             1069          (3) In making rules under Subsection (2), the commissioner shall require rules:
             1070          (a) with durational limits, amount limits, deductibles, and coinsurance for the treatment
             1071      of diabetes equitable or identical to coverage provided for the treatment of other illnesses or
             1072      diseases; and
             1073          (b) that provide coverage for:
             1074          (i) diabetes self-management training and patient management, including medical
             1075      nutrition therapy as defined by rule, provided by an accredited or certified program and referred
             1076      by an attending physician within the plan and consistent with the health plan provisions for
             1077      self-management education:
             1078          (A) recognized by the federal Health Care Financing Administration; or
             1079          (B) certified by the Department of Health; and
             1080          (ii) the following equipment, supplies, and appliances to treat diabetes when medically
             1081      necessary:
             1082          (A) blood glucose monitors, including those for the legally blind;
             1083          (B) test strips for blood glucose monitors;
             1084          (C) visual reading urine and ketone strips;
             1085          (D) lancets and lancet devices;
             1086          (E) insulin;
             1087          (F) injection aides, including those adaptable to meet the needs of the legally blind, and
             1088      infusion delivery systems;
             1089          (G) syringes;
             1090          (H) prescriptive oral agents for controlling blood glucose levels; and
             1091          (I) glucagon kits.
             1092          [(4) (a) Before October 1, 2003, the commissioner shall report to the Health and
             1093      Human Services Interim Committee on the effects of Section 31A-22-626 . The report shall be


             1094      based on three years of data and shall include, to the extent possible:]
             1095          [(i) a review of the rules established under Subsection (3);]
             1096          [(ii) the change in availability of coverage resulting from this section;]
             1097          [(iii) the extent to which persons have been benefitted by the provisions of this section;
             1098      and]
             1099          [(iv) the impact of this section on premiums.]
             1100          [(b) The Legislature shall consider the results of the report under Subsection (4)(a)
             1101      when determining whether to reauthorize the provisions of this section.]
             1102          Section 21. Section 31A-22-633 is amended to read:
             1103           31A-22-633. Exemptions from standards.
             1104          Notwithstanding the provisions of Title 31A, Insurance Code, any accident and health
             1105      insurer or health maintenance organization may offer a choice of coverage that is less or
             1106      different than is otherwise required by applicable state law if:
             1107          (1) the Department of Health offers a choice of coverage as part of a Medicaid waiver
             1108      under Title 26, Chapter 18, Medical Assistance Act, which includes:
             1109          (a) less or different coverage than the basic coverage;
             1110          (b) less or different coverage than is otherwise required in an insurance policy or health
             1111      maintenance organization contract under applicable state law; or
             1112          (c) less or different coverage than required by Subsection 31A-22-605 (4)(b); and
             1113          (2) the choice of coverage offered by the carrier:
             1114          (a) is the same or similar coverage as the coverage offered by the Department of Health
             1115      under Subsection (1);
             1116          (b) is offered to the same or similar population as the coverage offered by the
             1117      Department of Health under Subsection (1); and
             1118          (c) contains an explanation for each insured of coverage exclusions and limitations[;].
             1119          [(3) the commissioner and the executive director of the Department of Health shall
             1120      report to the Health and Human Services Interim Committee prior to November 15 of each year
             1121      concerning:]


             1122          [(a) the number of lives covered under any policy offered under the provisions of this
             1123      section or under the Medicaid waiver described in Subsection (1);]
             1124          [(b) the claims experienced under the policies or Medicaid programs described in
             1125      Subsection (3)(a);]
             1126          [(c) any cost shifting to the private sector for care not covered under the programs or
             1127      policies described in Subsection (3)(a); and]
             1128          [(d) efforts or agreements between the Department of Health, the commissioner,
             1129      insurers regulated under this chapter, and health care providers regarding combining publicly
             1130      funded coverage with private, employer-based coverage to increase benefits and health care
             1131      coverage.]
             1132          Section 22. Section 35A-3-207 is amended to read:
             1133           35A-3-207. Community-based prevention programs.
             1134          (1) As used in this section:
             1135          (a) "political subdivision" means a town, city, county, or school district;
             1136          (b) "qualified sponsor" means a:
             1137          (i) political subdivision;
             1138          (ii) community nonprofit, religious, or charitable organization;
             1139          (iii) regional or statewide nonprofit organization; or
             1140          (iv) private for profit or nonprofit child care organization with experience and expertise
             1141      in operating community-based prevention programs described in Subsection (2) and that are
             1142      licensed under Title 62A, Chapter 2, Licensure of Programs and Facilities.
             1143          (2) Within appropriations from the Legislature, the department may provide grants to
             1144      qualified sponsors for community-based prevention programs that:
             1145          (a) support parents in their primary care giving role to children;
             1146          (b) provide positive alternatives to idleness for school-aged children when school is not
             1147      in session; and
             1148          (c) support other community-based prevention programs.
             1149          (3) In awarding grants under this section, the department shall:


             1150          (a) request proposals for funding from potential qualified sponsors; and
             1151          (b) comply with the requirements of Subsection (4).
             1152          (4) In awarding these grants, the department shall ensure that each dollar of funds from
             1153      political subdivisions or private funds is matched for each dollar received from the department.
             1154      The value of in-kind contributions such as materials, supplies, paid labor, volunteer labor, and
             1155      the incremental increase in building maintenance and operation expenses incurred attributable
             1156      to the prevention program may be considered in meeting this match requirement.
             1157          (5) In awarding a grant under this section, the department shall consider:
             1158          (a) the cash portion of the proposed match in relation to the financial resources of the
             1159      qualified sponsor; and
             1160          (b) the extent to which the qualified sponsor has:
             1161          (i) consulted and collaborated with parents of children who are likely to participate,
             1162      local parent-teacher organizations, and other parent organizations[, and the appropriate local
             1163      interagency council established under Section 63M-9-301 ];
             1164          (ii) identified at risk factors that will be ameliorated through the proposed prevention
             1165      program;
             1166          (iii) identified protective factors and developmental assets that will be supported and
             1167      strengthened through the proposed prevention program; and
             1168          (iv) the financial support of parents and the organizations specified in Subsection
             1169      (5)(b)(i).
             1170          (6) At least 50 percent of the grants awarded under this section shall be awarded to
             1171      organizations described in Subsection (1)(b)(iv).
             1172          (7) No federal funds shall be used as matching funds under this act.
             1173          Section 23. Section 51-9-201 is amended to read:
             1174           51-9-201. Creation of Tobacco Settlement Restricted Account.
             1175          (1) There is created within the General Fund a restricted account known as the
             1176      "Tobacco Settlement Restricted Account."
             1177          (2) The account shall earn interest.


             1178          (3) The account shall consist of:
             1179          (a) on and after July 1, 2007, 60% of all funds of every kind that are received by the
             1180      state that are related to the settlement agreement that the state entered into with leading tobacco
             1181      manufacturers on November 23, 1998; and
             1182          (b) interest earned on the account.
             1183          (4) To the extent that funds will be available for appropriation in a given fiscal year,
             1184      those funds shall be appropriated from the account in the following order:
             1185          (a) $66,600 to the Office of the Attorney General for ongoing enforcement and defense
             1186      of the Tobacco Settlement Agreement;
             1187          (b) $18,500 to the State Tax Commission for ongoing enforcement of business
             1188      compliance with the Tobacco Tax Settlement Agreement;
             1189          (c) $10,452,900 to the Department of Health for the Children's Health Insurance
             1190      Program created in Section 26-40-103 and for restoration of dental benefits in the Children's
             1191      Health Insurance Program;
             1192          (d) $3,847,100 to the Department of Health for alcohol, tobacco, and other drug
             1193      prevention, reduction, cessation, and control programs that promote unified messages and
             1194      make use of media outlets, including radio, newspaper, billboards, and television, and with a
             1195      preference in funding given to tobacco-related programs;
             1196          (e) $193,700 to the Administrative Office of the Courts and $2,325,400 to the
             1197      Department of Human Services for the statewide expansion of the drug court program;
             1198          (f) $4,000,000 to the State Board of Regents for the University of Utah Health Sciences
             1199      Center to benefit the health and well-being of Utah citizens through in-state research,
             1200      treatment, and educational activities; and
             1201          (g) any remaining funds as directed by the Legislature through appropriation.
             1202          [(5) Each state agency identified in Subsection (4) shall provide an annual report on the
             1203      program and activities funded under Subsection (4) to:]
             1204          [(a) the Health and Human Services Interim Committee no later than September 1;
             1205      and]


             1206          [(b) the Social Services Appropriations Subcommittee.]
             1207          Section 24. Section 53A-15-205 is amended to read:
             1208           53A-15-205. Disability Determination Services Advisory Council -- Membership
             1209      -- Duties -- Requirements for DDDS.
             1210          (1) As used in this section, "council" means the Disability Determination Services
             1211      Advisory Council created in Subsection (2).
             1212          (2) There is created the Disability Determination Services Advisory Council to act as
             1213      an advisory council to the State Board of Education regarding the Division of Disability
             1214      Determination Services (DDDS) established under Chapter 24, Part 5, Division of Disability
             1215      Determination Services.
             1216          (3) The council is composed of the following members:
             1217          (a) the administrator of DDDS;
             1218          (b) a representative of the United States Department of Health and Human Services,
             1219      Social Security Administration, appointed by the board; and
             1220          (c) nine persons, appointed by the board in accordance with Subsections (5) and (6),
             1221      who represent a cross section of:
             1222          (i) persons with disabilities;
             1223          (ii) advocates for persons with disabilities;
             1224          (iii) health care providers;
             1225          (iv) representatives of allied state and local agencies; and
             1226          (v) representatives of the general public.
             1227          (4) The members appointed under Subsections (3)(a) and (3)(b) serve as nonvoting
             1228      members of the council.
             1229          (5) In appointing the members described in Subsection (3)(c), the board shall:
             1230          (a) solicit nominations from organizations and agencies that represent the interests of
             1231      members described in that subsection; and
             1232          (b) make every effort to create a balance in terms of geography, sex, race, ethnicity,
             1233      and type of both mental and physical disabilities.


             1234          (6) (a) In making initial appointments of members described in Subsection (3)(c), the
             1235      board shall appoint three members for two-year terms, three members for four-year terms, and
             1236      three members for six-year terms. All subsequent appointments are for four years.
             1237          (b) The board shall fill any vacancy that occurs on the council for any reason by
             1238      appointing a person for the unexpired term of the vacated member.
             1239          (c) Council members are eligible for one reappointment and serve until their successors
             1240      are appointed.
             1241          (7) Five voting members of the council constitute a quorum. The action of a majority
             1242      of a quorum represents the action of the council.
             1243          (8) Members of the council serve without compensation but may be reimbursed for
             1244      expenses incurred in the performance of their official duties.
             1245          (9) (a) The council shall annually elect a chairperson from among the membership
             1246      described, and shall adopt bylaws governing its activities.
             1247          (b) The chairperson shall set the meeting agenda.
             1248          (10) The council shall:
             1249          (a) advise DDDS and the Social Security Administration regarding its practices and
             1250      policies on the determination of claims for Social Security disability benefits;
             1251          (b) participate in the development of new internal practices and procedures of DDDS
             1252      and policies of the Social Security Administration regarding the evaluation of disability claims;
             1253          (c) recommend changes to practices and policies to ensure that DDDS is responsive to
             1254      individuals with a disability;
             1255          (d) review the DDDS budget to ensure that it is adequate to effectively evaluate
             1256      disability claims and to meet the needs of persons with disabilities who have claims pending
             1257      with DDDS; and
             1258          (e) review and recommend changes to policies and practices of allied state and federal
             1259      agencies, health care providers, and private community organizations.
             1260          (11) The council shall annually report to the board[, the governor, and the Legislative
             1261      Health and Human Services Interim Committee] regarding its activities.


             1262          (12) (a) To assist the council in its duties, DDDS shall provide the necessary staff
             1263      assistance to enable the council to make timely and effective recommendations.
             1264          (b) Staff assistance may include:
             1265          (i) distributing meeting agendas;
             1266          (ii) advising the chairpersons of the council regarding relevant items for council
             1267      discussion; and
             1268          (iii) providing reports, documents, budgets, memorandums, statutes, and regulations
             1269      regarding the management of DDDS.
             1270          (c) Staff assistance shall include maintaining minutes.
             1271          Section 25. Section 58-37f-801 is amended to read:
             1272           58-37f-801. Pilot program for real-time reporting for controlled substance
             1273      database -- Statewide implementation.
             1274          (1) As used in this section:
             1275          (a) "Pilot area" means the areas of the state that the division determines to operate the
             1276      pilot program in, under Subsection (3), which may include:
             1277          (i) the entire state; or
             1278          (ii) geographical areas within the state.
             1279          (b) "Pilot program" means the pilot program described in this section.
             1280          (2) There is established a pilot program for real-time reporting of data to, and access to
             1281      data from, the database by a pharmacy, a pharmaceutical facility, or a prescribing practitioner
             1282      beginning on July 1, 2010, and ending on July 1, 2012.
             1283          (3) In addition to fulfilling the requirements relating to the database on a statewide
             1284      basis, the division shall, in accordance with Subsection (4), upgrade, administer, and direct the
             1285      functioning of the database in geographical areas specified by the division, or on a statewide
             1286      basis, in a manner that provides for real-time reporting of information entered into, and
             1287      accessed from, the database by a pharmacy or pharmaceutical facility.
             1288          (4) The division shall, under state procurement laws, and with the technical assistance
             1289      of the Department of Technology Services, contract with a private entity to upgrade, operate,


             1290      and maintain the database in the pilot area.
             1291          (5) (a) All provisions and requirements of the statewide database, described in the
             1292      other parts of this chapter, are applicable to the database in the pilot area, to the extent that they
             1293      do not conflict with the requirements of this section.
             1294          (b) For purposes of the other parts of this chapter, and this section, the database in the
             1295      pilot area is considered part of the statewide database.
             1296          (6) A pharmacy or pharmaceutical facility shall cooperate with the division, or the
             1297      division's designee, to provide real-time submission of, and access to, information for the
             1298      database:
             1299          (a) in the pilot area; and
             1300          (b) when the division implements the pilot program as a permanent program under
             1301      Subsection [(10)] (9), on a statewide basis.
             1302          (7) The penalties and enforcement provisions described in the other parts of this
             1303      chapter apply to enforce the provisions of this section in relation to a pharmacy or
             1304      pharmaceutical facility that is located in, or operates in, the pilot area.
             1305          (8) The division may make rules, in accordance with Title 63G, Chapter 3, Utah
             1306      Administrative Rulemaking Act, to provide for the real-time reporting of, and access to,
             1307      information in accordance with the requirements of this section.
             1308          [(9) During the Legislature's 2009 interim, the division shall report to the Health and
             1309      Human Services Interim Committee regarding:]
             1310          [(a) the implementation, operation, and impact of the pilot program established in this
             1311      section;]
             1312          [(b) the progress made by the division in implementing the pilot program on a
             1313      statewide basis;]
             1314          [(c) the advisability of, and projected costs of, implementing the pilot program on a
             1315      statewide basis; and]
             1316          [(d) the use of the database by prescribing practitioners.]
             1317          [(10)] (9) The division shall, on or before July 1, 2012, implement the pilot program as


             1318      a permanent program on a statewide basis.
             1319          [(11)] (10) (a) The division shall, through the private entity contracted with under
             1320      Subsection (4), provide, free of charge, to a pharmacy or pharmaceutical facility that is required
             1321      to comply with Subsection (6), software, software installation assistance, and training, that will
             1322      enable the pharmacy or pharmaceutical facility to comply with Subsection (6).
             1323          (b) Notwithstanding Subsection [(11)] (10)(a), a pharmacy or pharmaceutical facility
             1324      required to comply with Subsection (6) may, instead of accepting installation of the software
             1325      provided by the division under Subsection [(11)] (10)(a), modify its own software in order to
             1326      comply with the requirements of Subsection (6), if the modification is made:
             1327          (i) except as provided in Subsection [(11)] (10)(d), at the expense of the pharmacy or
             1328      pharmaceutical facility;
             1329          (ii) in consultation with the division; and
             1330          (iii) within six months after the division notifies the pharmacy or pharmaceutical
             1331      facility, in writing, of the division's intention to install the software described in Subsection
             1332      [(11)] (10)(a).
             1333          (c) The division shall, through the private entity contracted with under Subsection (4),
             1334      cooperate with a pharmacy or pharmaceutical facility that is required to comply with
             1335      Subsection (6), to ensure that the installation and operation of the software described in
             1336      Subsection [(11)] (10)(a), or the provision of information from the pharmacy or pharmaceutical
             1337      facility to the database:
             1338          (i) complies with the security standards described in 45 C.F.R. Parts 160, 162, and 164,
             1339      Health Insurance Reform: Security Standards;
             1340          (ii) does not interfere with the proper functioning of the pharmacy's or pharmaceutical
             1341      facility's software or computer system; and
             1342          (iii) in order to minimize changes in existing protocols, provides, to the extent
             1343      practicable, for the transmission of data in the same manner that pharmacies currently transmit
             1344      information to insurance companies.
             1345          (d) The division may, within funds appropriated by the Legislature for this purpose,


             1346      reimburse a pharmacy for all or part of the costs of the in-house programing described in
             1347      Subsection [(11)] (10)(b), if:
             1348          (i) the pharmacy requests the reimbursement, in writing;
             1349          (ii) the pharmacy provides proof of the costs for the in-house programming to the
             1350      division;
             1351          (iii) the pharmacy requests the reimbursement prior to a deadline established by the
             1352      division; and
             1353          (iv) except as provided in Subsection [(11)] (10)(e), the division pays an equal
             1354      reimbursement amount to each pharmacy that complies with Subsections [(11)] (10)(d)(i)
             1355      through (iii).
             1356          (e) The division may reimburse a pharmacy described in Subsection [(11)] (10)(d)(iv)
             1357      for an amount that is less than the reimbursement paid to other pharmacies described in
             1358      Subsection [(11)] (10)(d)(iv), if:
             1359          (i) the proof of costs for in-house programming provided by the pharmacy establishes a
             1360      cost less than the amount reimbursed to the other pharmacies; and
             1361          (ii) the amount reimbursed to the pharmacy is equal to the amount established by the
             1362      proof of costs for in-house programming submitted by the pharmacy.
             1363          (f) Notwithstanding any other provision of this section, the division may, by rule, allow
             1364      up to 24 hours for the reporting of data to the database by a non-resident pharmacy, as defined
             1365      in Section 58-17b-102 .
             1366          Section 26. Section 58-77-201 is amended to read:
             1367           58-77-201. Board.
             1368          (1) There is created the Licensed Direct-entry Midwife Board consisting of:
             1369          (a) four licensed Direct-entry midwives; and
             1370          (b) one member of the general public.
             1371          (2) The board shall be appointed and serve in accordance with Section 58-1-201 .
             1372          (3) (a) The duties and responsibilities of the board shall be in accordance with Sections
             1373      58-1-202 and 58-1-203 .


             1374          (b) The board shall designate one of its members on a permanent or rotating basis to:
             1375          (i) assist the division in reviewing complaints concerning the unlawful or
             1376      unprofessional conduct of a licensed Direct-entry midwife; and
             1377          (ii) advise the division in its investigation of these complaints.
             1378          [(c) (i) For the years 2006 through 2011, the board shall present an annual report to the
             1379      Legislature's Health and Human Services Interim Committee describing the outcome data of
             1380      licensed Direct-entry midwives practicing in Utah.]
             1381          [(ii) The board shall base its report on data provided in large part from the Midwives'
             1382      Alliance of North America.]
             1383          (4) A board member who has, under Subsection (3), reviewed a complaint or advised
             1384      in its investigation may be disqualified from participating with the board when the board serves
             1385      as a presiding officer in an adjudicative proceeding concerning the complaint.
             1386          (5) Qualified faculty, board members, and other staff of Direct-entry midwifery
             1387      learning institutions may serve as one or more of the licensed Directed-entry midwives on the
             1388      board.
             1389          Section 27. Section 62A-3-110 is amended to read:
             1390           62A-3-110. "Out and About" Homebound Transportation Assistance Fund.
             1391          (1) (a) There is created a restricted special revenue fund known as the "Out and About"
             1392      Homebound Transportation Assistance Fund.
             1393          (b) The "Out and About" Homebound Transportation Assistance Fund shall consist of:
             1394          (i) private contributions;
             1395          (ii) donations or grants from public or private entities;
             1396          (iii) voluntary donations collected under Section 53-3-214.8 ; and
             1397          (iv) interest and earnings on account money.
             1398          (c) The cost of administering the "Out and About" Homebound Transportation
             1399      Assistance Fund shall be paid from money in the fund.
             1400          (2) The Division of Aging and Adult Services in the Department of Human Services
             1401      shall:


             1402          (a) administer the funds contained in the "Out and About" Homebound Transportation
             1403      Assistance Fund; and
             1404          (b) select qualified organizations and distribute the funds in the "Out and About"
             1405      Homebound Transportation Assistance Fund in accordance with Subsection (3)[; and].
             1406          [(c) make an annual report on the "Out and About" Homebound Transportation
             1407      Assistance Fund to the Social Services Appropriations Subcommittee.]
             1408          (3) (a) The division may distribute the funds in the "Out and About" Homebound
             1409      Transportation Assistance Fund to a selected organization that provides public transportation to
             1410      aging persons, high risk adults, or people with disabilities.
             1411          (b) An organization that provides public transportation to aging persons, high risk
             1412      adults, or people with disabilities may apply to the Division of Aging and Adult Services, in a
             1413      manner prescribed by the division, to receive all or part of the money contained in the "Out and
             1414      About" Homebound Transportation Assistance Fund.
             1415          Section 28. Section 62A-5-105 is amended to read:
             1416           62A-5-105. Division responsibilities -- Policy mediation.
             1417          (1) The division shall establish its rules in accordance with:
             1418          (a) the policy of the Legislature as set forth by this chapter; and
             1419          (b) Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
             1420          (2) The division shall:
             1421          (a) establish program policy for the division, the developmental center, and programs
             1422      and facilities operated by or under contract with the division;
             1423          (b) establish rules for the assessment and collection of fees for programs within the
             1424      division;
             1425          (c) no later than July 1, 2003, establish a graduated fee schedule based on ability to pay
             1426      and implement the schedule with respect to service recipients and their families where not
             1427      otherwise prohibited by federal law or regulation or not otherwise provided for in Section
             1428      62A-5-109 ;
             1429          (d) establish procedures to ensure that private citizens, consumers, private contract


             1430      providers, allied state and local agencies, and others are provided with an opportunity to
             1431      comment and provide input regarding any new policy or proposed revision to an existing
             1432      policy;
             1433          (e) provide a mechanism for systematic and regular review of existing policy and for
             1434      consideration of policy changes proposed by the persons and agencies described under
             1435      Subsection (2)(d);
             1436          (f) [(i)] establish and periodically review the criteria used to determine who may
             1437      receive services from the division and how the delivery of those services is prioritized within
             1438      available funding; [and]
             1439          [(ii) make periodic recommendations based on the review conducted under Subsection
             1440      (2)(f)(i) to the Health and Human Services Interim Committee beginning at or before the
             1441      September 2002 meeting of the committee;]
             1442          (g) review implementation and compliance by the division with policies established by
             1443      the board to ensure that the policies established by the Legislature in this chapter are carried
             1444      out; and
             1445          (h) annually report to the executive director.
             1446          (3) The executive director shall mediate any differences which arise between the
             1447      policies of the division and those of any other policy board or division in the department.
             1448          Section 29. Section 62A-5a-104 is amended to read:
             1449           62A-5a-104. Powers of council.
             1450          (1) The council has authority, after local or individual efforts have failed, [including,
             1451      with regard to persons under 22 years of age, actions by local interagency councils established
             1452      under Section 63M-9-301 ,] to:
             1453          (a) coordinate the appropriate transition of persons with disabilities who receive
             1454      services and support from one state agency to receive services and support from another state
             1455      agency;
             1456          (b) coordinate policies governing the provision of services and support for persons
             1457      with disabilities by state agencies; and


             1458          (c) consider issues regarding eligibility for services and support and, where possible,
             1459      develop uniform eligibility standards for state agencies.
             1460          (2) The council may receive appropriations from the Legislature to purchase services
             1461      and supports for persons with disabilities as the council deems appropriate.
             1462          Section 30. Section 62A-15-103 is amended to read:
             1463           62A-15-103. Division -- Creation -- Responsibilities.
             1464          (1) There is created the Division of Substance Abuse and Mental Health within the
             1465      department, under the administration and general supervision of the executive director. The
             1466      division is the substance abuse authority and the mental health authority for this state.
             1467          (2) The division shall:
             1468          (a) (i) educate the general public regarding the nature and consequences of substance
             1469      abuse by promoting school and community-based prevention programs;
             1470          (ii) render support and assistance to public schools through approved school-based
             1471      substance abuse education programs aimed at prevention of substance abuse;
             1472          (iii) promote or establish programs for the prevention of substance abuse within the
             1473      community setting through community-based prevention programs;
             1474          (iv) cooperate and assist other organizations and private treatment centers for substance
             1475      abusers, by providing them with essential materials for furthering programs of prevention and
             1476      rehabilitation of actual and potential substance abusers; and
             1477          (v) promote or establish programs for education and certification of instructors to
             1478      educate persons convicted of driving under the influence of alcohol or drugs or driving with
             1479      any measurable controlled substance in the body;
             1480          (b) (i) collect and disseminate information pertaining to mental health;
             1481          (ii) provide direction over the state hospital including approval of its budget,
             1482      administrative policy, and coordination of services with local service plans;
             1483          (iii) promulgate rules in accordance with Title 63G, Chapter 3, Utah Administrative
             1484      Rulemaking Act, to educate families concerning mental illness and promote family
             1485      involvement, when appropriate, and with patient consent, in the treatment program of a family


             1486      member; and
             1487          (iv) promulgate rules in accordance with Title 63G, Chapter 3, Utah Administrative
             1488      Rulemaking Act, to direct that all individuals receiving services through local mental health
             1489      authorities or the Utah State Hospital be informed about and, if desired, provided assistance in
             1490      completion of a declaration for mental health treatment in accordance with Section
             1491      62A-15-1002 ;
             1492          (c) (i) consult and coordinate with local substance abuse authorities and local mental
             1493      health authorities regarding programs and services;
             1494          (ii) provide consultation and other assistance to public and private agencies and groups
             1495      working on substance abuse and mental health issues;
             1496          (iii) promote and establish cooperative relationships with courts, hospitals, clinics,
             1497      medical and social agencies, public health authorities, law enforcement agencies, education and
             1498      research organizations, and other related groups;
             1499          (iv) promote or conduct research on substance abuse and mental health issues, and
             1500      submit to the governor and the Legislature recommendations for changes in policy and
             1501      legislation;
             1502          (v) receive, distribute, and provide direction over public funds for substance abuse and
             1503      mental health services;
             1504          (vi) monitor and evaluate programs provided by local substance abuse authorities and
             1505      local mental health authorities;
             1506          (vii) examine expenditures of any local, state, and federal funds;
             1507          (viii) monitor the expenditure of public funds by:
             1508          (A) local substance abuse authorities;
             1509          (B) local mental health authorities; and
             1510          (C) in counties where they exist, the private contract provider that has an annual or
             1511      otherwise ongoing contract to provide comprehensive substance abuse or mental health
             1512      programs or services for the local substance abuse authority or local mental health authorities;
             1513          (ix) contract with local substance abuse authorities and local mental health authorities


             1514      to provide a comprehensive continuum of services in accordance with division policy, contract
             1515      provisions, and the local plan;
             1516          (x) contract with private and public entities for special statewide or nonclinical services
             1517      according to division rules;
             1518          (xi) review and approve each local substance abuse authority's plan and each local
             1519      mental health authority's plan in order to ensure:
             1520          (A) a statewide comprehensive continuum of substance abuse services;
             1521          (B) a statewide comprehensive continuum of mental health services; and
             1522          (C) appropriate expenditure of public funds;
             1523          (xii) review and make recommendations regarding each local substance abuse
             1524      authority's contract with its provider of substance abuse programs and services and each local
             1525      mental health authority's contract with its provider of mental health programs and services to
             1526      ensure compliance with state and federal law and policy;
             1527          (xiii) monitor and ensure compliance with division rules and contract requirements;
             1528      and
             1529          (xiv) withhold funds from local substance abuse authorities, local mental health
             1530      authorities, and public and private providers for contract noncompliance, failure to comply
             1531      with division directives regarding the use of public funds, or for misuse of public funds or
             1532      money;
             1533          (d) assure that the requirements of this part are met and applied uniformly by local
             1534      substance abuse authorities and local mental health authorities across the state;
             1535          (e) require each local substance abuse authority and each local mental health authority
             1536      to submit its plan to the division by May 1 of each year; and
             1537          (f) conduct an annual program audit and review of each local substance abuse authority
             1538      in the state and its contract provider and each local mental health authority in the state and its
             1539      contract provider, including:
             1540          (i) a review and determination regarding whether:
             1541          (A) public funds allocated to local substance abuse authorities and local mental health


             1542      authorities are consistent with services rendered and outcomes reported by them or their
             1543      contract providers; and
             1544          (B) each local substance abuse authority and each local mental health authority is
             1545      exercising sufficient oversight and control over public funds allocated for substance abuse and
             1546      mental health programs and services; and
             1547          (ii) items determined by the division to be necessary and appropriate[;].
             1548          [(g) by July 1 of each year, provide to the Health and Human Services Interim
             1549      Committee and the Social Services Appropriations Subcommittee a written report that
             1550      includes:]
             1551          [(i) the annual audit and review;]
             1552          [(ii) the financial expenditures of each local substance abuse authority and its contract
             1553      provider and each local mental health authority and its contract provider;]
             1554          [(iii) the status of the compliance of each local authority and its contract provider with
             1555      its plan, state statutes, and the provisions of the contract awarded; and]
             1556          [(iv) whether audit guidelines established under Section 62A-15-110 and Subsection
             1557      67-3-1 (10) provide the division with sufficient criteria and assurances of appropriate
             1558      expenditures of public funds; and]
             1559          [(h) if requested by the Health and Human Services Interim Committee or the Social
             1560      Services Appropriations Subcommittee, provide an oral report as requested.]
             1561          (3) (a) The division may refuse to contract with and may pursue its legal remedies
             1562      against any local substance abuse authority or local mental health authority that fails, or has
             1563      failed, to expend public funds in accordance with state law, division policy, contract
             1564      provisions, or directives issued in accordance with state law.
             1565          (b) The division may withhold funds from a local substance abuse authority or local
             1566      mental health authority if the authority's contract with its provider of substance abuse or mental
             1567      health programs or services fails to comply with state and federal law or policy.
             1568          (4) Before reissuing or renewing a contract with any local substance abuse authority or
             1569      local mental health authority, the division shall review and determine whether the local


             1570      substance abuse authority or local mental health authority is complying with its oversight and
             1571      management responsibilities described in Sections 17-43-201 , 17-43-203 , 17-43-303 , and
             1572      17-43-309 . Nothing in this Subsection (4) may be used as a defense to the responsibility and
             1573      liability described in Section 17-43-303 and to the responsibility and liability described in
             1574      Section 17-43-203 .
             1575          (5) In carrying out its duties and responsibilities, the division may not duplicate
             1576      treatment or educational facilities that exist in other divisions or departments of the state, but
             1577      shall work in conjunction with those divisions and departments in rendering the treatment or
             1578      educational services that those divisions and departments are competent and able to provide.
             1579          (6) (a) The division may accept in the name of and on behalf of the state donations,
             1580      gifts, devises, or bequests of real or personal property or services to be used as specified by the
             1581      donor.
             1582          (b) Those donations, gifts, devises, or bequests shall be used by the division in
             1583      performing its powers and duties. Any money so obtained shall be considered private funds
             1584      and shall be deposited into an interest-bearing restricted special revenue fund to be used by the
             1585      division for substance abuse or mental health services. The state treasurer may invest the fund
             1586      and all interest shall remain with the fund.
             1587          (7) The division shall annually review with each local substance abuse authority and
             1588      each local mental health authority the authority's statutory and contract responsibilities
             1589      regarding:
             1590          (a) the use of public funds;
             1591          (b) oversight responsibilities regarding public funds; and
             1592          (c) governance of substance abuse and mental health programs and services.
             1593          (8) The Legislature may refuse to appropriate funds to the division upon the division's
             1594      failure to comply with the provisions of this part.
             1595          (9) If a local substance abuse authority contacts the division under Subsection
             1596      17-43-201 (9) for assistance in providing treatment services to a pregnant woman or pregnant
             1597      minor, the division shall:


             1598          (a) refer the pregnant woman or pregnant minor to a treatment facility that has the
             1599      capacity to provide the treatment services; or
             1600          (b) otherwise ensure that treatment services are made available to the pregnant woman
             1601      or pregnant minor.
             1602          Section 31. Section 62A-15-712 is amended to read:
             1603           62A-15-712. Responsibilities of the Division of Substance Abuse and Mental
             1604      Health.
             1605          (1) The division shall ensure that the requirements of this part are met and applied
             1606      uniformly by local mental health authorities across the state.
             1607          (2) Because the division must, under Section 62A-15-103 , contract with, review,
             1608      approve, and oversee local mental health authority plans, and withhold funds from local mental
             1609      health authorities and public and private providers for contract noncompliance or misuse of
             1610      public funds, the division shall:
             1611          (a) require each local mental health authority to submit its plan to the division by May
             1612      1 of each year; and
             1613          (b) conduct an annual program audit and review of each local mental health authority
             1614      in the state, and its contract provider.
             1615          [(3) (a) The division shall:]
             1616          [(i) provide a written report to the Health and Human Services Interim Committee by
             1617      July 1 of each year; and]
             1618          [(ii) provide an oral report to that committee, as requested.]
             1619          [(b) That report shall provide information regarding:]
             1620          [(i) the annual audit and review;]
             1621          [(ii) the financial expenditures of each local mental health authority and its contract
             1622      provider;]
             1623          [(iii) the status of each local authority's and its contract provider's compliance with its
             1624      plan, state statutes, and with the provisions of the contract awarded; and]
             1625          [(iv) whether audit guidelines established under Subsections 62A-15-713 (2)(a) and


             1626      67-3-1 (10) provide the division with sufficient criteria and assurances of appropriate
             1627      expenditures of public funds.]
             1628          [(4)] (3) The annual audit and review described in Subsection (2)(b) shall, in addition
             1629      to items determined by the division to be necessary and appropriate, include a review and
             1630      determination regarding whether or not:
             1631          (a) public funds allocated to local mental health authorities are consistent with services
             1632      rendered and outcomes reported by it or its contract provider; and
             1633          (b) each local mental health authority is exercising sufficient oversight and control over
             1634      public funds allocated for mental health programs and services.
             1635          [(5)] (4) The Legislature may refuse to appropriate funds to the division if the division
             1636      fails to comply with the procedures and requirements of this section.
             1637          Section 32. Section 63C-8-106 is amended to read:
             1638           63C-8-106. Rural residency training program.
             1639          (1) For purposes of this section:
             1640          (a) "Physician" means:
             1641          (i) a person licensed to practice medicine under Title 58, Chapter 67, Utah Medical
             1642      Practice Act or Title 58, Chapter 68, Utah Osteopathic Medical Practice Act; and
             1643          (ii) a person licensed to practice dentistry under Title 58, Chapter 69, Dentist and
             1644      Dental Hygienist Practice Act.
             1645          (b) "Rural residency training program" means an accredited clinical training program
             1646      as defined in Section 63C-8-101 which places a physician into a rural county for a part or all of
             1647      the physician's clinical training.
             1648          (2) (a) Subject to appropriations from the Legislature, the council shall establish a pilot
             1649      program to place physicians into rural residency training programs.
             1650          (b) The pilot program shall begin July 1, 2005 and sunset July 1, 2015, in accordance
             1651      with Section 63I-1-263 .
             1652          [(3) (a) The council shall report to the Legislature's Health and Human Services Interim
             1653      Committee concerning the implementation of the pilot program and the success of the program


             1654      in increasing the retention or recruitment of physicians in rural counties in the state.]
             1655          [(b) The report required by this Subsection (3) shall be made by November 30 of each
             1656      year.]
             1657          Section 33. Section 63I-1-263 (Effective 05/01/13) is amended to read:
             1658           63I-1-263 (Effective 05/01/13). Repeal dates, Titles 63A to 63M.
             1659          (1) Section 63A-4-204 , authorizing the Risk Management Fund to provide coverage to
             1660      any public school district which chooses to participate, is repealed July 1, 2016.
             1661          (2) Section 63A-5-603 , State Facility Energy Efficiency Fund, is repealed July 1, 2016.
             1662          (3) Section 63C-8-106 , rural residency training program, is repealed July 1, 2015.
             1663          (4) Title 63C, Chapter 13, Prison Relocation and Development Authority Act, is
             1664      repealed July 1, 2014.
             1665          (5) Subsection 63G-6a-1402 (7) authorizing certain transportation agencies to award a
             1666      contract for a design-build transportation project in certain circumstances, is repealed July 1,
             1667      2015.
             1668          (6) Title 63H, Chapter 4, Heber Valley Historic Railroad Authority, is repealed July 1,
             1669      2020.
             1670          (7) The Resource Development Coordinating Committee, created in Section
             1671      63J-4-501 , is repealed July 1, 2015.
             1672          (8) Title 63M, Chapter 1, Part 4, Enterprise Zone Act, is repealed July 1, 2018.
             1673          (9) (a) Title 63M, Chapter 1, Part 11, Recycling Market Development Zone Act, is
             1674      repealed January 1, 2021.
             1675          (b) Subject to Subsection (9)(c), Sections 59-7-610 and 59-10-1007 regarding tax
             1676      credits for certain persons in recycling market development zones, are repealed for taxable
             1677      years beginning on or after January 1, 2021.
             1678          (c) A person may not claim a tax credit under Section 59-7-610 or 59-10-1007 :
             1679          (i) for the purchase price of machinery or equipment described in Section 59-7-610 or
             1680      59-10-1007 , if the machinery or equipment is purchased on or after January 1, 2021; or
             1681          (ii) for an expenditure described in Subsection 59-7-610 (1)(b) or 59-10-1007 (1)(b), if


             1682      the expenditure is made on or after January 1, 2021.
             1683          (d) Notwithstanding Subsections (9)(b) and (c), a person may carry forward a tax credit
             1684      in accordance with Section 59-7-610 or 59-10-1007 if:
             1685          (i) the person is entitled to a tax credit under Section 59-7-610 or 59-10-1007 ; and
             1686          (ii) (A) for the purchase price of machinery or equipment described in Section
             1687      59-7-610 or 59-10-1007 , the machinery or equipment is purchased on or before December 31,
             1688      2020; or
             1689          (B) for an expenditure described in Subsection 59-7-610 (1)(b) or 59-10-1007 (1)(b), the
             1690      expenditure is made on or before December 31, 2020.
             1691          (10) (a) Section 63M-1-2507 , Health Care Compact is repealed on July 1, 2014.
             1692          (b) (i) The Legislature shall, before reauthorizing the Health Care Compact:
             1693          (A) direct the Health System Reform Task Force to evaluate the issues listed in
             1694      Subsection (10)(b)(ii), and by January 1, 2013 develop and recommend criteria for the
             1695      Legislature to use to negotiate the terms of the Health Care Compact; and
             1696          (B) prior to July 1, 2014, seek amendments to the Health Care Compact among the
             1697      member states that the Legislature determines are appropriate after considering the
             1698      recommendations of the Health System Reform Task Force.
             1699          (ii) The Health System Reform Task Force shall evaluate and develop criteria for the
             1700      Legislature regarding:
             1701          (A) the impact of the Supreme Court ruling on the Affordable Care Act;
             1702          (B) whether Utah is likely to be required to implement any part of the Affordable Care
             1703      Act prior to negotiating the compact with the federal government, such as Medicaid expansion
             1704      in 2014;
             1705          (C) whether the compact's current funding formula, based on adjusted 2010 state
             1706      expenditures, is the best formula for Utah and other state compact members to use for
             1707      establishing the block grants from the federal government;
             1708          (D) whether the compact's calculation of current year inflation adjustment factor,
             1709      without consideration of the regional medical inflation rate in the current year, is adequate to


             1710      protect the state from increased costs associated with administering a state based Medicaid and
             1711      a state based Medicare program;
             1712          (E) whether the state has the flexibility it needs under the compact to implement and
             1713      fund state based initiatives, or whether the compact requires uniformity across member states
             1714      that does not benefit Utah;
             1715          (F) whether the state has the option under the compact to refuse to take over the federal
             1716      Medicare program;
             1717          (G) whether a state based Medicare program would provide better benefits to the
             1718      elderly and disabled citizens of the state than a federally run Medicare program;
             1719          (H) whether the state has the infrastructure necessary to implement and administer a
             1720      better state based Medicare program;
             1721          (I) whether the compact appropriately delegates policy decisions between the
             1722      legislative and executive branches of government regarding the development and
             1723      implementation of the compact with other states and the federal government; and
             1724          (J) the impact on public health activities, including communicable disease surveillance
             1725      and epidemiology.
             1726          (11) The Crime Victim Reparations and Assistance Board, created in Section
             1727      63M-7-504 , is repealed July 1, 2017.
             1728          [(12) Title 63M, Chapter 9, Families, Agencies, and Communities Together for
             1729      Children and Youth At Risk Act, is repealed July 1, 2016.]
             1730          [(13)] (12) Title 63M, Chapter 11, Utah Commission on Aging, is repealed July 1,
             1731      2017.
             1732          Section 34. Section 63J-1-201 is amended to read:
             1733           63J-1-201. Governor's proposed budget to Legislature -- Contents -- Preparation
             1734      -- Appropriations based on current tax laws and not to exceed estimated revenues.
             1735          (1) The governor shall deliver, not later than 30 days before the date the Legislature
             1736      convenes in the annual general session, a confidential draft copy of the governor's proposed
             1737      budget recommendations to the Office of the Legislative Fiscal Analyst according to the


             1738      requirements of this section.
             1739          (2) (a) When submitting a proposed budget, the governor shall, within the first three
             1740      days of the annual general session of the Legislature, submit to the presiding officer of each
             1741      house of the Legislature:
             1742          (i) a proposed budget for the ensuing fiscal year;
             1743          (ii) a schedule for all of the proposed changes to appropriations in the proposed budget,
             1744      with each change clearly itemized and classified; and
             1745          (iii) as applicable, a document showing proposed changes in estimated revenues that
             1746      are based on changes in state tax laws or rates.
             1747          (b) The proposed budget shall include:
             1748          (i) a projection of the total estimated revenues and appropriations for the next fiscal
             1749      year;
             1750          (ii) the source of changes to all direct, indirect, and in-kind matching funds for all
             1751      federal grants or assistance programs included in the budget;
             1752          (iii) a plan of proposed changes to appropriations and estimated revenues for the next
             1753      fiscal year that is based upon the current fiscal year state tax laws and rates;
             1754          (iv) an itemized estimate of the proposed changes to appropriations for:
             1755          (A) the Legislative Department as certified to the governor by the president of the
             1756      Senate and the speaker of the House;
             1757          (B) the Executive Department;
             1758          (C) the Judicial Department as certified to the governor by the state court
             1759      administrator;
             1760          (D) changes to salaries payable by the state under the Utah Constitution or under law
             1761      for lease agreements planned for the next fiscal year; and
             1762          (E) all other changes to ongoing or one-time appropriations, including dedicated
             1763      credits, restricted funds, nonlapsing balances, grants, and federal funds;
             1764          (v) for each line item, the average annual dollar amount of staff funding associated
             1765      with all positions that were vacant during the last fiscal year;


             1766          (vi) deficits or anticipated deficits;
             1767          (vii) the recommendations for each state agency for new full-time employees for the
             1768      next fiscal year, which shall also be provided to the State Building Board as required by
             1769      Subsection 63A-5-103 (2);
             1770          (viii) any explanation that the governor may desire to make as to the important features
             1771      of the budget and any suggestion as to methods for the reduction of expenditures or increase of
             1772      the state's revenue; and
             1773          (ix) information detailing certain fee increases as required by Section 63J-1-504 .
             1774          (3) For the purpose of preparing and reporting the proposed budget:
             1775          (a) The governor shall require the proper state officials, including all public and higher
             1776      education officials, all heads of executive and administrative departments and state institutions,
             1777      bureaus, boards, commissions, and agencies expending or supervising the expenditure of the
             1778      state money, and all institutions applying for state money and appropriations, to provide
             1779      itemized estimates of changes in revenues and appropriations.
             1780          (b) The governor may require the persons and entities subject to Subsection (3)(a) to
             1781      provide other information under these guidelines and at times as the governor may direct,
             1782      which may include a requirement for program productivity and performance measures, where
             1783      appropriate, with emphasis on outcome indicators.
             1784          (c) The governor may require representatives of public and higher education, state
             1785      departments and institutions, and other institutions or individuals applying for state
             1786      appropriations to attend budget meetings.
             1787          (4) In submitting the budgets for the Departments of Health and Human Services and
             1788      the Office of the Attorney General, the governor shall consider a separate recommendation in
             1789      the governor's budget for changes in funds to be contracted to:
             1790          (a) local mental health authorities under Section 62A-15-110 ;
             1791          (b) local substance abuse authorities under Section 62A-15-110 ;
             1792          (c) area agencies under Section 62A-3-104.2 ;
             1793          (d) programs administered directly by and for operation of the Divisions of Substance


             1794      Abuse and Mental Health and Aging and Adult Services;
             1795          (e) local health departments under Title 26A, Chapter 1, Local Health Departments;
             1796      and
             1797          (f) counties for the operation of Children's Justice Centers under Section 67-5b-102 .
             1798          (5) (a) In making budget recommendations, the governor shall consider an amount
             1799      sufficient to grant the following entities the same percentage increase for wages and benefits
             1800      that the governor includes in the governor's budget for persons employed by the state:
             1801          (i) local health departments, local mental health authorities, local substance abuse
             1802      authorities, and area agencies;
             1803          (ii) local conservation districts and Utah Association of Conservation District
             1804      employees, as related to the budget for the Department of Agriculture; and
             1805          (iii) employees of corporations that provide direct services under contract with:
             1806          (A) the Utah State Office of Rehabilitation and the Division of Services for People
             1807      with Disabilities;
             1808          (B) the Division of Child and Family Services; and
             1809          (C) the Division of Juvenile Justice Services within the Department of Human
             1810      Services.
             1811          (b) If the governor does not include in the governor's budget an amount sufficient to
             1812      grant an increase for any entity described in Subsection (5)(a), the governor shall include a
             1813      message to the Legislature regarding the governor's reason for not including that amount.
             1814          [(6) (a) The Families, Agencies, and Communities Together Council may propose a
             1815      budget recommendation to the governor for collaborative service delivery systems operated
             1816      under Section 63M-9-402 , as provided under Subsection 63M-9-201 (4)(e).]
             1817          [(b) The Legislature may, through a specific program schedule, designate funds
             1818      appropriated for collaborative service delivery systems operated under Section 63M-9-402 .]
             1819          [(7)] (6) The governor shall include in the governor's budget the state's portion of the
             1820      budget for the Utah Communications Agency Network established in Title 63C, Chapter 7,
             1821      Utah Communications Agency Network Act.


             1822          [(8)] (7) (a) The governor shall include a separate recommendation in the governor's
             1823      budget for funds to maintain the operation and administration of the Utah Comprehensive
             1824      Health Insurance Pool. In making the recommendation, the governor may consider:
             1825          (i) actuarial analysis of growth or decline in enrollment projected over a period of at
             1826      least three years;
             1827          (ii) actuarial analysis of the medical and pharmacy claims costs projected over a period
             1828      of at least three years;
             1829          (iii) the annual Medical Care Consumer Price Index;
             1830          (iv) the annual base budget for the pool established by the Business, Economic
             1831      Development, and Labor Appropriations Subcommittee for each fiscal year;
             1832          (v) the growth or decline in insurance premium taxes and fees collected by the State
             1833      Tax Commission and the Insurance Department; and
             1834          (vi) the availability of surplus General Fund revenue under Section 63J-1-312 and
             1835      Subsection 59-14-204 (5).
             1836          (b) In considering the factors in Subsections [(8)] (7)(a)(i), (ii), and (iii), the governor
             1837      may consider the actuarial data and projections prepared for the board of the Utah
             1838      Comprehensive Health Insurance Pool as it develops the governor's financial statements and
             1839      projections for each fiscal year.
             1840          [(9)] (8) (a) In submitting the budget for the Department of Public Safety, the governor
             1841      shall include a separate recommendation in the governor's budget for maintaining a sufficient
             1842      number of alcohol-related law enforcement officers to maintain the enforcement ratio equal to
             1843      or below the number specified in Subsection 32B-1-201 (2).
             1844          (b) If the governor does not include in the governor's budget an amount sufficient to
             1845      maintain the number of alcohol-related law enforcement officers described in Subsection [(9)]
             1846      (8)(a), the governor shall include a message to the Legislature regarding the governor's reason
             1847      for not including that amount.
             1848          [(10)] (9) (a) The governor may revise all estimates, except those relating to the
             1849      Legislative Department, the Judicial Department, and those providing for the payment of


             1850      principal and interest to the state debt and for the salaries and expenditures specified by the
             1851      Utah Constitution or under the laws of the state.
             1852          (b) The estimate for the Judicial Department, as certified by the state court
             1853      administrator, shall also be included in the budget without revision, but the governor may make
             1854      separate recommendations on the estimate.
             1855          [(11)] (10) The total appropriations requested for expenditures authorized by the
             1856      budget may not exceed the estimated revenues from taxes, fees, and all other sources for the
             1857      next ensuing fiscal year.
             1858          [(12)] (11) If any item of the budget as enacted is held invalid upon any ground, the
             1859      invalidity does not affect the budget itself or any other item in it.
             1860          Section 35. Repealer.
             1861          This bill repeals:
             1862          Section 26-10b-105, Report on implementation.
             1863          Section 26-18-3.3, Study of privatization of eligibility determination.
             1864          Section 31A-29-113.5, Pilot Program for Chronic Disease and Pharmaceutical
             1865      Management of Bleeding Disorders.
             1866          Section 63M-9-101, Title.
             1867          Section 63M-9-102, Purpose of chapter.
             1868          Section 63M-9-103, Definitions.
             1869          Section 63M-9-104, Relationship to political subdivisions.
             1870          Section 63M-9-201, Families, Agencies, and Communities Together State Council
             1871      -- Composition -- Duties -- Interagency case management team.
             1872          Section 63M-9-202, Steering committee -- Membership -- Duties.
             1873          Section 63M-9-203, Staffing.
             1874          Section 63M-9-301, Local interagency council -- Composition -- Duties.
             1875          Section 63M-9-401, Prevention and early intervention programs -- Applicants --
             1876      Selection process.
             1877          Section 63M-9-402, Plans for collaborative service delivery systems.


             1878          Section 63M-9-501, Evaluation of programs -- Report to legislative interim
             1879      committee.


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