1     
LOCAL HEALTH DEPARTMENT AMENDMENTS

2     
2016 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Brad L. Dee

5     
Senate Sponsor: Allen M. Christensen

6     

7     LONG TITLE
8     General Description:
9          This bill provides a county governing body the option to combine the local health
10     department with the local mental health authority and the local substance abuse
11     authority.
12     Highlighted Provisions:
13          This bill:
14          ▸     amends definitions;
15          ▸     provides a county the option to create a united local health department, which
16     combines the local health department with the local substance abuse authority and
17     the local mental health authority;
18          ▸     permits multiple counties to join together in an interlocal agreement to form a
19     multicounty united local health department;
20          ▸     requires a united local health department to coordinate the duties of a local health
21     department, a local mental health authority, and a local substance abuse authority;
22          ▸     provides that the governing body of a county may select the executive director of a
23     united local health department;
24          ▸     amends the types of funds that may be established and maintained by a united local
25     health department; and
26          ▸     makes technical amendments.
27     Money Appropriated in this Bill:
28          None
29     Other Special Clauses:

30          None
31     Utah Code Sections Affected:
32     AMENDS:
33          17-43-201, as last amended by Laws of Utah 2014, Chapter 213
34          17-43-204, as last amended by Laws of Utah 2008, Chapter 194
35          17-43-301, as last amended by Laws of Utah 2014, Chapter 213
36          17-43-305, as last amended by Laws of Utah 2013, Chapter 17
37          26A-1-102, as last amended by Laws of Utah 2002, Chapter 249
38          26A-1-105, as last amended by Laws of Utah 2002, Chapter 249
39          26A-1-109, as last amended by Laws of Utah 2002, Chapter 249
40          26A-1-110, as last amended by Laws of Utah 2003, Chapter 131
41          26A-1-111, as last amended by Laws of Utah 2010, Chapter 324
42          26A-1-118, as last amended by Laws of Utah 2002, Chapter 249
43          26A-1-119, as last amended by Laws of Utah 2002, Chapter 249
44          62A-15-103, as last amended by Laws of Utah 2015, Chapter 412
45     ENACTS:
46          26A-1-105.5, Utah Code Annotated 1953
47     

48     Be it enacted by the Legislature of the state of Utah:
49          Section 1. Section 17-43-201 is amended to read:
50          17-43-201. Local substance abuse authorities -- Responsibilities.
51          (1) (a) (i) In each county operating under a county executive-council form of
52     government under Section 17-52-504, the county legislative body is the local substance abuse
53     authority, provided however that any contract for plan services shall be administered by the
54     county executive.
55          (ii) In each county operating under a council-manager form of government under
56     Section 17-52-505, the county manager is the local substance abuse authority.
57          (iii) In each county other than a county described in Subsection (1)(a)(i) or (ii), the

58     county legislative body is the local substance abuse authority.
59          (b) Within legislative appropriations and county matching funds required by this
60     section, and under the direction of the division, each local substance abuse authority shall:
61          (i) develop substance abuse prevention and treatment services plans;
62          (ii) provide substance abuse services to residents of the county; and
63          (iii) cooperate with efforts of the Division of Substance Abuse and Mental Health to
64     promote integrated programs that address an individual's substance abuse, mental health, and
65     physical healthcare needs, as described in Section 62A-15-103.
66          (c) Within legislative appropriations and county matching funds required by this
67     section, each local substance abuse authority shall cooperate with the efforts of the Department
68     of Human Services to promote a system of care, as defined in Section 62A-1-104, for minors
69     with or at risk for complex emotional and behavioral needs, as described in Section 62A-1-111.
70          (2) (a) By executing an interlocal agreement under Title 11, Chapter 13, Interlocal
71     Cooperation Act, two or more counties may join to:
72          (i) provide substance abuse prevention and treatment services; or
73          (ii) create a united local health department that provides substance abuse treatment
74     services, mental health services, and local health department services in accordance with
75     Subsection (3).
76          (b) The legislative bodies of counties joining to provide services may establish
77     acceptable ways of apportioning the cost of substance abuse services.
78          (c) Each agreement for joint substance abuse services shall:
79          (i) (A) designate the treasurer of one of the participating counties or another person as
80     the treasurer for the combined substance abuse authorities and as the custodian of money
81     available for the joint services; and
82          (B) provide that the designated treasurer, or other disbursing officer authorized by the
83     treasurer, may make payments from the money for the joint services upon audit of the
84     appropriate auditing officer or officers representing the participating counties;
85          (ii) provide for the appointment of an independent auditor or a county auditor of one of

86     the participating counties as the designated auditing officer for the combined substance abuse
87     authorities;
88          (iii) (A) provide for the appointment of the county or district attorney of one of the
89     participating counties as the designated legal officer for the combined substance abuse
90     authorities; and
91          (B) authorize the designated legal officer to request and receive the assistance of the
92     county or district attorneys of the other participating counties in defending or prosecuting
93     actions within their counties relating to the combined substance abuse authorities; and
94          (iv) provide for the adoption of management, clinical, financial, procurement,
95     personnel, and administrative policies as already established by one of the participating
96     counties or as approved by the legislative body of each participating county or interlocal board.
97          (d) An agreement for joint substance abuse services may provide for joint operation of
98     services and facilities or for operation of services and facilities under contract by one
99     participating local substance abuse authority for other participating local substance abuse
100     authorities.
101          (3) A county governing body may elect to combine the local substance abuse authority
102     with the local mental health authority created in Part 3, Local Mental Health Authorities, and
103     the local health department created in Title 26A, Chapter 1, Part 1, Local Health Department
104     Act, to create a united local health department under Section 26A-1-105.5. A local substance
105     abuse authority that joins a united local health department shall comply with this part.
106          (4) (a) Each local substance abuse authority is accountable to the department, the
107     Department of Health, and the state with regard to the use of state and federal funds received
108     from those departments for substance abuse services, regardless of whether the services are
109     provided by a private contract provider.
110          (b) Each local substance abuse authority shall comply, and require compliance by its
111     contract provider, with all directives issued by the department and the Department of Health
112     regarding the use and expenditure of state and federal funds received from those departments
113     for the purpose of providing substance abuse programs and services. The department and

114     Department of Health shall ensure that those directives are not duplicative or conflicting, and
115     shall consult and coordinate with local substance abuse authorities with regard to programs and
116     services.
117          [(4)] (5) Each local substance abuse authority shall:
118          (a) review and evaluate substance abuse prevention and treatment needs and services,
119     including substance abuse needs and services for individuals incarcerated in a county jail or
120     other county correctional facility;
121          (b) annually prepare and submit to the division a plan approved by the county
122     legislative body for funding and service delivery that includes:
123          (i) provisions for services, either directly by the substance abuse authority or by
124     contract, for adults, youth, and children, including those incarcerated in a county jail or other
125     county correctional facility; and
126          (ii) primary prevention, targeted prevention, early intervention, and treatment services;
127          (c) establish and maintain, either directly or by contract, programs licensed under Title
128     62A, Chapter 2, Licensure of Programs and Facilities;
129          (d) appoint directly or by contract a full or part time director for substance abuse
130     programs, and prescribe the director's duties;
131          (e) provide input and comment on new and revised rules established by the division;
132          (f) establish and require contract providers to establish administrative, clinical,
133     procurement, personnel, financial, and management policies regarding substance abuse services
134     and facilities, in accordance with the rules of the division, and state and federal law;
135          (g) establish mechanisms allowing for direct citizen input;
136          (h) annually contract with the division to provide substance abuse programs and
137     services in accordance with the provisions of Title 62A, Chapter 15, Substance Abuse and
138     Mental Health Act;
139          (i) comply with all applicable state and federal statutes, policies, audit requirements,
140     contract requirements, and any directives resulting from those audits and contract requirements;
141          (j) promote or establish programs for the prevention of substance abuse within the

142     community setting through community-based prevention programs;
143          (k) provide funding equal to at least 20% of the state funds that it receives to fund
144     services described in the plan;
145          (l) comply with the requirements and procedures of Title 11, Chapter 13, Interlocal
146     Cooperation Act, Title 17B, Chapter 1, Part 6, Fiscal Procedures for Local Districts, and Title
147     51, Chapter 2a, Accounting Reports from Political Subdivisions, Interlocal Organizations, and
148     Other Local Entities Act;
149          (m) for persons convicted of driving under the influence in violation of Section
150     41-6a-502 or 41-6a-517, conduct the following as defined in Section 41-6a-501:
151          (i) a screening;
152          (ii) an assessment;
153          (iii) an educational series; and
154          (iv) substance abuse treatment; and
155          (n) utilize proceeds of the accounts described in Subsection 62A-15-503(1) to
156     supplement the cost of providing the services described in Subsection [(4)] (5)(m).
157          [(5)] (6) Before disbursing any public funds, each local substance abuse authority shall
158     require that each entity that receives any public funds from the local substance abuse authority
159     agrees in writing that:
160          (a) the entity's financial records and other records relevant to the entity's performance
161     of the services provided to the local substance abuse authority shall be subject to examination
162     by:
163          (i) the division;
164          (ii) the local substance abuse authority director;
165          (iii) (A) the county treasurer and county or district attorney; or
166          (B) if two or more counties jointly provide substance abuse services under an
167     agreement under Subsection (2), the designated treasurer and the designated legal officer;
168          (iv) the county legislative body; and
169          (v) in a county with a county executive that is separate from the county legislative

170     body, the county executive;
171          (b) the county auditor may examine and audit the entity's financial and other records
172     relevant to the entity's performance of the services provided to the local substance abuse
173     authority; and
174          (c) the entity will comply with the provisions of Subsection [(3)] (4)(b).
175          [(6)] (7) A local substance abuse authority may receive property, grants, gifts, supplies,
176     materials, contributions, and any benefit derived therefrom, for substance abuse services. If
177     those gifts are conditioned upon their use for a specified service or program, they shall be so
178     used.
179          [(7)] (8) (a) As used in this section, "public funds" means the same as that term is
180     defined in Section 17-43-203.
181          (b) Public funds received for the provision of services pursuant to the local substance
182     abuse plan may not be used for any other purpose except those authorized in the contract
183     between the local substance abuse authority and the provider for the provision of plan services.
184          [(8)] (9) Subject to the requirements of the federal Substance Abuse Prevention and
185     Treatment Block Grant, [Public Law] Pub. L. No. 102-321, a local substance abuse authority
186     shall ensure that all substance abuse treatment programs that receive public funds:
187          (a) accept and provide priority for admission to a pregnant woman or a pregnant minor;
188     and
189          (b) if admission of a pregnant woman or a pregnant minor is not possible within 24
190     hours of the time that a request for admission is made, provide a comprehensive referral for
191     interim services that:
192          (i) are accessible to the pregnant woman or pregnant minor;
193          (ii) are best suited to provide services to the pregnant woman or pregnant minor;
194          (iii) may include:
195          (A) counseling;
196          (B) case management; or
197          (C) a support group; and

198          (iv) shall include a referral for:
199          (A) prenatal care; and
200          (B) counseling on the effects of alcohol and drug use during pregnancy.
201          [(9)] (10) If a substance abuse treatment program described in Subsection [(8)] (9) is
202     not able to accept and admit a pregnant woman or pregnant minor under Subsection [(8)] (9)
203     within 48 hours of the time that request for admission is made, the local substance abuse
204     authority shall contact the Division of Substance Abuse and Mental Health for assistance in
205     providing services to the pregnant woman or pregnant minor.
206          Section 2. Section 17-43-204 is amended to read:
207          17-43-204. Fees for substance abuse services -- Responsibility for cost of service if
208     rendered by authority to nonresident -- Authority may receive funds from other sources.
209          (1) Each local substance abuse authority shall charge a fee for substance abuse
210     services, except that substance abuse services may not be refused to any person because of
211     inability to pay.
212          (2) If a local substance abuse authority, through its designated provider, provides a
213     service described in Subsection 17-43-201[(4)](5) to a person who resides within the
214     jurisdiction of another local substance abuse authority, the local substance abuse authority in
215     whose jurisdiction the person resides is responsible for the cost of that service if its designated
216     provider has authorized the provision of that service.
217          (3) A local substance abuse authority and entities that contract with a local substance
218     abuse authority to provide substance abuse services may receive funds made available by
219     federal, state, or local health, substance abuse, mental health, education, welfare, or other
220     agencies, in accordance with the provisions of this part and Title 62A, Chapter 15, Substance
221     Abuse and Mental Health Act.
222          Section 3. Section 17-43-301 is amended to read:
223          17-43-301. Local mental health authorities -- Responsibilities.
224          (1) (a) (i) In each county operating under a county executive-council form of
225     government under Section 17-52-504, the county legislative body is the local mental health

226     authority, provided however that any contract for plan services shall be administered by the
227     county executive.
228          (ii) In each county operating under a council-manager form of government under
229     Section 17-52-505, the county manager is the local mental health authority.
230          (iii) In each county other than a county described in Subsection (1)(a)(i) or (ii), the
231     county legislative body is the local mental health authority.
232          (b) Within legislative appropriations and county matching funds required by this
233     section, under the direction of the division, each local mental health authority shall:
234          (i) provide mental health services to persons within the county; and
235          (ii) cooperate with efforts of the Division of Substance Abuse and Mental Health to
236     promote integrated programs that address an individual's substance abuse, mental health, and
237     physical healthcare needs, as described in Section 62A-15-103.
238          (c) Within legislative appropriations and county matching funds required by this
239     section, each local mental health authority shall cooperate with the efforts of the Department of
240     Human Services to promote a system of care, as defined in Section 62A-1-104, for minors with
241     or at risk for complex emotional and behavioral needs, as described in Section 62A-1-111.
242          (2) (a) By executing an interlocal agreement under Title 11, Chapter 13, Interlocal
243     Cooperation Act, two or more counties may join to:
244          (i) provide mental health prevention and treatment services; or
245          (ii) create a united local health department that combines substance abuse treatment
246     services, mental health services, and local health department services in accordance with
247     Subsection (3).
248          (b) The legislative bodies of counties joining to provide services may establish
249     acceptable ways of apportioning the cost of mental health services.
250          (c) Each agreement for joint mental health services shall:
251          (i) (A) designate the treasurer of one of the participating counties or another person as
252     the treasurer for the combined mental health authorities and as the custodian of money
253     available for the joint services; and

254          (B) provide that the designated treasurer, or other disbursing officer authorized by the
255     treasurer, may make payments from the money available for the joint services upon audit of the
256     appropriate auditing officer or officers representing the participating counties;
257          (ii) provide for the appointment of an independent auditor or a county auditor of one of
258     the participating counties as the designated auditing officer for the combined mental health
259     authorities;
260          (iii) (A) provide for the appointment of the county or district attorney of one of the
261     participating counties as the designated legal officer for the combined mental health
262     authorities; and
263          (B) authorize the designated legal officer to request and receive the assistance of the
264     county or district attorneys of the other participating counties in defending or prosecuting
265     actions within their counties relating to the combined mental health authorities; and
266          (iv) provide for the adoption of management, clinical, financial, procurement,
267     personnel, and administrative policies as already established by one of the participating
268     counties or as approved by the legislative body of each participating county or interlocal board.
269          (d) An agreement for joint mental health services may provide for:
270          (i) joint operation of services and facilities or for operation of services and facilities
271     under contract by one participating local mental health authority for other participating local
272     mental health authorities; and
273          (ii) allocation of appointments of members of the mental health advisory council
274     between or among participating counties.
275          (3) A county governing body may elect to combine the local mental health authority
276     with the local substance abuse authority created in Part 2, Local Substance Abuse Authorities,
277     and the local health department created in Title 26A, Chapter 1, Part 1, Local Health
278     Department Act, to create a united local health department under Section 26A-1-105.5. A local
279     mental health authority that joins with a united local health department shall comply with this
280     part.
281          (4) (a) Each local mental health authority is accountable to the department, the

282     Department of Health, and the state with regard to the use of state and federal funds received
283     from those departments for mental health services, regardless of whether the services are
284     provided by a private contract provider.
285          (b) Each local mental health authority shall comply, and require compliance by its
286     contract provider, with all directives issued by the department and the Department of Health
287     regarding the use and expenditure of state and federal funds received from those departments
288     for the purpose of providing mental health programs and services. The department and
289     Department of Health shall ensure that those directives are not duplicative or conflicting, and
290     shall consult and coordinate with local mental health authorities with regard to programs and
291     services.
292          [(4)] (5) (a) Each local mental health authority shall:
293          (i) review and evaluate mental health needs and services, including mental health needs
294     and services for persons incarcerated in a county jail or other county correctional facility;
295          (ii) as provided in Subsection [(4)] (5)(b), annually prepare and submit to the division a
296     plan approved by the county legislative body for mental health funding and service delivery,
297     either directly by the local mental health authority or by contract;
298          (iii) establish and maintain, either directly or by contract, programs licensed under Title
299     62A, Chapter 2, Licensure of Programs and Facilities;
300          (iv) appoint, directly or by contract, a full-time or part-time director for mental health
301     programs and prescribe the director's duties;
302          (v) provide input and comment on new and revised rules established by the division;
303          (vi) establish and require contract providers to establish administrative, clinical,
304     personnel, financial, procurement, and management policies regarding mental health services
305     and facilities, in accordance with the rules of the division, and state and federal law;
306          (vii) establish mechanisms allowing for direct citizen input;
307          (viii) annually contract with the division to provide mental health programs and
308     services in accordance with the provisions of Title 62A, Chapter 15, Substance Abuse and
309     Mental Health Act;

310          (ix) comply with all applicable state and federal statutes, policies, audit requirements,
311     contract requirements, and any directives resulting from those audits and contract requirements;
312          (x) provide funding equal to at least 20% of the state funds that it receives to fund
313     services described in the plan;
314          (xi) comply with the requirements and procedures of Title 11, Chapter 13, Interlocal
315     Cooperation Act, Title 17B, Chapter 1, Part 6, Fiscal Procedures for Local Districts, and Title
316     51, Chapter 2a, Accounting Reports from Political Subdivisions, Interlocal Organizations, and
317     Other Local Entities Act; and
318          (xii) take and retain physical custody of minors committed to the physical custody of
319     local mental health authorities by a judicial proceeding under Title 62A, Chapter 15, Part 7,
320     Commitment of Persons Under Age 18 to Division of Substance Abuse and Mental Health.
321          (b) Each plan under Subsection [(4)] (5)(a)(ii) shall include services for adults, youth,
322     and children, which shall include:
323          (i) inpatient care and services;
324          (ii) residential care and services;
325          (iii) outpatient care and services;
326          (iv) 24-hour crisis care and services;
327          (v) psychotropic medication management;
328          (vi) psychosocial rehabilitation, including vocational training and skills development;
329          (vii) case management;
330          (viii) community supports, including in-home services, housing, family support
331     services, and respite services;
332          (ix) consultation and education services, including case consultation, collaboration
333     with other county service agencies, public education, and public information; and
334          (x) services to persons incarcerated in a county jail or other county correctional facility.
335          [(5)] (6) Before disbursing any public funds, each local mental health authority shall
336     require that each entity that receives any public funds from a local mental health authority
337     agrees in writing that:

338          (a) the entity's financial records and other records relevant to the entity's performance
339     of the services provided to the mental health authority shall be subject to examination by:
340          (i) the division;
341          (ii) the local mental health authority director;
342          (iii) (A) the county treasurer and county or district attorney; or
343          (B) if two or more counties jointly provide mental health services under an agreement
344     under Subsection (2), the designated treasurer and the designated legal officer;
345          (iv) the county legislative body; and
346          (v) in a county with a county executive that is separate from the county legislative
347     body, the county executive;
348          (b) the county auditor may examine and audit the entity's financial and other records
349     relevant to the entity's performance of the services provided to the local mental health
350     authority; and
351          (c) the entity will comply with the provisions of Subsection [(3)] (4)(b).
352          [(6)] (7) A local mental health authority may receive property, grants, gifts, supplies,
353     materials, contributions, and any benefit derived therefrom, for mental health services. If those
354     gifts are conditioned upon their use for a specified service or program, they shall be so used.
355          [(7)] (8) (a) As used in this section, "public funds" means the same as that term is
356     defined in Section 17-43-303.
357          (b) Public funds received for the provision of services pursuant to the local mental
358     health plan may not be used for any other purpose except those authorized in the contract
359     between the local mental health authority and the provider for the provision of plan services.
360          Section 4. Section 17-43-305 is amended to read:
361          17-43-305. Responsibility for cost of services provided by local mental health
362     authority.
363          If a local mental health authority, through its designated provider, provides any service
364     described in Subsection 17-43-301[(4)](5)(b) to a person who resides within the jurisdiction of
365     another local mental health authority, the local mental health authority in whose jurisdiction the

366     person resides is responsible for the cost of that service if its designated provider has
367     authorized the provision of that service.
368          Section 5. Section 26A-1-102 is amended to read:
369          26A-1-102. Definitions.
370          As used in this part:
371          (1) "Board" means a local board of health established under Section 26A-1-109.
372          (2) "County governing body" means one of the types of county government provided
373     for in Title 17, Chapter 52, Part 5, Forms of County Government.
374          (3) "County health department" means a local health department that serves a county
375     and municipalities located within that county.
376          (4) "Department" means the Department of Health created in Title 26, Chapter 1,
377     Department of Health Organization.
378          (5) "Local health department" means:
379          (a) a single county [or] local health department;
380          (b) a multicounty local health department [established under this part.];
381          (c) a united local health department; or
382          (d) a multicounty united local health department.
383          (6) "Mental health authority" means a local mental health authority created in Section
384     17-43-301.
385          (7) "Multicounty local health department" means a local health department that is
386     formed under Section 26A-1-105 and that serves two or more contiguous counties and
387     municipalities within those counties.
388          (8) "Multicounty united local health department" means a united local health
389     department that is formed under Section 26A-1-105.5 and that serves two or more contiguous
390     counties and municipalities within those counties.
391          (9) "Single county local health department" means a local health department that is
392     created by the governing body of one county to provide services to the county and the
393     municipalities within that county.

394          (10) "Substance abuse authority" means a local substance abuse authority created in
395     Section 17-43-201.
396          (11) "United local health department":
397          (a) means a substance abuse authority, a mental health authority, and a local health
398     department that join together under Section 26A-1-105.5; and
399          (b) includes a multicounty united local health department.
400          Section 6. Section 26A-1-105 is amended to read:
401          26A-1-105. Multicounty local health departments.
402          (1) Two or more contiguous counties may [unite to create and maintain a local health
403     department], by executing an agreement pursuant to the provisions of Title 11, Chapter 13,
404     Interlocal Cooperation Act, unite to create and maintain a local health department that does not
405     combine the substance abuse authority and the mental health authority with the local health
406     department.
407          (2) Any municipalities within counties comprising a multicounty local health
408     department under Subsection (1) shall be served by the multicounty local health department.
409          Section 7. Section 26A-1-105.5 is enacted to read:
410          26A-1-105.5. United local health department -- Multicounty united local health
411     department -- Election by county governing body -- Appointment of director.
412          (1) A county governing body may elect to:
413          (a) form a united local health department for the purpose of combining into a single
414     entity the duties of:
415          (i) the local health department;
416          (ii) the mental health authority; and
417          (iii) the substance abuse authority; and
418          (b) provide for the coordination of services for the populations served by the entities
419     described in Subsection (1)(a).
420          (2) (a) Two or more contiguous counties may, by executing an agreement pursuant to
421     the provisions of Title 11, Chapter 13, Interlocal Cooperation Act, unite to create and maintain

422     a multicounty united local health department.
423          (b) Any municipalities within counties comprising a multicounty united local health
424     department under Subsection (2)(a) shall be served by the multicounty united local health
425     department.
426          (3) A united local health department created under this section shall administer the
427     programs and services of each entity listed in Subsections (1)(a) in accordance with:
428          (a) this chapter;
429          (b) Title 17, Chapter 43, Part 2, Local Substance Abuse Authorities; and
430          (c) Title 17, Chapter 43, Part 3, Local Mental Health Authorities.
431          (4) (a) Notwithstanding Section 26A-1-110:
432          (i) the county governing body shall, in consultation with the board, appoint an
433     executive director for a united local health department and determine the executive director's
434     compensation; and
435          (ii) the county governing bodies of a multicounty united local health department shall,
436     in consultation with the board, appoint an executive director for the multicounty local health
437     department and determine the executive director's compensation.
438          (b) An executive director appointed under Subsection (4)(a):
439          (i) shall serve as the local health officer; and
440          (ii) may be removed for cause under Section 26A-1-111.
441          (5) The treasurer of a united local health department may establish and maintain funds
442     in addition to the local health department fund established under Section 26A-1-119, if the
443     additional fund is necessary to:
444          (a) provide substance abuse authority services or mental health authority services; and
445          (b) comply with federal regulation or federal statute.
446          Section 8. Section 26A-1-109 is amended to read:
447          26A-1-109. Local boards of health -- Membership -- Organization -- Meetings.
448          (1) A local health department shall have a board of health with at least three members.
449          (a) (i) Board members shall be appointed pursuant to county ordinance or interlocal

450     agreement by the counties creating the local health department.
451          (ii) The board may include representatives from the municipalities included within the
452     area served by the local health department.
453          (b) The board shall be nonpartisan.
454          (c) An employee of the local health department may not be a board member.
455          (2) (a) As possible, of the initial board:
456          (i) 1/3 shall serve a term of one year;
457          (ii) 1/3 shall serve a term of two years; and
458          (iii) 1/3 shall serve a term of three years.
459          (b) All subsequent appointments shall be for terms of three years and shall be made, as
460     possible, so 1/3 of the terms of office of those serving on the board expire each year. Members
461     appointed to fill vacancies shall hold office until expiration of the terms of their predecessors.
462          (c) Board members may be removed by the appointing county for cause prior to the
463     expiration of the member's term. Any board member removed pursuant to this Subsection (2)
464     may request and receive a hearing before the county legislative body prior to the effective date
465     of the removal.
466          (3) (a) All members of the board shall reside within the boundaries of the area served
467     by the local health department.
468          (b) A majority of the members may not:
469          (i) be primarily engaged in providing health care to individuals or in the administration
470     of facilities or institutions in which health care is provided;
471          (ii) hold a fiduciary position or have a fiduciary interest in any entity involved in the
472     provision of health care;
473          (iii) receive either directly or through a spouse more than 1/10 of the member's gross
474     income from any entity or activity relating to health care; and
475          (iv) be members of one type of business or profession.
476          (4) (a) The board shall at its organizational meeting elect from its members a chairman
477     and a vice chairman and secretary.

478          (b) The health officer of the local health department appointed pursuant to Section
479     26A-1-110 or Section 26A-1-105.5 may serve as secretary to the board.
480          (5) (a) (i) Regular meetings of the board shall be held not less than once every three
481     months.
482          (ii) Special meetings may be called by the chairman, the health officer, or a majority of
483     the members at any time on three days' notice by mail, or in case of emergency, as soon as
484     possible after the members of the board have been notified.
485          (b) A board may adopt and amend bylaws for the transaction of its business. A
486     majority of the board members constitute a quorum.
487          (c) Members serve without compensation, but shall be reimbursed for actual and
488     necessary traveling and subsistence expenses when absent from their place of residence in
489     attendance at authorized meetings.
490          (d) All meetings are presumed to have been called and held in accordance with this
491     section and all orders and proceedings are presumed to be authorized unless the contrary is
492     proved.
493          (6) The board shall annually report the operations of the local health department and
494     the board to the local governing bodies of the municipalities and counties served by the local
495     health department.
496          (7) The board shall annually send a copy of the local health department's approved
497     budget to the department and all local governing bodies of the municipalities and counties
498     served by the local health department. The report shall be submitted no later than 30 days after
499     the beginning of the local health department's fiscal year.
500          (8) The board shall determine the general public health policies to be followed in
501     administration of the local health department and may adopt and enforce public health rules,
502     regulations, and standards necessary to implement the board's public health policies. The board
503     shall adopt written procedures to carry out the provisions of this section.
504          Section 9. Section 26A-1-110 is amended to read:
505          26A-1-110. Local health officer -- Powers and duties -- Vacancy.

506          (1) [The] Except as provided in Section 26A-1-105.5, the board shall appoint a local
507     health officer and determine the officer's compensation:
508          (a) subject to ratification by the county executive of the county or counties in the local
509     health department; and
510          (b) as provided by:
511          (i) ordinance adopted by a county creating a county health department; or
512          (ii) the interlocal agreement pursuant to which a multicounty health department is
513     created.
514          (2) The local health officer shall:
515          (a) have the qualifications of training and experience for that office equivalent to those
516     approved by the department for local health officers;
517          (b) be the administrative and executive officer of the local health department and
518     devote full time to the duties of the office;
519          (c) if provisions have been made with the department, act as the local registrar of vital
520     statistics within the local health department's boundaries without additional compensation or
521     payment of fees provided by law;
522          (d) (i) prior to the beginning of each fiscal year, prepare an annual budget approved by
523     the board and present it:
524          (A) to the county legislative body if the local health department is a county health
525     department; or
526          (B) to the entity designated in the interlocal agreement creating the local health
527     department if the local health department is a multicounty health department; and
528          (ii) obtain final approval of the annual budget from the governing bodies designated in
529     Subsection (2)(d)(i)(A) or (B) after the governing body either:
530          (A) reviews and approves the budget; or
531          (B) amends and approves the budget; and
532          (e) prepare an annual report and provide it to the department and all counties in the
533     local health department.

534          (3) The report under Subsection (2)(e) shall contain a copy of the independent financial
535     audit required under Section 26A-1-115, a description of the population served by the local
536     health department, and other information as requested by the board or the county or counties
537     creating the local health department.
538          (4) In the absence or disability of the local health officer, or if there is a vacancy in that
539     office, the board shall appoint an acting health officer for a temporary period not to exceed one
540     year. The appointment shall be ratified by the county executive of the county or counties in the
541     local health department.
542          Section 10. Section 26A-1-111 is amended to read:
543          26A-1-111. Removal of local health officer.
544          (1) The local health officer may be removed for cause in accordance with this section
545     by:
546          (a) the board, if the local health officer is appointed for a single county local health
547     department; [or]
548          (b) a majority of the counties in the local health department if:
549          (i) the local health department is:
550          (A) a multicounty local health department created under Section 26A-1-105; or
551          (B) a multicounty united local health department created under Section 26A-1-105.5;
552     and
553          (ii) the county executives rescind[,] or withdraw, in writing, the ratification of the local
554     health officer; or
555          (c) the county governing body, if the local health department is a united local health
556     department for a single county, and the county governing body rescinds or withdraws, in
557     writing, the ratification of the local health officer.
558          (2) (a) A hearing shall be granted, if requested by the local health officer, prior to
559     removal of the local health officer.
560          (b) If a hearing is requested, it shall be conducted by a five-member panel with:
561          (i) two elected members from the county or counties in the local health department,

562     selected by the county executives;
563          (ii) two members of the board of the local health department who are not elected
564     officials of the counties in the local health department, selected by the board; and
565          (iii) one member selected by the members appointed under Subsections (2)(b)(i) and
566     (ii), however, the member appointed under this Subsection (2)(b)(iii) may not be an elected
567     official of the counties in the local health department and may not be a member of the board of
568     the local health department.
569          (c) (i) The hearing panel shall report its decision regarding termination to the board and
570     to the counties in the local health department.
571          (ii) The counties and board receiving the report shall vote on whether to retain or
572     terminate the local health officer.
573          (iii) The health officer is terminated if:
574          (A) the board votes to terminate; or
575          (B) a majority of the counties in the local health department vote to terminate.
576          Section 11. Section 26A-1-118 is amended to read:
577          26A-1-118. Treasurer of local department -- Bond.
578          (1) [In county health departments, the] The county treasurer shall serve as treasurer of
579     [the] a local health department.
580          (2) Unless another county treasurer is designated pursuant to the interlocal agreement
581     creating the multicounty local health department or the multicounty united local health
582     department, the county treasurer of the county in which the headquarters of the multicounty
583     local health department or the multicounty united local health department is located shall serve
584     as treasurer of the multicounty local health department.
585          (3) The official bond of a county treasurer shall cover the duties as treasurer of a local
586     health department.
587          Section 12. Section 26A-1-119 is amended to read:
588          26A-1-119. Local health department fund -- Sources -- Uses.
589          (1) [The] Except as provided in Section 26A-1-105.5, the treasurer of a local health

590     department shall, as part of the department organization, create a local health department fund
591     to which shall be credited any money appropriated or otherwise made available by participating
592     counties or other local political subdivisions, and any money received from the state, federal
593     government, or from surpluses, grants, fees, or donations for local health purposes.
594          (2) (a) Money credited to the fund shall be placed in a restricted account and expended
595     only for maintenance and operation of the local health department.
596          (b) Claims or demands against the fund shall be allowed on certification by the health
597     officer or other employee of the local health department designated by the health officer.
598          Section 13. Section 62A-15-103 is amended to read:
599          62A-15-103. Division -- Creation -- Responsibilities.
600          (1) There is created the Division of Substance Abuse and Mental Health within the
601     department, under the administration and general supervision of the executive director. The
602     division is the substance abuse authority and the mental health authority for this state.
603          (2) The division shall:
604          (a) (i) educate the general public regarding the nature and consequences of substance
605     abuse by promoting school and community-based prevention programs;
606          (ii) render support and assistance to public schools through approved school-based
607     substance abuse education programs aimed at prevention of substance abuse;
608          (iii) promote or establish programs for the prevention of substance abuse within the
609     community setting through community-based prevention programs;
610          (iv) cooperate with and assist treatment centers, recovery residences, and other
611     organizations that provide services to individuals recovering from a substance abuse disorder,
612     by identifying and disseminating information about effective practices and programs;
613          (v) promote integrated programs that address an individual's substance abuse, mental
614     health, physical health, and criminal risk factors;
615          (vi) establish and promote an evidence-based continuum of screening, assessment,
616     prevention, treatment, and recovery support services in the community for individuals with
617     substance abuse and mental illness that addresses criminal risk factors;

618          (vii) evaluate the effectiveness of programs described in Subsection (2);
619          (viii) consider the impact of the programs described in Subsection (2) on:
620          (A) emergency department utilization;
621          (B) jail and prison populations;
622          (C) the homeless population; and
623          (D) the child welfare system; and
624          (ix) promote or establish programs for education and certification of instructors to
625     educate persons convicted of driving under the influence of alcohol or drugs or driving with
626     any measurable controlled substance in the body;
627          (b) (i) collect and disseminate information pertaining to mental health;
628          (ii) provide direction over the state hospital including approval of its budget,
629     administrative policy, and coordination of services with local service plans;
630          (iii) promulgate rules in accordance with Title 63G, Chapter 3, Utah Administrative
631     Rulemaking Act, to educate families concerning mental illness and promote family
632     involvement, when appropriate, and with patient consent, in the treatment program of a family
633     member; and
634          (iv) promulgate rules in accordance with Title 63G, Chapter 3, Utah Administrative
635     Rulemaking Act, to direct that all individuals receiving services through local mental health
636     authorities or the Utah State Hospital be informed about and, if desired, provided assistance in
637     completion of a declaration for mental health treatment in accordance with Section
638     62A-15-1002;
639          (c) (i) consult and coordinate with local substance abuse authorities and local mental
640     health authorities regarding programs and services;
641          (ii) provide consultation and other assistance to public and private agencies and groups
642     working on substance abuse and mental health issues;
643          (iii) promote and establish cooperative relationships with courts, hospitals, clinics,
644     medical and social agencies, public health authorities, law enforcement agencies, education and
645     research organizations, and other related groups;

646          (iv) promote or conduct research on substance abuse and mental health issues, and
647     submit to the governor and the Legislature recommendations for changes in policy and
648     legislation;
649          (v) receive, distribute, and provide direction over public funds for substance abuse and
650     mental health services;
651          (vi) monitor and evaluate programs provided by local substance abuse authorities and
652     local mental health authorities;
653          (vii) examine expenditures of any local, state, and federal funds;
654          (viii) monitor the expenditure of public funds by:
655          (A) local substance abuse authorities;
656          (B) local mental health authorities; and
657          (C) in counties where they exist, the private contract provider that has an annual or
658     otherwise ongoing contract to provide comprehensive substance abuse or mental health
659     programs or services for the local substance abuse authority or local mental health authorities;
660          (ix) contract with local substance abuse authorities and local mental health authorities
661     to provide a comprehensive continuum of services that include community-based services for
662     individuals involved in the criminal justice system, in accordance with division policy, contract
663     provisions, and the local plan;
664          (x) contract with private and public entities for special statewide or nonclinical
665     services, or services for individuals involved in the criminal justice system, according to
666     division rules;
667          (xi) review and approve each local substance abuse authority's plan and each local
668     mental health authority's plan in order to ensure:
669          (A) a statewide comprehensive continuum of substance abuse services;
670          (B) a statewide comprehensive continuum of mental health services;
671          (C) services result in improved overall health and functioning;
672          (D) a statewide comprehensive continuum of community-based services designed to
673     reduce criminal risk factors for individuals who are determined to have substance abuse or

674     mental illness conditions or both, and who are involved in the criminal justice system;
675          (E) compliance, where appropriate, with the certification requirements in Subsection
676     (2)(i); and
677          (F) appropriate expenditure of public funds;
678          (xii) review and make recommendations regarding each local substance abuse
679     authority's contract with its provider of substance abuse programs and services and each local
680     mental health authority's contract with its provider of mental health programs and services to
681     ensure compliance with state and federal law and policy;
682          (xiii) monitor and ensure compliance with division rules and contract requirements;
683     and
684          (xiv) withhold funds from local substance abuse authorities, local mental health
685     authorities, and public and private providers for contract noncompliance, failure to comply
686     with division directives regarding the use of public funds, or for misuse of public funds or
687     money;
688          (d) assure that the requirements of this part are met and applied uniformly by local
689     substance abuse authorities and local mental health authorities across the state;
690          (e) require each local substance abuse authority and each local mental health authority
691     to submit its plan to the division by May 1 of each year;
692          (f) conduct an annual program audit and review of each local substance abuse authority
693     in the state and its contract provider and each local mental health authority in the state and its
694     contract provider, including:
695          (i) a review and determination regarding whether:
696          (A) public funds allocated to local substance abuse authorities and local mental health
697     authorities are consistent with services rendered and outcomes reported by them or their
698     contract providers; and
699          (B) each local substance abuse authority and each local mental health authority is
700     exercising sufficient oversight and control over public funds allocated for substance abuse and
701     mental health programs and services; and

702          (ii) items determined by the division to be necessary and appropriate; and
703          (g) define "prevention" by rule as required under Title 32B, Chapter 2, Part 4,
704     Alcoholic Beverage and Substance Abuse Enforcement and Treatment Restricted Account Act;
705          (h) establish by rule, in accordance with Title 63G, Chapter 3, Utah Administrative
706     Rulemaking Act, minimum standards and requirements for the provision of substance abuse
707     and mental health treatment to individuals who are required to participate in treatment by the
708     court or the Board of Pardons and Parole, or who are incarcerated, including:
709          (i) collaboration with the Department of Corrections, the Utah Substance Abuse
710     Advisory Council to develop and coordinate the standards, including standards for county and
711     state programs serving individuals convicted of class A and class B misdemeanors;
712          (ii) determining that the standards ensure available treatment includes the most current
713     practices and procedures demonstrated by recognized scientific research to reduce recidivism,
714     including focus on the individual's criminal risk factors; and
715          (iii) requiring that all public and private treatment programs meet the standards
716     established under this Subsection (2)(h) in order to receive public funds allocated to the
717     division, the Department of Corrections, or the Commission on Criminal and Juvenile Justice
718     for the costs of providing screening, assessment, prevention, treatment, and recovery support;
719          (i) establish by rule, in accordance with Title 63G, Chapter 3, Utah Administrative
720     Rulemaking Act, the requirements and procedures for the certification of licensed public and
721     private providers who provide, as part of their practice, substance abuse and mental health
722     treatment to individuals involved in the criminal justice system, including:
723          (i) collaboration with the Department of Corrections, the Utah Substance Abuse
724     Advisory Council, and the Utah Association of Counties to develop, coordinate, and implement
725     the certification process;
726          (ii) basing the certification process on the standards developed under Subsection (2)(h)
727     for the treatment of individuals involved in the criminal justice system; and
728          (iii) the requirement that all public and private providers of treatment to individuals
729     involved in the criminal justice system shall obtain certification on or before July 1, 2016, and

730     shall renew the certification every two years, in order to qualify for funds allocated to the
731     division, the Department of Corrections, or the Commission on Criminal and Juvenile Justice
732     on or after July 1, 2016;
733          (j) collaboration with the Commission on Criminal and Juvenile Justice to analyze and
734     provide recommendations to the Legislature regarding:
735          (i) pretrial services and the resources needed for the reduced recidivism efforts;
736          (ii) county jail and county behavioral health early-assessment resources needed for
737     offenders convicted of a class A or class B misdemeanor; and
738          (iii) the replacement of federal dollars associated with drug interdiction law
739     enforcement task forces that are reduced;
740          (k) (i) establish performance goals and outcome measurements for all treatment
741     programs for which minimum standards are established under Subsection (2)(h), including
742     recidivism data and data regarding cost savings associated with recidivism reduction and the
743     reduction in the number of inmates, that are obtained in collaboration with the Administrative
744     Office of the Courts and the Department of Corrections; and
745          (ii) collect data to track and determine whether the goals and measurements are being
746     attained and make this information available to the public;
747          (l) in its discretion, use the data to make decisions regarding the use of funds allocated
748     to the division, the Administrative Office of the Courts, and the Department of Corrections to
749     provide treatment for which standards are established under Subsection (2)(h); and
750          (m) annually, on or before August 31, submit the data collected under Subsection (2)(j)
751     to the Commission on Criminal and Juvenile Justice, which shall compile a report of findings
752     based on the data and provide the report to the legislative Judiciary Interim Committee, the
753     Health and Human Services Interim Committee, the Law Enforcement and Criminal Justice
754     Interim Committee, and the related appropriations subcommittees.
755          (3) (a) The division may refuse to contract with and may pursue its legal remedies
756     against any local substance abuse authority or local mental health authority that fails, or has
757     failed, to expend public funds in accordance with state law, division policy, contract

758     provisions, or directives issued in accordance with state law.
759          (b) The division may withhold funds from a local substance abuse authority or local
760     mental health authority if the authority's contract with its provider of substance abuse or mental
761     health programs or services fails to comply with state and federal law or policy.
762          (4) Before reissuing or renewing a contract with any local substance abuse authority or
763     local mental health authority, the division shall review and determine whether the local
764     substance abuse authority or local mental health authority is complying with its oversight and
765     management responsibilities described in Sections 17-43-201, 17-43-203, 17-43-303, and
766     17-43-309. Nothing in this Subsection (4) may be used as a defense to the responsibility and
767     liability described in Section 17-43-303 and to the responsibility and liability described in
768     Section 17-43-203.
769          (5) In carrying out its duties and responsibilities, the division may not duplicate
770     treatment or educational facilities that exist in other divisions or departments of the state, but
771     shall work in conjunction with those divisions and departments in rendering the treatment or
772     educational services that those divisions and departments are competent and able to provide.
773          (6) The division may accept in the name of and on behalf of the state donations, gifts,
774     devises, or bequests of real or personal property or services to be used as specified by the
775     donor.
776          (7) The division shall annually review with each local substance abuse authority and
777     each local mental health authority the authority's statutory and contract responsibilities
778     regarding:
779          (a) the use of public funds;
780          (b) oversight responsibilities regarding public funds; and
781          (c) governance of substance abuse and mental health programs and services.
782          (8) The Legislature may refuse to appropriate funds to the division upon the division's
783     failure to comply with the provisions of this part.
784          (9) If a local substance abuse authority contacts the division under Subsection
785     17-43-201[(9)](10) for assistance in providing treatment services to a pregnant woman or

786     pregnant minor, the division shall:
787          (a) refer the pregnant woman or pregnant minor to a treatment facility that has the
788     capacity to provide the treatment services; or
789          (b) otherwise ensure that treatment services are made available to the pregnant woman
790     or pregnant minor.