Representative Edward H. Redd proposes the following substitute bill:


1     
SYSTEM OF CARE DEVELOPMENT

2     
2016 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Edward H. Redd

5     
Senate Sponsor: Todd Weiler

6     

7     LONG TITLE
8     General Description:
9          This bill amends the Department of Human Services' authority related to developing a
10     system of care.
11     Highlighted Provisions:
12          This bill:
13          ▸     amends a definition;
14          ▸     clarifies the authority of the Department of Human Services related to developing a
15     system of care for minors with complex emotional and behavioral needs; and
16          ▸     modifies the components of a system of care; and
17          ▸     authorizes the department to develop an information technology infrastructure to
18     implement the system of care.
19     Money Appropriated in this Bill:
20          None
21     Other Special Clauses:
22          None
23     Utah Code Sections Affected:
24     AMENDS:
25          17-43-201, as last amended by Laws of Utah 2014, Chapter 213
26          17-43-301, as last amended by Laws of Utah 2014, Chapter 213
27          62A-1-104, as last amended by Laws of Utah 2014, Chapter 213
28          62A-1-111, as last amended by Laws of Utah 2014, Chapter 213
29     ENACTS:
30          62A-1-121, Utah Code Annotated 1953
31     

32     Be it enacted by the Legislature of the state of Utah:
33          Section 1. Section 17-43-201 is amended to read:
34          17-43-201. Local substance abuse authorities -- Responsibilities.
35          (1) (a) (i) In each county operating under a county executive-council form of
36     government under Section 17-52-504, the county legislative body is the local substance abuse
37     authority, provided however that any contract for plan services shall be administered by the
38     county executive.
39          (ii) In each county operating under a council-manager form of government under
40     Section 17-52-505, the county manager is the local substance abuse authority.
41          (iii) In each county other than a county described in Subsection (1)(a)(i) or (ii), the
42     county legislative body is the local substance abuse authority.
43          (b) Within legislative appropriations and county matching funds required by this
44     section, and under the direction of the division, each local substance abuse authority shall:
45          (i) develop substance abuse prevention and treatment services plans;
46          (ii) provide substance abuse services to residents of the county; and
47          (iii) cooperate with efforts of the Division of Substance Abuse and Mental Health to
48     promote integrated programs that address an individual's substance abuse, mental health, and
49     physical healthcare needs, as described in Section 62A-15-103.
50          (c) Within legislative appropriations and county matching funds required by this
51     section, each local substance abuse authority shall cooperate with the efforts of the Department
52     of Human Services to promote a system of care, as defined in Section 62A-1-104, for minors
53     with [or at risk for] complex emotional and behavioral needs, as described in Section
54     [62A-1-111] 62A-1-121.
55          (2) (a) By executing an interlocal agreement under Title 11, Chapter 13, Interlocal
56     Cooperation Act, two or more counties may join to provide substance abuse prevention and
57     treatment services.
58          (b) The legislative bodies of counties joining to provide services may establish
59     acceptable ways of apportioning the cost of substance abuse services.
60          (c) Each agreement for joint substance abuse services shall:
61          (i) (A) designate the treasurer of one of the participating counties or another person as
62     the treasurer for the combined substance abuse authorities and as the custodian of money
63     available for the joint services; and
64          (B) provide that the designated treasurer, or other disbursing officer authorized by the
65     treasurer, may make payments from the money for the joint services upon audit of the
66     appropriate auditing officer or officers representing the participating counties;
67          (ii) provide for the appointment of an independent auditor or a county auditor of one of
68     the participating counties as the designated auditing officer for the combined substance abuse
69     authorities;
70          (iii) (A) provide for the appointment of the county or district attorney of one of the
71     participating counties as the designated legal officer for the combined substance abuse
72     authorities; and
73          (B) authorize the designated legal officer to request and receive the assistance of the
74     county or district attorneys of the other participating counties in defending or prosecuting
75     actions within their counties relating to the combined substance abuse authorities; and
76          (iv) provide for the adoption of management, clinical, financial, procurement,
77     personnel, and administrative policies as already established by one of the participating
78     counties or as approved by the legislative body of each participating county or interlocal board.
79          (d) An agreement for joint substance abuse services may provide for joint operation of
80     services and facilities or for operation of services and facilities under contract by one
81     participating local substance abuse authority for other participating local substance abuse
82     authorities.
83          (3) (a) Each local substance abuse authority is accountable to the department, the
84     Department of Health, and the state with regard to the use of state and federal funds received
85     from those departments for substance abuse services, regardless of whether the services are
86     provided by a private contract provider.
87          (b) Each local substance abuse authority shall comply, and require compliance by its
88     contract provider, with all directives issued by the department and the Department of Health
89     regarding the use and expenditure of state and federal funds received from those departments
90     for the purpose of providing substance abuse programs and services. The department and
91     Department of Health shall ensure that those directives are not duplicative or conflicting, and
92     shall consult and coordinate with local substance abuse authorities with regard to programs and
93     services.
94          (4) Each local substance abuse authority shall:
95          (a) review and evaluate substance abuse prevention and treatment needs and services,
96     including substance abuse needs and services for individuals incarcerated in a county jail or
97     other county correctional facility;
98          (b) annually prepare and submit to the division a plan approved by the county
99     legislative body for funding and service delivery that includes:
100          (i) provisions for services, either directly by the substance abuse authority or by
101     contract, for adults, youth, and children, including those incarcerated in a county jail or other
102     county correctional facility; and
103          (ii) primary prevention, targeted prevention, early intervention, and treatment services;
104          (c) establish and maintain, either directly or by contract, programs licensed under Title
105     62A, Chapter 2, Licensure of Programs and Facilities;
106          (d) appoint directly or by contract a full or part time director for substance abuse
107     programs, and prescribe the director's duties;
108          (e) provide input and comment on new and revised rules established by the division;
109          (f) establish and require contract providers to establish administrative, clinical,
110     procurement, personnel, financial, and management policies regarding substance abuse services
111     and facilities, in accordance with the rules of the division, and state and federal law;
112          (g) establish mechanisms allowing for direct citizen input;
113          (h) annually contract with the division to provide substance abuse programs and
114     services in accordance with the provisions of Title 62A, Chapter 15, Substance Abuse and
115     Mental Health Act;
116          (i) comply with all applicable state and federal statutes, policies, audit requirements,
117     contract requirements, and any directives resulting from those audits and contract requirements;
118          (j) promote or establish programs for the prevention of substance abuse within the
119     community setting through community-based prevention programs;
120          (k) provide funding equal to at least 20% of the state funds that it receives to fund
121     services described in the plan;
122          (l) comply with the requirements and procedures of Title 11, Chapter 13, Interlocal
123     Cooperation Act, Title 17B, Chapter 1, Part 6, Fiscal Procedures for Local Districts, and Title
124     51, Chapter 2a, Accounting Reports from Political Subdivisions, Interlocal Organizations, and
125     Other Local Entities Act;
126          (m) for persons convicted of driving under the influence in violation of Section
127     41-6a-502 or 41-6a-517, conduct the following as defined in Section 41-6a-501:
128          (i) a screening;
129          (ii) an assessment;
130          (iii) an educational series; and
131          (iv) substance abuse treatment; and
132          (n) utilize proceeds of the accounts described in Subsection 62A-15-503(1) to
133     supplement the cost of providing the services described in Subsection (4)(m).
134          (5) Before disbursing any public funds, each local substance abuse authority shall
135     require that each entity that receives any public funds from the local substance abuse authority
136     agrees in writing that:
137          (a) the entity's financial records and other records relevant to the entity's performance
138     of the services provided to the local substance abuse authority shall be subject to examination
139     by:
140          (i) the division;
141          (ii) the local substance abuse authority director;
142          (iii) (A) the county treasurer and county or district attorney; or
143          (B) if two or more counties jointly provide substance abuse services under an
144     agreement under Subsection (2), the designated treasurer and the designated legal officer;
145          (iv) the county legislative body; and
146          (v) in a county with a county executive that is separate from the county legislative
147     body, the county executive;
148          (b) the county auditor may examine and audit the entity's financial and other records
149     relevant to the entity's performance of the services provided to the local substance abuse
150     authority; and
151          (c) the entity will comply with the provisions of Subsection (3)(b).
152          (6) A local substance abuse authority may receive property, grants, gifts, supplies,
153     materials, contributions, and any benefit derived therefrom, for substance abuse services. If
154     those gifts are conditioned upon their use for a specified service or program, they shall be so
155     used.
156          (7) (a) As used in this section, "public funds" means the same as that term is defined in
157     Section 17-43-203.
158          (b) Public funds received for the provision of services pursuant to the local substance
159     abuse plan may not be used for any other purpose except those authorized in the contract
160     between the local substance abuse authority and the provider for the provision of plan services.
161          (8) Subject to the requirements of the federal Substance Abuse Prevention and
162     Treatment Block Grant, Public Law 102-321, a local substance abuse authority shall ensure
163     that all substance abuse treatment programs that receive public funds:
164          (a) accept and provide priority for admission to a pregnant woman or a pregnant minor;
165     and
166          (b) if admission of a pregnant woman or a pregnant minor is not possible within 24
167     hours of the time that a request for admission is made, provide a comprehensive referral for
168     interim services that:
169          (i) are accessible to the pregnant woman or pregnant minor;
170          (ii) are best suited to provide services to the pregnant woman or pregnant minor;
171          (iii) may include:
172          (A) counseling;
173          (B) case management; or
174          (C) a support group; and
175          (iv) shall include a referral for:
176          (A) prenatal care; and
177          (B) counseling on the effects of alcohol and drug use during pregnancy.
178          (9) If a substance abuse treatment program described in Subsection (8) is not able to
179     accept and admit a pregnant woman or pregnant minor under Subsection (8) within 48 hours of
180     the time that request for admission is made, the local substance abuse authority shall contact
181     the Division of Substance Abuse and Mental Health for assistance in providing services to the
182     pregnant woman or pregnant minor.
183          Section 2. Section 17-43-301 is amended to read:
184          17-43-301. Local mental health authorities -- Responsibilities.
185          (1) (a) (i) In each county operating under a county executive-council form of
186     government under Section 17-52-504, the county legislative body is the local mental health
187     authority, provided however that any contract for plan services shall be administered by the
188     county executive.
189          (ii) In each county operating under a council-manager form of government under
190     Section 17-52-505, the county manager is the local mental health authority.
191          (iii) In each county other than a county described in Subsection (1)(a)(i) or (ii), the
192     county legislative body is the local mental health authority.
193          (b) Within legislative appropriations and county matching funds required by this
194     section, under the direction of the division, each local mental health authority shall:
195          (i) provide mental health services to persons within the county; and
196          (ii) cooperate with efforts of the Division of Substance Abuse and Mental Health to
197     promote integrated programs that address an individual's substance abuse, mental health, and
198     physical healthcare needs, as described in Section 62A-15-103.
199          (c) Within legislative appropriations and county matching funds required by this
200     section, each local mental health authority shall cooperate with the efforts of the Department of
201     Human Services to promote a system of care, as defined in Section 62A-1-104, for minors with
202     [or at risk for] complex emotional and behavioral needs, as described in Section [62A-1-111]
203     62A-1-121.
204          (2) (a) By executing an interlocal agreement under Title 11, Chapter 13, Interlocal
205     Cooperation Act, two or more counties may join to provide mental health prevention and
206     treatment services.
207          (b) The legislative bodies of counties joining to provide services may establish
208     acceptable ways of apportioning the cost of mental health services.
209          (c) Each agreement for joint mental health services shall:
210          (i) (A) designate the treasurer of one of the participating counties or another person as
211     the treasurer for the combined mental health authorities and as the custodian of money
212     available for the joint services; and
213          (B) provide that the designated treasurer, or other disbursing officer authorized by the
214     treasurer, may make payments from the money available for the joint services upon audit of the
215     appropriate auditing officer or officers representing the participating counties;
216          (ii) provide for the appointment of an independent auditor or a county auditor of one of
217     the participating counties as the designated auditing officer for the combined mental health
218     authorities;
219          (iii) (A) provide for the appointment of the county or district attorney of one of the
220     participating counties as the designated legal officer for the combined mental health
221     authorities; and
222          (B) authorize the designated legal officer to request and receive the assistance of the
223     county or district attorneys of the other participating counties in defending or prosecuting
224     actions within their counties relating to the combined mental health authorities; and
225          (iv) provide for the adoption of management, clinical, financial, procurement,
226     personnel, and administrative policies as already established by one of the participating
227     counties or as approved by the legislative body of each participating county or interlocal board.
228          (d) An agreement for joint mental health services may provide for:
229          (i) joint operation of services and facilities or for operation of services and facilities
230     under contract by one participating local mental health authority for other participating local
231     mental health authorities; and
232          (ii) allocation of appointments of members of the mental health advisory council
233     between or among participating counties.
234          (3) (a) Each local mental health authority is accountable to the department, the
235     Department of Health, and the state with regard to the use of state and federal funds received
236     from those departments for mental health services, regardless of whether the services are
237     provided by a private contract provider.
238          (b) Each local mental health authority shall comply, and require compliance by its
239     contract provider, with all directives issued by the department and the Department of Health
240     regarding the use and expenditure of state and federal funds received from those departments
241     for the purpose of providing mental health programs and services. The department and
242     Department of Health shall ensure that those directives are not duplicative or conflicting, and
243     shall consult and coordinate with local mental health authorities with regard to programs and
244     services.
245          (4) (a) Each local mental health authority shall:
246          (i) review and evaluate mental health needs and services, including mental health needs
247     and services for persons incarcerated in a county jail or other county correctional facility;
248          (ii) as provided in Subsection (4)(b), annually prepare and submit to the division a plan
249     approved by the county legislative body for mental health funding and service delivery, either
250     directly by the local mental health authority or by contract;
251          (iii) establish and maintain, either directly or by contract, programs licensed under Title
252     62A, Chapter 2, Licensure of Programs and Facilities;
253          (iv) appoint, directly or by contract, a full-time or part-time director for mental health
254     programs and prescribe the director's duties;
255          (v) provide input and comment on new and revised rules established by the division;
256          (vi) establish and require contract providers to establish administrative, clinical,
257     personnel, financial, procurement, and management policies regarding mental health services
258     and facilities, in accordance with the rules of the division, and state and federal law;
259          (vii) establish mechanisms allowing for direct citizen input;
260          (viii) annually contract with the division to provide mental health programs and
261     services in accordance with the provisions of Title 62A, Chapter 15, Substance Abuse and
262     Mental Health Act;
263          (ix) comply with all applicable state and federal statutes, policies, audit requirements,
264     contract requirements, and any directives resulting from those audits and contract requirements;
265          (x) provide funding equal to at least 20% of the state funds that it receives to fund
266     services described in the plan;
267          (xi) comply with the requirements and procedures of Title 11, Chapter 13, Interlocal
268     Cooperation Act, Title 17B, Chapter 1, Part 6, Fiscal Procedures for Local Districts, and Title
269     51, Chapter 2a, Accounting Reports from Political Subdivisions, Interlocal Organizations, and
270     Other Local Entities Act; and
271          (xii) take and retain physical custody of minors committed to the physical custody of
272     local mental health authorities by a judicial proceeding under Title 62A, Chapter 15, Part 7,
273     Commitment of Persons Under Age 18 to Division of Substance Abuse and Mental Health.
274          (b) Each plan under Subsection (4)(a)(ii) shall include services for adults, youth, and
275     children, which shall include:
276          (i) inpatient care and services;
277          (ii) residential care and services;
278          (iii) outpatient care and services;
279          (iv) 24-hour crisis care and services;
280          (v) psychotropic medication management;
281          (vi) psychosocial rehabilitation, including vocational training and skills development;
282          (vii) case management;
283          (viii) community supports, including in-home services, housing, family support
284     services, and respite services;
285          (ix) consultation and education services, including case consultation, collaboration
286     with other county service agencies, public education, and public information; and
287          (x) services to persons incarcerated in a county jail or other county correctional facility.
288          (5) Before disbursing any public funds, each local mental health authority shall require
289     that each entity that receives any public funds from a local mental health authority agrees in
290     writing that:
291          (a) the entity's financial records and other records relevant to the entity's performance
292     of the services provided to the mental health authority shall be subject to examination by:
293          (i) the division;
294          (ii) the local mental health authority director;
295          (iii) (A) the county treasurer and county or district attorney; or
296          (B) if two or more counties jointly provide mental health services under an agreement
297     under Subsection (2), the designated treasurer and the designated legal officer;
298          (iv) the county legislative body; and
299          (v) in a county with a county executive that is separate from the county legislative
300     body, the county executive;
301          (b) the county auditor may examine and audit the entity's financial and other records
302     relevant to the entity's performance of the services provided to the local mental health
303     authority; and
304          (c) the entity will comply with the provisions of Subsection (3)(b).
305          (6) A local mental health authority may receive property, grants, gifts, supplies,
306     materials, contributions, and any benefit derived therefrom, for mental health services. If those
307     gifts are conditioned upon their use for a specified service or program, they shall be so used.
308          (7) (a) As used in this section, "public funds" means the same as that term is defined in
309     Section 17-43-303.
310          (b) Public funds received for the provision of services pursuant to the local mental
311     health plan may not be used for any other purpose except those authorized in the contract
312     between the local mental health authority and the provider for the provision of plan services.
313          Section 3. Section 62A-1-104 is amended to read:
314          62A-1-104. Definitions.
315          (1) As used in this title:
316          (a) "Concurrence of the board" means agreement by a majority of the members of a
317     board.
318          (b) "Department" means the Department of Human Services established in Section
319     62A-1-102.
320          (c) "Executive director" means the executive director of the department, appointed
321     pursuant to Section 62A-1-108.
322          (d) "System of care" means a broad, flexible array of services and supports, as
323     described in Section 62A-1-121, for minors with [or at risk for] complex emotional and
324     behavioral needs [that: (i) is community based; (ii) integrates service planning, service
325     coordination, and management across state and local entities; (iii) includes individualized,
326     person-centered planning; (iv) builds meaningful partnerships with families and children; and
327     (v) provides supportive management and policy infrastructure that is organized into a
328     coordinated network.] who are receiving services through the department or any of the
329     department's divisions, offices, or institutions, or who are at risk of needing services through
330     the department or any of the department's divisions, offices, or institutions.
331          (2) The definitions provided in Subsection (1) are to be applied in addition to
332     definitions contained throughout this title which are applicable to specific chapters or parts.
333          Section 4. Section 62A-1-111 is amended to read:
334          62A-1-111. Department authority.
335          (1) The department may, in addition to all other authority and responsibility granted to
336     it by law:
337          [(1)] (a) adopt rules, not inconsistent with law, as the department may consider
338     necessary or desirable for providing social services to the people of this state;
339          [(2)] (b) establish and manage client trust accounts in the department's institutions and
340     community programs, at the request of the client or the client's legal guardian or representative,
341     or in accordance with federal law;
342          [(3)] (c) purchase, as authorized or required by law, services that the department is
343     responsible to provide for legally eligible persons;
344          [(4)] (d) conduct adjudicative proceedings for clients and providers in accordance with
345     the procedures of Title 63G, Chapter 4, Administrative Procedures Act;
346          [(5)] (e) establish eligibility standards for its programs, not inconsistent with state or
347     federal law or regulations;
348          [(6)] (f) take necessary steps, including legal action, to recover money or the monetary
349     value of services provided to a recipient who was not eligible;
350          [(7)] (g) set and collect fees for its services;
351          [(8)] (h) license agencies, facilities, and programs, except as otherwise allowed,
352     prohibited, or limited by law;
353          [(9)] (i) acquire, manage, and dispose of any real or personal property needed or owned
354     by the department, not inconsistent with state law;
355          [(10)] (j) receive gifts, grants, devises, and donations; gifts, grants, devises, donations,
356     or the proceeds thereof, may be credited to the program designated by the donor, and may be
357     used for the purposes requested by the donor, as long as the request conforms to state and
358     federal policy; all donated funds shall be considered private, nonlapsing funds and may be
359     invested under guidelines established by the state treasurer;
360          [(11)] (k) accept and employ volunteer labor or services; the department is authorized
361     to reimburse volunteers for necessary expenses, when the department considers that
362     reimbursement to be appropriate;
363          [(12)] (l) carry out the responsibility assigned in the Workforce Services Plan by the
364     State Council on Workforce Services;
365          [(13)] (m) carry out the responsibility assigned by Section 35A-8-602 with respect to
366     coordination of services for the homeless;
367          [(14)] (n) carry out the responsibility assigned by Section 62A-5a-105 with respect to
368     coordination of services for students with a disability;
369          [(15)] (o) provide training and educational opportunities for its staff;
370          [(16)] (p) collect child support payments and any other money due to the department;
371          [(17)] (q) apply the provisions of Title 78B, Chapter 12, Utah Child Support Act, to
372     parents whose child lives out of the home in a department licensed or certified setting;
373          [(18)] (r) establish policy and procedures, within appropriations authorized by the
374     Legislature, in cases where the department is given custody of a minor by the juvenile court
375     pursuant to Section 78A-6-117 or ordered to prepare an attainment plan for a minor found not
376     competent to proceed pursuant to Section 78A-6-1301; any policy and procedures shall
377     include:
378          [(a)] (i) designation of interagency teams for each juvenile court district in the state;
379          [(b)] (ii) delineation of assessment criteria and procedures;
380          [(c)] (iii) minimum requirements, and timeframes, for the development and
381     implementation of a collaborative service plan for each minor placed in department custody;
382     and
383          [(d)] (iv) provisions for submittal of the plan and periodic progress reports to the court;
384          [(19)] (s) carry out the responsibilities assigned to it by statute;
385          [(20)] (t) examine and audit the expenditures of any public funds provided to local
386     substance abuse authorities, local mental health authorities, local area agencies on aging, and
387     any person, agency, or organization that contracts with or receives funds from those authorities
388     or agencies. Those local authorities, area agencies, and any person or entity that contracts with
389     or receives funds from those authorities or area agencies, shall provide the department with any
390     information the department considers necessary. The department is further authorized to issue
391     directives resulting from any examination or audit to local authorities, area agencies, and
392     persons or entities that contract with or receive funds from those authorities with regard to any
393     public funds. If the department determines that it is necessary to withhold funds from a local
394     mental health authority or local substance abuse authority based on failure to comply with state
395     or federal law, policy, or contract provisions, it may take steps necessary to ensure continuity of
396     services. For purposes of this Subsection (20) "public funds" means the same as that term is
397     defined in Section 62A-15-102; and
398          [(21)] (u) pursuant to Subsection 62A-2-106(1)(d), accredit one or more agencies and
399     persons to provide intercountry adoption services[; and].
400          [(22) within appropriations authorized by the Legislature,]
401          (2) The department shall promote and develop a system of care, as [defined in Section
402     62A-1-104, within the department and with contractors that provide services to the department
403     or any of the department's divisions] described in Section 62A-1-121.
404          Section 5. Section 62A-1-121 is enacted to read:
405          62A-1-121. System of care.
406          (1) The department shall promote and develop a system of care within the department
407     or any of the department's divisions, offices, or institutions.
408          (2) The system of care shall serve minors with complex emotional and behavioral
409     needs who are receiving services through the department or any of the department's divisions,
410     offices, or institutions, or who are at risk of needing services through the department or any of
411     the department's divisions, offices, or institutions.
412          (3) The system of care shall incorporate a broad, flexible array of services and supports
413     that:
414          (a) is home and community based;
415          (b) integrates service planning, service coordination, and management across state and
416     local entities in a team-based approach;
417          (c) includes individualized, person-centered planning;
418          (d) builds meaningful partnerships with minors and minors' families; and
419          (e) provides supportive management and policy infrastructure that is organized into a
420     coordinated network.
421          (4) The department may develop an information technology infrastructure to
422     implement the system of care, including the following components:
423          (a) sharing of information between minors' families and state and local entities
424     involved in the care of the minors, in accordance with state and federal law;
425          (b) documentation of care provided to minors and minors' families;
426          (c) an electronic health record system that complies with federal privacy requirements,
427     including the Health Insurance Portability and Accountability Act of 1996; and
428          (d) design and develop a data collection system for purposes of data mining and
429     extracting the aggregate data to make informed business decisions.
430          (5) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, the
431     department shall make rules to accomplish the requirements described in Subsection (4).