Senator Evan J. Vickers proposes the following substitute bill:





Chief Sponsor: Evan J. Vickers

House Sponsor: Kay L. McIff


9     General Description:
10          This bill repeals Utah Code provisions requiring certain reports, primarily to various
11     entities of the Utah Legislature, on health and human services issues, and repeals other
12     statutory requirements.
13     Highlighted Provisions:
14          This bill:
15          ▸     repeals and amends provisions requiring certain reports, primarily to various entities
16     of the Utah Legislature, on health and human services issues, including expired
17     reporting provisions;
18          ▸     repeals an expired provision for the Department of Health to study and implement a
19     patient-centered medical home demonstration project;
20          ▸     repeals an expired provision for the Health and Human Services Interim Committee
21     to study whether statewide practice standards should be implemented to assist the
22     Child Welfare Parental Defense Program to provide legal services to indigent
23     parents whose children are in the custody of the Division of Child and Family
24     Services; and
25          ▸     makes technical changes.

26     Money Appropriated in this Bill:
27          None
28     Other Special Clauses:
29          None
30     Utah Code Sections Affected:
31     AMENDS:
32          26-8a-105, as last amended by Laws of Utah 2015, Chapter 167
33          26-18-2.4, as last amended by Laws of Utah 2012, Chapters 242 and 343
34          26-18-3, as last amended by Laws of Utah 2013, Chapter 167
35          26-18-405, as enacted by Laws of Utah 2011, Chapter 211
36          26-50-202, as last amended by Laws of Utah 2012, Chapter 242
37          26-52-202, as last amended by Laws of Utah 2014, Chapter 302
38          59-14-204, as last amended by Laws of Utah 2012, Chapter 341
39          62A-1-119, as last amended by Laws of Utah 2013, Chapter 400
40          62A-4a-401, as last amended by Laws of Utah 2013, Chapter 171
41          62A-15-1101, as last amended by Laws of Utah 2015, Chapter 85

43     Be it enacted by the Legislature of the state of Utah:
44          Section 1. Section 26-8a-105 is amended to read:
45          26-8a-105. Department powers.
46          The department shall:
47          (1) coordinate the emergency medical services within the state;
48          (2) administer this chapter and the rules established pursuant to it;
49          (3) establish a voluntary task force representing a diversity of emergency medical
50     service providers to advise the department and the committee on rules;
51          (4) establish an emergency medical service personnel peer review board to advise the
52     department concerning discipline of emergency medical service personnel under this chapter;
53     and
54          (5) adopt rules in accordance with Title 63G, Chapter 3, Utah Administrative
55     Rulemaking Act, to:
56          (a) license ambulance providers and paramedic providers;

57          (b) permit ambulances and emergency medical response vehicles, including approving
58     an emergency vehicle operator's course in accordance with Section 26-8a-304;
59          (c) establish:
60          (i) the qualifications for membership of the peer review board created by this section;
61          (ii) a process for placing restrictions on a certification while an investigation is
62     pending;
63          (iii) the process for the investigation and recommendation by the peer review board;
64     and
65          (iv) the process for determining the status of a license or certification while a peer
66     review board investigation is pending;
67          (d) establish application, submission, and procedural requirements for licenses,
68     designations, certificates, and permits; and
69          (e) establish and implement the programs, plans, and responsibilities as specified in
70     other sections of this chapter[; and].
71          [(6) report to the Legislature's Health and Human Services Interim Committee on or
72     before July 15, 2015, regarding rules developed under Subsection (5)(c).]
73          Section 2. Section 26-18-2.4 is amended to read:
74          26-18-2.4. Medicaid drug program -- Preferred drug list.
75          (1) A Medicaid drug program developed by the department under Subsection
76     26-18-2.3(2)(f):
77          (a) shall, notwithstanding Subsection 26-18-2.3(1)(b), be based on clinical and
78     cost-related factors which include medical necessity as determined by a provider in accordance
79     with administrative rules established by the Drug Utilization Review Board;
80          (b) may include therapeutic categories of drugs that may be exempted from the drug
81     program;
82          (c) may include placing some drugs, except the drugs described in Subsection (2), on a
83     preferred drug list to the extent determined appropriate by the department;
84          (d) notwithstanding the requirements of Part 2, Drug Utilization Review Board, shall
85     immediately implement the prior authorization requirements for a nonpreferred drug that is in
86     the same therapeutic class as a drug that is:
87          (i) on the preferred drug list on the date that this act takes effect; or

88          (ii) added to the preferred drug list after this act takes effect; and
89          (e) except as prohibited by Subsections 58-17b-606(4) and (5), shall establish the prior
90     authorization requirements established under Subsections (1)(c) and (d) which shall permit a
91     health care provider or the health care provider's agent to obtain a prior authorization override
92     of the preferred drug list through the department's pharmacy prior authorization review process,
93     and which shall:
94          (i) provide either telephone or fax approval or denial of the request within 24 hours of
95     the receipt of a request that is submitted during normal business hours of Monday through
96     Friday from 8 a.m. to 5 p.m.;
97          (ii) provide for the dispensing of a limited supply of a requested drug as determined
98     appropriate by the department in an emergency situation, if the request for an override is
99     received outside of the department's normal business hours; and
100          (iii) require the health care provider to provide the department with documentation of
101     the medical need for the preferred drug list override in accordance with criteria established by
102     the department in consultation with the Pharmacy and Therapeutics Committee.
103          (2) (a) For purposes of this Subsection (2):
104          (i) "Immunosuppressive drug":
105          (A) means a drug that is used in immunosuppressive therapy to inhibit or prevent
106     activity of the immune system to aid the body in preventing the rejection of transplanted organs
107     and tissue; and
108          (B) does not include drugs used for the treatment of autoimmune disease or diseases
109     that are most likely of autoimmune origin.
110          (ii) "Psychotropic drug" means the following classes of drugs: atypical anti-psychotic,
111     anti-depressants, anti-convulsant/mood stabilizer, anti-anxiety, attention deficit hyperactivity
112     disorder stimulants, or sedative/hypnotics.
113          (iii) "Stabilized" means a health care provider has documented in the patient's medical
114     chart that a patient has achieved a stable or steadfast medical state within the past 90 days using
115     a particular psychotropic drug.
116          (b) A preferred drug list developed under the provisions of this section may not
117     include:
118          (i) except as provided in Subsection (2)(e), a psychotropic or anti-psychotic drug; or

119          (ii) an immunosuppressive drug.
120          (c) The state Medicaid program shall reimburse for a prescription for an
121     immunosuppressive drug as written by the health care provider for a patient who has undergone
122     an organ transplant. For purposes of Subsection 58-17b-606(4), and with respect to patients
123     who have undergone an organ transplant, the prescription for a particular immunosuppressive
124     drug as written by a health care provider meets the criteria of demonstrating to the Department
125     of Health a medical necessity for dispensing the prescribed immunosuppressive drug.
126          (d) Notwithstanding the requirements of Part 2, Drug Utilization Review Board, the
127     state Medicaid drug program may not require the use of step therapy for immunosuppressive
128     drugs without the written or oral consent of the health care provider and the patient.
129          (e) The department may include a sedative hypnotic on a preferred drug list in
130     accordance with Subsection (2)(f).
131          (f) The department shall grant a prior authorization for a sedative hypnotic that is not
132     on the preferred drug list under Subsection (2)(e), if the health care provider has documentation
133     related to one of the following conditions for the Medicaid client:
134          (i) a trial and failure of at least one preferred agent in the drug class, including the
135     name of the preferred drug that was tried, the length of therapy, and the reason for the
136     discontinuation;
137          (ii) detailed evidence of a potential drug interaction between current medication and
138     the preferred drug;
139          (iii) detailed evidence of a condition or contraindication that prevents the use of the
140     preferred drug;
141          (iv) objective clinical evidence that a patient is at high risk of adverse events due to a
142     therapeutic interchange with a preferred drug;
143          (v) the patient is a new or previous Medicaid client with an existing diagnosis
144     previously stabilized with a nonpreferred drug; or
145          (vi) other valid reasons as determined by the department.
146          (g) A prior authorization granted under Subsection (2)(f) is valid for one year from the
147     date the department grants the prior authorization and shall be renewed in accordance with
148     Subsection (2)(f).
149          [(3) The department shall report to the Health and Human Services Interim Committee

150     and to the Social Services Appropriations Subcommittee prior to November 1, 2013, regarding
151     the savings to the Medicaid program resulting from the use of the preferred drug list permitted
152     by Subsection (1).]
153          Section 3. Section 26-18-3 is amended to read:
154          26-18-3. Administration of Medicaid program by department -- Reporting to the
155     Legislature -- Disciplinary measures and sanctions -- Funds collected -- Eligibility
156     standards -- Internal audits -- Studies -- Health opportunity accounts.
157          (1) The department shall be the single state agency responsible for the administration
158     of the Medicaid program in connection with the United States Department of Health and
159     Human Services pursuant to Title XIX of the Social Security Act.
160          (2) (a) The department shall implement the Medicaid program through administrative
161     rules in conformity with this chapter, Title 63G, Chapter 3, Utah Administrative Rulemaking
162     Act, the requirements of Title XIX, and applicable federal regulations.
163          (b) The rules adopted under Subsection (2)(a) shall include, in addition to other rules
164     necessary to implement the program:
165          (i) the standards used by the department for determining eligibility for Medicaid
166     services;
167          (ii) the services and benefits to be covered by the Medicaid program;
168          (iii) reimbursement methodologies for providers under the Medicaid program; and
169          (iv) a requirement that:
170          (A) a person receiving Medicaid services shall participate in the electronic exchange of
171     clinical health records established in accordance with Section 26-1-37 unless the individual
172     opts out of participation;
173          (B) prior to enrollment in the electronic exchange of clinical health records the enrollee
174     shall receive notice of enrollment in the electronic exchange of clinical health records and the
175     right to opt out of participation at any time; and
176          (C) beginning July 1, 2012, when the program sends enrollment or renewal information
177     to the enrollee and when the enrollee logs onto the program's website, the enrollee shall receive
178     notice of the right to opt out of the electronic exchange of clinical health records.
179          (3) (a) The department shall, in accordance with Subsection (3)(b), report to the Social
180     Services Appropriations Subcommittee when the department:

181          (i) implements a change in the Medicaid State Plan;
182          (ii) initiates a new Medicaid waiver;
183          (iii) initiates an amendment to an existing Medicaid waiver;
184          (iv) applies for an extension of an application for a waiver or an existing Medicaid
185     waiver; or
186          (v) initiates a rate change that requires public notice under state or federal law.
187          (b) The report required by Subsection (3)(a) shall:
188          (i) be submitted to the Social Services Appropriations Subcommittee prior to the
189     department implementing the proposed change; and
190          (ii) include:
191          (A) a description of the department's current practice or policy that the department is
192     proposing to change;
193          (B) an explanation of why the department is proposing the change;
194          (C) the proposed change in services or reimbursement, including a description of the
195     effect of the change;
196          (D) the effect of an increase or decrease in services or benefits on individuals and
197     families;
198          (E) the degree to which any proposed cut may result in cost-shifting to more expensive
199     services in health or human service programs; and
200          (F) the fiscal impact of the proposed change, including:
201          (I) the effect of the proposed change on current or future appropriations from the
202     Legislature to the department;
203          (II) the effect the proposed change may have on federal matching dollars received by
204     the state Medicaid program;
205          (III) any cost shifting or cost savings within the department's budget that may result
206     from the proposed change; and
207          (IV) identification of the funds that will be used for the proposed change, including any
208     transfer of funds within the department's budget.
209          (4) Any rules adopted by the department under Subsection (2) are subject to review and
210     reauthorization by the Legislature in accordance with Section 63G-3-502.
211          (5) The department may, in its discretion, contract with the Department of Human

212     Services or other qualified agencies for services in connection with the administration of the
213     Medicaid program, including:
214          (a) the determination of the eligibility of individuals for the program;
215          (b) recovery of overpayments; and
216          (c) consistent with Section 26-20-13, and to the extent permitted by law and quality
217     control services, enforcement of fraud and abuse laws.
218          (6) The department shall provide, by rule, disciplinary measures and sanctions for
219     Medicaid providers who fail to comply with the rules and procedures of the program, provided
220     that sanctions imposed administratively may not extend beyond:
221          (a) termination from the program;
222          (b) recovery of claim reimbursements incorrectly paid; and
223          (c) those specified in Section 1919 of Title XIX of the federal Social Security Act.
224          (7) Funds collected as a result of a sanction imposed under Section 1919 of Title XIX
225     of the federal Social Security Act shall be deposited in the General Fund as dedicated credits to
226     be used by the division in accordance with the requirements of Section 1919 of Title XIX of
227     the federal Social Security Act.
228          (8) (a) In determining whether an applicant or recipient is eligible for a service or
229     benefit under this part or Chapter 40, Utah Children's Health Insurance Act, the department
230     shall, if Subsection (8)(b) is satisfied, exclude from consideration one passenger vehicle
231     designated by the applicant or recipient.
232          (b) Before Subsection (8)(a) may be applied:
233          (i) the federal government shall:
234          (A) determine that Subsection (8)(a) may be implemented within the state's existing
235     public assistance-related waivers as of January 1, 1999;
236          (B) extend a waiver to the state permitting the implementation of Subsection (8)(a); or
237          (C) determine that the state's waivers that permit dual eligibility determinations for
238     cash assistance and Medicaid are no longer valid; and
239          (ii) the department shall determine that Subsection (8)(a) can be implemented within
240     existing funding.
241          (9) (a) For purposes of this Subsection (9):
242          (i) "aged, blind, or has a disability" means an aged, blind, or disabled individual, as

243     defined in 42 U.S.C. Sec. 1382c(a)(1); and
244          (ii) "spend down" means an amount of income in excess of the allowable income
245     standard that shall be paid in cash to the department or incurred through the medical services
246     not paid by Medicaid.
247          (b) In determining whether an applicant or recipient who is aged, blind, or has a
248     disability is eligible for a service or benefit under this chapter, the department shall use 100%
249     of the federal poverty level as:
250          (i) the allowable income standard for eligibility for services or benefits; and
251          (ii) the allowable income standard for eligibility as a result of spend down.
252          (10) The department shall conduct internal audits of the Medicaid program.
253          [(11) In order to determine the feasibility of contracting for direct Medicaid providers
254     for primary care services, the department shall: (a) issue a request for information for direct
255     contracting for primary services that shall provide that a provider shall exclusively serve all
256     Medicaid clients:]
257          [(i) in a geographic area;]
258          [(ii) for a defined range of primary care services; and]
259          [(iii) for a predetermined total contracted amount; and]
260          [(b) by February 1, 2011, report to the Social Services Appropriations Subcommittee
261     on the response to the request for information under Subsection (11)(a).]
262          [(12) (a) By December 31, 2010, the department shall:]
263          [(i) determine the feasibility of implementing a three year patient-centered medical
264     home demonstration project in an area of the state using existing budget funds; and]
265          [(ii) report the department's findings and recommendations under Subsection (12)(a)(i)
266     to the Social Services Appropriations Subcommittee.]
267          [(b) If the department determines that the medical home demonstration project
268     described in Subsection (12)(a) is feasible, and the Social Services Appropriations
269     Subcommittee recommends that the demonstration project be implemented, the department
270     shall:]
271          [(i) implement the demonstration project; and]
272          [(ii) by December 1, 2012, make recommendations to the Social Services
273     Appropriations Subcommittee regarding the:]

274          [(A) continuation of the demonstration project;]
275          [(B) expansion of the demonstration project to other areas of the state; and]
276          [(C) cost savings incurred by the implementation of the demonstration project.]
277          [(13)] (12) (a) The department may apply for and, if approved, implement a
278     demonstration program for health opportunity accounts, as provided for in 42 U.S.C. Sec.
279     1396u-8.
280          (b) A health opportunity account established under Subsection [(13)] (12)(a) shall be
281     an alternative to the existing benefits received by an individual eligible to receive Medicaid
282     under this chapter.
283          (c) Subsection [(13)] (12)(a) is not intended to expand the coverage of the Medicaid
284     program.
285          Section 4. Section 26-18-405 is amended to read:
286          26-18-405. Waivers to maximize replacement of fee-for-service delivery model.
287          (1) The department shall develop a proposal to amend the state plan for the Medicaid
288     program in a way that maximizes replacement of the fee-for-service delivery model with one or
289     more risk-based delivery models.
290          (2) The proposal shall:
291          (a) restructure the program's provider payment provisions to reward health care
292     providers for delivering the most appropriate services at the lowest cost and in ways that,
293     compared to services delivered before implementation of the proposal, maintain or improve
294     recipient health status;
295          (b) restructure the program's cost sharing provisions and other incentives to reward
296     recipients for personal efforts to:
297          (i) maintain or improve their health status; and
298          (ii) use providers that deliver the most appropriate services at the lowest cost;
299          (c) identify the evidence-based practices and measures, risk adjustment methodologies,
300     payment systems, funding sources, and other mechanisms necessary to reward providers for
301     delivering the most appropriate services at the lowest cost, including mechanisms that:
302          (i) pay providers for packages of services delivered over entire episodes of illness
303     rather than for individual services delivered during each patient encounter; and
304          (ii) reward providers for delivering services that make the most positive contribution to

305     a recipient's health status;
306          (d) limit total annual per-patient-per-month expenditures for services delivered through
307     fee-for-service arrangements to total annual per-patient-per-month expenditures for services
308     delivered through risk-based arrangements covering similar recipient populations and services;
309     and
310          (e) limit the rate of growth in per-patient-per-month General Fund expenditures for the
311     program to the rate of growth in General Fund expenditures for all other programs, when the
312     rate of growth in the General Fund expenditures for all other programs is greater than zero.
313          (3) To the extent possible, the department shall develop the proposal with the input of
314     stakeholder groups representing those who will be affected by the proposal.
315          [(4) No later than June 1, 2011, the department shall submit a written report on the
316     development of the proposal to the Legislature's Executive Appropriations Committee, Social
317     Services Appropriations Subcommittee, and Health and Human Services Interim Committee.]
318          [(5)] (4) No later than July 1, 2011, the department shall submit to the Centers for
319     Medicare and Medicaid Services within the United States Department of Health and Human
320     Services a request for waivers from federal statutory and regulatory law necessary to implement
321     the proposal.
322          [(6)] (5) After the request for waivers has been made, and prior to its implementation,
323     the department shall report to the Legislature in accordance with Section 26-18-3 on any
324     modifications to the request proposed by the department or made by the Centers for Medicare
325     and Medicaid Services.
326          [(7)] (6) The department shall implement the proposal in the fiscal year that follows the
327     fiscal year in which the United States Secretary of Health and Human Services approves the
328     request for waivers.
329          Section 5. Section 26-50-202 is amended to read:
330          26-50-202. Traumatic Brain Injury Advisory Committee -- Membership -- Time
331     limit.
332          (1) On or after July 1 of each year, the executive director may create a Traumatic Brain
333     Injury Advisory Committee of not more than nine members.
334          (2) The committee shall be composed of members of the community who are familiar
335     with traumatic brain injury, its causes, diagnosis, treatment, rehabilitation, and support

336     services, including:
337          (a) persons with a traumatic brain injury;
338          (b) family members of a person with a traumatic brain injury;
339          (c) representatives of an association which advocates for persons with traumatic brain
340     injuries;
341          (d) specialists in a profession that works with brain injury patients; and
342          (e) department representatives.
343          (3) The department shall provide staff support to the committee.
344          (4) (a) If a vacancy occurs in the committee membership for any reason, a replacement
345     may be appointed for the unexpired term.
346          (b) The committee shall elect a chairperson from the membership.
347          (c) A majority of the committee constitutes a quorum at any meeting, and, if a quorum
348     exists, the action of the majority of members present shall be the action of the committee.
349          (d) The committee may adopt bylaws governing the committee's activities.
350          (e) A committee member may be removed by the executive director:
351          (i) if the member is unable or unwilling to carry out the member's assigned
352     responsibilities; or
353          (ii) for good cause.
354          (5) The committee shall comply with the procedures and requirements of:
355          (a) Title 52, Chapter 4, Open and Public Meetings Act; and
356          (b) Title 63G, Chapter 2, Government Records Access and Management Act.
357          (6) A member may not receive compensation or benefits for the member's service, but,
358     at the executive director's discretion, may receive per diem and travel expenses in accordance
359     with:
360          (a) Section 63A-3-106;
361          (b) Section 63A-3-107; and
362          (c) rules made by the Division of Finance pursuant to Sections 63A-3-106 and
363     63A-3-107.
364          (7) Not later than November 30 of each year the committee shall provide a written
365     report summarizing the activities of the committee to:
366          (a) the executive director of the department; and

367          [(b) the Health and Human Services Interim Committee; and]
368          [(c)] (b) the Social Services Appropriations Subcommittee.
369          (8) The committee shall cease to exist on December 31 of each year, unless the
370     executive director determines it necessary to continue.
371          Section 6. Section 26-52-202 is amended to read:
372          26-52-202. Autism Treatment Account Advisory Committee -- Membership --
373     Time limit.
374          (1) (a) There is created an Autism Treatment Account Advisory Committee consisting
375     of six members appointed by the governor to two-year terms of office as follows:
376          (i) one individual holding a doctorate degree who has experience in treating persons
377     with an autism spectrum disorder;
378          (ii) one board certified behavior analyst;
379          (iii) one physician licensed under Title 58, Chapter 67, Utah Medical Practice Act, or
380     Title 58, Chapter 68, Utah Osteopathic Medical Practice Act, who has completed a residency
381     program in pediatrics;
382          (iv) one employee of the Department of Health; and
383          (v) two individuals who are familiar with autism spectrum disorders and their effects,
384     diagnosis, treatment, rehabilitation, and support needs, including:
385          (A) family members of a person with an autism spectrum disorder;
386          (B) representatives of an association which advocates for persons with an autism
387     spectrum disorder; and
388          (C) specialists or professionals who work with persons with autism spectrum disorders.
389          (b) Notwithstanding the requirements of Subsection (1)(a), the governor shall, at the
390     time of appointment or reappointment, adjust the length of terms to ensure that the terms of
391     committee members are staggered so that approximately half of the committee is appointed
392     every year.
393          (c) If a vacancy occurs in the committee membership for any reason, the governor may
394     appoint a replacement for the unexpired term.
395          (2) The department shall provide staff support to the committee.
396          (3) (a) The committee shall elect a chair from the membership on an annual basis.
397          (b) A majority of the committee constitutes a quorum at any meeting, and, if a quorum

398     exists, the action of the majority of members present shall be the action of the committee.
399          (c) The executive director may remove a committee member:
400          (i) if the member is unable or unwilling to carry out the member's assigned
401     responsibilities; or
402          (ii) for good cause.
403          (4) The committee shall, in accordance with Title 63G, Chapter 3, Utah Administrative
404     Rulemaking Act, make rules governing the committee's activities that comply with the
405     requirements of this title, including rules that:
406          (a) establish criteria and procedures for selecting qualified children to participate in the
407     program;
408          (b) establish the services, providers, and treatments to include in the program, and the
409     qualifications, criteria, and procedures for evaluating the providers and treatments; and
410          (c) address and avoid conflicts of interest that may arise in relation to the committee
411     and its duties.
412          (5) As part of its duties under Subsection 26-52-201(5), the committee shall, at
413     minimum:
414          (a) offer applied behavior analysis provided by or supervised by a board certified
415     behavior analyst or a licensed psychologist with equivalent university training and supervised
416     experience;
417          (b) collaborate with existing telehealth networks to reach children in rural and
418     under-served areas of the state; and
419          (c) engage family members in the treatment process.
420          (6) The committee shall meet as necessary to carry out its duties and shall meet upon a
421     call of the committee chair or a call of a majority of the committee members.
422          (7) The committee shall comply with the procedures and requirements of:
423          (a) Title 52, Chapter 4, Open and Public Meetings Act; and
424          (b) Title 63G, Chapter 2, Government Records Access and Management Act.
425          (8) Committee members may not receive compensation or per diem allowance for their
426     services.
427          (9) Not later than November 30 of each year, the committee shall provide a written
428     report summarizing the activities of the committee to[: (a)] the executive director of the

429     department[;].
430          [(b) the Legislature's Health and Human Services Interim Committee; and]
431          [(c) the Legislature's Social Services Appropriations Subcommittee.]
432          (10) The report under Subsection (9) shall include:
433          (a) the number of children diagnosed with autism spectrum disorder who are receiving
434     services under this chapter;
435          (b) the types of services provided to qualified children under this chapter; and
436          (c) results of any evaluations on the effectiveness of treatments and services provided
437     under this chapter.
438          Section 7. Section 59-14-204 is amended to read:
439          59-14-204. Tax basis -- Rate -- Future increase -- Cigarette Tax Restricted
440     Account -- Appropriation and expenditure of revenues.
441          (1) Except for cigarettes described under Subsection 59-14-210(3), there is levied a tax
442     upon the sale, use, storage, or distribution of cigarettes in the state.
443          (2) The rates of the tax levied under Subsection (1) are, beginning on July 1, 2010:
444          (a) 8.5 cents on each cigarette, for all cigarettes weighing not more than three pounds
445     per thousand cigarettes; and
446          (b) 9.963 cents on each cigarette, for all cigarettes weighing in excess of three pounds
447     per thousand cigarettes.
448          (3) Except as otherwise provided under this chapter, the tax levied under Subsection
449     (1) shall be paid by any person who is the manufacturer, jobber, importer, distributor,
450     wholesaler, retailer, user, or consumer.
451          (4) The tax rates specified in this section shall be increased by the commission by the
452     same amount as any future reduction in the federal excise tax on cigarettes.
453          (5) (a) There is created within the General Fund a restricted account known as the
454     "Cigarette Tax Restricted Account."
455          (b) The Cigarette Tax Restricted Account consists of:
456          (i) the first $7,950,000 of the revenues collected from a tax under this section; and
457          (ii) any other appropriations the Legislature makes to the Cigarette Tax Restricted
458     Account.
459          (c) For each fiscal year beginning with fiscal year 2011-12 and subject to appropriation

460     by the Legislature, the Division of Finance shall distribute money from the Cigarette Tax
461     Restricted Account as follows:
462          (i) $250,000 to the Department of Health to be expended for a tobacco prevention and
463     control media campaign targeted towards children;
464          (ii) $2,900,000 to the Department of Health to be expended for tobacco prevention,
465     reduction, cessation, and control programs;
466          (iii) $2,000,000 to the University of Utah Health Sciences Center for the Huntsman
467     Cancer Institute to be expended for cancer research; and
468          (iv) $2,800,000 to the University of Utah Health Sciences Center to be expended for
469     medical education at the University of Utah School of Medicine.
470          (d) In determining how to appropriate revenue deposited into the Cigarette Tax
471     Restricted Account that is not otherwise appropriated under Subsection (5)(c), the Legislature
472     shall give particular consideration to enhancing Medicaid provider reimbursement rates and
473     medical coverage for the uninsured.
474          [(e) Any program or entity that receives funding under Subsection (5)(c) shall provide
475     an annual report to the Health and Human Services Interim Committee no later that September
476     1 of each year. The report shall include:]
477          [(i) the amount funded;]
478          [(ii) the amount expended;]
479          [(iii) a description of the effectiveness of the program; and]
480          [(iv) if the program is a tobacco cessation program, the report required in Section
481     51-9-203.]
482          Section 8. Section 62A-1-119 is amended to read:
483          62A-1-119. Respite Care Assistance Fund -- Use of money -- Restrictions --
484     Annual report.
485          (1) There is created an expendable special revenue fund known as the Respite Care
486     Assistance Fund.
487          (2) The fund shall consist of:
488          (a) gifts, grants, devises, donations, and bequests of real property, personal property, or
489     services, from any source, made to the fund; and
490          (b) any additional amounts as appropriated by the Legislature.

491          (3) The fund shall be administered by the director of the Utah Developmental
492     Disabilities Council.
493          (4) The fund money shall be used for the following activities:
494          (a) to support a respite care information and referral system;
495          (b) to educate and train caregivers and respite care providers; and
496          (c) to provide grants to caregivers.
497          (5) An individual who receives services paid for from the fund shall:
498          (a) be a resident of Utah; and
499          (b) be a primary care giver for:
500          (i) an aging individual; or
501          (ii) an individual with a cognitive, mental, or physical disability.
502          (6) The fund money may not be used for:
503          (a) administrative expenses that are normally provided for by legislative appropriation;
504     or
505          (b) direct services or support mechanisms that are available from or provided by
506     another government or private agency.
507          (7) All interest and other earnings derived from the fund money shall be deposited into
508     the fund.
509          (8) The state treasurer shall invest the money in the fund under Title 51, Chapter 7,
510     State Money Management Act.
511          [(9) The Department of Human Services shall make an annual report to the appropriate
512     appropriations subcommittee of the Legislature regarding the status of the fund, including a
513     report on the contributions received, expenditures made, and programs and services funded.]
514          Section 9. Section 62A-4a-401 is amended to read:
515          62A-4a-401. Legislative purpose -- Report and study items.
516          [(1)] It is the purpose of this part to protect the best interests of children, offer
517     protective services to prevent harm to children, stabilize the home environment, preserve
518     family life whenever possible, and encourage cooperation among the states in dealing with the
519     problem of abuse or neglect.
520          [(2) The division shall, during the 2013 interim, report to the Health and Human
521     Services Interim Committee on:]

522          [(a) the division's efforts to use existing staff and funds while shifting resources away
523     from foster care and to in-home services;]
524          [(b) a proposal to:]
525          [(i) keep sibling groups together, as much as possible; and]
526          [(ii) provide necessary services to available structured foster families to avoid sending
527     foster children to proctor homes;]
528          [(c) the disparity between foster care payments and adoption subsidies, and whether an
529     adjustment to those rates could result in savings to the state; and]
530          [(d) the utilization of guardianship, in the event an appropriate adoptive placement is
531     not available after a termination of parental rights.]
532          [(3) The Health and Human Services Interim Committee shall, during the 2013 interim,
533     study whether statewide practice standards should be implemented to assist the Child Welfare
534     Parental Defense Program with its mission to provide legal services to indigent parents whose
535     children are in the custody of the division.]
536          Section 10. Section 62A-15-1101 is amended to read:
537          62A-15-1101. Suicide prevention -- Reporting requirements.
538          (1) As used in the section:
539          (a) "Bureau" means the Bureau of Criminal Identification created in Section 53-10-201
540     within the Department of Public Safety.
541          (b) "Division" means the Division of Substance Abuse and Mental Health.
542          (c) "Intervention" means an effort to prevent a person from attempting suicide.
543          (d) "Postvention" means mental health intervention after a suicide attempt or death to
544     prevent or contain contagion.
545          (e) "State suicide prevention coordinator" means an individual designated by the
546     division as described in Subsections (2) and (3).
547          (2) The division shall appoint a state suicide prevention coordinator to administer a
548     state suicide prevention program composed of suicide prevention, intervention, and postvention
549     programs, services, and efforts.
550          (3) The state suicide prevention program may include the following components:
551          (a) delivery of resources, tools, and training to community-based coalitions;
552          (b) evidence-based suicide risk assessment tools and training;

553          (c) town hall meetings for building community-based suicide prevention strategies;
554          (d) suicide prevention gatekeeper training;
555          (e) training to identify warning signs and to manage an at-risk individual's crisis;
556          (f) evidence-based intervention training;
557          (g) intervention skills training; and
558          (h) postvention training.
559          (4) The state suicide prevention coordinator shall coordinate with at least the
560     following:
561          (a) local mental health and substance abuse authorities;
562          (b) the State Board of Education, including the State Office of Education suicide
563     prevention coordinator described in Section 53A-15-1301;
564          (c) the Department of Health;
565          (d) health care providers, including emergency rooms; and
566          (e) other public health suicide prevention efforts.
567          (5) The state suicide prevention coordinator shall provide a written report[, and shall
568     orally report] to the Health and Human Services Interim Committee[,] by the October meeting
569     every year, on:
570          (a) implementation of the state suicide prevention program, as described in Subsections
571     (2) and (3);
572          (b) data measuring the effectiveness of each component of the state suicide prevention
573     program;
574          (c) funds appropriated for each component of the state suicide prevention program; and
575          (d) five-year trends of suicides in Utah, including subgroups of youths and adults and
576     other subgroups identified by the state suicide prevention coordinator.
577          (6) The state suicide prevention coordinator shall report to the Legislature's Education
578     Interim Committee, by the October 2015 meeting, jointly with the State Board of Education, on
579     the coordination of suicide prevention programs and efforts with the State Board of Education
580     and the State Office of Education suicide prevention coordinator as described in Section
581     53A-15-1301.
582          (7) The state suicide prevention coordinator shall consult with the bureau to implement
583     and manage the operation of a firearm safety program, as described in Subsection

584     53-10-202(18) and Section 53-10-202.1.
585          (8) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, the
586     division shall make rules governing the implementation of the state suicide prevention
587     program, consistent with this section.