1     
MENTAL HEALTH CRISIS LINE AMENDMENTS

2     
2018 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Steve Eliason

5     
Senate Sponsor: Daniel W. Thatcher

6     Cosponsors:
7     Cheryl K. Acton
8     Carl R. Albrecht
9     Patrice M. Arent
10     Stewart E. Barlow
11     Kay J. Christofferson
12     Susan Duckworth
13     Justin L. Fawson
14     Gage Froerer
15     Stephen G. Handy
Sandra Hollins
Eric K. Hutchings
Brian S. King
Carol Spackman Moss
Derrin R. Owens
Jeremy A. Peterson
Val K. Potter
Paul Ray
Edward H. Redd
Adam Robertson
Robert M. Spendlove
Norman K. Thurston
R. Curt Webb
Elizabeth Weight
John R. Westwood
Mark A. Wheatley
Mike Winder

16     

17     LONG TITLE
18     General Description:
19          This bill addresses the operation of the statewide mental health crisis line and local
20     mental health crisis lines.
21     Highlighted Provisions:
22          This bill:
23          ▸     defines terms;
24          ▸     directs the Division of Substance Abuse and Mental Health (division) to enter into
25     or modify contracts to provide the statewide mental health crisis line;
26          ▸     requires the division to ensure that the statewide mental health crisis line meets
27     certain staffing and operational standards;
28          ▸     requires local mental health authorities to ensure that local mental health crisis lines
29     meet certain staffing and operational standards;
30          ▸     requires local mental health authorities and the division to ensure that calls may be
31     transferred from local mental health crisis lines to the statewide mental health crisis
32     line to ensure a timely and effective response to calls;
33          ▸     amends the duties of the Mental Health Crisis Line Commission; and
34          ▸     makes technical and conforming changes.
35     Money Appropriated in this Bill:
36          None
37     Other Special Clauses:
38          None
39     Utah Code Sections Affected:
40     AMENDS:
41          17-43-301, as last amended by Laws of Utah 2016, Chapter 113
42          17-43-305, as last amended by Laws of Utah 2016, Chapter 113
43          63C-18-203, as enacted by Laws of Utah 2017, Chapter 23
44     ENACTS:
45          62A-15-1301, Utah Code Annotated 1953
46          62A-15-1302, Utah Code Annotated 1953
47          62A-15-1303, Utah Code Annotated 1953
48     

49     Be it enacted by the Legislature of the state of Utah:
50          Section 1. Section 17-43-301 is amended to read:
51          17-43-301. Local mental health authorities -- Responsibilities.
52          (1) As used in this section:
53          (a) "Crisis worker" means the same as that term is defined in Section 62A-15-1301.
54          (b) "Local mental health crisis line" means the same as that term is defined in Section
55     63C-18-102.
56          (c) "Mental health therapist" means the same as that term is defined in Section
57     58-60-102.
58          (d) "Public funds" means the same as that term is defined in Section 17-43-303.
59          (e) "Statewide mental health crisis line" means the same as that term is defined in
60     Section 63C-18-102.
61          [(1)] (2) (a) (i) In each county operating under a county executive-council form of
62     government under Section 17-52-504, the county legislative body is the local mental health
63     authority, provided however that any contract for plan services shall be administered by the
64     county executive.
65          (ii) In each county operating under a council-manager form of government under
66     Section 17-52-505, the county manager is the local mental health authority.
67          (iii) In each county other than a county described in Subsection [(1)] (2)(a)(i) or (ii),
68     the county legislative body is the local mental health authority.
69          (b) Within legislative appropriations and county matching funds required by this
70     section, under the direction of the division, each local mental health authority shall:
71          (i) provide mental health services to persons within the county; and
72          (ii) cooperate with efforts of the Division of Substance Abuse and Mental Health to
73     promote integrated programs that address an individual's substance abuse, mental health, and
74     physical healthcare needs, as described in Section 62A-15-103.
75          (c) Within legislative appropriations and county matching funds required by this
76     section, each local mental health authority shall cooperate with the efforts of the Department of
77     Human Services to promote a system of care, as defined in Section 62A-1-104, for minors with
78     or at risk for complex emotional and behavioral needs, as described in Section 62A-1-111.
79          [(2)] (3) (a) By executing an interlocal agreement under Title 11, Chapter 13, Interlocal
80     Cooperation Act, two or more counties may join to:
81          (i) provide mental health prevention and treatment services; or
82          (ii) create a united local health department that combines substance abuse treatment
83     services, mental health services, and local health department services in accordance with
84     Subsection [(3)] (4).
85          (b) The legislative bodies of counties joining to provide services may establish
86     acceptable ways of apportioning the cost of mental health services.
87          (c) Each agreement for joint mental health services shall:
88          (i) (A) designate the treasurer of one of the participating counties or another person as
89     the treasurer for the combined mental health authorities and as the custodian of money
90     available for the joint services; and
91          (B) provide that the designated treasurer, or other disbursing officer authorized by the
92     treasurer, may make payments from the money available for the joint services upon audit of the
93     appropriate auditing officer or officers representing the participating counties;
94          (ii) provide for the appointment of an independent auditor or a county auditor of one of
95     the participating counties as the designated auditing officer for the combined mental health
96     authorities;
97          (iii) (A) provide for the appointment of the county or district attorney of one of the
98     participating counties as the designated legal officer for the combined mental health
99     authorities; and
100          (B) authorize the designated legal officer to request and receive the assistance of the
101     county or district attorneys of the other participating counties in defending or prosecuting
102     actions within their counties relating to the combined mental health authorities; and
103          (iv) provide for the adoption of management, clinical, financial, procurement,
104     personnel, and administrative policies as already established by one of the participating
105     counties or as approved by the legislative body of each participating county or interlocal board.
106          (d) An agreement for joint mental health services may provide for:
107          (i) joint operation of services and facilities or for operation of services and facilities
108     under contract by one participating local mental health authority for other participating local
109     mental health authorities; and
110          (ii) allocation of appointments of members of the mental health advisory council
111     between or among participating counties.
112          [(3)] (4) A county governing body may elect to combine the local mental health
113     authority with the local substance abuse authority created in Part 2, Local Substance Abuse
114     Authorities, and the local health department created in Title 26A, Chapter 1, Part 1, Local
115     Health Department Act, to create a united local health department under Section 26A-1-105.5.
116     A local mental health authority that joins with a united local health department shall comply
117     with this part.
118          [(4)] (5) (a) Each local mental health authority is accountable to the department, the
119     Department of Health, and the state with regard to the use of state and federal funds received
120     from those departments for mental health services, regardless of whether the services are
121     provided by a private contract provider.
122          (b) Each local mental health authority shall comply, and require compliance by its
123     contract provider, with all directives issued by the department and the Department of Health
124     regarding the use and expenditure of state and federal funds received from those departments
125     for the purpose of providing mental health programs and services. The department and
126     Department of Health shall ensure that those directives are not duplicative or conflicting, and
127     shall consult and coordinate with local mental health authorities with regard to programs and
128     services.
129          [(5)] (6) (a) Each local mental health authority shall:
130          (i) review and evaluate mental health needs and services, including mental health needs
131     and services for persons incarcerated in a county jail or other county correctional facility;
132          (ii) [as provided] in accordance with Subsection [(5)] (6)(b), annually prepare and
133     submit to the division a plan approved by the county legislative body for mental health funding
134     and service delivery, either directly by the local mental health authority or by contract;
135          (iii) establish and maintain, either directly or by contract, programs licensed under Title
136     62A, Chapter 2, Licensure of Programs and Facilities;
137          (iv) appoint, directly or by contract, a full-time or part-time director for mental health
138     programs and prescribe the director's duties;
139          (v) provide input and comment on new and revised rules established by the division;
140          (vi) establish and require contract providers to establish administrative, clinical,
141     personnel, financial, procurement, and management policies regarding mental health services
142     and facilities, in accordance with the rules of the division, and state and federal law;
143          (vii) establish mechanisms allowing for direct citizen input;
144          (viii) annually contract with the division to provide mental health programs and
145     services in accordance with the provisions of Title 62A, Chapter 15, Substance Abuse and
146     Mental Health Act;
147          (ix) comply with all applicable state and federal statutes, policies, audit requirements,
148     contract requirements, and any directives resulting from those audits and contract requirements;
149          (x) provide funding equal to at least 20% of the state funds that it receives to fund
150     services described in the plan;
151          (xi) comply with the requirements and procedures of Title 11, Chapter 13, Interlocal
152     Cooperation Act, Title 17B, Chapter 1, Part 6, Fiscal Procedures for Local Districts, and Title
153     51, Chapter 2a, Accounting Reports from Political Subdivisions, Interlocal Organizations, and
154     Other Local Entities Act; and
155          (xii) take and retain physical custody of minors committed to the physical custody of
156     local mental health authorities by a judicial proceeding under Title 62A, Chapter 15, Part 7,
157     Commitment of Persons Under Age 18 to Division of Substance Abuse and Mental Health.
158          (b) Each plan under Subsection [(5)] (6)(a)(ii) shall include services for adults, youth,
159     and children, which shall include:
160          (i) inpatient care and services;
161          (ii) residential care and services;
162          (iii) outpatient care and services;
163          (iv) 24-hour crisis care and services;
164          (v) psychotropic medication management;
165          (vi) psychosocial rehabilitation, including vocational training and skills development;
166          (vii) case management;
167          (viii) community supports, including in-home services, housing, family support
168     services, and respite services;
169          (ix) consultation and education services, including case consultation, collaboration
170     with other county service agencies, public education, and public information; and
171          (x) services to persons incarcerated in a county jail or other county correctional facility.
172          (7) (a) If a local mental health authority provides for a local mental health crisis line
173     under the plan for 24-hour crisis care and services described in Subsection (6)(b)(iv), the local
174     mental health authority shall:
175          (i) collaborate with the statewide mental health crisis line described in Section
176     62A-15-1302;
177          (ii) ensure that each individual who answers calls to the local mental health crisis line:
178          (A) is a mental health therapist or a crisis worker; and
179          (B) meets the standards of care and practice established by the Division of Substance
180     Abuse and Mental Health, in accordance with Section 62A-15-1302; and
181          (iii) ensure that when necessary, based on the local mental health crisis line's capacity,
182     calls are immediately routed to the statewide mental health crisis line to ensure that when an
183     individual calls the local mental health crisis line, regardless of the time, date, or number of
184     individuals trying to simultaneously access the local mental health crisis line, a mental health
185     therapist or a crisis worker answers the call without the caller first:
186          (A) waiting on hold; or
187          (B) being screened by an individual other than a mental health therapist or crisis
188     worker.
189          (b) If a local mental health authority does not provide for a local mental health crisis
190     line under the plan for 24-hour crisis care and services described in Subsection (6)(b)(iv), the
191     local mental health authority shall use the statewide mental health crisis line as a local crisis
192     line resource.
193          [(6)] (8) Before disbursing any public funds, each local mental health authority shall
194     require that each entity that receives any public funds from a local mental health authority
195     agrees in writing that:
196          (a) the entity's financial records and other records relevant to the entity's performance
197     of the services provided to the mental health authority shall be subject to examination by:
198          (i) the division;
199          (ii) the local mental health authority director;
200          (iii) (A) the county treasurer and county or district attorney; or
201          (B) if two or more counties jointly provide mental health services under an agreement
202     under Subsection [(2)] (3), the designated treasurer and the designated legal officer;
203          (iv) the county legislative body; and
204          (v) in a county with a county executive that is separate from the county legislative
205     body, the county executive;
206          (b) the county auditor may examine and audit the entity's financial and other records
207     relevant to the entity's performance of the services provided to the local mental health
208     authority; and
209          (c) the entity will comply with the provisions of Subsection [(4)] (5)(b).
210          [(7)] (9) A local mental health authority may receive property, grants, gifts, supplies,
211     materials, contributions, and any benefit derived therefrom, for mental health services. If those
212     gifts are conditioned upon their use for a specified service or program, they shall be so used.
213          [(8) (a) As used in this section, "public funds" means the same as that term is defined
214     in Section 17-43-303.]
215          [(b)] (10) Public funds received for the provision of services pursuant to the local
216     mental health plan may not be used for any other purpose except those authorized in the
217     contract between the local mental health authority and the provider for the provision of plan
218     services.
219          Section 2. Section 17-43-305 is amended to read:
220          17-43-305. Responsibility for cost of services provided by local mental health
221     authority.
222          If a local mental health authority, through its designated provider, provides any service
223     described in Subsection [17-43-301(5)] 17-43-301(6)(b) to a person who resides within the
224     jurisdiction of another local mental health authority, the local mental health authority in whose
225     jurisdiction the person resides is responsible for the cost of that service if its designated
226     provider has authorized the provision of that service.
227          Section 3. Section 62A-15-1301 is enacted to read:
228     
Part 13. Statewide Mental Health Crisis Line

229          62A-15-1301. Definitions.
230          As used in this part:
231          (1) "Commission" means the Mental Health Crisis Line Commission created in Section
232     63C-18-202.
233          (2) "Crisis worker" means an individual who:
234          (a) meets the standards of qualification or certification that the division sets, in
235     accordance with Section 62A-15-1302; and
236          (b) staffs the statewide mental health crisis line or a local mental health crisis line
237     under the supervision of at least one mental health therapist.
238          (3) "Local mental health crisis line" means the same as that term is defined in Section
239     63C-18-102.
240          (4) "Mental health therapist" means the same as that term is defined in Section
241     58-60-102.
242          (5) "Statewide mental health crisis line" means the same as that term is defined in
243     Section 63C-18-102.
244          Section 4. Section 62A-15-1302 is enacted to read:
245          62A-15-1302. Contracts for statewide mental health crisis line -- Crisis worker
246     qualification or certification.
247          (1) (a) The division shall enter into a new contract or modify an existing contract to
248     manage and operate the statewide mental health crisis line, in accordance with this part, and to
249     encourage collaboration with local mental health crisis lines.
250          (b) Through the contract described in Subsection (1)(a) and in consultation with the
251     commission, the division shall set standards of care and practice for the mental health
252     therapists and crisis workers who staff the statewide mental health crisis line.
253          (2) (a) The division shall establish training and minimum standards for the
254     qualification or certification of crisis workers who staff the statewide mental health crisis line
255     and local mental health crisis lines.
256          (b) The division may make rules, in accordance with Title 63G, Chapter 3, Utah
257     Administrative Rulemaking Act, necessary to establish the training and minimum standards
258     described in Subsection (2)(a).
259          Section 5. Section 62A-15-1303 is enacted to read:
260          62A-15-1303. Statewide mental health crisis line operational standards.
261          In consultation with the commission, the division shall ensure that:
262          (1) the following individuals are available to staff and answer calls to the statewide
263     mental health crisis line 24 hours per day, 365 days per calendar year:
264          (a) mental health therapists; or
265          (b) crisis workers;
266          (2) a sufficient amount of staff is available to ensure that when an individual calls the
267     statewide mental health crisis line, regardless of the time, date, or number of individuals trying
268     to simultaneously access the statewide mental health crisis line, an individual described in
269     Subsection (1) answers the call without the caller first:
270          (a) waiting on hold; or
271          (b) being screened by an individual other than a mental health therapist or crisis
272     worker; and
273          (3) the statewide mental health crisis line has capacity to accept all calls that local
274     mental health crisis lines route to the statewide mental health crisis line.
275          Section 6. Section 63C-18-203 is amended to read:
276          63C-18-203. Commission duties -- Reporting requirements.
277          (1) (a) The commission shall:
278          (i) identify a method to integrate existing local mental health crisis lines to ensure each
279     individual who accesses a local mental health crisis line is connected to a qualified mental or
280     behavioral health professional, regardless of the time, date, or number of individuals trying to
281     simultaneously access the local mental health crisis line;
282          (ii) study how to establish and implement a statewide mental health crisis line,
283     including identifying:
284          (A) a statewide phone number or other means for an individual to easily access the
285     statewide mental health crisis line, including a short code for text messaging and an N11
286     number for calls;
287          (B) a supply of qualified mental or behavioral health professionals to staff the
288     statewide mental health crisis line; and
289          (C) a funding mechanism to operate and maintain the statewide mental health crisis
290     line; and
291          (iii) coordinate with local mental health authorities in fulfilling the commission's duties
292     described in Subsections (1)(a)(i) and (ii).
293          (b) The commission may conduct other business related to the commission's duties
294     described in Subsection (1)(a).
295          [(2) Before November 30, 2017, the commission shall report to the Political
296     Subdivisions Interim Committee regarding:]
297          [(a) the extent to which the commission fulfilled the commission's duties described in
298     Subsection (1); and]
299          [(b) recommendations for future legislation related to integrating local mental health
300     crisis lines or establishing a statewide mental health crisis line.]
301          (2) The commission shall consult with the Division of Substance Abuse and Mental
302     Health regarding the standards and operation of the statewide mental health crisis line, in
303     accordance with Title 62A, Chapter 15, Part 13, Statewide Mental Health Crisis Line.