1     
DIVISION OF SUBSTANCE ABUSE AND MENTAL HEALTH

2     
AMENDMENTS

3     
2018 GENERAL SESSION

4     
STATE OF UTAH

5     
Chief Sponsor: Kelly B. Miles

6     
Senate Sponsor: ____________

7     

8     LONG TITLE
9     General Description:
10          This bill requires that the expenditure of state funds on substance use disorder or mental
11     health treatment or programming be limited to evidence-based treatment or
12     programming.
13     Highlighted Provisions:
14          This bill:
15          ▸     amends and defines terms;
16          ▸     requires the local substance abuse authorities and the mental health authorities to
17     identify in their state plans which programs and treatments are evidence-based;
18          ▸     establishes requirements for an evidence-based treatment program;
19          ▸     requires the division, the local substance abuse authorities, and the local mental
20     health authorities to incrementally increase the percentage of evidence-based
21     treatment programming;
22          ▸     requires that certain training be for the provision of evidence-based treatment
23     programs;
24          ▸     specifies the allocation of certain future appropriations through fiscal year 2025;
25          ▸     creates the Outcome Improvement Advisory Board; and
26          ▸     makes technical changes.
27     Money Appropriated in this Bill:
28          None
29     Other Special Clauses:
30          None
31     Utah Code Sections Affected:
32     AMENDS:
33          17-43-102, as last amended by Laws of Utah 2009, Chapter 75
34          17-43-201, as last amended by Laws of Utah 2016, Chapter 113
35          17-43-203, as last amended by Laws of Utah 2004, Chapter 80
36          17-43-301, as last amended by Laws of Utah 2016, Chapter 113
37          17-43-303, as last amended by Laws of Utah 2004, Chapter 80
38          62A-15-102, as last amended by Laws of Utah 2015, Chapter 412
39          62A-15-103, as last amended by Laws of Utah 2017, Chapter 163
40          63I-1-262, as last amended by Laws of Utah 2017, Chapter 459
41     ENACTS:
42          62A-15-114, Utah Code Annotated 1953
43          62A-15-115, Utah Code Annotated 1953
44     

45     Be it enacted by the Legislature of the state of Utah:
46          Section 1. Section 17-43-102 is amended to read:
47          17-43-102. Definitions.
48          As used in this chapter:
49          (1) "Department" means the Department of Human Services created in Section
50     62A-1-102.
51          (2) "Division" means the Division of Substance Abuse and Mental Health created
52     within the Department of Human Services in Section 62A-1-105.
53          (3) "Evidence-based" means that a treatment program:
54          (a) is based upon a written manual or protocol that specifies the nature of the services,
55     the quality of the service, the target population, and the amount of service that constitutes the
56     program; and
57          (b) is supported by scientific research that:
58          (i) demonstrated through two or more client samples of the target population that the
59     program improves client outcome central to the purpose of the program; and
60          (ii) evaluated the effect of the program through randomized control trials or
61     quasi-experimental studies.
62          Section 2. Section 17-43-201 is amended to read:
63          17-43-201. Local substance abuse authorities -- Responsibilities.
64          (1) (a) (i) In each county operating under a county executive-council form of
65     government under Section 17-52-504, the county legislative body is the local substance abuse
66     authority, provided however that any contract for plan services shall be administered by the
67     county executive.
68          (ii) In each county operating under a council-manager form of government under
69     Section 17-52-505, the county manager is the local substance abuse authority.
70          (iii) In each county other than a county described in Subsection (1)(a)(i) or (ii), the
71     county legislative body is the local substance abuse authority.
72          (b) Within [legislative] legislative appropriations and county matching funds required
73     by this section, and under the direction of the division, each local substance abuse authority
74     shall:
75          (i) develop substance [abuse] use disorder prevention and treatment services plans;
76          (ii) provide substance [abuse] use disorder services to residents of the county; [and]
77          (iii) cooperate with efforts of the Division of Substance Abuse and Mental Health to
78     promote integrated programs that address an individual's substance [abuse] use disorder,
79     mental health, and physical health care needs, as described in Section 62A-15-103[.]; and
80          (iv) promote evidence-based treatment programming.
81          (c) Within [legislative] legislative appropriations and county matching funds required
82     by this section, each local substance abuse authority shall cooperate with the efforts of the
83     [Department of Human Services] department to promote a system of care, as defined in Section
84     62A-1-104, for minors with or at risk for complex emotional and behavioral needs, as
85     described in Section 62A-1-111.
86          (2) (a) By executing an interlocal agreement under Title 11, Chapter 13, Interlocal
87     Cooperation Act, two or more counties may join to:
88          (i) provide substance [abuse] use disorder prevention and treatment services; or
89          (ii) create a united local health department that provides substance [abuse] use disorder
90     treatment services, mental health services, and local health department services in accordance
91     with Subsection (3).
92          (b) The legislative bodies of counties joining to provide services may establish
93     acceptable ways of apportioning the cost of substance [abuse] use disorder services.
94          (c) Each agreement for joint substance [abuse] use disorder services shall:
95          (i) (A) designate the treasurer of one of the participating counties or another person as
96     the treasurer for the combined substance abuse authorities and as the custodian of money
97     available for the joint services; and
98          (B) provide that the designated treasurer, or other disbursing officer authorized by the
99     treasurer, may make payments from the money for the joint services upon audit of the
100     appropriate auditing officer or officers representing the participating counties;
101          (ii) provide for the appointment of an independent auditor or a county auditor of one of
102     the participating counties as the designated auditing officer for the combined substance abuse
103     authorities;
104          (iii) (A) provide for the appointment of the county or district attorney of one of the
105     participating counties as the designated legal officer for the combined substance abuse
106     authorities; and
107          (B) authorize the designated legal officer to request and receive the assistance of the
108     county or district attorneys of the other participating counties in defending or prosecuting
109     actions within their counties relating to the combined substance abuse authorities; and
110          (iv) provide for the adoption of management, clinical, financial, procurement,
111     personnel, and administrative policies as already established by one of the participating
112     counties or as approved by the legislative body of each participating county or interlocal board.
113          (d) An agreement for joint substance [abuse] use disorder services may provide for
114     joint operation of services and facilities or for operation of services and facilities under contract
115     by one participating local substance abuse authority for other participating local substance
116     abuse authorities.
117          (3) A county governing body may elect to combine the local substance abuse authority
118     with the local mental health authority created in Part 3, Local Mental Health Authorities, and
119     the local health department created in Title 26A, Chapter 1, Part 1, Local Health Department
120     Act, to create a united local health department under Section 26A-1-105.5. A local substance
121     abuse authority that joins a united local health department shall comply with this part.
122          (4) (a) Each local substance abuse authority is accountable to the department, the
123     Department of Health, and the state with regard to the use of state and federal funds received
124     from those departments for substance [abuse] use disorder services, regardless of whether the
125     services are provided by a private contract provider.
126          (b) Each local substance abuse authority shall comply, and require compliance by its
127     contract provider, with all directives issued by the department and the Department of Health
128     regarding the use and expenditure of state and federal funds received from those departments
129     for the purpose of providing substance [abuse] use disorder programs and services. The
130     department and Department of Health shall ensure that those directives are not duplicative or
131     conflicting, and shall consult and coordinate with local substance abuse authorities with regard
132     to programs and services.
133          (5) Each local substance abuse authority shall:
134          (a) review and evaluate substance [abuse] use disorder prevention and treatment needs
135     and services, including substance [abuse] use disorder needs and services for individuals
136     incarcerated in a county jail or other county correctional facility;
137          (b) annually prepare and submit to the division a plan approved by the county
138     legislative body for funding and service delivery that includes:
139          (i) provisions for services, either directly by the substance abuse authority or by
140     contract, for adults, youth, and children, including those incarcerated in a county jail or other
141     county correctional facility; [and]
142          (ii) primary prevention, targeted prevention, early intervention, and treatment services;
143     and
144          (iii) identification of whether each treatment program within the plan is
145     evidence-based;
146          (c) establish and maintain, either directly or by contract, programs licensed under Title
147     62A, Chapter 2, Licensure of Programs and Facilities;
148          (d) appoint directly or by contract a [full or part time] full-time or part-time director for
149     substance [abuse] use disorder programs, and prescribe the director's duties;
150          (e) provide input and comment on new and revised rules established by the division;
151          (f) establish and require contract providers to establish administrative, clinical,
152     procurement, personnel, financial, and management policies regarding substance [abuse] use
153     disorder services and facilities, in accordance with the rules of the division, and state and
154     federal law;
155          (g) establish mechanisms allowing for direct citizen input;
156          (h) annually contract with the division to provide substance [abuse] use disorder
157     programs and services in accordance with the provisions of Title 62A, Chapter 15, Substance
158     Abuse and Mental Health Act;
159          (i) comply with all applicable state and federal statutes, policies, audit requirements,
160     contract requirements, and any directives resulting from those audits and contract requirements;
161          (j) promote or establish evidence-based programs for the prevention of substance
162     [abuse] use disorder within the community setting through community-based prevention
163     programs;
164          (k) provide funding equal to at least 20% of the state funds that it receives to fund
165     services described in the plan;
166          (l) comply with the requirements and procedures of Title 11, Chapter 13, Interlocal
167     Cooperation Act, Title 17B, Chapter 1, Part 6, Fiscal Procedures for Local Districts, and Title
168     51, Chapter 2a, Accounting Reports from Political Subdivisions, Interlocal Organizations, and
169     Other Local Entities Act;
170          (m) for [persons] individuals convicted of driving under the influence in violation of
171     Section 41-6a-502 or 41-6a-517, conduct the following as defined in Section 41-6a-501:
172          (i) a screening;
173          (ii) an assessment;
174          (iii) an educational series; and
175          (iv) substance [abuse] use disorder treatment; and
176          (n) utilize proceeds of the accounts described in Subsection 62A-15-503(1) to
177     supplement the cost of providing the services described in Subsection (5)(m).
178          (6) Before disbursing any public funds, each local substance abuse authority shall
179     require that each entity that receives any public funds from the local substance abuse authority
180     agrees in writing that:
181          (a) the entity's financial records and other records relevant to the entity's performance
182     of the services provided to the local substance abuse authority shall be subject to examination
183     by:
184          (i) the division;
185          (ii) the local substance abuse authority director;
186          (iii) (A) the county treasurer and county or district attorney; or
187          (B) if two or more counties jointly provide substance abuse services under an
188     agreement under Subsection (2), the designated treasurer and the designated legal officer;
189          (iv) the county legislative body; and
190          (v) in a county with a county executive that is separate from the county legislative
191     body, the county executive;
192          (b) the county auditor may examine and audit the entity's financial and other records
193     relevant to the entity's performance of the services provided to the local substance abuse
194     authority; and
195          (c) the entity will comply with the provisions of Subsection (4)(b).
196          (7) A local substance abuse authority may receive property, grants, gifts, supplies,
197     materials, contributions, and any benefit derived therefrom, for substance [abuse] use disorder
198     services. If those gifts are conditioned upon their use for a specified service or program, they
199     shall be so used.
200          (8) (a) As used in this section, "public funds" means the same as that term is defined in
201     Section 17-43-203.
202          (b) Public funds received for the provision of services pursuant to the local substance
203     abuse plan may not be used for any other purpose except those authorized in the contract
204     between the local substance [abuse] use disorder authority and the provider for the provision of
205     plan services.
206          (9) Subject to the requirements of the federal Substance Abuse Prevention and
207     Treatment Block Grant, Pub. L. No. 102-321, a local substance abuse authority shall ensure
208     that all substance [abuse] use disorder treatment programs that receive public funds:
209          (a) accept and provide priority for admission to a pregnant woman or a pregnant minor;
210     and
211          (b) if admission of a pregnant woman or a pregnant minor is not possible within 24
212     hours of the time that a request for admission is made, provide a comprehensive referral for
213     interim services that:
214          (i) are accessible to the pregnant woman or pregnant minor;
215          (ii) are best suited to provide services to the pregnant woman or pregnant minor;
216          (iii) may include:
217          (A) counseling;
218          (B) case management; or
219          (C) a support group; and
220          (iv) shall include a referral for:
221          (A) prenatal care; and
222          (B) counseling on the effects of alcohol and drug use during pregnancy.
223          (10) If a substance [abuse] use disorder treatment program described in Subsection (9)
224     is not able to accept and admit a pregnant woman or pregnant minor under Subsection (9)
225     within 48 hours of the time that request for admission is made, the local substance abuse
226     authority shall contact the Division of Substance Abuse and Mental Health for assistance in
227     providing services to the pregnant woman or pregnant minor.
228          Section 3. Section 17-43-203 is amended to read:
229          17-43-203. Definition of "public funds" -- Responsibility for oversight of public
230     funds -- Substance use disorder programs and services.
231          (1) As used in this section, "public funds":
232          (a) means:
233          (i) federal money received from the department or the Department of Health; and
234          (ii) state money appropriated by the Legislature to the department, the Department of
235     Health, a county governing body, or a local substance abuse authority for the purposes of
236     providing substance [abuse] use disorder programs or services; and
237          (b) includes that federal and state money:
238          (i) even after the money has been transferred by a local substance abuse authority to a
239     private provider under an annual or otherwise ongoing contract to provide comprehensive
240     substance [abuse] use disorder programs or services for the local substance abuse authority;
241     and
242          (ii) while in the possession of the private provider.
243          (2) Each local substance abuse authority is responsible for oversight of all public funds
244     received by it, to determine that those public funds are utilized in accordance with federal and
245     state law, the rules and policies of the department and the Department of Health, and the
246     provisions of any contract between the local substance abuse authority and the department, the
247     Department of Health, or a private provider. That oversight includes requiring that neither the
248     contract provider, as described in Subsection (1), nor any of its employees:
249          (a) violate any applicable federal or state criminal law;
250          (b) knowingly violate any applicable rule or policy of the department or Department of
251     Health, or any provision of contract between the local substance abuse authority and the
252     department, the Department of Health, or the private provider;
253          (c) knowingly keep any false account or make any false entry or erasure in any account
254     of or relating to the public funds;
255          (d) fraudulently alter, falsify, conceal, destroy, or obliterate any account of or relating
256     to public funds;
257          (e) fail to ensure competent oversight for lawful disbursement of public funds;
258          (f) appropriate public funds for an unlawful use or for a use that is not in compliance
259     with contract provisions; or
260          (g) knowingly or intentionally use public funds unlawfully or in violation of a
261     governmental contract provision, or in violation of state policy.
262          (3) Each local substance abuse authority that knows or reasonably should know of any
263     of the circumstances described in Subsection (2), and that fails or refuses to take timely
264     corrective action in good faith shall, in addition to any other penalties provided by law, be
265     required to make full and complete repayment to the state of all public funds improperly used
266     or expended.
267          (4) Any public funds required to be repaid to the state by a local substance abuse
268     authority under Subsection (3), based upon the actions or failure of the contract provider, may
269     be recovered by the local substance abuse authority from its contract provider, in addition to
270     the local substance abuse authority's costs and attorney's fees.
271          (5) Each local substance abuse authority is responsible to ensure that the authority and
272     the authority's contract provider expends state money, as described in Subsection (1), in
273     accordance with Subsection 62A-15-103(8).
274          Section 4. Section 17-43-301 is amended to read:
275          17-43-301. Local mental health authorities -- Responsibilities.
276          (1) (a) (i) In each county operating under a county executive-council form of
277     government under Section 17-52-504, the county legislative body is the local mental health
278     authority, provided however that any contract for plan services shall be administered by the
279     county executive.
280          (ii) In each county operating under a council-manager form of government under
281     Section 17-52-505, the county manager is the local mental health authority.
282          (iii) In each county other than a county described in Subsection (1)(a)(i) or (ii), the
283     county legislative body is the local mental health authority.
284          (b) Within [legislative] legislative appropriations and county matching funds required
285     by this section, under the direction of the division, each local mental health authority shall:
286          (i) provide mental health services to persons within the county; [and]
287          (ii) cooperate with efforts of the Division of Substance Abuse and Mental Health to
288     promote integrated programs that address an individual's substance [abuse] use disorder,
289     mental health, and physical health care needs, as described in Section 62A-15-103[.]; and
290          (iii) promote evidence-based treatment programming.
291          (c) Within [legislative] legislative appropriations and county matching funds required
292     by this section, each local mental health authority shall cooperate with the efforts of the
293     Department of Human Services to promote a system of care, as defined in Section 62A-1-104,
294     for minors with or at risk for complex emotional and behavioral needs, as described in Section
295     62A-1-111.
296          (2) (a) By executing an interlocal agreement under Title 11, Chapter 13, Interlocal
297     Cooperation Act, two or more counties may join to:
298          (i) provide mental health prevention and treatment services; or
299          (ii) create a united local health department that combines substance abuse treatment
300     services, mental health services, and local health department services in accordance with
301     Subsection (3).
302          (b) The legislative bodies of counties joining to provide services may establish
303     acceptable ways of apportioning the cost of mental health services.
304          (c) Each agreement for joint mental health services shall:
305          (i) (A) designate the treasurer of one of the participating counties or another person as
306     the treasurer for the combined mental health authorities and as the custodian of money
307     available for the joint services; and
308          (B) provide that the designated treasurer, or other disbursing officer authorized by the
309     treasurer, may make payments from the money available for the joint services upon audit of the
310     appropriate auditing officer or officers representing the participating counties;
311          (ii) provide for the appointment of an independent auditor or a county auditor of one of
312     the participating counties as the designated auditing officer for the combined mental health
313     authorities;
314          (iii) (A) provide for the appointment of the county or district attorney of one of the
315     participating counties as the designated legal officer for the combined mental health
316     authorities; and
317          (B) authorize the designated legal officer to request and receive the assistance of the
318     county or district attorneys of the other participating counties in defending or prosecuting
319     actions within their counties relating to the combined mental health authorities; and
320          (iv) provide for the adoption of management, clinical, financial, procurement,
321     personnel, and administrative policies as already established by one of the participating
322     counties or as approved by the legislative body of each participating county or interlocal board.
323          (d) An agreement for joint mental health services may provide for:
324          (i) joint operation of services and facilities or for operation of services and facilities
325     under contract by one participating local mental health authority for other participating local
326     mental health authorities; and
327          (ii) allocation of appointments of members of the mental health advisory council
328     between or among participating counties.
329          (3) A county governing body may elect to combine the local mental health authority
330     with the local substance abuse authority created in Part 2, Local Substance Abuse Authorities,
331     and the local health department created in Title 26A, Chapter 1, Part 1, Local Health
332     Department Act, to create a united local health department under Section 26A-1-105.5. A local
333     mental health authority that joins with a united local health department shall comply with this
334     part.
335          (4) (a) Each local mental health authority is accountable to the department, the
336     Department of Health, and the state with regard to the use of state and federal funds received
337     from those departments for mental health services, regardless of whether the services are
338     provided by a private contract provider.
339          (b) Each local mental health authority shall comply, and require compliance by its
340     contract provider, with all directives issued by the department and the Department of Health
341     regarding the use and expenditure of state and federal funds received from those departments
342     for the purpose of providing mental health programs and services. The department and
343     Department of Health shall ensure that those directives are not duplicative or conflicting, and
344     shall consult and coordinate with local mental health authorities with regard to programs and
345     services.
346          (5) (a) Each local mental health authority shall:
347          (i) review and evaluate mental health needs and services, including mental health needs
348     and services for [persons] individuals incarcerated in a county jail or other county correctional
349     facility;
350          (ii) as provided in Subsection (5)(b), annually prepare and submit to the division a plan
351     approved by the county legislative body for mental health funding and service delivery, either
352     directly by the local mental health authority or by contract;
353          (iii) establish and maintain, either directly or by contract, programs licensed under Title
354     62A, Chapter 2, Licensure of Programs and Facilities;
355          (iv) appoint, directly or by contract, a full-time or part-time director for mental health
356     programs and prescribe the director's duties;
357          (v) provide input and comment on new and revised rules established by the division;
358          (vi) establish and require contract providers to establish administrative, clinical,
359     personnel, financial, procurement, and management policies regarding mental health services
360     and facilities, in accordance with the rules of the division, and state and federal law;
361          (vii) establish mechanisms allowing for direct citizen input;
362          (viii) annually contract with the division to provide mental health programs and
363     services in accordance with the provisions of Title 62A, Chapter 15, Substance Abuse and
364     Mental Health Act;
365          (ix) comply with all applicable state and federal statutes, policies, audit requirements,
366     contract requirements, and any directives resulting from those audits and contract requirements;
367          (x) provide funding equal to at least 20% of the state funds that it receives to fund
368     services described in the plan;
369          (xi) comply with the requirements and procedures of Title 11, Chapter 13, Interlocal
370     Cooperation Act, Title 17B, Chapter 1, Part 6, Fiscal Procedures for Local Districts, and Title
371     51, Chapter 2a, Accounting Reports from Political Subdivisions, Interlocal Organizations, and
372     Other Local Entities Act; and
373          (xii) take and retain physical custody of minors committed to the physical custody of
374     local mental health authorities by a judicial proceeding under Title 62A, Chapter 15, Part 7,
375     Commitment of Persons Under Age 18 to Division of Substance Abuse and Mental Health.
376          (b) Each plan under Subsection (5)(a)(ii) shall include services for adults, youth, and
377     children, which shall include:
378          (i) identification of whether each treatment program within the plan is evidence-based;
379     and
380          [(i)] (ii) inpatient care and services;
381          [(ii)] (iii) residential care and services;
382          [(iii)] (iv) outpatient care and services;
383          [(iv)] (v) 24-hour crisis care and services;
384          [(v)] (vi) psychotropic medication management;
385          [(vi)] (vii) psychosocial rehabilitation, including vocational training and skills
386     development;
387          [(vii)] (viii) case management;
388          [(viii)] (ix) community supports, including in-home services, housing, family support
389     services, and respite services;
390          [(ix)] (x) consultation and education services, including case consultation,
391     collaboration with other county service agencies, public education, and public information; and
392          [(x)] (xi) services to [persons] individuals incarcerated in a county jail or other county
393     correctional facility.
394          (6) Before disbursing any public funds, each local mental health authority shall require
395     that each entity that receives [any] public funds from a local mental health authority agrees in
396     writing that:
397          (a) the entity's financial records and other records relevant to the entity's performance
398     of the services provided to the mental health authority shall be subject to examination by:
399          (i) the division;
400          (ii) the local mental health authority director;
401          (iii) (A) the county treasurer and county or district attorney; or
402          (B) if two or more counties jointly provide mental health services under an agreement
403     under Subsection (2), the designated treasurer and the designated legal officer;
404          (iv) the county legislative body; and
405          (v) in a county with a county executive that is separate from the county legislative
406     body, the county executive;
407          (b) the county auditor may examine and audit the entity's financial and other records
408     relevant to the entity's performance of the services provided to the local mental health
409     authority; and
410          (c) the entity will comply with the provisions of Subsection (4)(b).
411          (7) A local mental health authority may receive property, grants, gifts, supplies,
412     materials, contributions, and any benefit derived therefrom, for mental health services. If those
413     gifts are conditioned upon their use for a specified service or program, they shall be so used.
414          (8) (a) As used in this section, "public funds" means the same as that term is defined in
415     Section 17-43-303.
416          (b) Public funds received for the provision of services pursuant to the local mental
417     health plan may not be used for any other purpose except those authorized in the contract
418     between the local mental health authority and the provider for the provision of plan services.
419          Section 5. Section 17-43-303 is amended to read:
420          17-43-303. Definition of "public funds" -- Responsibility for oversight of public
421     funds -- Mental health programs and services.
422          (1) As used in this section, "public funds":
423          (a) means:
424          (i) federal money received from the department or the Department of Health; and
425          (ii) state money appropriated by the Legislature to the department, the Department of
426     Health, a county governing body, or a local mental health authority for the purposes of
427     providing mental health programs or services; and
428          (b) includes that federal and state money:
429          (i) even after the money has been transferred by a local mental health authority to a
430     private provider under an annual or otherwise ongoing contract to provide comprehensive
431     mental health programs or services for the local mental health authority; and
432          (ii) while in the possession of the private provider.
433          (2) Each local mental health authority is responsible for oversight of all public funds
434     received by it, to determine that those public funds are utilized in accordance with federal and
435     state law, the rules and policies of the department and the Department of Health, and the
436     provisions of any contract between the local mental health authority and the department, the
437     Department of Health, or a private provider. That oversight includes requiring that neither the
438     contract provider, as described in Subsection (1), nor any of its employees:
439          (a) violate any applicable federal or state criminal law;
440          (b) knowingly violate any applicable rule or policy of the department or Department of
441     Health, or any provision of contract between the local mental health authority and the
442     department, the Department of Health, or the private provider;
443          (c) knowingly keep any false account or make any false entry or erasure in any account
444     of or relating to the public funds;
445          (d) fraudulently alter, falsify, conceal, destroy, or obliterate any account of or relating
446     to public funds;
447          (e) fail to ensure competent oversight for lawful disbursement of public funds;
448          (f) appropriate public funds for an unlawful use or for a use that is not in compliance
449     with contract provisions; or
450          (g) knowingly or intentionally use public funds unlawfully or in violation of a
451     governmental contract provision, or in violation of state policy.
452          (3) A local mental health authority that knew or reasonably should have known of any
453     of the circumstances described in Subsection (2), and that fails or refuses to take timely
454     corrective action in good faith shall, in addition to any other penalties provided by law, be
455     required to make full and complete repayment to the state of all public funds improperly used
456     or expended.
457          (4) Any public funds required to be repaid to the state by a local mental health
458     authority pursuant to Subsection (3), based upon the actions or failure of the contract provider,
459     may be recovered by the local mental health authority from its contract provider, in addition to
460     the local mental health authority's costs and attorney's fees.
461          (5) Each local mental health authority is responsible to ensure that the authority and the
462     authority's contract provider expends state money, as described in Subsection (1), in
463     accordance with Subsection 62A-15-103(8).
464          Section 6. Section 62A-15-102 is amended to read:
465          62A-15-102. Definitions.
466          As used in this chapter:
467          (1) "Board" means the Outcome Improvement Advisory Board.
468          [(1)] (2) "Criminal risk factors" means a person's characteristics and behaviors that:
469          (a) affect the person's risk of engaging in criminal behavior; and
470          (b) are diminished when addressed by effective treatment, supervision, and other
471     support resources, resulting in reduced risk of criminal behavior.
472          [(2)] (3) "Director" means the director of the Division of Substance Abuse and Mental
473     Health.
474          [(3)] (4) "Division" means the Division of Substance Abuse and Mental Health
475     established in Section 62A-15-103.
476          (5) "Evidence-based" means the same as that term is defined in Section 17-43-102.
477          [(4)] (6) "Local mental health authority" means a county legislative body.
478          [(5)] (7) "Local substance abuse authority" means a county legislative body.
479          [(6)] (8) (a) "Public funds" means federal money received from the [Department of
480     Human Services] department or the Department of Health[,] and state money [appropriated by
481     the Legislature to the Department of Human Services, the Department of Health, a county
482     governing body, or a local substance abuse authority, or a local mental health authority for the
483     purposes of providing substance abuse or mental health programs or services].
484          (b) "Public funds" include federal and state money that has been transferred by a local
485     substance abuse authority or a local mental health authority to a private provider under an
486     annual or otherwise ongoing contract to provide comprehensive substance abuse or mental
487     health programs or services for the local substance abuse authority or local mental health
488     authority. The money maintains the nature of "public funds" while in the possession of the
489     private entity that has an annual or otherwise ongoing contract with a local substance abuse
490     authority or a local mental health authority to provide comprehensive substance abuse or
491     mental health programs or services for the local substance abuse authority or local mental
492     health authority.
493          (c) Public funds received for the provision of services pursuant to substance abuse or
494     mental health service plans may not be used for any other purpose except those authorized in
495     the contract between the local mental health or substance abuse authority and provider for the
496     provision of plan services.
497          [(7)] (9) "Severe mental disorder" means schizophrenia, major depression, bipolar
498     disorders, delusional disorders, psychotic disorders, and other mental disorders as defined by
499     the division.
500          (10) "State money" means money appropriated by the Legislature to the Department of
501     Human Services, the Department of Health, a county governing body, a local substance abuse
502     authority, or a local mental health authority for the provision of substance use disorder or
503     mental health programming.
504          Section 7. Section 62A-15-103 is amended to read:
505          62A-15-103. Division -- Creation -- Responsibilities.
506          (1) There is created the Division of Substance Abuse and Mental Health within the
507     department, under the administration and general supervision of the executive director. The
508     division is the substance abuse authority and the mental health authority for this state.
509          (2) The division shall:
510          (a) (i) educate the general public regarding the nature and consequences of substance
511     [abuse] use disorder by promoting school and community-based prevention programs;
512          (ii) render support and assistance to public schools through approved school-based
513     substance [abuse] use disorder education programs aimed at prevention of substance [abuse]
514     use disorder;
515          (iii) promote or establish programs for the prevention of substance [abuse] use disorder
516     within the community setting through community-based prevention programs;
517          (iv) cooperate with and assist treatment centers, recovery residences, and other
518     organizations that provide services to individuals recovering from a substance [abuse] use
519     disorder, by identifying and disseminating information about effective practices and programs;
520          (v) promulgate rules in accordance with Title 63G, Chapter 3, Utah Administrative
521     Rulemaking Act, to develop, in collaboration with public and private programs, minimum
522     standards for public and private providers of substance [abuse] use disorder and mental health
523     programs licensed by the [Department of Human Services] department under Title 62A,
524     Chapter 2, Licensure of Programs and Facilities;
525          (vi) promote integrated programs that address an individual's substance [abuse] use
526     disorder, mental health, physical health, and criminal risk factors;
527          (vii) establish and promote [an] a diverse evidence-based continuum of screening,
528     assessment, prevention, treatment, and recovery support services in the community for
529     individuals with substance [abuse] use disorder and mental illness that addresses criminal risk
530     factors;
531          (viii) evaluate the effectiveness of programs described in this Subsection (2);
532          (ix) consider the impact of the programs described in this Subsection (2) on:
533          (A) emergency department utilization;
534          (B) jail and prison populations;
535          (C) the homeless population; and
536          (D) the child welfare system; and
537          (x) promote or establish programs for education and certification of instructors to
538     educate [persons] individuals convicted of driving under the influence of alcohol or drugs or
539     driving with any measurable controlled substance in the body;
540          (b) (i) collect and disseminate information pertaining to mental health;
541          (ii) provide direction over the state hospital including approval of its budget,
542     administrative policy, and coordination of services with local service plans;
543          (iii) promulgate rules in accordance with Title 63G, Chapter 3, Utah Administrative
544     Rulemaking Act, to educate families concerning mental illness and promote family
545     involvement, when appropriate, and with patient consent, in the treatment program of a family
546     member; and
547          (iv) promulgate rules in accordance with Title 63G, Chapter 3, Utah Administrative
548     Rulemaking Act, to direct that all individuals receiving services through local mental health
549     authorities or the Utah State Hospital be informed about and, if desired, provided assistance in
550     completion of a declaration for mental health treatment in accordance with Section
551     62A-15-1002;
552          (c) (i) consult and coordinate with local substance abuse authorities and local mental
553     health authorities regarding programs and services;
554          (ii) provide consultation and other assistance to public and private agencies and groups
555     working on substance [abuse] use disorder and mental health issues;
556          (iii) promote and establish cooperative relationships with courts, hospitals, clinics,
557     medical and social agencies, public health authorities, law enforcement agencies, education and
558     research organizations, and other related groups;
559          (iv) in consultation with the board, promote or conduct research on substance [abuse]
560     use disorder and mental health issues, and submit to the governor and the Legislature
561     recommendations for changes in policy and legislation;
562          (v) receive, distribute, and provide direction over public funds for substance [abuse]
563     use disorder and mental health services;
564          (vi) monitor and evaluate programs provided by local substance abuse authorities and
565     local mental health authorities with a weighted metric that assigns 50% of the total available
566     score to compliance with Subsection 62A-15-103(2)(n);
567          (vii) examine expenditures of any local, state, and federal funds;
568          (viii) monitor the expenditure of public funds by:
569          (A) local substance abuse authorities;
570          (B) local mental health authorities; and
571          (C) in counties where they exist, the private contract provider that has an annual or
572     otherwise ongoing contract to provide comprehensive substance abuse or mental health
573     programs or services for the local substance abuse authority or local mental health authorities;
574          (ix) contract with local substance abuse authorities and local mental health authorities
575     to provide a comprehensive continuum of services that include community-based services for
576     individuals involved in the criminal justice system, in accordance with division policy, contract
577     provisions, and the local plan;
578          (x) contract with private and public entities for special statewide or nonclinical
579     services, or services for individuals involved in the criminal justice system, according to
580     division rules;
581          (xi) review and approve each local substance abuse authority's plan and each local
582     mental health authority's plan in order to ensure:
583          (A) a statewide comprehensive continuum of substance [abuse] use disorder services;
584          (B) a statewide comprehensive continuum of mental health services;
585          (C) services result in improved overall health and functioning;
586          (D) a statewide comprehensive continuum of community-based services designed to
587     reduce criminal risk factors for individuals who are determined to have [substance abuse or] a
588     substance use disorder or a mental illness [conditions] or both, and who are involved in the
589     criminal justice system;
590          (E) compliance, where appropriate, with the certification requirements in Subsection
591     (2)(i); and
592          (F) appropriate expenditure of public funds;
593          (xii) review and make recommendations regarding each local substance abuse
594     authority's contract with its provider of substance [abuse] use disorder programs and services
595     and each local mental health authority's contract with its provider of mental health programs
596     and services to ensure compliance with state and federal law and policy;
597          (xiii) monitor and ensure compliance with division rules and contract requirements;
598     and
599          (xiv) withhold funds from local substance abuse authorities, local mental health
600     authorities, and public and private providers for contract noncompliance, failure to comply
601     with division directives regarding the use of public funds, or for misuse of public funds or
602     money;
603          (d) [assure] ensure that the requirements of this part are met and applied uniformly by
604     local substance abuse authorities and local mental health authorities across the state;
605          (e) require each local substance abuse authority and each local mental health authority
606     to submit its plan to the division by May 1 of each year;
607          (f) conduct an annual program audit and review of each local substance abuse authority
608     in the state and its contract provider and each local mental health authority in the state and its
609     contract provider, including:
610          (i) a review and determination regarding whether:
611          (A) public funds allocated to local substance abuse authorities and local mental health
612     authorities are consistent with services rendered and outcomes reported by them or their
613     contract providers; and
614          (B) each local substance abuse authority and each local mental health authority is
615     exercising sufficient oversight and control over public funds allocated for substance [abuse]
616     use disorder and mental health programs and services; and
617          (ii) items determined by the division to be necessary and appropriate; [and]
618          (g) define "prevention" by rule as required under Title 32B, Chapter 2, Part 4,
619     Alcoholic Beverage and Substance Abuse Enforcement and Treatment Restricted Account Act;
620          (h) establish by rule, in accordance with Title 63G, Chapter 3, Utah Administrative
621     Rulemaking Act, minimum standards and requirements for the provision of substance [abuse]
622     use disorder and mental health treatment to individuals who are required to participate in
623     treatment by the court or the Board of Pardons and Parole, or who are incarcerated, including:
624          (i) collaboration with the Department of Corrections and the Utah Substance Use and
625     Mental Health Advisory Council to develop and coordinate the standards, including standards
626     for county and state programs serving individuals convicted of class A and class B
627     misdemeanors;
628          (ii) determining that the standards ensure available treatment includes the most current
629     practices and procedures demonstrated by recognized scientific research to reduce recidivism,
630     including focus on the individual's criminal risk factors; and
631          (iii) requiring that all public and private treatment programs meet the standards
632     established under this Subsection (2)(h) in order to receive public funds allocated to the
633     division, the Department of Corrections, or the Commission on Criminal and Juvenile Justice
634     for the costs of providing screening, assessment, prevention, treatment, and recovery support;
635          (i) establish by rule, in accordance with Title 63G, Chapter 3, Utah Administrative
636     Rulemaking Act, the requirements and procedures for the certification of licensed public and
637     private providers who provide, as part of their practice, substance abuse and mental health
638     treatment to individuals involved in the criminal justice system, including:
639          (i) collaboration with the Department of Corrections, the Utah Substance Use and
640     Mental Health Advisory Council, and the Utah Association of Counties to develop, coordinate,
641     and implement the certification process;
642          (ii) basing the certification process on the standards developed under Subsection (2)(h)
643     for the treatment of individuals involved in the criminal justice system; and
644          (iii) the requirement that all public and private providers of treatment to individuals
645     involved in the criminal justice system shall obtain certification on or before July 1, 2016, and
646     shall renew the certification every two years, in order to qualify for funds allocated to the
647     division, the Department of Corrections, or the Commission on Criminal and Juvenile Justice
648     on or after July 1, 2016;
649          (j) collaborate with the Commission on Criminal and Juvenile Justice to analyze and
650     provide recommendations to the Legislature regarding:
651          (i) pretrial services and the resources needed for the reduced recidivism efforts;
652          (ii) county jail and county behavioral health early-assessment resources needed for
653     offenders convicted of a class A or class B misdemeanor; and
654          (iii) the replacement of federal dollars associated with drug interdiction law
655     enforcement task forces that are reduced;
656          (k) (i) establish performance goals and outcome measurements for all treatment
657     programs for which minimum standards are established under Subsection (2)(h), including
658     recidivism data and data regarding cost savings associated with recidivism reduction and the
659     reduction in the number of inmates, that are obtained in collaboration with the Administrative
660     Office of the Courts and the Department of Corrections; and
661          (ii) collect data to track and determine whether the goals and measurements are being
662     attained and make this information available to the public;
663          (l) in its discretion, use the data to make decisions regarding the use of funds allocated
664     to the division, the Administrative Office of the Courts, and the Department of Corrections to
665     provide treatment for which standards are established under Subsection (2)(h); [and]
666          (m) annually, on or before August 31, submit the data collected under Subsection (2)(j)
667     to the Commission on Criminal and Juvenile Justice, which shall compile a report of findings
668     based on the data and provide the report to the legislative Judiciary Interim Committee, the
669     Health and Human Services Interim Committee, the Law Enforcement and Criminal Justice
670     Interim Committee, and the related appropriations subcommittees[.]; and
671          (n) ensure that an evidence-based treatment program is:
672          (i) provided by an individual who, within six months after the day on which the
673     individual begins to provide the treatment program, receives training that includes:
674          (A) a discussion of the theory behind the treatment program;
675          (B) demonstrations of how to provide the treatment program; and
676          (C) practice of the necessary components of the treatment program;
677          (ii) provided by an individual who receives, at least quarterly, ongoing training on the
678     provision of the treatment program, including individualized feedback of the individual's
679     provision of the treatment program, by another individual who is trained in and who
680     demonstrates proficiency in the treatment program;
681          (iii) monitored monthly through direct observation to:
682          (A) ensure that the treatment program is delivered as prescribed in the applicable
683     program manual or protocol; and
684          (B) identify the need for corrective action when the program manual or protocol
685     requirements are not met; and
686          (iv) administered according to a sustainability plan that includes a description of how
687     the administering authority will:
688          (A) continue the practice of the treatment program regardless of staff turnover; and
689          (B) fund the treatment program.
690          (3) (a) The division may refuse to contract with and may pursue its legal remedies
691     against any local substance abuse authority or local mental health authority that fails, or has
692     failed, to expend public funds in accordance with state law, division policy, contract
693     provisions, or directives issued in accordance with state law.
694          (b) The division may withhold funds from a local substance abuse authority or local
695     mental health authority if the authority's contract with its provider of substance [abuse] use
696     disorder or mental health programs or services fails to comply with state and federal law or
697     policy.
698          (4) Before reissuing or renewing a contract with any local substance abuse authority or
699     local mental health authority, the division shall review and determine whether the local
700     substance abuse authority or local mental health authority is complying with its oversight and
701     management responsibilities described in Sections 17-43-201, 17-43-203, 17-43-303, and
702     17-43-309. Nothing in this Subsection (4) may be used as a defense to the responsibility and
703     liability described in Section 17-43-303 and to the responsibility and liability described in
704     Section 17-43-203.
705          (5) In carrying out its duties and responsibilities, the division may not duplicate
706     treatment or educational facilities that exist in other divisions or departments of the state, but
707     shall work in conjunction with those divisions and departments in rendering the treatment or
708     educational services that those divisions and departments are competent and able to provide.
709          (6) The division may accept in the name of and on behalf of the state donations, gifts,
710     devises, or bequests of real or personal property or services to be used as specified by the
711     donor.
712          (7) The division shall annually review with each local substance abuse authority and
713     each local mental health authority the authority's statutory and contract responsibilities
714     regarding:
715          (a) the use of public funds;
716          (b) oversight responsibilities regarding public funds; and
717          (c) governance of substance [abuse] use disorder and mental health programs and
718     services.
719          [(8) The Legislature may refuse to appropriate funds to the division upon the division's
720     failure to comply with the provisions of this part.]
721          (8) Excluding screening and outcome instruments, the division shall require that:
722          (a) beginning in fiscal year 2020, 20% of all individual psychotherapy and individual
723     therapeutic behavioral services that are billed by a local substance abuse authority or a local
724     mental health authority are evidence-based;
725          (b) beginning in fiscal year 2020, 33% of all group psychotherapy and group
726     therapeutic behavioral services that are billed by a local substance abuse authority or a local
727     mental health authority are evidence-based;
728          (c) beginning in fiscal year 2021, 33% of all individual psychotherapy and individual
729     therapeutic behavioral services that are billed by a local substance abuse authority or a local
730     mental health authority are evidence-based;
731          (d) beginning in fiscal year 2021, 50% of all group psychotherapy and group
732     therapeutic behavioral services that are billed by a local substance abuse authority or a local
733     mental health authority are evidence-based;
734          (e) beginning in fiscal year 2022, 40% of all individual psychotherapy and individual
735     therapeutic behavioral services that are billed by a local substance abuse authority or a local
736     mental health authority are evidence-based; and
737          (f) beginning in fiscal year 2022, 66% of all group psychotherapy and group
738     therapeutic behavioral services that are billed by a local substance abuse authority or a local
739     mental health authority are evidence-based.
740          (9) Training that is recommended or offered by the division for the prevention or
741     treatment of a substance use disorder or a mental illness shall be training for the provision of an
742     evidence-based program.
743          [(9)] (10) If a local substance abuse authority contacts the division under Subsection
744     17-43-201(10) for assistance in providing treatment services to a pregnant woman or pregnant
745     minor, the division shall:
746          (a) refer the pregnant woman or pregnant minor to a treatment facility that has the
747     capacity to provide the treatment services; or
748          (b) otherwise ensure that treatment services are made available to the pregnant woman
749     or pregnant minor.
750          (11) The Legislature may refuse to appropriate funds to the division upon the division's
751     failure to comply with the provisions of this part.
752          Section 8. Section 62A-15-114 is enacted to read:
753          62A-15-114. Outcome Improvement Advisory Board.
754          (1) The division shall establish the board.
755          (2) The board shall be comprised of:
756          (a) eight voting board members:
757          (i) who have expertise in evidence-based or research-based behavioral health practices;
758          (ii) who are not employed by the department; and
759          (iii) at least three of whom are not otherwise involved with publically funded
760     behavioral health; and
761          (b) a nonvoting staff member employed by the division, who:
762          (i) shall serve the board as an advisor; and
763          (ii) shall select the eight voting board members.
764          (3) The board shall:
765          (a) certify that a treatment program is evidence-based for purposes of Subsection
766     62A-15-103(8);
767          (b) review the implementation practice and sustainability plan associated with an
768     evidence-based treatment program; and
769          (c) advise the division on strategies, practices, or treatment programs that may improve
770     client outcomes.
771          Section 9. Section 62A-15-115 is enacted to read:
772          62A-15-115. Allocation of funding.
773          (1) As used in this section, "division services" means services provided by the division,
774     by a local substance abuse authority, by a local mental health authority, or by a contractor of
775     the division, a local substance abuse authority, or a local mental health authority.
776          (2) Beginning fiscal year 2019, newly appropriated funds for the purposes of increasing
777     the number of clients receiving division services or improving a client's access to division
778     services shall be allocated:
779          (a) 60% to increase the number of clients receiving division services; and
780          (b) 40% to increase the quality of existing services, including:
781          (i) the adoption of evidence-based treatment programs; or
782          (ii) the training necessary to effectively provide evidence-based treatment programs.
783          Section 10. Section 63I-1-262 is amended to read:
784          63I-1-262. Repeal dates, Title 62A.
785          (1) Section 62A-4a-213 is repealed July 1, 2019.
786          (2) Section 62A-4a-202.9 is repealed December 31, 2019.
787          (3) Section 62A-15-115 is repealed June 30, 2025.
788          [(3)] (4) Subsection 62A-15-1101(5) is repealed July 1, 2018.




Legislative Review Note
Office of Legislative Research and General Counsel