1     
SUBSTANCE USE AND HEALTH CARE AMENDMENTS

2     
2019 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Brad M. Daw

5     
Senate Sponsor: Todd Weiler

6     

7     LONG TITLE
8     General Description:
9          This bill modifies and enacts provisions relating to substance use, mental health
10     treatment, and health care.
11     Highlighted Provisions:
12          This bill:
13          ▸     defines terms;
14          ▸     modifies provisions requiring a county jail and the Department of Corrections to
15     report certain information to the Commission on Criminal and Juvenile Justice
16     regarding an inmate's death;
17          ▸     modifies provisions relating to licensing of a practitioner who dispenses certain
18     opiate agonists;
19          ▸     requires the Commission on Criminal and Juvenile Justice to convene a committee
20     to study certain health care and other services provided to inmates in a correctional
21     facility; and
22          ▸     makes technical changes.
23     Money Appropriated in this Bill:
24          None
25     Other Special Clauses:
26          None
27     Utah Code Sections Affected:
28     AMENDS:
29          17-22-32, as enacted by Laws of Utah 2018, Chapter 437

30          63I-1-263, as last amended by Laws of Utah 2018, Chapters 85, 144, 182, 261, 321,
31     338, 340, 347, 369, 428, 430, and 469
32          64-13-45, as enacted by Laws of Utah 2018, Chapter 437
33     ENACTS:
34          58-17b-309.7, Utah Code Annotated 1953
35          63M-7-211, Utah Code Annotated 1953
36     

37     Be it enacted by the Legislature of the state of Utah:
38          Section 1. Section 17-22-32 is amended to read:
39          17-22-32. County jail reporting requirements.
40          (1) As used in this section:
41          (a) (i) "In-custody death" means an inmate death that occurs while the inmate is in the
42     custody of a county jail.
43          (ii) "In-custody death" includes an inmate death that occurs while the inmate is:
44          (A) being transported for medical care; or
45          (B) receiving medical care outside of a county jail.
46          (b) "Inmate" means an individual who is processed or booked into custody or housed in
47     a county jail in the state.
48          (c) "Opiate" means the same as that term is defined in Section 58-37-2.
49          (2) [So that the state may oversee the inmate health care system, a] A county jail shall
50     submit a report to the Commission on Criminal and Juvenile Justice, created in Section
51     63M-7-201, before [August 1] June 15 of each year that includes:
52          (a) the number of in-custody deaths that occurred during the preceding calendar year;
53          (b) the known, or discoverable on reasonable inquiry, causes and contributing factors
54     of each of the in-custody deaths described in Subsection (2)(a);
55          (c) the county jail's policy for notifying an inmate's next of kin after the inmate's
56     in-custody death;
57          (d) the county jail policies, procedures, and protocols:

58          (i) for treatment of an inmate experiencing withdrawal from alcohol or substance use,
59     including use of opiates; [and]
60          (ii) [relating] that relate to the county jail's provision, or lack of provision, of
61     medications used to treat, mitigate, or address an inmate's symptoms of withdrawal, including
62     methadone and all forms of buprenorphine and naltrexone; and
63          (iii) that relate to screening, assessment, and treatment of an inmate for a substance use
64     or mental health disorder; and
65          (e) any report the county jail provides or is required to provide under federal law or
66     regulation relating to inmate deaths.
67          (3) The Commission on Criminal and Juvenile Justice shall:
68          (a) compile the information from the reports described in Subsection (2);
69          (b) omit or redact any identifying information of an inmate in the compilation to the
70     extent omission or redaction is necessary to comply with state and federal law ; and
71          (c) submit the compilation to the Law Enforcement and Criminal Justice Interim
72     Committee and the Utah Substance Use and Mental Health Advisory Council before November
73     1 of each year.
74          (4) The Commission on Criminal and Juvenile Justice may not provide access to or use
75     a county jail's policies, procedures, or protocols submitted under this section in a manner or for
76     a purpose not described in this section.
77          Section 2. Section 58-17b-309.7 is enacted to read:
78          58-17b-309.7. Exemptions from licensure -- Opioid treatment program.
79          (1) As used in this section:
80          (a) "Dispense" means to prepare, package, or label for subsequent use.
81          (b) "Nurse practitioner" means an individual who is licensed to practice as an advanced
82     practice registered nurse under Chapter 31b, Nurse Practice Act.
83          (c) "Opioid treatment program" means a program or practitioner that is:
84          (i) engaged in opioid treatment of an individual using an opiate agonist medication;
85          (ii) registered under 21 U.S.C. Sec. 823(g)(1);

86          (iii) licensed by the Office of Licensing, within the Department of Human Services,
87     created in Section 62A-2-103; and
88          (iv) certified by the Substance Abuse and Mental Health Services Administration in
89     accordance with 42 C.F.R. 8.11.
90          (d) "Physician" means an individual licensed to practice as a physician or osteopath in
91     this state under Chapter 67, Utah Medical Practice Act, or Chapter 68, Utah Osteopathic
92     Medical Practice Act.
93          (e) "Physician assistant" means an individual who is licensed to practice as a physician
94     assistant under Chapter 70a, Physician Assistant Act.
95          (f) "Practitioner" means a nurse practitioner, physician's assistant, or a registered nurse.
96          (g) "Registered nurse" means the same as that term is defined in Section 78B-3-403.
97          (2) A practitioner may dispense methadone at an opioid treatment program regardless
98     of whether the practitioner is licensed to dispense methadone under this chapter if the
99     practitioner:
100          (a) is operating under the direction of a pharmacist;
101          (b) dispenses the methadone under the direction of a pharmacist; and
102          (c) acts in accordance with division rule.
103          (3) The division shall, in consultation with pharmacies, physicians, and practitioners
104     who work in an opioid treatment program, make rules in accordance with Title 63G, Chapter 3,
105     Utah Administrative Rulemaking Act, to establish guidelines under which a practitioner may
106     dispense methadone to a patient in an opioid treatment program under this section.
107          Section 3. Section 63I-1-263 is amended to read:
108          63I-1-263. Repeal dates, Titles 63A to 63N.
109          (1) Subsection 63A-5-104(4)(h) is repealed on July 1, 2024.
110          (2) Section 63A-5-603, State Facility Energy Efficiency Fund, is repealed July 1, 2023.
111          (3) Title 63C, Chapter 4a, Constitutional and Federalism Defense Act, is repealed July
112     1, 2028.
113          (4) Title 63C, Chapter 4b, Commission for the Stewardship of Public Lands, is

114     repealed November 30, 2019.
115          (5) Title 63C, Chapter 16, Prison Development Commission Act, is repealed July 1,
116     2020.
117          (6) Title 63C, Chapter 17, Point of the Mountain Development Commission Act, is
118     repealed July 1, 2021.
119          (7) Title 63C, Chapter 18, Mental Health Crisis Line Commission, is repealed July 1,
120     2023.
121          (8) Title 63G, Chapter 21, Agreements to Provide State Services, is repealed July 1,
122     2025.
123          (9) Title 63H, Chapter 4, Heber Valley Historic Railroad Authority, is repealed July 1,
124     2020.
125          (10) Title 63H, Chapter 8, Utah Housing Corporation Act, is repealed July 1, 2026.
126          (11) Section 63M-7-211 is repealed on December 31, 2019.
127          [(11)] (12) On July 1, 2025:
128          (a) in Subsection 17-27a-404(3)(c)(ii), the language that states "the Resource
129     Development Coordinating Committee," is repealed;
130          (b) Subsection 23-14-21(2)(c) is amended to read "(c) provide notification of proposed
131     sites for the transplant of species to local government officials having jurisdiction over areas
132     that may be affected by a transplant.";
133          (c) in Subsection 23-14-21(3), the language that states "and the Resource Development
134     Coordinating Committee" is repealed;
135          (d) in Subsection 23-21-2.3(1), the language that states "the Resource Development
136     Coordinating Committee created in Section 63J-4-501 and" is repealed;
137          (e) in Subsection 23-21-2.3(2), the language that states "the Resource Development
138     Coordinating Committee and" is repealed;
139          (f) Subsection 63J-4-102(1) is repealed and the remaining subsections are renumbered
140     accordingly;
141          (g) Subsections 63J-4-401(5)(a) and (c) are repealed;

142          (h) Subsection 63J-4-401(5)(b) is renumbered to Subsection 63J-4-401(5)(a) and the
143     word "and" is inserted immediately after the semicolon;
144          (i) Subsection 63J-4-401(5)(d) is renumbered to Subsection 63J-4-401(5)(b);
145          (j) Sections 63J-4-501, 63J-4-502, 63J-4-503, 63J-4-504, and 63J-4-505 are repealed;
146     and
147          (k) Subsection 63J-4-603(1)(e)(iv) is repealed and the remaining subsections are
148     renumbered accordingly.
149          [(12)] (13) Subsection 63J-1-602.1(13), Nurse Home Visiting Restricted Account is
150     repealed July 1, 2026.
151          [(13)] (14) Subsection 63J-1-602.2(4), referring to dedicated credits to the Utah
152     Marriage Commission, is repealed July 1, 2023.
153          [(14)] (15) (a) Subsection 63J-1-602.1(51), relating to the Utah Statewide Radio
154     System Restricted Account, is repealed July 1, 2022.
155          (b) When repealing Subsection 63J-1-602.1(51), the Office of Legislative Research and
156     General Counsel shall, in addition to the office's authority under Subsection 36-12-12(3), make
157     necessary changes to subsection numbering and cross references.
158          [(15)] (16) The Crime Victim Reparations and Assistance Board, created in Section
159     63M-7-504, is repealed July 1, 2027.
160          [(16)] (17) Title 63M, Chapter 11, Utah Commission on Aging, is repealed July 1,
161     2027.
162          [(17)] (18) Title 63N, Chapter 2, Part 2, Enterprise Zone Act, is repealed July 1, 2028.
163          [(18)] (19) (a) Title 63N, Chapter 2, Part 4, Recycling Market Development Zone Act,
164     is repealed January 1, 2021.
165          (b) Subject to Subsection [(18)] (19)(c), Sections 59-7-610 and 59-10-1007 regarding
166     tax credits for certain persons in recycling market development zones, are repealed for taxable
167     years beginning on or after January 1, 2021.
168          (c) A person may not claim a tax credit under Section 59-7-610 or 59-10-1007:
169          (i) for the purchase price of machinery or equipment described in Section 59-7-610 or

170     59-10-1007, if the machinery or equipment is purchased on or after January 1, 2021; or
171          (ii) for an expenditure described in Subsection 59-7-610(1)(b) or 59-10-1007(1)(b), if
172     the expenditure is made on or after January 1, 2021.
173          (d) Notwithstanding Subsections [(18)] (19)(b) and (c), a person may carry forward a
174     tax credit in accordance with Section 59-7-610 or 59-10-1007 if:
175          (i) the person is entitled to a tax credit under Section 59-7-610 or 59-10-1007; and
176          (ii) (A) for the purchase price of machinery or equipment described in Section
177     59-7-610 or 59-10-1007, the machinery or equipment is purchased on or before December 31,
178     2020; or
179          (B) for an expenditure described in Subsection 59-7-610(1)(b) or 59-10-1007(1)(b), the
180     expenditure is made on or before December 31, 2020.
181          [(19)] (20) Section 63N-2-512 is repealed on July 1, 2021.
182          [(20)] (21) (a) Title 63N, Chapter 2, Part 6, Utah Small Business Jobs Act, is repealed
183     January 1, 2021.
184          (b) Section 59-9-107 regarding tax credits against premium taxes is repealed for
185     calendar years beginning on or after January 1, 2021.
186          (c) Notwithstanding Subsection [(20)] (21)(b), an entity may carry forward a tax credit
187     in accordance with Section 59-9-107 if:
188          (i) the person is entitled to a tax credit under Section 59-9-107 on or before December
189     31, 2020; and
190          (ii) the qualified equity investment that is the basis of the tax credit is certified under
191     Section 63N-2-603 on or before December 31, 2023.
192          [(21)] (22) Subsections 63N-3-109(2)(f) and 63N-3-109(2)(g)(i)(C) are repealed July 1,
193     2023.
194          [(22)] (23) Title 63N, Chapter 4, Part 4, Rural Employment Expansion Program, is
195     repealed July 1, 2023.
196          [(23)] (24) Title 63N, Chapter 9, Part 2, Outdoor Recreational Infrastructure Grant
197     Program, is repealed January 1, 2023.

198          [(24)] (25) Title 63N, Chapter 12, Part 4, Career and Technical Education Board, is
199     repealed July 1, 2018.
200          Section 4. Section 63M-7-211 is enacted to read:
201          63M-7-211. Inmate health care study -- Creation -- Membership -- Duties --
202     Reporting.
203          (1) As used in this section:
204          (a) "Commission" means the Commission on Criminal and Juvenile Justice created in
205     Section 63M-7-201.
206          (b) "Correctional facility" means:
207          (i) a facility operated by or contracted with the Department of Corrections to house a
208     criminal offender in either a secure or nonsecure setting; or
209          (ii) a county jail.
210          (2) The commission shall create a committee to study:
211          (a) treatment provided to inmates in a county jail for substance use or mental health
212     disorders, including withdrawal from alcohol or other drugs;
213          (b) contraception provided to female inmates in correctional facilities;
214          (c) health care and treatment of pregnant inmates in correctional facilities;
215          (d) body cavity searches of arrestees or inmates in correctional facilities; and
216          (e) continuation of medication and mental health treatment for inmates who are
217     transferred from a county jail to the Department of Corrections.
218          (3) The committee shall consist of:
219          (a) a representative from the Division of Substance Abuse and Mental Health within
220     the Department of Human Services;
221          (b) a representative from a local substance abuse and mental health authority from:
222          (i) a county of the first class, as classified in Section 17-50-501; and
223          (ii) a county of the second, third, fourth, fifth, or sixth class, as classified in Section
224     17-50-501;
225          (c) a representative from the Department of Health;

226          (d) a representative from the Utah Sheriff's Association;
227          (e) a representative from the Statewide Association of Prosecutors of Utah;
228          (f) a representative from the Utah Association of Counties;
229          (g) a representative from the Utah Association of Criminal Defense Lawyers;
230          (h) a physician actively engaged in correctional health care in a county jail from:
231          (i) a county of the first class, as classified in Section 17-50-501; and
232          (ii) a county of the second, third, fourth, fifth, or sixth class, as classified in Section
233     17-50-501;
234          (i) a psychiatric service provider actively engaged in correctional health care;
235          (j) a district attorney or a county attorney actively engaged in the practice of civil or
236     constitutional law from:
237          (i) a county of the first class, as classified in Section 17-50-501; and
238          (ii) a county of the second, third, fourth, fifth, or sixth class, as classified in Section
239     17-50-501;
240          (k) a representative from a community-based substance use treatment provider in the
241     state;
242          (l) a physician from a community-based health care facility that specializes in women's
243     health;
244          (m) a representative from the Department of Corrections;
245          (n) a representative from an organization with expertise in civil rights or civil liberties
246     of incarcerated individuals; and
247          (o) other stakeholders, as determined by the commission.
248          (4) Before June 15, 2019, a correctional facility shall submit to the committee a copy of
249     the correctional facility's existing policies, procedures, and protocols for:
250          (a) treatment of an inmate in a county jail experiencing a substance use or mental
251     health disorder, including withdrawal from alcohol or other drugs;
252          (b) providing contraception to a female inmate in a correctional facility;
253          (c) providing health care and treatment for a pregnant inmate in a correctional facility,

254     including any restraints required during a pregnant inmate's labor and delivery;
255          (d) a body cavity search of an arrestee or inmate in a correctional facility; and
256          (e) providing medication and mental health treatment for inmates who are transferred
257     from a county jail to the Department of Corrections.
258          (5) The committee shall:
259          (a) survey the policies, procedures, and protocols submitted by a correctional facility
260     under Subsection (4) taking the following into consideration:
261          (i) the needs and limitations of correctional health care, particularly in rural areas of the
262     state;
263          (ii) evidence-based practices;
264          (iii) tools and protocols for substance use screening and assessment;
265          (iv) the transition of an inmate from treatment or health care in a correctional facility to
266     community-based treatment or health care; and
267          (v) the needs of different correctional facility populations; and
268          (b) based on the results of the survey under Subsection (5)(a), develop
269     recommendations relating to:
270          (i) whether model policies, procedures, and protocols for correctional facilities are
271     necessary; and
272          (ii) development and implementation of any model policies the committee finds
273     necessary under Subsection (5)(b)(i).
274          (6) (a) Each member of the committee may have access to and use a correctional
275     facility's policies, procedures, or protocols submitted under this section for the purposes
276     described in this section.
277          (b) Neither the commission, the committee, nor a member of the committee may
278     provide access to or use a correctional facility's policies, procedures, or protocols submitted
279     under this section in a manner or for a purpose not described in this section.
280          (7) (a) Before November 30, 2019, the commission shall present a report of the results
281     of the survey and the committee's recommendations under Subsection (5) to the Law

282     Enforcement and Criminal Justice Interim Committee.
283          (b) The commission is not required to include in the report described in Subsection
284     (7)(a) the policies, procedures, or protocols of a correctional facility that were submitted under
285     Subsection (4) on or after June 15, 2019.
286          (c) As part of the report described in Subsection (7)(a), the commission shall state
287     which, if any, correctional facilities did not submit policies, procedures, or protocols under
288     Subsection (4) before June 15, 2019.
289          Section 5. Section 64-13-45 is amended to read:
290          64-13-45. Department reporting requirements.
291          (1) As used in this section:
292          (a) (i) "In-custody death" means an inmate death that occurs while the inmate is in the
293     custody of the department.
294          (ii) "In-custody death" includes an inmate death that occurs while the inmate is:
295          (A) being transported for medical care; or
296          (B) receiving medical care outside of a correctional facility, other than a county jail.
297          (b) "Inmate" means an individual who is processed or booked into custody or housed in
298     the department or a correctional facility other than a county jail.
299          (c) "Opiate" means the same as that term is defined in Section 58-37-2.
300          (2) [So that the state may oversee the inmate health care system, the] The department
301     shall submit a report to the Commission on Criminal and Juvenile Justice, created in Section
302     63M-7-201, before [August 1] June 15 of each year that includes:
303          (a) the number of in-custody deaths that occurred during the preceding calendar year;
304          (b) the known, or discoverable on reasonable inquiry, causes and contributing factors
305     of each of the in-custody deaths described in Subsection (2)(a);
306          (c) the department's policy for notifying an inmate's next of kin after the inmate's
307     in-custody death;
308          (d) the department policies, procedures, and protocols:
309          (i) for treatment of an inmate experiencing withdrawal from alcohol or substance use,

310     including use of opiates; [and]
311          (ii) [relating] that relate to the department's provision, or lack of provision, of
312     medications used to treat, mitigate, or address an inmate's symptoms of withdrawal, including
313     methadone and all forms of buprenorphine and naltrexone; and
314          (iii) that relate to screening, assessment, and treatment of an inmate for a substance use
315     disorder or mental health disorder; and
316          (e) any report the department provides or is required to provide under federal law or
317     regulation relating to inmate deaths.
318          (3) The Commission on Criminal and Juvenile Justice shall:
319          (a) compile the information from the reports described in Subsection (2);
320          (b) omit or redact any identifying information of an inmate in the compilation to the
321     extent omission or redaction is necessary to comply with state and federal law ; and
322          (c) submit the compilation to the Law Enforcement and Criminal Justice Interim
323     Committee and the Utah Substance Use and Mental Health Advisory Council before November
324     1 of each year.
325          (4) The Commission on Criminal and Juvenile Justice may not provide access to or use
326     the department's policies, procedures, or protocols submitted under this section in a manner or
327     for a purpose not described in this section.