1     
SUBSTANCE USE AND HEALTH CARE AMENDMENTS

2     
2020 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Brad M. Daw

5     
Senate Sponsor: Allen M. Christensen

6     

7     LONG TITLE
8     Committee Note:
9          The Health and Human Services Interim Committee recommended this bill.
10               Legislative Vote:     10 voting for     0 voting against     7 absent
11     General Description:
12          This bill modifies and enacts provisions relating to substance use treatment, mental
13     health treatment, and health care provided in a correctional facility and the Utah State
14     Hospital.
15     Highlighted Provisions:
16          This bill:
17          ▸     defines terms;
18          ▸     directs the Department of Health to apply for a waiver under the state Medicaid plan
19     to offer a program to provide Medicaid coverage to certain inmates during the 30
20     days before release from a correctional facility;
21          ▸     creates a refundable tax credit for certain practitioners who provide substance use
22     disorder treatment or mental health therapy in a correctional facility or the Utah
23     State Hospital;
24          ▸     creates a substance use and mental health telehealth pilot program to be conducted
25     in one or more county jails; and
26          ▸     makes technical changes.
27     Money Appropriated in this Bill:
28          None
29     Other Special Clauses:
30          This bill provides a special effective date.
31     Utah Code Sections Affected:
32     AMENDS:
33          58-1-111, as enacted by Laws of Utah 2016, Chapter 407
34          59-10-1111, as enacted by Laws of Utah 2016, Chapter 407
35          63I-1-262, as last amended by Laws of Utah 2019, Chapters 246, 257, 440 and last
36     amended by Coordination Clause, Laws of Utah 2019, Chapter 246
37     ENACTS:
38          26-18-420, Utah Code Annotated 1953
39          62A-15-118, Utah Code Annotated 1953
40     

41     Be it enacted by the Legislature of the state of Utah:
42          Section 1. Section 26-18-420 is enacted to read:
43          26-18-420. Medicaid waiver for coverage of qualified inmates leaving prison or
44     jail.
45          (1) As used in this section:
46          (a) "Correctional facility" means:
47          (i) a county jail;
48          (ii) the Department of Corrections, created in Section 64-13-2; or
49          (iii) a prison, penitentiary, or other institution operated by or under contract with the
50     Department of Corrections for the confinement of an offender, as defined in Section 64-13-1.
51          (b) "Qualified inmate" means an individual who:
52          (i) is incarcerated in a correctional facility; and
53          (ii) has:
54          (A) a chronic physical or behavioral health condition;
55          (B) a mental illness, as defined in Section 62A-15-602; or
56          (C) an opioid use disorder.
57          (2) Before July 1, 2020, the division shall apply for a Medicaid waiver or a state plan
58     amendment with CMS to offer a program to provide Medicaid coverage for a qualified inmate
59     during the 30 days immediately before the day on which the qualified inmate is released from a
60     correctional facility.
61          (3) If the waiver or state plan amendment described in Subsection (2) is approved, the
62     department shall report to the Health and Human Services Interim Committee each year before
63     November 30 while the waiver or state plan amendment is in effect regarding:
64          (a) the number of qualified inmates served under the program;
65          (b) the cost of the program; and
66          (c) the effectiveness of the program, including:
67          (i) any reduction in the number of emergency room visits or hospitalizations by
68     inmates after release from a correctional facility;
69          (ii) any reduction in the number of inmates undergoing inpatient treatment after release
70     from a correctional facility;
71          (iii) any reduction in overdose rates and deaths of inmates after release from a
72     correctional facility; and
73          (iv) any other costs or benefits as a result of the program.
74          Section 2. Section 58-1-111 is amended to read:
75          58-1-111. Tax credit certificate --Mental health practitioners and substance use
76     therapists -- Underserved populations.
77          (1) As used in this section:
78          (a) "Average of 20 hours or more per week" means that the quotient calculated when
79     dividing the claimant's total hours providing licensed services, in-custody mental health
80     therapy, or in-custody substance use disorder treatment in the state during the taxable year by
81     the number of weeks in which the claimant is licensed in the state during the taxable year is
82     greater than or equal to 20.
83          [(a)] (b) "Average of 30 hours or more per week" means that the quotient calculated
84     when dividing the claimant's total hours providing licensed services, in-custody mental health
85     therapy, or in-custody substance use disorder treatment in the state during the taxable year by
86     the number of weeks in which the claimant is licensed in the state during the taxable year is
87     greater than or equal to 30.
88          (c) "In-custody mental health therapy" means the provision of behavioral health
89     treatment within the scope of practice of a mental health therapist in a secure facility in the
90     state.
91          (d) "In-custody substance use disorder treatment" means the provision of behavioral
92     health treatment within the scope of practice of a substance use disorder counselor in a secure
93     facility in the state.
94          [(b)] (e) "Licensed services" means the provision of behavioral health treatment in the
95     state [and] within the scope of practice of:
96          (i) a psychiatrist[,];
97          (ii) a psychiatric mental health nurse practitioner[,]; or
98          (iii) a volunteer health practitioner.
99          (f) "Medication-assisted treatment" means treatment of a substance use disorder that
100     includes the use of a drug that is approved by the federal Food and Drug Administration for the
101     treatment of a substance use disorder in conjunction with behavioral health therapy.
102          (g) "Mental health therapist" means an individual who is licensed under Chapter 60,
103     Mental Health Professional Practice Act, for the practice of mental health therapy, as defined in
104     Section 58-60-102.
105          [(c)] (h) "Psychiatric mental health nurse practitioner" means an individual who:
106          (i) is licensed under Chapter 31b, Nurse Practice Act, for the practice of advanced
107     practice registered nursing, as [that term is] defined in Section 58-31b-102; and
108          (ii) holds a certification recognized by the American Nurses Credentialing Center of
109     the American Association of Colleges of Nursing as a psychiatric mental health nurse
110     practitioner.
111          [(d)] (i) "Psychiatrist" means an individual who:
112          (i) is licensed as a physician under:
113          (A) Chapter 67, Utah Medical Practice Act;
114          (B) Chapter 67b, Interstate Medical Licensure Compact; or
115          (C) Chapter 68, Utah Osteopathic Medical Practice Act; and
116          (ii) is board eligible for a psychiatry specialization recognized by the American Board
117     of Medical Specialists or the American Osteopathic Association's Bureau of Osteopathic
118     Specialists.
119          (j) "Secure facility" means:
120          (i) a county jail;
121          (ii) the Department of Corrections, created in Section 64-13-2;
122          (iii) a prison, penitentiary, or other institution operated by or under contract with the
123     Department of Corrections for the confinement of an offender, as defined in Section 64-13-1;
124     or
125          (iv) the Utah State Hospital, created in Section 62A-15-601.
126          (k) "Substance use disorder counselor" means an individual who is licensed under
127     Chapter 60, Mental Health Professional Practice Act, to practice as a licensed advanced
128     substance use disorder counselor, as defined in Section 58-60-502.
129          [(e)] (l) "Underserved population" means:
130          (i) an individual located in a county of the third, fourth, fifth, or sixth class, as
131     [designated] classified in Section 17-50-501; or
132          (ii) a Native American Indian.
133          [(f)] (m) "Volunteer retired psychiatrist" means an individual:
134          (i) described in Subsection (1)[(d)](i) who, during the calendar year, did not receive
135     payment for providing licensed services; or
136          (ii) (A) licensed under Chapter 81, Retired Volunteer Health Care Practitioner Act; and
137          (B) previously or currently board certified in psychiatry.
138          (2) (a) An individual who seeks to obtain a state income tax credit under Subsections
139     59-10-1111(2) through [(4)] (6) shall file an application with the division with respect to each
140     taxable year in which the individual seeks a state income tax credit.
141          (b) An individual may qualify for a tax credit certificate under this section for no more
142     than 10 taxable years for each tax credit.
143          (3) The application for a tax credit certificate under Subsection 59-10-1111(2) shall
144     require the individual to provide the following to the division:
145          (a) the date on which the individual obtained a license and the specialization described
146     in Subsection (1)[(c)](h)(ii) or [(d)] (i)(ii);
147          (b) (i) an attestation that the individual was licensed on or after January 1, 2017, to
148     provide licensed services; or
149          (ii) if the individual was licensed to provide licensed services prior to January 1, 2017,
150     an attestation:
151          (A) that the individual did not provide licensed services for the two calendar years
152     before the date the individual initially applied for the income tax credit under this subsection;
153     and
154          (B) the date on which the individual resumed providing licensed services in the state;
155     and
156          (c) other information as required by the division by administrative rule adopted in
157     accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
158          (4) An application for a tax credit certificate under Subsection 59-10-1111(3) shall
159     require the individual to attest to the division:
160          (a) that the individual averaged 30 or more hours per week during the taxable year
161     providing licensed services;
162          (b) that the individual devoted 25% or more of the individual's total hours of licensed
163     services in the taxable year to an underserved population;
164          (c) the type of underserved population for which the individual provided services
165     during the taxable year; and
166          (d) other information as required by the division by administrative rule adopted in
167     accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
168          (5) An application for a tax credit certificate under Subsection 59-10-1111(4) shall
169     require the individual to attest to the division:
170          (a) whether the individual is licensed under Subsection (1)[(f)](m)(i) or (ii);
171          (b) that the individual did not receive payment during the calendar year for providing
172     licensed services;
173          (c) that during the calendar year, the individual provided at least 300 hours of licensed
174     services to an underserved population, the homeless population, or veterans without receiving
175     payment for providing the licensed services;
176          (d) a description of the type of population described in Subsection (5)(c) for which the
177     individual provided licensed services; and
178          (e) other information as required by the division by administrative rule adopted in
179     accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
180          (6) An application for a tax credit certificate under Subsection 59-10-1111(5) shall
181     require the individual to attest to the division:
182          (a) that the individual averaged 30 hours or more per week during the taxable year
183     providing in-custody mental health therapy;
184          (b) a list of each secure facility in which the individual provided in-custody mental
185     health therapy during the taxable year; and
186          (c) other information as required by the division by administrative rule adopted in
187     accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
188          (7) An application for a tax credit certificate under Subsection 59-10-1111(6) shall
189     require the individual to attest to the division:
190          (a) that the individual averaged 20 hours or more per week during the taxable year
191     providing in-custody substance use disorder treatment;
192          (b) if used, a description of the type of medication-assisted treatment used by the
193     individual in providing the in-custody substance use disorder treatment;
194          (c) a list of each secure facility in which the individual provided the substance use
195     disorder treatment during the taxable year; and
196          (d) other information as required by the division by administrative rule adopted in
197     accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
198          [(6)] (8) (a) The division shall issue a tax credit certificate in accordance with this
199     subsection.
200          (b) The tax credit certificate may state that an individual is entitled to:
201          (i) a tax credit under Subsection 59-10-1111(2) if the individual meets the
202     requirements of Subsection (3);
203          (ii) a tax credit under Subsection 59-10-1111(3) if the individual meets the
204     requirements of Subsection (4);
205          (iii) a tax credit under Subsection 59-10-1111(4) if the individual meets the
206     requirements of Subsection (5); [or]
207          (iv) a tax credit under Subsection 59-10-1111(5) if the individual meets the
208     requirements of Subsection (6);
209          (v) a tax credit under Subsection 59-10-1111(6) if the individual meets the
210     requirements of Subsection (7); or
211          [(iv)] (vi) a tax credit under Subsections 59-10-1111(2) and (3) if the individual meets
212     the requirements of Subsections (3) and (4).
213          [(7)] (9) (a) The division may issue a tax credit certificate to an individual under
214     Subsection 59-10-1111(2) for no more than 10 taxable years after the date on which the
215     individual resumed services under Subsection (3)(b)(ii).
216          (b) The division may issue a tax credit certificate to an individual under Subsections
217     59-10-1111(3) [and (4)] through (6) for no more than 10 taxable years.
218          [(8)] (10) The division shall provide a copy of a tax credit certificate issued under this
219     section to the individual and the State Tax Commission.
220          Section 3. Section 59-10-1111 is amended to read:
221          59-10-1111. Refundable tax credit for mental health practitioners and substance
222     use therapists.
223          (1) As used in this section:
224          (a) "Mental health therapist" means the same as that term is defined in Section
225     58-1-111.
226          [(a)] (b) "Psychiatric mental health nurse practitioner" means the same as that term is
227     defined in Section 58-1-111.
228          [(b)] (c) "Psychiatrist" means the same as that term is defined in Section 58-1-111.
229          (d) "Substance use disorder counselor" means the same as that term is defined in
230     Section 58-1-111.
231          [(c)] (e) "Tax credit certificate" means a certificate issued by the Division of
232     Occupational and Professional Licensing under Section 58-1-111 certifying that the claimant is
233     entitled to a tax credit under this section.
234          [(d)] (f) "Volunteer retired psychiatrist" means the same as that term is defined in
235     Section 58-1-111.
236          (2) A claimant who is a psychiatrist or a psychiatric mental health nurse practitioner
237     and who submits a tax credit certificate issued by the Division of Occupational and
238     Professional Licensing under Subsection 58-1-111(3), may claim a refundable tax credit:
239          (a) as provided in this section; and
240          (b) in the amount of $10,000.
241          (3) A claimant who is a psychiatrist or a psychiatric mental health nurse practitioner
242     and who submits a tax credit certificate under Subsection 58-1-111(4) may claim a refundable
243     tax credit:
244          (a) as provided in this section; and
245          (b) in the amount of $10,000.
246          (4) A claimant who is a volunteer retired psychiatrist and who submits a tax credit
247     certificate under Subsection 58-1-111(5) may claim a refundable tax credit:
248          (a) as provided in this section; and
249          (b) in the amount of $10,000.
250          (5) A claimant who is a mental health therapist and who submits a tax credit certificate
251     under Subsection 58-1-111(6) may claim a refundable tax credit:
252          (a) as provided in this section; and
253          (b) in the amount of $10,000.
254          (6) A claimant who is a substance use disorder counselor and who submits a tax credit
255     certificate under Subsection 58-1-111(7) may claim a refundable tax credit:
256          (a) as provided in this section; and
257          (b) in the amount of $10,000.
258          [(5)] (7) A claimant may claim a tax credit under Subsections (2) through [(4)] (6) for
259     no more than 10 taxable years for each tax credit.
260          [(6)] (8) (a) In accordance with any rules prescribed by the commission under
261     Subsection [(6)] (8)(b), the commission shall make a refund to a claimant who claims a tax
262     credit under this section if the amount of the tax credit exceeds the claimant's tax liability for
263     the taxable year.
264          (b) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, the
265     commission may make rules providing procedures for making a refund to a claimant as
266     required by Subsection [(6)] (8)(a).
267          Section 4. Section 62A-15-118 is enacted to read:
268          62A-15-118. Substance Use and Mental Health Telehealth Pilot Program.
269          (1) As used in this section:
270          (a) "Inmate" means an individual incarcerated in a rural county jail.
271          (b) "Project" means a pilot project that provides telehealth services to inmates.
272          (c) "Rural county" means a county of the second, third, fourth, fifth, or sixth class, as
273     classified in Section 17-50-501.
274          (d) "Telehealth services" means mental health or substance use disorder treatment
275     provided remotely through the use of telecommunications technology.
276          (2) (a) On or before July 1, 2020, the division shall issue a request for proposals in
277     accordance with this section to award a grant to one or more county jails to develop and
278     implement a project.
279          (b) The division shall award all grants under this section before December 31, 2020.
280          (c) A project shall run for two years.
281          (3) The purpose of a project is to:
282          (a) determine how telehealth services can be used in the state to:
283          (i) increase access to mental health and substance use disorder treatment to inmates;
284          (ii) reduce the number of deaths in rural county jails due to suicide or withdrawal
285     symptoms;
286          (iii) reduce the number of overdose deaths of inmates with a substance use disorder
287     after release from a rural county jail; and
288          (iv) reduce the costs associated with providing mental health and substance use
289     disorder treatment to inmates; and
290          (b) identify methods of using telehealth services for inmates.
291          (4) An application for a grant under this section shall:
292          (a) be submitted jointly by:
293          (i) a rural county jail;
294          (ii) a local substance abuse and mental health authority; and
295          (iii) a provider of telehealth services;
296          (b) identify the inmate population to which the rural county jail will provide telehealth
297     services;
298          (c) identify the type of telehealth services that the rural county jail will provide;
299          (d) explain how the inmate population described in Subsection (4)(b) will benefit from
300     the provision of telehealth services;
301          (e) provide details regarding:
302          (i) how the rural county jail plans to provide telehealth services;
303          (ii) how the proposed project will ensure that consideration is given to the capacity and
304     availability of the rural county jail and community health care resources;
305          (iii) how the rural county jail, telehealth service provider, and local mental health and
306     substance abuse authority will coordinate to ensure timely and effective provision of telehealth
307     services;
308          (iv) the projected costs of the proposed project;
309          (v) the sustainability of the proposed project; and
310          (vi) the methods the proposed project will use to:
311          (A) protect the privacy of each inmate who participates in the proposed project;
312          (B) collect nonidentifying data relating to the proposed project; and
313          (C) provide transparency on the costs and operation of the proposed project; and
314          (f) provide other information requested by the division to ensure that the proposed
315     project satisfies the criteria described in Subsection (5).
316          (5) In evaluating an application for the grant, the division shall consider:
317          (a) the extent to which the proposed project will fulfill the purposes described in
318     Subsection (3);
319          (b) the extent to which the inmate population described in Subsection (4)(b) is likely to
320     benefit from the proposed project;
321          (c) the cost of the proposed project;
322          (d) the viability and innovation of the proposed project; and
323          (e) the extent to which the proposed project will yield useful data to evaluate the
324     effectiveness of the proposed project.
325          (6) Before June 30, 2021, the division shall report to the Law Enforcement and
326     Criminal Justice Interim Committee regarding:
327          (a) each county jail that is part of a project; and
328          (b) the details and duration of each project.
329          (7) Before June 30, 2023, the division shall report to the Law Enforcement and
330     Criminal Justice Interim Committee regarding:
331          (a) the outcomes of each project;
332          (b) data gathered in relation to each project;
333          (c) knowledge gained relating to the provision of telehealth services in county jails;
334          (d) recommendations for the future use of telehealth services in county jails; and
335          (e) obstacles encountered in the provision of telehealth services in rural county jails.
336          Section 5. Section 63I-1-262 is amended to read:
337          63I-1-262. Repeal dates, Title 62A.
338          (1) Subsections 62A-1-120(8)(g), (h), and (i) relating to completion of premarital
339     counseling or education under Section 30-1-34 are repealed July 1, 2023.
340          (2) Section 62A-3-209 is repealed July 1, 2023.
341          (3) Section 62A-4a-202.9 is repealed December 31, 2021.
342          (4) Section 62A-4a-213 is repealed July 1, 2024.
343          (5) Section 62A-15-114 is repealed December 31, 2021.
344          (6) Subsections 62A-15-116(1) and (4), the language that states "In consultation with
345     the SafeUT and School Safety Commission, established in Section 53B-17-1203," is repealed
346     January 1, 2023.
347          (7) Section 62A-15-118 is repealed December 31, 2023.
348          [(7)] (8) Subsections 62A-15-1100(1) and 62A-15-1101[(8)](9), in relation to the Utah
349     Substance Use and Mental Health Advisory Council, are repealed January 1, 2023.
350          [(8)] (9) In relation to the Mental Health Crisis Line Commission, on July 1, 2023:
351          (a) Subsections 62A-15-1301(1) and 62A-15-1401(1) are repealed;
352          (b) Subsection 62A-15-1302(1)(b), the language that states "and in consultation with
353     the commission" is repealed;
354          (c) Section 62A-15-1303, the language that states "In consultation with the
355     commission," is repealed; and
356          (d) Subsection 62A-15-1402(2)(a), the language that states "With recommendations
357     from the commission," is repealed.
358          Section 6. Effective date.
359          The amendments to Sections 58-1-111 and 59-10-1111 take effect for a taxable year
360     beginning on or after January 1, 2021.