1     
STATE AGENCY REALIGNMENT

2     
2021 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Paul Ray

5     
Senate Sponsor: Jacob L. Anderegg

6     

7     LONG TITLE
8     General Description:
9          This bill creates the Department of Health and Human Services and provides for the
10     transition of the Department of Health and the Department of Human Services into the
11     newly created single state agency.
12     Highlighted Provisions:
13          This bill:
14          ▸     creates the Department of Health and Human Services to combine the functions of
15     the Department of Health and the Department of Human Services;
16          ▸     describes the duties, responsibilities, and powers of the agency created in this bill;
17          ▸     provides for the transition of the Department of Health and the Department of
18     Human Services into the agency created in this bill;
19          ▸     amends the certain responsibilities of the Department of Workforce Services,
20     particularly relating to administration of Medicaid eligibility; and
21          ▸     creates a sunset date for certain provisions relating to the transition to the agency
22     created in this bill.
23     Money Appropriated in this Bill:
24          This bill appropriates in fiscal year 2022:
25          ▸     to General Fund Restricted - Department of Health and Human Services Transition
26     Restricted Account, as a one-time appropriation:
27               •     from the General Fund, One-time, $1,500,000.
28          ▸     to Department of Health - Executive Director's Operations, as an ongoing

29     appropriation:
30               •     from the General Fund, Ongoing, ($135,000).
31               •     from Federal Funds, Ongoing, ($135,000).
32          ▸     to Department of Health - Executive Director's Operations, as a one-time
33     appropriation:
34               •     from the General Fund, One-time, $135,000.
35               •     from Federal Funds, One-time, $135,000.
36          ▸     to Department of Health - Medicaid and Health Financing, as an ongoing
37     appropriation:
38               •     from the General Fund, Ongoing, ($486,500).
39               •     from the Federal Funds, Ongoing, ($486,500).
40          ▸     to Department of Health - Medicaid and Health Financing, as a one-time
41     appropriation:
42               •     from the General Fund, One-time, $486,500.
43               •     from Federal Funds, One-time, $486,500.
44          ▸     to Department of Health - Executive Director's Operations, as an ongoing
45     appropriation:
46               •     from the General Fund, Ongoing, ($58,200).
47               •     from Federal Funds, Ongoing, ($58,200).
48          ▸     to Department of Health - Executive Director's Operations, as a one-time
49     appropriation:
50               •     from the General Fund, One-time, $58,200.
51               •     from Federal Funds, One-time, $58,200.
52          ▸     to Department of Workforce Services - Operations and Policy, as an ongoing
53     appropriation:
54               •     from the General Fund, Ongoing, $486,500.
55               •     from the Federal Funds, Ongoing, $486,500.

56          ▸     to Department of Workforce Services - Operations and Policy, as a one-time
57     appropriation:
58               •     from the General Fund, One-time, ($486,500).
59               •     from Federal Funds, One-time, ($486,500).
60          ▸     to Department of Workforce Services - Administration, as an ongoing
61     appropriation:
62               •     from the General Fund, Ongoing, $58,200.
63               •     from Federal Funds, Ongoing, $58,200.
64          ▸     to Department of Workforce Services - Administration, as a one-time
65     appropriation:
66               •     from the General Fund, One-time, ($58,200).
67               •     from Federal Funds, One-time, ($58,200).
68          ▸     to Department of Health - Executive Director's Operations, as a one-time
69     appropriation:
70               •     from the Department of Health and Human Services Transition Restricted
71     Account, One-time, $1,500,000.
72               •     from Federal Funds, One-time, $1,500,000.
73          ▸     to Department of Human Services - Executive Director Operations, as a one-time
74     appropriation:
75               •     from the Department of Health and Human Services Transition Restricted
76     Account, One-time, $1,500,000.
77               •     from Federal Funds, One-time, $1,500,000.
78     Other Special Clauses:
79          This bill provides a special effective date.
80     Utah Code Sections Affected:
81     AMENDS:
82          26-18-3, as last amended by Laws of Utah 2019, Chapters 104 and 253

83          35A-1-304, as last amended by Laws of Utah 1998, Chapter 116
84          35A-1-307, as repealed and reenacted by Laws of Utah 1997, Chapter 375
85          35A-3-103, as last amended by Laws of Utah 2016, Chapters 296 and 348
86          63I-2-226, as last amended by Laws of Utah 2020, Chapters 154, 187, 215, and 354
87     ENACTS:
88          26B-1-101, Utah Code Annotated 1953
89          26B-1-102, Utah Code Annotated 1953
90          26B-1-103, Utah Code Annotated 1953
91          26B-1-201, Utah Code Annotated 1953
92          26B-1-201.1, Utah Code Annotated 1953
93     

94     Be it enacted by the Legislature of the state of Utah:
95          Section 1. Section 26-18-3 is amended to read:
96          26-18-3. Administration of Medicaid program by department -- Reporting to the
97     Legislature -- Disciplinary measures and sanctions -- Funds collected -- Eligibility
98     standards -- Internal audits -- Health opportunity accounts.
99          (1) The department shall be the single state agency responsible for the administration
100     of the Medicaid program in connection with the United States Department of Health and
101     Human Services pursuant to Title XIX of the Social Security Act.
102          (2) (a) The department shall implement the Medicaid program through administrative
103     rules in conformity with this chapter, Title 63G, Chapter 3, Utah Administrative Rulemaking
104     Act, the requirements of Title XIX, and applicable federal regulations.
105          (b) The rules adopted under Subsection (2)(a) shall include, in addition to other rules
106     necessary to implement the program:
107          (i) the standards used by the department for determining eligibility for Medicaid
108     services;
109          (ii) the services and benefits to be covered by the Medicaid program;

110          (iii) reimbursement methodologies for providers under the Medicaid program; and
111          (iv) a requirement that:
112          (A) a person receiving Medicaid services shall participate in the electronic exchange of
113     clinical health records established in accordance with Section 26-1-37 unless the individual
114     opts out of participation;
115          (B) prior to enrollment in the electronic exchange of clinical health records the enrollee
116     shall receive notice of enrollment in the electronic exchange of clinical health records and the
117     right to opt out of participation at any time; and
118          (C) beginning July 1, 2012, when the program sends enrollment or renewal information
119     to the enrollee and when the enrollee logs onto the program's website, the enrollee shall receive
120     notice of the right to opt out of the electronic exchange of clinical health records.
121          (3) (a) The department shall, in accordance with Subsection (3)(b), report to the Social
122     Services Appropriations Subcommittee when the department:
123          (i) implements a change in the Medicaid State Plan;
124          (ii) initiates a new Medicaid waiver;
125          (iii) initiates an amendment to an existing Medicaid waiver;
126          (iv) applies for an extension of an application for a waiver or an existing Medicaid
127     waiver;
128          (v) applies for or receives approval for a change in any capitation rate within the
129     Medicaid program; or
130          (vi) initiates a rate change that requires public notice under state or federal law.
131          (b) The report required by Subsection (3)(a) shall:
132          (i) be submitted to the Social Services Appropriations Subcommittee prior to the
133     department implementing the proposed change; and
134          (ii) include:
135          (A) a description of the department's current practice or policy that the department is
136     proposing to change;

137          (B) an explanation of why the department is proposing the change;
138          (C) the proposed change in services or reimbursement, including a description of the
139     effect of the change;
140          (D) the effect of an increase or decrease in services or benefits on individuals and
141     families;
142          (E) the degree to which any proposed cut may result in cost-shifting to more expensive
143     services in health or human service programs; and
144          (F) the fiscal impact of the proposed change, including:
145          (I) the effect of the proposed change on current or future appropriations from the
146     Legislature to the department;
147          (II) the effect the proposed change may have on federal matching dollars received by
148     the state Medicaid program;
149          (III) any cost shifting or cost savings within the department's budget that may result
150     from the proposed change; and
151          (IV) identification of the funds that will be used for the proposed change, including any
152     transfer of funds within the department's budget.
153          (4) Any rules adopted by the department under Subsection (2) are subject to review and
154     reauthorization by the Legislature in accordance with Section 63G-3-502.
155          (5) The department may, in its discretion, contract with the Department of Human
156     Services or other qualified agencies for services in connection with the administration of the
157     Medicaid program, including:
158          (a) the determination of the eligibility of individuals for the program;
159          (b) recovery of overpayments; and
160          (c) consistent with Section 26-20-13, and to the extent permitted by law and quality
161     control services, enforcement of fraud and abuse laws.
162          (6) The department shall provide, by rule, disciplinary measures and sanctions for
163     Medicaid providers who fail to comply with the rules and procedures of the program, provided

164     that sanctions imposed administratively may not extend beyond:
165          (a) termination from the program;
166          (b) recovery of claim reimbursements incorrectly paid; and
167          (c) those specified in Section 1919 of Title XIX of the federal Social Security Act.
168          (7) (a) Funds collected as a result of a sanction imposed under Section 1919 of Title
169     XIX of the federal Social Security Act shall be deposited in the General Fund as dedicated
170     credits to be used by the division in accordance with the requirements of Section 1919 of Title
171     XIX of the federal Social Security Act.
172          (b) In accordance with Section 63J-1-602.2, sanctions collected under this Subsection
173     (7) are nonlapsing.
174          (8) (a) In determining whether an applicant or recipient is eligible for a service or
175     benefit under this part or Chapter 40, Utah Children's Health Insurance Act, the department
176     shall, if Subsection (8)(b) is satisfied, exclude from consideration one passenger vehicle
177     designated by the applicant or recipient.
178          (b) Before Subsection (8)(a) may be applied:
179          (i) the federal government shall:
180          (A) determine that Subsection (8)(a) may be implemented within the state's existing
181     public assistance-related waivers as of January 1, 1999;
182          (B) extend a waiver to the state permitting the implementation of Subsection (8)(a); or
183          (C) determine that the state's waivers that permit dual eligibility determinations for
184     cash assistance and Medicaid are no longer valid; and
185          (ii) the department shall determine that Subsection (8)(a) can be implemented within
186     existing funding.
187          (9) (a) For purposes of this Subsection (9):
188          (i) "aged, blind, or has a disability" means an aged, blind, or disabled individual, as
189     defined in 42 U.S.C. Sec. 1382c(a)(1); and
190          (ii) "spend down" means an amount of income in excess of the allowable income

191     standard that shall be paid in cash to the department or incurred through the medical services
192     not paid by Medicaid.
193          (b) In determining whether an applicant or recipient who is aged, blind, or has a
194     disability is eligible for a service or benefit under this chapter, the department shall use 100%
195     of the federal poverty level as:
196          (i) the allowable income standard for eligibility for services or benefits; and
197          (ii) the allowable income standard for eligibility as a result of spend down.
198          (10) The department shall conduct internal audits of the Medicaid program.
199          (11) (a) The department may apply for and, if approved, implement a demonstration
200     program for health opportunity accounts, as provided for in 42 U.S.C. Sec. 1396u-8.
201          (b) A health opportunity account established under Subsection (11)(a) shall be an
202     alternative to the existing benefits received by an individual eligible to receive Medicaid under
203     this chapter.
204          (c) Subsection (11)(a) is not intended to expand the coverage of the Medicaid program.
205          (12) (a) (i) The department shall apply for, and if approved, implement an amendment
206     to the state plan under this Subsection (12) for benefits for:
207          (A) medically needy pregnant women;
208          (B) medically needy children; and
209          (C) medically needy parents and caretaker relatives.
210          (ii) The department may implement the eligibility standards of Subsection (12)(b) for
211     eligibility determinations made on or after the date of the approval of the amendment to the
212     state plan.
213          (b) In determining whether an applicant is eligible for benefits described in Subsection
214     (12)(a)(i), the department shall:
215          (i) disregard resources held in an account in the savings plan created under Title 53B,
216     Chapter 8a, Utah Educational Savings Plan, if the beneficiary of the account is:
217          (A) under the age of 26; and

218          (B) living with the account owner, as that term is defined in Section 53B-8a-102, or
219     temporarily absent from the residence of the account owner; and
220          (ii) include the withdrawals from an account in the Utah Educational Savings Plan as
221     resources for a benefit determination, if the withdrawal was not used for qualified higher
222     education costs as that term is defined in Section 53B-8a-102.5.
223          (13) (a) The department may not deny or terminate eligibility for Medicaid solely
224     because an individual is:
225          (i) incarcerated; and
226          (ii) not an inmate as defined in Section 64-13-1.
227          (b) Subsection (13)(a) does not require the Medicaid program to provide coverage for
228     any services for an individual while the individual is incarcerated.
229          (14) The department is a party to, and may intervene at any time in, any judicial or
230     administrative action:
231          (a) to which the Department of Workforce Services is a party; and
232          (b) that involves medical assistance under:
233          (i) Title 26, Chapter 18, Medical Assistance Act; or
234          (ii) Title 26, Chapter 40, Utah Children's Health Insurance Act.
235          Section 2. Section 26B-1-101 is enacted to read:
236     
TITLE 26B. DEPARTMENT OF HEALTH AND HUMAN SERVICES

237     
CHAPTER 1. GENERAL PROVISIONS AND ORGANIZATION

238     
Part 1. General Provisions

239          26B-1-101. Title.
240          This title is known as the "Department of Health and Human Services."
241          Section 3. Section 26B-1-102 is enacted to read:
242          26B-1-102. Definitions.
243          As used in this title:
244          (1) "Department" means the Department of Health and Human Services created in

245     Section 26B-1-201.
246          (2) "Department of Health" means the Department of Health created in Section 26-1-4.
247          (3) "Department of Human Services" means the Department of Human Services
248     created in Section 62A-1-102.
249          Section 4. Section 26B-1-103 is enacted to read:
250          26B-1-103. Purpose of title -- Consolidation of functions into single state agency.
251          The purpose of this title is to consolidate into a single agency of state government all of
252     the functions exercised by:
253          (1) the Department of Health, including all of the powers and duties described in Title
254     26, Utah Health Code; and
255          (2) the Department of Human Services, including all of the powers and duties
256     described in Title 62A, Utah Human Services Code.
257          Section 5. Section 26B-1-201 is enacted to read:
258     
Part 2. Organization

259          26B-1-201. Department of Health and Human Services -- Creation -- Duties.
260          (1) There is created within state government the Department of Health and Human
261     Services, which has all of the policymaking functions, regulatory and enforcement powers,
262     rights, duties, and responsibilities outlined in this title.
263          (2) In addition to Subsection (1), during the transition period described in Section
264     26B-1-201.1, the Department of Health and Human Services may exercise any of the
265     policymaking functions, regulatory and enforcement powers, rights, duties, and responsibilities
266     of the Department of Health and the Department of Human Services under the joint direction
267     of:
268          (a) the executive director of the Department of Health; and
269          (b) the executive director of the Department of Human Services.
270          Section 6. Section 26B-1-201.1 is enacted to read:
271          26B-1-201.1. Transition to single state agency -- Transition plan -- Restricted

272     Account.
273          (1) As used in this section:
274          (a) "Transition agencies" means the:
275          (i) Department of Health; and
276          (ii) Department of Human Services.
277          (b) "Transition period" means the period of time:
278          (i) during which the transition of the department to the Department of Health and
279     Human Services takes place; and
280          (ii) beginning on the effective date of the bill, and ending on July 1, 2022.
281          (2) On or before December 1, 2021, the transition agencies shall develop a written
282     transition plan for merging the functions of the transition agencies into the Department of
283     Health and Human Services on July 1, 2022, in order to:
284          (a) more efficiently and effectively manage health and human services programs that
285     are the responsibility of the state;
286          (b) establish a health and human services policy for the state; and
287          (c) promote health and the quality of life in the health and human services field.
288          (3) The written transition plan described in Subsection (2) shall describe:
289          (a) the tasks that need to be completed before the move on July 1, 2022, including a
290     description of:
291          (i) how the transition agencies solicited comment from stakeholders, including:
292          (A) employees of the transition agencies;
293          (B) clients and partners of the transition agencies;
294          (C) members of the public;
295          (D) the Legislature; and
296          (E) the executive office of the governor;
297          (ii) the proposed organizational structure of the department, including the transition of
298     responsibilities of employees, by job title and classification, under the newly proposed

299     organizational structure and a plan for these transitions;
300          (iii) office space and infrastructure requirements related to the transition;
301          (iv) any work site location changes for transitioning employees;
302          (v) the transition of service delivery sites;
303          (vi) amendments needed to existing contracts, including grants;
304          (vii) legislative changes needed to implement the transition described in this section;
305          (viii) how the transition agencies will coordinate agency rules;
306          (ix) procedures for the transfer and reconciliation of budgeting and funding of the
307     department as the transition agencies transition into the department; and
308          (x) the transition of technology services to the department;
309          (b) the tasks that may need to be completed after the transition on July 1, 2022; and
310          (c) how the transition to the department will be funded, including details of:
311          (i) how expenses associated with the transition will be managed;
312          (ii) how funding for services provided by the transition agencies will be managed to
313     ensure services will be provided by the transition agencies and the department without
314     interruption; and
315          (iii) how federal funds will be used by or transferred between the transition agencies
316     and the department to ensure services will be provided by the transition agencies and the
317     department without interruption.
318          (4) The written transition plan described in Subsection (2) shall:
319          (a) include a detailed timeline for the completion of the tasks described in Subsection
320     (3)(a);
321          (b) be updated at least one time in every two week period until the transition is
322     complete;
323          (c) describe how information will be provided to clients of the transition agencies and
324     the department regarding any changes to where services will be provided and the hours services
325     will be provided;

326          (d) be provided to the:
327          (i) Health and Human Services Interim Committee;
328          (ii) Social Services Appropriations Subcommittee;
329          (iii) the executive office of the governor;
330          (iv) Division of Finance; and
331          (v) Department of Technology Services; and
332          (e) be made available to employees that are transitioning or may potentially be
333     transitioned.
334          (5) The transition agencies shall publish information that provides a full overview of
335     the written transition plan and how the move may affect client services offered by the transition
336     agencies on the transition agencies' respective websites, including regular updates regarding:
337          (a) how the move may affect client services offered by the transition agencies;
338          (b) information regarding the location where services are provided and the hours
339     services are provided; and
340          (c) contact information so that clients of the transition agencies can contact
341     transitioning employees and obtain information regarding client services.
342          (6) The transition agencies may, separately or collectively, enter into a memorandum of
343     understanding regarding how costs and responsibilities will be shared to:
344          (a) ensure that services provided under agreements with the federal government,
345     including new and ongoing grant programs, are fulfilled;
346          (b) ensure that commitments made by the transition agencies are met;
347          (c) provide ongoing or shared services as needed, including the provision of payments
348     to the department from the transition agencies; and
349          (d) ensure that money from the Department of Health and Human Services Transition
350     Restricted Account created in Subsection (8) is used appropriately by the transition agencies
351     and the department.
352          (7) In implementing the written transition plan described in this section, the transition

353     agencies and the department shall protect existing services, programs, and access to services
354     provided by the transition agencies.
355          (8) (a) There is created a restricted account within the General Fund known as the
356     "Department of Health and Human Services Transition Restricted Account."
357          (b) The restricted account shall consist of appropriations made by the Legislature.
358          (c) Subject to appropriation, the transition agencies and the department may spend
359     money from the restricted account to pay for expenses related to moving the transition agencies
360     into the department, including staff and legal services.
361          Section 7. Section 35A-1-304 is amended to read:
362          35A-1-304. Review authority of the Workforce Appeals Board.
363          (1) (a) In accordance with this title and Title 63G, Chapter 4, Administrative
364     Procedures Act, the Workforce Appeals Board may allow an appeal from a decision of an
365     administrative law judge from a formal adjudicative proceeding if a motion for review is filed
366     with the Division of Adjudication within the designated time by any party entitled to the notice
367     of the administrative law judge's decision.
368          (b) An appeal filed by the party shall be allowed as of right if the decision of the
369     administrative law judge did not affirm the department's prior decision.
370          (c) If the Workforce Appeals Board denies an application for appeal from the decision
371     of an administrative law judge, the decision of the administrative law judge is considered a
372     decision of the Workforce Appeals Board for purposes of judicial review and is subject to
373     judicial review if further appeal is initiated under this title.
374          (2) On appeal, the Workforce Appeals Board may on the basis of the evidence
375     previously submitted in the case, or upon the basis of any additional evidence it requires:
376          (a) affirm the decision of the administrative law judge;
377          (b) modify the decision of the administrative law judge; or
378          (c) reverse the findings, conclusions, and decision of the administrative law judge.
379          (3) The Workforce Appeals Board shall promptly notify the parties to any proceedings

380     before it of its decision, including its findings and conclusions, and the decision is a final order
381     of the department unless within 30 days after the date the decision of the Workforce Appeals
382     Board is issued, further appeal is initiated under this title.
383          Section 8. Section 35A-1-307 is amended to read:
384          35A-1-307. Scope of part.
385          This part does not apply to adjudication under[: (1) Chapter 3, Employment Support
386     Act; or (2)] Chapter 5, Part 1, Job Training Coordination Act.
387          Section 9. Section 35A-3-103 is amended to read:
388          35A-3-103. Department responsibilities.
389          The department shall:
390          (1) administer public assistance programs assigned by the Legislature and the
391     governor;
392          (2) determine eligibility for public assistance programs in accordance with the
393     requirements of this chapter;
394          (3) cooperate with the federal government in the administration of public assistance
395     programs;
396          (4) administer state employment services;
397          (5) provide for the compilation of necessary or desirable information, statistics, and
398     reports;
399          (6) perform other duties and functions required by law;
400          (7) monitor the application of eligibility policy;
401          (8) develop personnel training programs for effective and efficient operation of the
402     programs administered by the department;
403          (9) provide refugee resettlement services in accordance with Section 35A-3-701;
404          (10) provide child care assistance for children in accordance with Part 2, Office of
405     Child Care; [and]
406          (11) provide services that enable an applicant or recipient to qualify for affordable

407     housing in cooperation with:
408          (a) the Utah Housing Corporation;
409          (b) the Housing and Community Development Division; and
410          (c) local housing authorities[.];
411          (12) in accordance with 42 C.F.R. Sec. 431.10, develop non-clinical eligibility policy
412     and procedures to implement the eligibility state plan, waivers, and administrative rules
413     developed and issued by the Department of Health and Human Services for medical assistance
414     under:
415          (a) Title 26, Chapter 18, Medical Assistance Act; and
416          (b) Title 26, Chapter 40, Utah Children's Health Insurance Act;
417          (13) administer the Medicaid Eligibility Quality Control function in accordance with
418     42 C.F.R. Sec. 431.812; and
419          (14) conduct eligibility hearings and issue final decisions in adjudicative proceedings,
420     including expedited appeals as defined in 42 C.F.R. Sec. 431.224, for medical assistance
421     eligibility under:
422          (a) Title 26, Chapter 18, Medical Assistance Act; or
423          (b) Title 26, Chapter 40, Utah Children's Health Insurance Act.
424          Section 10. Section 63I-2-226 is amended to read:
425          63I-2-226. Repeal dates, Title 26 through 26B.
426          (1) Subsection 26-1-7(1)(c), in relation to the Air Ambulance Committee, is repealed
427     July 1, 2024.
428          (2) Subsection 26-7-8(3) is repealed January 1, 2027.
429          (3) Section 26-8a-107 is repealed July 1, 2024.
430          (4) Subsection 26-8a-203(3)(a)(i) is repealed January 1, 2023.
431          (5) Section 26-8a-211 is repealed July 1, 2023.
432          (6) In relation to the Air Ambulance Committee, on July 1, 2024, Subsection
433     26-8a-602(1)(a) is amended to read:

434          "(a) provide the patient or the patient's representative with the following information
435     before contacting an air medical transport provider:
436          (i) which health insurers in the state the air medical transport provider contracts with;
437          (ii) if sufficient data is available, the average charge for air medical transport services
438     for a patient who is uninsured or out of network; and
439          (iii) whether the air medical transport provider balance bills a patient for any charge
440     not paid by the patient's health insurer; and".
441          (7) Subsection 26-18-2.4(3)(e) is repealed January 1, 2023.
442          (8) Subsection 26-18-411(8), related to reporting on the health coverage improvement
443     program, is repealed January 1, 2023.
444          (9) Subsection 26-18-420(5), related to reporting on coverage for in vitro fertilization
445     and genetic testing, is repealed July 1, 2030.
446          [(10) Subsection 26-21-28(2)(b) is repealed January 1, 2021.]
447          [(11)] (10) In relation to the Air Ambulance Committee, July 1, 2024, Subsection
448     26-21-32(1)(a) is amended to read:
449          "(a) provide the patient or the patient's representative with the following information
450     before contacting an air medical transport provider:
451          (i) which health insurers in the state the air medical transport provider contracts with;
452          (ii) if sufficient data is available, the average charge for air medical transport services
453     for a patient who is uninsured or out of network; and
454          (iii) whether the air medical transport provider balance bills a patient for any charge
455     not paid by the patient's health insurer; and".
456          [(12)] (11) Subsection 26-33a-106.1(2)(a) is repealed January 1, 2023.
457          [(13)] (12) Title 26, Chapter 46, Utah Health Care Workforce Financial Assistance
458     Program, is repealed July 1, 2027.
459          [(14) Subsection 26-55-107(8) is repealed January 1, 2021.]
460          [(15)] (13) Subsection 26-61-202(4)(b) is repealed January 1, 2022.

461          [(16)] (14) Subsection 26-61-202(5) is repealed January 1, 2022.
462          (15) Section 26B-1-201.1 is repealed July 1, 2022.
463          Section 11. Appropriation.
464          The following sums of money are appropriated for the fiscal year beginning July 1,
465     2021, and ending June 30, 2022. These are additions to amounts previously appropriated for
466     fiscal year 2022.
467          Subsection 11(a). Operating and Capital Budgets.
468          Under the terms and conditions of Title 63J, Chapter 1, Budgetary Procedures Act, the
469     Legislature appropriates the following sums of money from the funds or accounts indicated for
470     the use and support of the government of the state of Utah.
471     ITEM 1
472          To Department of Health -- Executive Director's Operations
473               From General Fund
($135,000)

474               From General Fund, One-time
$135,000

475               From Federal Funds
($135,000)

476               From Federal Funds, One-time
$135,000

477     ITEM 2
478          To Department of Health -- Medicaid and Health Financing
479               From General Fund
($486,500)

480               From General Fund, One-time
$486,500

481               From Federal Funds
($486,500)

482               From Federal Funds, One-time
$486,500

483     ITEM 3
484          To Department of Health -- Executive Director's Operations
485               From General Fund
($58,200)

486               From General Fund, One-time
$58,200

487               From Federal Funds
($58,200)


488               From Federal Funds, One-time
$58,200

489     ITEM 4
490          To Department of Health -- Executive Director's Operations
491               From Department of Health and Human Services Transition Restricted
492               Account, One-time
$1,500,000

493               From Federal Funds, One-Time
$1,500,000

494               Schedule of Programs:
495                    Program Operations                    $3,000,000
496     ITEM 5
497          To Department of Human Services -- Executive Director Operations
498               From Department of Health and Human Services Transition Restricted
499               Account, One-time
$1,500,000

500               From Federal Funds, One-Time
$1,500,000

501               Schedule of Programs:
502                    Fiscal Operations                    $3,000,000
503     ITEM 6
504          To Department of Workforce Services -- Operations and Policy
505               From General Fund
$486,500

506               From General Fund, One-time
($486,500)

507               From Federal Funds
$486,500

508               From Federal Funds, One-time
($486,500)

509     ITEM 7
510          To Department of Workforce Services -- Administration
511               From General Fund
$58,200

512               From General Fund, One-time
($58,200)

513               From Federal Funds
$58,200

514               From Federal Funds, One-time
($58,200)


515          Subsection 11(b). Restricted Fund and Account Transfers.
516          The Legislature authorizes the State Division of Finance to transfer the following
517     amounts between the following funds or accounts as indicated. Expenditures and outlays from
518     the funds to which the money is transferred must be authorized by an appropriation.
519     ITEM 1
520          To General Fund Restricted -- Department of Health and Human Services Transition
521          Restricted Account
522               From General Fund, One-time
$1,500,000

523               From Federal Funds, One-time
$1,500,000

524               Schedule of Programs:
525                    General Fund Restricted -- Department of Health and Human Services
526                    Transition Restricted Account          $3,000,000
527          Section 12. Effective date.
528          (1) Except as provided in Subsection (2), if approved by two-thirds of all the members
529     elected to each house, this bill takes effect upon approval by the governor, or the day following
530     the constitutional time limit of Utah Constitution, Article VII, Section 8, without the governor's
531     signature, or in the case of a veto, the date of veto override.
532          (2) The actions affecting the following sections take effect on July 1, 2022:
533          (a) Section 26-18-3;
534          (b) Section 35A-1-304;
535          (c) Section 35A-1-307; and
536          (d) Section 35A-3-103.