Senator Kathleen A. Riebe proposes the following substitute bill:


1     
MOBILE CRISIS OUTREACH TEAM EXPANSION

2     
2021 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Kathleen A. Riebe

5     
House Sponsor: Andrew Stoddard

6     

7     LONG TITLE
8     General Description:
9          This bill creates additional mobile crisis outreach teams.
10     Highlighted Provisions:
11          This bill:
12          ▸     requires the Division of Substance Abuse and Mental Health to create and monitor
13     additional mobile crisis outreach teams; and
14          ▸     exempts local substance abuse authorities and local mental health authorities from
15     providing matching funds for mobile crisis outreach teams.
16     Money Appropriated in this Bill:
17          This bill appropriates in fiscal year 2022:
18          ▸     to the Department of Human Services -- Division of Substance Abuse and Mental
19     Health, as an ongoing appropriation:
20               •     from the General Fund, $4,200,000.
21     Other Special Clauses:
22          None
23     Utah Code Sections Affected:
24     AMENDS:
25          17-43-201, as last amended by Laws of Utah 2018, Chapter 68

26          17-43-301, as last amended by Laws of Utah 2020, Chapter 303
27          62A-15-116, as last amended by Laws of Utah 2020, Chapter 303
28     

29     Be it enacted by the Legislature of the state of Utah:
30          Section 1. Section 17-43-201 is amended to read:
31          17-43-201. Local substance abuse authorities -- Responsibilities.
32          (1) (a) (i) In each county operating under a county executive-council form of
33     government under Section 17-52a-203, the county legislative body is the local substance abuse
34     authority, provided however that any contract for plan services shall be administered by the
35     county executive.
36          (ii) In each county operating under a council-manager form of government under
37     Section 17-52a-204, the county manager is the local substance abuse authority.
38          (iii) In each county other than a county described in Subsection (1)(a)(i) or (ii), the
39     county legislative body is the local substance abuse authority.
40          (b) Within legislative appropriations and county matching funds required by this
41     section, and under the direction of the division, each local substance abuse authority shall:
42          (i) develop substance abuse prevention and treatment services plans;
43          (ii) provide substance abuse services to residents of the county; and
44          (iii) cooperate with efforts of the Division of Substance Abuse and Mental Health to
45     promote integrated programs that address an individual's substance abuse, mental health, and
46     physical healthcare needs, as described in Section 62A-15-103.
47          (c) Within legislative appropriations and county matching funds required by this
48     section, each local substance abuse authority shall cooperate with the efforts of the Department
49     of Human Services to promote a system of care, as defined in Section 62A-1-104, for minors
50     with or at risk for complex emotional and behavioral needs, as described in Section 62A-1-111.
51          (2) (a) By executing an interlocal agreement under Title 11, Chapter 13, Interlocal
52     Cooperation Act, two or more counties may join to:
53          (i) provide substance abuse prevention and treatment services; or
54          (ii) create a united local health department that provides substance abuse treatment
55     services, mental health services, and local health department services in accordance with
56     Subsection (3).

57          (b) The legislative bodies of counties joining to provide services may establish
58     acceptable ways of apportioning the cost of substance abuse services.
59          (c) Each agreement for joint substance abuse services shall:
60          (i) (A) designate the treasurer of one of the participating counties or another person as
61     the treasurer for the combined substance abuse authorities and as the custodian of money
62     available for the joint services; and
63          (B) provide that the designated treasurer, or other disbursing officer authorized by the
64     treasurer, may make payments from the money for the joint services upon audit of the
65     appropriate auditing officer or officers representing the participating counties;
66          (ii) provide for the appointment of an independent auditor or a county auditor of one of
67     the participating counties as the designated auditing officer for the combined substance abuse
68     authorities;
69          (iii) (A) provide for the appointment of the county or district attorney of one of the
70     participating counties as the designated legal officer for the combined substance abuse
71     authorities; and
72          (B) authorize the designated legal officer to request and receive the assistance of the
73     county or district attorneys of the other participating counties in defending or prosecuting
74     actions within their counties relating to the combined substance abuse authorities; and
75          (iv) provide for the adoption of management, clinical, financial, procurement,
76     personnel, and administrative policies as already established by one of the participating
77     counties or as approved by the legislative body of each participating county or interlocal board.
78          (d) An agreement for joint substance abuse services may provide for joint operation of
79     services and facilities or for operation of services and facilities under contract by one
80     participating local substance abuse authority for other participating local substance abuse
81     authorities.
82          (3) A county governing body may elect to combine the local substance abuse authority
83     with the local mental health authority created in Part 3, Local Mental Health Authorities, and
84     the local health department created in Title 26A, Chapter 1, Part 1, Local Health Department
85     Act, to create a united local health department under Section 26A-1-105.5. A local substance
86     abuse authority that joins a united local health department shall comply with this part.
87          (4) (a) Each local substance abuse authority is accountable to the department, the

88     Department of Health, and the state with regard to the use of state and federal funds received
89     from those departments for substance abuse services, regardless of whether the services are
90     provided by a private contract provider.
91          (b) Each local substance abuse authority shall comply, and require compliance by its
92     contract provider, with all directives issued by the department and the Department of Health
93     regarding the use and expenditure of state and federal funds received from those departments
94     for the purpose of providing substance abuse programs and services. The department and
95     Department of Health shall ensure that those directives are not duplicative or conflicting, and
96     shall consult and coordinate with local substance abuse authorities with regard to programs and
97     services.
98          (5) Each local substance abuse authority shall:
99          (a) review and evaluate substance abuse prevention and treatment needs and services,
100     including substance abuse needs and services for individuals incarcerated in a county jail or
101     other county correctional facility;
102          (b) annually prepare and submit to the division a plan approved by the county
103     legislative body for funding and service delivery that includes:
104          (i) provisions for services, either directly by the substance abuse authority or by
105     contract, for adults, youth, and children, including those incarcerated in a county jail or other
106     county correctional facility; and
107          (ii) primary prevention, targeted prevention, early intervention, and treatment services;
108          (c) establish and maintain, either directly or by contract, programs licensed under Title
109     62A, Chapter 2, Licensure of Programs and Facilities;
110          (d) appoint directly or by contract a full or part time director for substance abuse
111     programs, and prescribe the director's duties;
112          (e) provide input and comment on new and revised rules established by the division;
113          (f) establish and require contract providers to establish administrative, clinical,
114     procurement, personnel, financial, and management policies regarding substance abuse services
115     and facilities, in accordance with the rules of the division, and state and federal law;
116          (g) establish mechanisms allowing for direct citizen input;
117          (h) annually contract with the division to provide substance abuse programs and
118     services in accordance with the provisions of Title 62A, Chapter 15, Substance Abuse and

119     Mental Health Act;
120          (i) comply with all applicable state and federal statutes, policies, audit requirements,
121     contract requirements, and any directives resulting from those audits and contract requirements;
122          (j) promote or establish programs for the prevention of substance abuse within the
123     community setting through community-based prevention programs;
124          (k) except as described in Subsection (11), provide funding equal to at least 20% of the
125     state funds that it receives to fund services described in the plan;
126          (l) comply with the requirements and procedures of Title 11, Chapter 13, Interlocal
127     Cooperation Act, Title 17B, Chapter 1, Part 6, Fiscal Procedures for Local Districts, and Title
128     51, Chapter 2a, Accounting Reports from Political Subdivisions, Interlocal Organizations, and
129     Other Local Entities Act;
130          (m) for persons convicted of driving under the influence in violation of Section
131     41-6a-502 or 41-6a-517, conduct the following as defined in Section 41-6a-501:
132          (i) a screening;
133          (ii) an assessment;
134          (iii) an educational series; and
135          (iv) substance abuse treatment; and
136          (n) utilize proceeds of the accounts described in Subsection 62A-15-503(1) to
137     supplement the cost of providing the services described in Subsection (5)(m).
138          (6) Before disbursing any public funds, each local substance abuse authority shall
139     require that each entity that receives any public funds from the local substance abuse authority
140     agrees in writing that:
141          (a) the entity's financial records and other records relevant to the entity's performance
142     of the services provided to the local substance abuse authority shall be subject to examination
143     by:
144          (i) the division;
145          (ii) the local substance abuse authority director;
146          (iii) (A) the county treasurer and county or district attorney; or
147          (B) if two or more counties jointly provide substance abuse services under an
148     agreement under Subsection (2), the designated treasurer and the designated legal officer;
149          (iv) the county legislative body; and

150          (v) in a county with a county executive that is separate from the county legislative
151     body, the county executive;
152          (b) the county auditor may examine and audit the entity's financial and other records
153     relevant to the entity's performance of the services provided to the local substance abuse
154     authority; and
155          (c) the entity will comply with the provisions of Subsection (4)(b).
156          (7) A local substance abuse authority may receive property, grants, gifts, supplies,
157     materials, contributions, and any benefit derived therefrom, for substance abuse services. If
158     those gifts are conditioned upon their use for a specified service or program, they shall be so
159     used.
160          (8) (a) As used in this section, "public funds" means the same as that term is defined in
161     Section 17-43-203.
162          (b) Public funds received for the provision of services pursuant to the local substance
163     abuse plan may not be used for any other purpose except those authorized in the contract
164     between the local substance abuse authority and the provider for the provision of plan services.
165          (9) Subject to the requirements of the federal Substance Abuse Prevention and
166     Treatment Block Grant, Pub. L. No. 102-321, a local substance abuse authority shall ensure
167     that all substance abuse treatment programs that receive public funds:
168          (a) accept and provide priority for admission to a pregnant woman or a pregnant minor;
169     and
170          (b) if admission of a pregnant woman or a pregnant minor is not possible within 24
171     hours of the time that a request for admission is made, provide a comprehensive referral for
172     interim services that:
173          (i) are accessible to the pregnant woman or pregnant minor;
174          (ii) are best suited to provide services to the pregnant woman or pregnant minor;
175          (iii) may include:
176          (A) counseling;
177          (B) case management; or
178          (C) a support group; and
179          (iv) shall include a referral for:
180          (A) prenatal care; and

181          (B) counseling on the effects of alcohol and drug use during pregnancy.
182          (10) If a substance abuse treatment program described in Subsection (9) is not able to
183     accept and admit a pregnant woman or pregnant minor under Subsection (9) within 48 hours of
184     the time that request for admission is made, the local substance abuse authority shall contact
185     the Division of Substance Abuse and Mental Health for assistance in providing services to the
186     pregnant woman or pregnant minor.
187          (11) Subsection (5)(k) does not apply to state funds a local substance abuse authority
188     receives for a mobile crisis outreach team created under Section 62A-15-116.
189          Section 2. Section 17-43-301 is amended to read:
190          17-43-301. Local mental health authorities -- Responsibilities.
191          (1) As used in this section:
192          (a) "Assisted outpatient treatment" means the same as that term is defined in Section
193     62A-15-602.
194          (b) "Crisis worker" means the same as that term is defined in Section 62A-15-1301.
195          (c) "Local mental health crisis line" means the same as that term is defined in Section
196     62A-15-1301.
197          (d) "Mental health therapist" means the same as that term is defined in Section
198     58-60-102.
199          (e) "Public funds" means the same as that term is defined in Section 17-43-303.
200          (f) "Statewide mental health crisis line" means the same as that term is defined in
201     Section 62A-15-1301.
202          (2) (a) (i) In each county operating under a county executive-council form of
203     government under Section 17-52a-203, the county legislative body is the local mental health
204     authority, provided however that any contract for plan services shall be administered by the
205     county executive.
206          (ii) In each county operating under a council-manager form of government under
207     Section 17-52a-204, the county manager is the local mental health authority.
208          (iii) In each county other than a county described in Subsection (2)(a)(i) or (ii), the
209     county legislative body is the local mental health authority.
210          (b) Within legislative appropriations and county matching funds required by this
211     section, under the direction of the division, each local mental health authority shall:

212          (i) provide mental health services to individuals within the county; and
213          (ii) cooperate with efforts of the Division of Substance Abuse and Mental Health to
214     promote integrated programs that address an individual's substance abuse, mental health, and
215     physical healthcare needs, as described in Section 62A-15-103.
216          (c) Within legislative appropriations and county matching funds required by this
217     section, each local mental health authority shall cooperate with the efforts of the Department of
218     Human Services to promote a system of care, as defined in Section 62A-1-104, for minors with
219     or at risk for complex emotional and behavioral needs, as described in Section 62A-1-111.
220          (3) (a) By executing an interlocal agreement under Title 11, Chapter 13, Interlocal
221     Cooperation Act, two or more counties may join to:
222          (i) provide mental health prevention and treatment services; or
223          (ii) create a united local health department that combines substance abuse treatment
224     services, mental health services, and local health department services in accordance with
225     Subsection (4).
226          (b) The legislative bodies of counties joining to provide services may establish
227     acceptable ways of apportioning the cost of mental health services.
228          (c) Each agreement for joint mental health services shall:
229          (i) (A) designate the treasurer of one of the participating counties or another person as
230     the treasurer for the combined mental health authorities and as the custodian of money
231     available for the joint services; and
232          (B) provide that the designated treasurer, or other disbursing officer authorized by the
233     treasurer, may make payments from the money available for the joint services upon audit of the
234     appropriate auditing officer or officers representing the participating counties;
235          (ii) provide for the appointment of an independent auditor or a county auditor of one of
236     the participating counties as the designated auditing officer for the combined mental health
237     authorities;
238          (iii) (A) provide for the appointment of the county or district attorney of one of the
239     participating counties as the designated legal officer for the combined mental health
240     authorities; and
241          (B) authorize the designated legal officer to request and receive the assistance of the
242     county or district attorneys of the other participating counties in defending or prosecuting

243     actions within their counties relating to the combined mental health authorities; and
244          (iv) provide for the adoption of management, clinical, financial, procurement,
245     personnel, and administrative policies as already established by one of the participating
246     counties or as approved by the legislative body of each participating county or interlocal board.
247          (d) An agreement for joint mental health services may provide for:
248          (i) joint operation of services and facilities or for operation of services and facilities
249     under contract by one participating local mental health authority for other participating local
250     mental health authorities; and
251          (ii) allocation of appointments of members of the mental health advisory council
252     between or among participating counties.
253          (4) A county governing body may elect to combine the local mental health authority
254     with the local substance abuse authority created in Part 2, Local Substance Abuse Authorities,
255     and the local health department created in Title 26A, Chapter 1, Part 1, Local Health
256     Department Act, to create a united local health department under Section 26A-1-105.5. A local
257     mental health authority that joins with a united local health department shall comply with this
258     part.
259          (5) (a) Each local mental health authority is accountable to the department, the
260     Department of Health, and the state with regard to the use of state and federal funds received
261     from those departments for mental health services, regardless of whether the services are
262     provided by a private contract provider.
263          (b) Each local mental health authority shall comply, and require compliance by its
264     contract provider, with all directives issued by the department and the Department of Health
265     regarding the use and expenditure of state and federal funds received from those departments
266     for the purpose of providing mental health programs and services. The department and
267     Department of Health shall ensure that those directives are not duplicative or conflicting, and
268     shall consult and coordinate with local mental health authorities with regard to programs and
269     services.
270          (6) (a) Each local mental health authority shall:
271          (i) review and evaluate mental health needs and services, including mental health needs
272     and services for:
273          (A) an individual incarcerated in a county jail or other county correctional facility; and

274          (B) an individual who is a resident of the county and who is court ordered to receive
275     assisted outpatient treatment under Section 62A-15-630.5;
276          (ii) in accordance with Subsection (6)(b), annually prepare and submit to the division a
277     plan approved by the county legislative body for mental health funding and service delivery,
278     either directly by the local mental health authority or by contract;
279          (iii) establish and maintain, either directly or by contract, programs licensed under Title
280     62A, Chapter 2, Licensure of Programs and Facilities;
281          (iv) appoint, directly or by contract, a full-time or part-time director for mental health
282     programs and prescribe the director's duties;
283          (v) provide input and comment on new and revised rules established by the division;
284          (vi) establish and require contract providers to establish administrative, clinical,
285     personnel, financial, procurement, and management policies regarding mental health services
286     and facilities, in accordance with the rules of the division, and state and federal law;
287          (vii) establish mechanisms allowing for direct citizen input;
288          (viii) annually contract with the division to provide mental health programs and
289     services in accordance with the provisions of Title 62A, Chapter 15, Substance Abuse and
290     Mental Health Act;
291          (ix) comply with all applicable state and federal statutes, policies, audit requirements,
292     contract requirements, and any directives resulting from those audits and contract requirements;
293          (x) except as described in Subsection (12), provide funding equal to at least 20% of the
294     state funds that it receives to fund services described in the plan;
295          (xi) comply with the requirements and procedures of Title 11, Chapter 13, Interlocal
296     Cooperation Act, Title 17B, Chapter 1, Part 6, Fiscal Procedures for Local Districts, and Title
297     51, Chapter 2a, Accounting Reports from Political Subdivisions, Interlocal Organizations, and
298     Other Local Entities Act; and
299          (xii) take and retain physical custody of minors committed to the physical custody of
300     local mental health authorities by a judicial proceeding under Title 62A, Chapter 15, Part 7,
301     Commitment of Persons Under Age 18 to Division of Substance Abuse and Mental Health.
302          (b) Each plan under Subsection (6)(a)(ii) shall include services for adults, youth, and
303     children, which shall include:
304          (i) inpatient care and services;

305          (ii) residential care and services;
306          (iii) outpatient care and services;
307          (iv) 24-hour crisis care and services;
308          (v) psychotropic medication management;
309          (vi) psychosocial rehabilitation, including vocational training and skills development;
310          (vii) case management;
311          (viii) community supports, including in-home services, housing, family support
312     services, and respite services;
313          (ix) consultation and education services, including case consultation, collaboration
314     with other county service agencies, public education, and public information; and
315          (x) services to persons incarcerated in a county jail or other county correctional facility.
316          (7) (a) If a local mental health authority provides for a local mental health crisis line
317     under the plan for 24-hour crisis care and services described in Subsection (6)(b)(iv), the local
318     mental health authority shall:
319          (i) collaborate with the statewide mental health crisis line described in Section
320     62A-15-1302;
321          (ii) ensure that each individual who answers calls to the local mental health crisis line:
322          (A) is a mental health therapist or a crisis worker; and
323          (B) meets the standards of care and practice established by the Division of Substance
324     Abuse and Mental Health, in accordance with Section 62A-15-1302; and
325          (iii) ensure that when necessary, based on the local mental health crisis line's capacity,
326     calls are immediately routed to the statewide mental health crisis line to ensure that when an
327     individual calls the local mental health crisis line, regardless of the time, date, or number of
328     individuals trying to simultaneously access the local mental health crisis line, a mental health
329     therapist or a crisis worker answers the call without the caller first:
330          (A) waiting on hold; or
331          (B) being screened by an individual other than a mental health therapist or crisis
332     worker.
333          (b) If a local mental health authority does not provide for a local mental health crisis
334     line under the plan for 24-hour crisis care and services described in Subsection (6)(b)(iv), the
335     local mental health authority shall use the statewide mental health crisis line as a local crisis

336     line resource.
337          (8) Before disbursing any public funds, each local mental health authority shall require
338     that each entity that receives any public funds from a local mental health authority agrees in
339     writing that:
340          (a) the entity's financial records and other records relevant to the entity's performance
341     of the services provided to the mental health authority shall be subject to examination by:
342          (i) the division;
343          (ii) the local mental health authority director;
344          (iii) (A) the county treasurer and county or district attorney; or
345          (B) if two or more counties jointly provide mental health services under an agreement
346     under Subsection (3), the designated treasurer and the designated legal officer;
347          (iv) the county legislative body; and
348          (v) in a county with a county executive that is separate from the county legislative
349     body, the county executive;
350          (b) the county auditor may examine and audit the entity's financial and other records
351     relevant to the entity's performance of the services provided to the local mental health
352     authority; and
353          (c) the entity will comply with the provisions of Subsection (5)(b).
354          (9) A local mental health authority may receive property, grants, gifts, supplies,
355     materials, contributions, and any benefit derived therefrom, for mental health services. If those
356     gifts are conditioned upon their use for a specified service or program, they shall be so used.
357          (10) Public funds received for the provision of services pursuant to the local mental
358     health plan may not be used for any other purpose except those authorized in the contract
359     between the local mental health authority and the provider for the provision of plan services.
360          (11) A local mental health authority shall provide assisted outpatient treatment
361     services, as described in Section 62A-15-630.4, to a resident of the county who has been
362     ordered under Section 62A-15-630.5 to receive assisted outpatient treatment.
363          (12) Subsection (6)(a)(x) does not apply to state funds a local mental health authority
364     receives for a mobile crisis outreach team created under Section 62A-15-116.
365          Section 3. Section 62A-15-116 is amended to read:
366          62A-15-116. Mobile crisis outreach team expansion.

367          (1) In consultation with the Behavioral Health Crisis Response Commission,
368     established in Section 63C-18-202, the division shall [award grants for the development of:]
369     work with counties to have at least 14 operating mobile crisis outreach teams throughout the
370     state on or before July 1, 2022.
371          [(a) five mobile crisis outreach teams:]
372          [(i) in counties of the second, third, fourth, fifth, or sixth class; or]
373          [(ii) in counties of the first class, if no more than two mobile crisis outreach teams are
374     operating or have been awarded a grant to operate in the county; and]
375          [(b) at least three mobile crisis outreach teams in counties of the third, fourth, fifth, or
376     sixth class.]
377          (2) A mobile crisis outreach team [awarded a grant under] described in Subsection (1)
378     shall provide mental health crisis services 24 hours per day, 7 days per week, and every day of
379     the year.
380          [(3) The division shall prioritize the award of a grant described in Subsection (1) to
381     entities, based on:]
382          [(a) the number of individuals the proposed mobile crisis outreach team will serve;
383     and]
384          [(b) the percentage of matching funds the entity will provide to develop the proposed
385     mobile crisis outreach team.]
386          [(4) An entity does not need to have resources already in place to be awarded a grant
387     described in Subsection (1).]
388          [(5)] (3) In consultation with the Behavioral Health Crisis Response Commission,
389     established in Section 63C-18-202, the division shall make rules, in accordance with Title 63G,
390     Chapter 3, Utah Administrative Rulemaking Act, for the [application and award of the grants]
391     creation of the mobile crisis outreach teams described in Subsection (1).
392          Section 4. Appropriation.
393          The following sums of money are appropriated for the fiscal year beginning July 1,
394     2021, and ending June 30, 2022. These are additions to amounts previously appropriated for
395     fiscal year 2022. Under the terms and conditions of Title 63J, Chapter 1, Budgetary Procedure
396     Act, the Legislature appropriates the following sums of money from the funds or accounts
397     indicated for the use and support of the government of the state of Utah.

398     ITEM 1
399          To Department of Human Services -- Division of Substance Abuse and Mental Health
400          From General Fund
$4,200,000

401               Schedule of Programs:
402               Community Mental Health Services               $4,200,000
403          The Legislature intends that the Division of Substance Abuse and Mental Health
404     expend appropriations provided under this item for the creation of mobile crisis outreach teams
405     described in Section 62A-15-116.