This document includes Senate Committee Amendments incorporated into the bill on Tue, Jan 25, 2022 at 9:39 AM by lpoole.
This document includes House Floor Amendments incorporated into the bill on Tue, Mar 1, 2022 at 6:58 PM by pflowers.
1     
BEHAVIORAL HEALTH SERVICES AMENDMENTS

2     
2022 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Michael S. Kennedy

5     
House Sponsor: Stewart E. Barlow

6     

7     LONG TITLE
8     Committee Note:
9          The Health and Human Services Interim Committee recommended this bill.
10               Legislative Vote:     15 voting for     0 voting against     3 absent
11     General Description:
12          This bill addresses behavioral health treatment and services.
13     Highlighted Provisions:
14          This bill:
15          ▸     defines terms;
16          ▸     requires the Department of Health to:
17               •     award a grant to a local mental health authority to implement or expand an
18     integrated behavioral health program;
19               •     develop a proposal to allow the state Medicaid program to reimburse a local
20     mental health authority for Ŝ→ [behavioral] physical ←Ŝ health services in an integrated
20a     behavioral
21     health care setting Ŝ→ [at an increased rate] ←Ŝ ; and
22               •     apply for a waiver under the state Medicaid plan to implement the proposal;
23          ▸     allows a certain medication-assistance treatment drug to be recycled under the
24     Charitable Prescription Drug Recycling Act, subject to federal law;
25          ▸     creates a sunset date;
26          ▸     creates reporting requirements; and
27          ▸     makes technical and conforming changes.
28     Money Appropriated in this Bill:
29          This bill appropriates in fiscal year 2023:
29a          Ĥ→ ▸ to Department of Health and Human Services -- Integrated Health Care
29b     Services -- Medicaid Behavioral Health Services, as an ongoing appropriation:
29c               • from General Fund, $116,000; and ←Ĥ
30          ▸     to Department of Health Ŝ→ and Human Services ←Ŝ -- Ŝ→ [Family Health and
30a     Preparedness] Integrated Health Care Services -- Medicaid Behavioral Health Services ←Ŝ , as
30b     a one-time
31     appropriation:
32               •     from General Fund, One-time, Ĥ→ [$200,000] $87,000 ←Ĥ .
33     Other Special Clauses:
34          None
35     Utah Code Sections Affected:
36     AMENDS:
37          58-17b-902, as last amended by Laws of Utah 2021, Chapter 397
38          58-17b-905, as last amended by Laws of Utah 2021, Chapter 397
39          63I-1-226, as last amended by Laws of Utah 2021, Chapters 13, 50, 64, 163, 182, 234,
40     and 417
41     ENACTS:
42          26-1-43, Utah Code Annotated 1953
43          26-18-427, Utah Code Annotated 1953
44     

45     Be it enacted by the Legislature of the state of Utah:
46          Section 1. Section 26-1-43 is enacted to read:
47          26-1-43. Integrated behavioral health care grant program.
48          (1) As used in this section:
49          (a) "Integrated behavioral health care services" means coordinated physical and
50     behavioral health care services for one patient.
51          (b) "Local mental health authority" means a local mental health authority described in
52     Section 17-43-301.
53          (c) "Project" means a project described in Subsection (2).
54          (2) Before July 1 Ĥ→ [, 2022] of each year ←Ĥ , the department shall issue a request for
54a     proposals in
55     accordance with this section to award a grant to a local mental health authority for development
56     or expansion of a project to provide effective delivery of integrated behavioral health care
57     services.
58          (3) To be considered for a grant award under Subsection (2), a local mental health
59     authority shall submit an application to the department that:
60          (a) explains the benefits of integrated behavioral health care services to a patient who is
61     receiving mental health or substance use disorder treatment;
62          (b) describes the local mental health authority's operational plan for delivery of
63     integrated behavioral health care services under the proposed project and any data or
64     evidence-based practices supporting the likely success of the operational plan;
65          (c) includes:
66          (i) the number of patients to be served by the local mental health authority's proposed
67     project; and
68          (ii) the cost of the local mental health authority's proposed project; and
69          (d) provides details regarding:
70          (i) any plan to use funding sources in addition to the grant award under this section for
71     the local mental health authority's proposed project;
72          (ii) any existing or planned contracts or partnerships between the local mental health
73     authority and other individuals or entities to develop or implement the local mental health
74     authority's proposed project; and
75          (iii) the sustainability and reliability of the local mental health authority's proposed
76     project.
77          (4) In evaluating a local mental health authority's application under Subsection (3) to
78     determine the grant award under Subsection (2), the department shall consider:
79          (a) how the local mental health authority's proposed project will ensure effective
80     provision of integrated behavioral health care services;
81          (b) the cost of the local mental health authority's proposed project;
82          (c) the extent to which any existing or planned contracts or partnerships or additional
83     funding sources described in the local mental health authority's application are likely to benefit
84     the proposed project; and
85          (d) the sustainability and reliability of the local mental health authority's proposed
86     project.
87          (5) Before July 1, 2025, the department shall report to the Health and Human Services
88     Interim Committee regarding:
89          (a) any knowledge gained or obstacles encountered in providing integrated behavioral
90     health care services under each project;
91          (b) data gathered in relation to each project; and
92          (c) recommendations for expanding a project statewide.
93          Section 2. Section 26-18-427 is enacted to read:
94          26-18-427. Medicaid waiver for increased integrated health care reimbursement.
95          (1) As used in this section:
96          (a) "Local mental health authority" means a local mental health authority described in
97     Section 17-43-301.
98          (b) "Integrated health care setting" means a health care or behavioral health care setting
99     that provides integrated physical and behavioral health care services.
100          (2) The department shall develop a proposal to allow the state Medicaid program to
101     reimburse a local mental health authority for covered Ŝ→ [behavioral] physical ←Ŝ health care
101a     services provided
102     in an integrated health care setting Ŝ→ [at an increased capitation rate within the state Medicaid
103     program] to Medicaid eligible individuals ←Ŝ .
104          (3) Before December 31, 2022, the department shall apply for a Medicaid waiver or a
105     state plan amendment with CMS to implement the proposal described in Subsection (2).
106          (4) If the waiver or state plan amendment described in Subsection (3) is approved, the
107     department shall:
108          (a) implement the proposal described in Subsection (2); and
109          (b) while the waiver or state plan amendment is in effect, submit a report to the Health
110     and Human Services Interim Committee each year before November 30 detailing:
111          (i) the number of patients served under the waiver or state plan amendment;
112          (ii) the cost of the waiver or state plan amendment; and
113          (iii) any benefits of the waiver or state plan amendment.
114          Section 3. Section 58-17b-902 is amended to read:
115          58-17b-902. Definitions.
116          As used in this part:
117          (1) "Assisted living facility" means the same as that term is defined in Section 26-21-2.
118          (2) "Cancer drug" means a drug that controls or kills neoplastic cells and includes a
119     drug used in chemotherapy to destroy cancer cells.
120          (3) "Charitable clinic" means a charitable nonprofit corporation that:
121          (a) holds a valid exemption from federal income taxation issued under Section 501(a),
122     Internal Revenue Code;
123          (b) is exempt from federal income taxation under Section 501(c)(3), Internal Revenue
124     Code;
125          (c) provides, on an outpatient basis, for a period of less than 24 consecutive hours, to
126     an individual not residing or confined at a facility owned or operated by the charitable
127     nonprofit corporation:
128          (i) advice;
129          (ii) counseling;
130          (iii) diagnosis;
131          (iv) treatment;
132          (v) surgery; or
133          (vi) care or services relating to the preservation or maintenance of health; and
134          (d) has a licensed outpatient pharmacy.
135          (4) "Charitable pharmacy" means an eligible pharmacy that is operated by a charitable
136     clinic.
137          (5) "County health department" means the same as that term is defined in Section
138     26A-1-102.
139          (6) "Donated prescription drug" means a prescription drug that an eligible donor or
140     individual donates to an eligible pharmacy under the program.
141          (7) "Eligible donor" means a donor that donates a prescription drug from within the
142     state and is:
143          (a) a nursing care facility;
144          (b) an assisted living facility;
145          (c) a licensed intermediate care facility for people with an intellectual disability;
146          (d) a manufacturer;
147          (e) a pharmaceutical wholesale distributor;
148          (f) an eligible pharmacy; or
149          (g) a physician's office.
150          (8) "Eligible pharmacy" means a pharmacy that:
151          (a) is registered by the division as eligible to participate in the program; and
152          (b) (i) is licensed in the state as a Class A retail pharmacy; or
153          (ii) is operated by:
154          (A) a county;
155          (B) a county health department;
156          (C) a pharmacy under contract with a county health department;
157          (D) the Department of Health, created in Section 26-1-4;
158          (E) the Division of Substance Abuse and Mental Health, created in Section
159     62A-15-103; or
160          (F) a charitable clinic.
161          (9) (a) "Eligible prescription drug" means a prescription drug, described in Section
162     58-17b-904, that is not:
163          [(a)] (i) except as provided in Subsection (9)(b), a controlled substance; or
164          [(b)] (ii) a drug that can only be dispensed to a patient registered with the drug's
165     manufacturer in accordance with federal Food and Drug Administration requirements.
166          (b) "Eligible prescription drug" includes a medication-assisted treatment drug that may
167     be accepted, transferred, and dispensed under the program in accordance with federal law.
168          (10) "Licensed intermediate care facility for people with an intellectual disability"
169     means the same as that term is defined in Section 58-17b-503.
170          (11) "Medically indigent individual" means an individual who:
171          (a) (i) does not have health insurance; and
172          (ii) lacks reasonable means to purchase prescribed medications; or
173          (b) (i) has health insurance; and
174          (ii) lacks reasonable means to pay the insured's portion of the cost of the prescribed
175     medications.
176          (12) "Medication-assisted treatment drug" means buprenorphine prescribed to treat
177     substance use withdrawal symptoms or an opiate use disorder.
178          [(12)] (13) "Nursing care facility" means the same as that term is defined in Section
179     26-18-501.
180          [(13)] (14) "Physician's office" means a fixed medical facility that:
181          (a) is staffed by a physician, physician's assistant, nurse practitioner, or registered
182     nurse, licensed under Title 58, Occupations and Professions; and
183          (b) treats an individual who presents at, or is transported to, the facility.
184          [(14)] (15) "Program" means the Charitable Prescription Drug Recycling Program
185     created in Section 58-17b-903.
186          [(15)] (16) "Unit pack" means the same as that term is defined in Section 58-17b-503.
187          [(16)] (17) "Unlawful conduct" means the same as that term is defined in Sections
188     58-1-501 and 58-17b-501.
189          [(17)] (18) "Unprofessional conduct" means the same as that term is defined in
190     Sections 58-1-501 and 58-17b-502.
191          Section 4. Section 58-17b-905 is amended to read:
192          58-17b-905. Participation in program -- Requirements -- Fees.
193          (1) An eligible donor, an individual, or an eligible pharmacy may participate in the
194     program.
195          (2) An eligible pharmacy:
196          (a) shall comply with all applicable federal and state laws related to the storage,
197     disposal, and distribution of a prescription drug;
198          (b) shall comply with all applicable federal and state laws related to the acceptance and
199     transfer of a prescription drug, including 21 U.S.C. Chapter 9, Subchapter V, Part H,
200     Pharmaceutical Distribution Supply Chain;
201          (c) shall, before accepting or dispensing a prescription drug under the program, inspect
202     each prescription drug to determine whether the prescription drug is an eligible prescription
203     drug;
204          (d) may dispense an eligible prescription drug to a medically indigent individual who:
205          (i) is located in the state when the drug is dispensed; and
206          (ii) has a prescription issued by a practitioner;
207          (e) may charge a handling fee, adopted by the division under Section 63J-1-504; and
208          (f) may not accept, transfer, or dispense a prescription drug in violation of the federal
209     Food, Drug, and Cosmetic Act, 21 U.S.C. Sec. 301 et seq.
210          Section 5. Section 63I-1-226 is amended to read:
211          63I-1-226. Repeal dates, Title 26.
212          (1) Subsection 26-1-7(1)(f), related to the Residential Child Care Licensing Advisory
213     Committee, is repealed July 1, 2024.
214          (2) Subsection 26-1-7(1)(h), related to the Primary Care Grant Committee, is repealed
215     July 1, 2025.
216          (3) Section 26-1-7.5, which creates the Utah Health Advisory Council, is repealed July
217     1, 2025.
218          (4) Section 26-1-40 is repealed July 1, 2022.
219          (5) Section 26-1-41 is repealed July 1, 2026.
220          (6) Section 26-7-10 is repealed July 1, 2025.
221          (7) Subsection 26-7-11(5), regarding reports to the Legislature, is repealed July 1,
222     2028.
223          (8) Section 26-7-14 is repealed December 31, 2027.
224          (9) Title 26, Chapter 9f, Utah Digital Health Service Commission Act, is repealed July
225     1, 2025.
226          (10) Subsection 26-10-6(5), which creates the Newborn Hearing Screening Committee,
227     is repealed July 1, 2026.
228          (11) Section 26-10b-106, which creates the Primary Care Grant Committee, is repealed
229     July 1, 2025.
230          (12) Subsection 26-15c-104(3), relating to a limitation on the number of
231     microenterprise home kitchen permits that may be issued, is repealed on July 1, 2022.
232          (13) Subsection 26-18-2.6(9), which addresses reimbursement for dental hygienists, is
233     repealed July 1, 2028.
234          (14) Section 26-18-27 is repealed July 1, 2025.
235          (15) Section 26-1-43 is repealed December 31, Ĥ→ [2022] 2025 ←Ĥ .
236          [(15)] (16) Title 26, Chapter 18, Part 2, Drug Utilization Review Board, is repealed
237     July 1, 2027.
238          [(16)] (17) Subsection 26-18-418(2), the language that states "and the Behavioral
239     Health Crisis Response Commission created in Section 63C-18-202" is repealed July 1, 2023.
240          [(17)] (18) Section 26-33a-117 is repealed on December 31, 2023.
241          [(18)] (19) Title 26, Chapter 33a, Utah Health Data Authority Act, is repealed July 1,
242     2024.
243          [(19)] (20) Title 26, Chapter 36b, Inpatient Hospital Assessment Act, is repealed July
244     1, 2024.
245          [(20)] (21) Title 26, Chapter 36c, Medicaid Expansion Hospital Assessment Act, is
246     repealed July 1, 2024.
247          [(21)] (22) Title 26, Chapter 36d, Hospital Provider Assessment Act, is repealed July
248     1, 2024.
249          [(22)] (23) Section 26-39-201, which creates the Residential Child Care Licensing
250     Advisory Committee, is repealed July 1, 2024.
251          [(23)] (24) Section 26-40-104, which creates the Utah Children's Health Insurance
252     Program Advisory Council, is repealed July 1, 2025.
253          [(24)] (25) Section 26-50-202, which creates the Traumatic Brain Injury Advisory
254     Committee, is repealed July 1, 2025.
255          [(25)] (26) Title 26, Chapter 54, Spinal Cord and Brain Injury Rehabilitation Fund and
256     Pediatric Neuro-Rehabilitation Fund, is repealed January 1, 2025.
257          [(26)] (27) Title 26, Chapter 63, Nurse Home Visiting Pay-for-Success Program, is
258     repealed July 1, 2026.
259          [(27)] (28) Title 26, Chapter 66, Early Childhood Utah Advisory Council, is repealed
260     July 1, 2026.
261          [(28)] (29) Title 26, Chapter 68, COVID-19 Vaccine Restrictions Act, is repealed July
262     1, 2024.
263          Section 6. Appropriation.
264          The following sums of money are appropriated for the fiscal year beginning July 1,
265     2022, and ending June 30, 2023. These are additions to amounts previously appropriated for
266     fiscal year 2023. Under the terms and conditions of Title 63J, Chapter 1, Budgetary Procedures
267     Act, the Legislature appropriates the following sums of money from the funds or accounts
268     indicated for the use and support of the government of the state of Utah.
269     ITEM 1
270          To Ŝ→ [Department of Health -- Family Health and Preparedness] Department of Health
270a     and Human Services -- Integrated Health Care Services ←Ŝ
271               Ĥ→ From General Fund                              $116,000 ←Ĥ
271a               From General Fund, One-time                Ĥ→ [$200,000] $87,000 ←Ĥ
272               Schedule of Programs:
273                     Ŝ→ [Integrated Behavioral Health Care Grant] Medicaid Behavioral
273a     Health Services ←Ŝ            Ĥ→ [$200,000] $203,000 ←Ĥ
274          The Legislature intends that Ŝ→ [the Department of Health use] ←Ŝ the appropriations
274a     provided
275     under this item Ŝ→ be used ←Ŝ to award grants under the Integrated Behavioral Health Care
275a     Grant Program
276     created in Section 26-1-43.