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7 LONG TITLE
8 General Description:
9 This bill addresses behavioral health treatment and services.
10 Highlighted Provisions:
11 This bill:
12 ▸ defines terms;
13 ▸ requires the Department of Health to:
14 • award a grant to a local mental health authority to implement or expand an
15 integrated behavioral health program;
16 • develop a proposal to allow the state Medicaid program to reimburse a local
17 mental health authority for physical health services in an integrated behavioral
18 health care setting; and
19 • apply for a waiver under the state Medicaid plan to implement the proposal;
20 ▸ allows a certain medication-assistance treatment drug to be recycled under the
21 Charitable Prescription Drug Recycling Act, subject to federal law;
22 ▸ creates a sunset date;
23 ▸ creates reporting requirements; and
24 ▸ makes technical and conforming changes.
25 Money Appropriated in this Bill:
26 This bill appropriates in fiscal year 2023:
27 ▸ to Department of Health and Human Services -- Integrated Health Care Services --
28 Medicaid Behavioral Health Services, as an ongoing appropriation:
29 • from General Fund, $116,000; and
30 ▸ to Department of Health and Human Services -- Integrated Health Care Services --
31 Medicaid Behavioral Health Services, as a one-time appropriation:
32 • from General Fund, One-time, $87,000.
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
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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 of each year, the department shall issue a request for 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) "Integrated health care setting" means a health care or behavioral health care setting
97 that provides integrated physical and behavioral health care services.
98 (b) "Local mental health authority" means a local mental health authority described in
99 Section 17-43-301.
100 (2) The department shall develop a proposal to allow the state Medicaid program to
101 reimburse a local mental health authority for covered physical health care services provided in
102 an integrated health care setting to Medicaid eligible individuals.
103 (3) Before December 31, 2022, the department shall apply for a Medicaid waiver or a
104 state plan amendment with CMS to implement the proposal described in Subsection (2).
105 (4) If the waiver or state plan amendment described in Subsection (3) is approved, the
106 department shall:
107 (a) implement the proposal described in Subsection (2); and
108 (b) while the waiver or state plan amendment is in effect, submit a report to the Health
109 and Human Services Interim Committee each year before November 30 detailing:
110 (i) the number of patients served under the waiver or state plan amendment;
111 (ii) the cost of the waiver or state plan amendment; and
112 (iii) any benefits of the waiver or state plan amendment.
113 Section 3. Section 58-17b-902 is amended to read:
114 58-17b-902. Definitions.
115 As used in this part:
116 (1) "Assisted living facility" means the same as that term is defined in Section 26-21-2.
117 (2) "Cancer drug" means a drug that controls or kills neoplastic cells and includes a
118 drug used in chemotherapy to destroy cancer cells.
119 (3) "Charitable clinic" means a charitable nonprofit corporation that:
120 (a) holds a valid exemption from federal income taxation issued under Section 501(a),
121 Internal Revenue Code;
122 (b) is exempt from federal income taxation under Section 501(c)(3), Internal Revenue
123 Code;
124 (c) provides, on an outpatient basis, for a period of less than 24 consecutive hours, to
125 an individual not residing or confined at a facility owned or operated by the charitable
126 nonprofit corporation:
127 (i) advice;
128 (ii) counseling;
129 (iii) diagnosis;
130 (iv) treatment;
131 (v) surgery; or
132 (vi) care or services relating to the preservation or maintenance of health; and
133 (d) has a licensed outpatient pharmacy.
134 (4) "Charitable pharmacy" means an eligible pharmacy that is operated by a charitable
135 clinic.
136 (5) "County health department" means the same as that term is defined in Section
137 26A-1-102.
138 (6) "Donated prescription drug" means a prescription drug that an eligible donor or
139 individual donates to an eligible pharmacy under the program.
140 (7) "Eligible donor" means a donor that donates a prescription drug from within the
141 state and is:
142 (a) a nursing care facility;
143 (b) an assisted living facility;
144 (c) a licensed intermediate care facility for people with an intellectual disability;
145 (d) a manufacturer;
146 (e) a pharmaceutical wholesale distributor;
147 (f) an eligible pharmacy; or
148 (g) a physician's office.
149 (8) "Eligible pharmacy" means a pharmacy that:
150 (a) is registered by the division as eligible to participate in the program; and
151 (b) (i) is licensed in the state as a Class A retail pharmacy; or
152 (ii) is operated by:
153 (A) a county;
154 (B) a county health department;
155 (C) a pharmacy under contract with a county health department;
156 (D) the Department of Health, created in Section 26-1-4;
157 (E) the Division of Substance Abuse and Mental Health, created in Section
158 62A-15-103; or
159 (F) a charitable clinic.
160 (9) (a) "Eligible prescription drug" means a prescription drug, described in Section
161 58-17b-904, that is not:
162 [
163 [
164 manufacturer in accordance with federal Food and Drug Administration requirements.
165 (b) "Eligible prescription drug" includes a medication-assisted treatment drug that may
166 be accepted, transferred, and dispensed under the program in accordance with federal law.
167 (10) "Licensed intermediate care facility for people with an intellectual disability"
168 means the same as that term is defined in Section 58-17b-503.
169 (11) "Medically indigent individual" means an individual who:
170 (a) (i) does not have health insurance; and
171 (ii) lacks reasonable means to purchase prescribed medications; or
172 (b) (i) has health insurance; and
173 (ii) lacks reasonable means to pay the insured's portion of the cost of the prescribed
174 medications.
175 (12) "Medication-assisted treatment drug" means buprenorphine prescribed to treat
176 substance use withdrawal symptoms or an opiate use disorder.
177 [
178 26-18-501.
179 [
180 (a) is staffed by a physician, physician's assistant, nurse practitioner, or registered
181 nurse, licensed under Title 58, Occupations and Professions; and
182 (b) treats an individual who presents at, or is transported to, the facility.
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184 created in Section 58-17b-903.
185 [
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187 58-1-501 and 58-17b-501.
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189 Sections 58-1-501 and 58-17b-502.
190 Section 4. Section 58-17b-905 is amended to read:
191 58-17b-905. Participation in program -- Requirements -- Fees.
192 (1) An eligible donor, an individual, or an eligible pharmacy may participate in the
193 program.
194 (2) An eligible pharmacy:
195 (a) shall comply with all applicable federal and state laws related to the storage,
196 disposal, and distribution of a prescription drug;
197 (b) shall comply with all applicable federal and state laws related to the acceptance and
198 transfer of a prescription drug, including 21 U.S.C. Chapter 9, Subchapter V, Part H,
199 Pharmaceutical Distribution Supply Chain;
200 (c) shall, before accepting or dispensing a prescription drug under the program, inspect
201 each prescription drug to determine whether the prescription drug is an eligible prescription
202 drug;
203 (d) may dispense an eligible prescription drug to a medically indigent individual who:
204 (i) is located in the state when the drug is dispensed; and
205 (ii) has a prescription issued by a practitioner;
206 (e) may charge a handling fee, adopted by the division under Section 63J-1-504; and
207 (f) may not accept, transfer, or dispense a prescription drug in violation of the federal
208 Food, Drug, and Cosmetic Act, 21 U.S.C. Sec. 301 et seq.
209 Section 5. Section 63I-1-226 is amended to read:
210 63I-1-226. Repeal dates, Title 26.
211 (1) Subsection 26-1-7(1)(f), related to the Residential Child Care Licensing Advisory
212 Committee, is repealed July 1, 2024.
213 (2) Subsection 26-1-7(1)(h), related to the Primary Care Grant Committee, is repealed
214 July 1, 2025.
215 (3) Section 26-1-7.5, which creates the Utah Health Advisory Council, is repealed July
216 1, 2025.
217 (4) Section 26-1-40 is repealed July 1, 2022.
218 (5) Section 26-1-41 is repealed July 1, 2026.
219 (6) Section 26-7-10 is repealed July 1, 2025.
220 (7) Subsection 26-7-11(5), regarding reports to the Legislature, is repealed July 1,
221 2028.
222 (8) Section 26-7-14 is repealed December 31, 2027.
223 (9) Title 26, Chapter 9f, Utah Digital Health Service Commission Act, is repealed July
224 1, 2025.
225 (10) Subsection 26-10-6(5), which creates the Newborn Hearing Screening Committee,
226 is repealed July 1, 2026.
227 (11) Section 26-10b-106, which creates the Primary Care Grant Committee, is repealed
228 July 1, 2025.
229 (12) Subsection 26-15c-104(3), relating to a limitation on the number of
230 microenterprise home kitchen permits that may be issued, is repealed on July 1, 2022.
231 (13) Subsection 26-18-2.6(9), which addresses reimbursement for dental hygienists, is
232 repealed July 1, 2028.
233 (14) Section 26-18-27 is repealed July 1, 2025.
234 (15) Section 26-1-43 is repealed December 31, 2025.
235 [
236 July 1, 2027.
237 [
238 Health Crisis Response Commission created in Section 63C-18-202" is repealed July 1, 2023.
239 [
240 [
241 2024.
242 [
243 1, 2024.
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245 repealed July 1, 2024.
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247 1, 2024.
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249 Advisory Committee, is repealed July 1, 2024.
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251 Program Advisory Council, is repealed July 1, 2025.
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253 Committee, is repealed July 1, 2025.
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255 Pediatric Neuro-Rehabilitation Fund, is repealed January 1, 2025.
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257 repealed July 1, 2026.
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259 July 1, 2026.
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261 1, 2024.
262 Section 6. Appropriation.
263 The following sums of money are appropriated for the fiscal year beginning July 1,
264 2022, and ending June 30, 2023. These are additions to amounts previously appropriated for
265 fiscal year 2023. Under the terms and conditions of Title 63J, Chapter 1, Budgetary Procedures
266 Act, the Legislature appropriates the following sums of money from the funds or accounts
267 indicated for the use and support of the government of the state of Utah.
268 ITEM 1
269 To Department of Health and Human Services -- Integrated Health Care Services
270 From General Fund
$116,000
271 From General Fund, One-time
$87,000
272 Schedule of Programs:
273 Medicaid Behavioral Health Services $203,000
274 The Legislature intends that the appropriations provided under this item be used to
275 award grants under the integrated behavioral health care grant program created in Section
276 26-1-43.