1     
HEALTH AND HUMAN SERVICES RECODIFICATION -

2     
HEALTH CARE DELIVERY AND REPEALS

3     
2023 GENERAL SESSION

4     
STATE OF UTAH

5     
Chief Sponsor: Jacob L. Anderegg

6     
House Sponsor: Raymond P. Ward

7     

8     LONG TITLE
9     Committee Note:
10          The Health and Human Services Interim Committee recommended this bill.
11               Legislative Vote:     14 voting for     0 voting against     4 absent
12     General Description:
13          This bill recodifies and repeals portions of the Utah Health Code and Utah Human
14     Services Code.
15     Highlighted Provisions:
16          This bill:
17          ▸     recodifies provisions regarding health care delivery and access;
18          ▸     repeals certain sections in the Utah Health Code and Utah Human Services Code
19     that are no longer needed following the recodification; and
20          ▸     makes technical and corresponding changes.
21     Money Appropriated in this Bill:
22          None
23     Other Special Clauses:
24          This bill provides revisor instructions.
25     Utah Code Sections Affected:
26     AMENDS:
27          26B-4-101, as enacted by Laws of Utah 2022, Chapter 255

28     RENUMBERS AND AMENDS:
29          26B-4-102, (Renumbered from 26-8a-105, as last amended by Laws of Utah 2019,
30     Chapter 265)
31          26B-4-103, (Renumbered from 26-8a-106, as last amended by Laws of Utah 2017,
32     Chapter 326)
33          26B-4-104, (Renumbered from 26-8a-201, as enacted by Laws of Utah 1999, Chapter
34     141)
35          26B-4-105, (Renumbered from 26-8a-202, as enacted by Laws of Utah 1999, Chapter
36     141)
37          26B-4-106, (Renumbered from 26-8a-203, as last amended by Laws of Utah 2022,
38     Chapter 387)
39          26B-4-107, (Renumbered from 26-8a-207, as last amended by Laws of Utah 2020,
40     Chapters 215 and 230)
41          26B-4-108, (Renumbered from 26-8a-208, as last amended by Laws of Utah 2022,
42     Chapter 255)
43          26B-4-109, (Renumbered from 26-8a-210, as enacted by Laws of Utah 2020, Chapter
44     215)
45          26B-4-110, (Renumbered from 26-8a-212, as enacted by Laws of Utah 2022, Chapter
46     404)
47          26B-4-111, (Renumbered from 26-8a-250, as enacted by Laws of Utah 2000, Chapter
48     305)
49          26B-4-112, (Renumbered from 26-8a-252, as enacted by Laws of Utah 2000, Chapter
50     305)
51          26B-4-113, (Renumbered from 26-8a-253, as last amended by Laws of Utah 2011,
52     Chapter 297)
53          26B-4-114, (Renumbered from 26-8a-254, as enacted by Laws of Utah 2000, Chapter
54     305)
55          26B-4-115, (Renumbered from 26-8a-301, as last amended by Laws of Utah 2021,
56     Chapter 237)
57          26B-4-116, (Renumbered from 26-8a-302, as last amended by Laws of Utah 2022,
58     Chapters 255 and 460)

59          26B-4-117, (Renumbered from 26-8a-303, as last amended by Laws of Utah 2019,
60     Chapter 265)
61          26B-4-118, (Renumbered from 26-8a-304, as last amended by Laws of Utah 2019,
62     Chapter 265)
63          26B-4-119, (Renumbered from 26-8a-305, as enacted by Laws of Utah 1999, Chapter
64     141)
65          26B-4-120, (Renumbered from 26-8a-306, as last amended by Laws of Utah 2021,
66     Chapter 237)
67          26B-4-121, (Renumbered from 26-8a-307, as last amended by Laws of Utah 2021,
68     Chapter 208)
69          26B-4-122, (Renumbered from 26-8a-308, as last amended by Laws of Utah 2017,
70     Chapter 326)
71          26B-4-123, (Renumbered from 26-8a-309, as enacted by Laws of Utah 1999, Chapter
72     141)
73          26B-4-124, (Renumbered from 26-8a-310, as last amended by Laws of Utah 2022,
74     Chapters 255, 335, and 415)
75          26B-4-125, (Renumbered from 26-8a-310.5, as enacted by Laws of Utah 2021, Chapter
76     237)
77          26B-4-126, (Renumbered from 26-8a-501, as last amended by Laws of Utah 2017,
78     Chapter 326)
79          26B-4-127, (Renumbered from 26-8a-502, as last amended by Laws of Utah 2021,
80     Chapter 237)
81          26B-4-128, (Renumbered from 26-8a-502.1, as enacted by Laws of Utah 2022, Chapter
82     457)
83          26B-4-129, (Renumbered from 26-8a-503, as last amended by Laws of Utah 2019,
84     Chapter 346)
85          26B-4-130, (Renumbered from 26-8a-504, as last amended by Laws of Utah 2008,
86     Chapter 382)
87          26B-4-131, (Renumbered from 26-8a-505, as enacted by Laws of Utah 1999, Chapter
88     141)
89          26B-4-132, (Renumbered from 26-8a-506, as last amended by Laws of Utah 2017,

90     Chapter 326)
91          26B-4-133, (Renumbered from 26-8a-507, as enacted by Laws of Utah 1999, Chapter
92     141)
93          26B-4-134, (Renumbered from 26-8a-601, as last amended by Laws of Utah 2021,
94     Chapter 237)
95          26B-4-135, (Renumbered from 26-8a-602, as enacted by Laws of Utah 2019, Chapter
96     262)
97          26B-4-136, (Renumbered from 26-8a-603, as enacted by Laws of Utah 2022, Chapter
98     347)
99          26B-4-137, (Renumbered from 26-8c-102, as enacted by Laws of Utah 2016, Chapter
100     97)
101          26B-4-150, (Renumbered from 26-8a-401, as last amended by Laws of Utah 2021,
102     Chapter 265)
103          26B-4-151, (Renumbered from 26-8a-402, as last amended by Laws of Utah 2021,
104     Chapter 265)
105          26B-4-152, (Renumbered from 26-8a-403, as last amended by Laws of Utah 2006,
106     Chapter 209)
107          26B-4-153, (Renumbered from 26-8a-404, as last amended by Laws of Utah 2022,
108     Chapter 351)
109          26B-4-154, (Renumbered from 26-8a-405, as last amended by Laws of Utah 2019,
110     Chapter 390)
111          26B-4-155, (Renumbered from 26-8a-405.1, as last amended by Laws of Utah 2021,
112     Chapter 265)
113          26B-4-156, (Renumbered from 26-8a-405.2, as last amended by Laws of Utah 2011,
114     Chapter 297)
115          26B-4-157, (Renumbered from 26-8a-405.3, as last amended by Laws of Utah 2021,
116     Chapter 355)
117          26B-4-158, (Renumbered from 26-8a-405.4, as last amended by Laws of Utah 2021,
118     Chapter 265)
119          26B-4-159, (Renumbered from 26-8a-405.5, as last amended by Laws of Utah 2021,
120     Chapter 265)

121          26B-4-160, (Renumbered from 26-8a-406, as last amended by Laws of Utah 2011,
122     Chapter 297)
123          26B-4-161, (Renumbered from 26-8a-407, as last amended by Laws of Utah 2008,
124     Chapter 382)
125          26B-4-162, (Renumbered from 26-8a-408, as last amended by Laws of Utah 2017,
126     Chapter 326)
127          26B-4-163, (Renumbered from 26-8a-409, as last amended by Laws of Utah 2017,
128     Chapter 326)
129          26B-4-164, (Renumbered from 26-8a-410, as last amended by Laws of Utah 2011,
130     Chapter 297)
131          26B-4-165, (Renumbered from 26-8a-411, as last amended by Laws of Utah 2003,
132     Chapter 213)
133          26B-4-166, (Renumbered from 26-8a-412, as enacted by Laws of Utah 1999, Chapter
134     141)
135          26B-4-167, (Renumbered from 26-8a-413, as last amended by Laws of Utah 2022,
136     Chapter 274)
137          26B-4-168, (Renumbered from 26-8a-414, as last amended by Laws of Utah 2008,
138     Chapter 382)
139          26B-4-169, (Renumbered from 26-8a-415, as enacted by Laws of Utah 1999, Chapter
140     141)
141          26B-4-170, (Renumbered from 26-8a-416, as last amended by Laws of Utah 2022,
142     Chapter 351)
143          26B-4-201, (Renumbered from 26-61a-102, as last amended by Laws of Utah 2022,
144     Chapters 290 and 452)
145          26B-4-202, (Renumbered from 26-61a-103, as last amended by Laws of Utah 2022,
146     Chapters 290 and 415)
147          26B-4-203, (Renumbered from 26-61a-104, as last amended by Laws of Utah 2022,
148     Chapters 277 and 452)
149          26B-4-204, (Renumbered from 26-61a-106, as last amended by Laws of Utah 2022,
150     Chapters 415 and 452)
151          26B-4-205, (Renumbered from 26-61a-107, as last amended by Laws of Utah 2021,

152     Chapter 337)
153          26B-4-206, (Renumbered from 26-61a-108, as enacted by Laws of Utah 2018, Third
154     Special Session, Chapter 1)
155          26B-4-207, (Renumbered from 26-61a-111, as last amended by Laws of Utah 2022,
156     Chapters 174, 256, and 290)
157          26B-4-208, (Renumbered from 26-61a-112, as enacted by Laws of Utah 2018, Third
158     Special Session, Chapter 1)
159          26B-4-209, (Renumbered from 26-61a-113, as last amended by Laws of Utah 2020,
160     Chapters 12 and 354)
161          26B-4-210, (Renumbered from 26-61a-114, as enacted by Laws of Utah 2018, Third
162     Special Session, Chapter 1)
163          26B-4-211, (Renumbered from 26-61a-115, as enacted by Laws of Utah 2019, First
164     Special Session, Chapter 5)
165          26B-4-212, (Renumbered from 26-61-103, as enacted by Laws of Utah 2017, Chapter
166     398)
167          26B-4-213, (Renumbered from 26-61a-201, as last amended by Laws of Utah 2022,
168     Chapters 198, 290, and 452)
169          26B-4-214, (Renumbered from 26-61a-202, as last amended by Laws of Utah 2022,
170     Chapters 290 and 452)
171          26B-4-215, (Renumbered from 26-61a-203, as last amended by Laws of Utah 2019,
172     First Special Session, Chapter 5)
173          26B-4-216, (Renumbered from 26-61a-204, as last amended by Laws of Utah 2022,
174     Chapters 198 and 290)
175          26B-4-217, (Renumbered from 26-61a-401, as last amended by Laws of Utah 2022,
176     Chapters 290 and 415)
177          26B-4-218, (Renumbered from 26-61a-402, as renumbered and amended by Laws of
178     Utah 2018, Third Special Session, Chapter 1)
179          26B-4-219, (Renumbered from 26-61a-403, as last amended by Laws of Utah 2022,
180     Chapters 415 and 452)
181          26B-4-220, (Renumbered from 26-61a-701, as enacted by Laws of Utah 2018, Third
182     Special Session, Chapter 1)

183          26B-4-221, (Renumbered from 26-61a-702, as last amended by Laws of Utah 2022,
184     Chapter 452)
185          26B-4-222, (Renumbered from 26-61a-703, as last amended by Laws of Utah 2022,
186     Chapter 97)
187          26B-4-223, (Renumbered from 26-61a-116, as enacted by Laws of Utah 2022, Chapter
188     452)
189          26B-4-224, (Renumbered from 26-61a-301, as last amended by Laws of Utah 2022,
190     Chapter 290)
191          26B-4-225, (Renumbered from 26-61a-302, as last amended by Laws of Utah 2019,
192     First Special Session, Chapter 5)
193          26B-4-226, (Renumbered from 26-61a-303, as last amended by Laws of Utah 2022,
194     Chapters 290 and 415)
195          26B-4-227, (Renumbered from 26-61a-304, as last amended by Laws of Utah 2019,
196     First Special Session, Chapter 5)
197          26B-4-228, (Renumbered from 26-61a-305, as last amended by Laws of Utah 2022,
198     Chapter 290)
199          26B-4-229, (Renumbered from 26-61a-501, as last amended by Laws of Utah 2022,
200     Chapters 290 and 415)
201          26B-4-230, (Renumbered from 26-61a-502, as last amended by Laws of Utah 2022,
202     Chapter 290)
203          26B-4-231, (Renumbered from 26-61a-503, as last amended by Laws of Utah 2022,
204     Chapter 415)
205          26B-4-232, (Renumbered from 26-61a-504, as last amended by Laws of Utah 2021,
206     Chapter 350)
207          26B-4-233, (Renumbered from 26-61a-505, as last amended by Laws of Utah 2022,
208     Chapter 452 and last amended by Coordination Clause, Laws of Utah 2022, Chapter
209     290)
210          26B-4-234, (Renumbered from 26-61a-506, as last amended by Laws of Utah 2022,
211     Chapter 415)
212          26B-4-235, (Renumbered from 26-61a-507, as last amended by Laws of Utah 2020,
213     Chapter 12)

214          26B-4-236, (Renumbered from 26-61a-601, as last amended by Laws of Utah 2021,
215     Chapter 337)
216          26B-4-237, (Renumbered from 26-61a-602, as last amended by Laws of Utah 2020,
217     Chapter 354)
218          26B-4-238, (Renumbered from 26-61a-603, as last amended by Laws of Utah 2020,
219     Chapter 12)
220          26B-4-239, (Renumbered from 26-61a-604, as last amended by Laws of Utah 2022,
221     Chapters 290 and 452)
222          26B-4-240, (Renumbered from 26-61a-605, as last amended by Laws of Utah 2022,
223     Chapter 415)
224          26B-4-241, (Renumbered from 26-61a-606, as last amended by Laws of Utah 2022,
225     Chapters 290 and 415)
226          26B-4-242, (Renumbered from 26-61a-607, as last amended by Laws of Utah 2022,
227     Chapter 452)
228          26B-4-301, (Renumbered from 26-10b-101, as last amended by Laws of Utah 2022,
229     Chapter 255)
230          26B-4-302, (Renumbered from 26-8b-201, as enacted by Laws of Utah 2009, Chapter
231     22)
232          26B-4-303, (Renumbered from 26-8b-202, as enacted by Laws of Utah 2009, Chapter
233     22)
234          26B-4-304, (Renumbered from 26-8b-301, as last amended by Laws of Utah 2013,
235     Chapter 98)
236          26B-4-305, (Renumbered from 26-8b-302, as enacted by Laws of Utah 2009, Chapter
237     22)
238          26B-4-306, (Renumbered from 26-8b-303, as last amended by Laws of Utah 2013,
239     Chapter 98)
240          26B-4-307, (Renumbered from 26-8b-401, as enacted by Laws of Utah 2009, Chapter
241     22)
242          26B-4-308, (Renumbered from 26-8b-402, as enacted by Laws of Utah 2013, Chapter
243     98)
244          26B-4-309, (Renumbered from 26-8b-501, as enacted by Laws of Utah 2013, Chapter

245     98)
246          26B-4-310, (Renumbered from 26-10b-102, as last amended by Laws of Utah 2014,
247     Chapter 384)
248          26B-4-311, (Renumbered from 26-10b-103, as last amended by Laws of Utah 2014,
249     Chapter 384)
250          26B-4-312, (Renumbered from 26-10b-104, as last amended by Laws of Utah 2014,
251     Chapter 384)
252          26B-4-313, (Renumbered from 26-10b-107, as enacted by Laws of Utah 2014, Chapter
253     384)
254          26B-4-314, (Renumbered from 26-9-1, as enacted by Laws of Utah 1981, Chapter 126)
255          26B-4-315, (Renumbered from 26-9-2, as enacted by Laws of Utah 1981, Chapter 126)
256          26B-4-316, (Renumbered from 26-9-3, as last amended by Laws of Utah 2001, Chapter
257     95)
258          26B-4-317, (Renumbered from 26-9-5, as enacted by Laws of Utah 2012, Chapter 408)
259          26B-4-318, (Renumbered from 26-10-2, as last amended by Laws of Utah 2011,
260     Chapters 147, 366 and last amended by Coordination Clause, Laws of Utah 2011,
261     Chapter 366)
262          26B-4-319, (Renumbered from 26-10-6, as last amended by Laws of Utah 2022,
263     Chapter 255)
264          26B-4-320, (Renumbered from 26-10-7, as enacted by Laws of Utah 1981, Chapter
265     126)
266          26B-4-321, (Renumbered from 26-10-9, as last amended by Laws of Utah 2022,
267     Chapter 430)
268          26B-4-322, (Renumbered from 26-10-11, as last amended by Laws of Utah 2021,
269     Chapter 50)
270          26B-4-323, (Renumbered from 26-10-13, as enacted by Laws of Utah 2017, Chapter
271     351)
272          26B-4-401, (Renumbered from 26-53-102, as last amended by Laws of Utah 2013,
273     Chapter 18)
274          26B-4-402, (Renumbered from 26-10-5, as last amended by Laws of Utah 2016,
275     Chapter 144)

276          26B-4-403, (Renumbered from 26-53-201, as enacted by Laws of Utah 2011, Chapter
277     97)
278          26B-4-404, (Renumbered from 26-53-301, as enacted by Laws of Utah 2011, Chapter
279     97)
280          26B-4-405, (Renumbered from 26-53-401, as last amended by Laws of Utah 2014,
281     Chapter 165)
282          26B-4-406, (Renumbered from 26-41-103, as last amended by Laws of Utah 2019,
283     Chapter 236)
284          26B-4-407, (Renumbered from 26-41-104, as last amended by Laws of Utah 2019,
285     Chapter 236)
286          26B-4-408, (Renumbered from 26-41-104.1, as enacted by Laws of Utah 2019, Chapter
287     236)
288          26B-4-409, (Renumbered from 26-41-105, as last amended by Laws of Utah 2020,
289     Chapter 372)
290          26B-4-410, (Renumbered from 26-41-106, as last amended by Laws of Utah 2019,
291     Chapter 236)
292          26B-4-411, (Renumbered from 26-41-107, as last amended by Laws of Utah 2019,
293     Chapter 236)
294          26B-4-501, (Renumbered from 26-64-102, as last amended by Laws of Utah 2022,
295     Chapter 415)
296          26B-4-502, (Renumbered from 26-21b-201, as last amended by Laws of Utah 2010,
297     Chapter 140)
298          26B-4-503, (Renumbered from 26-64-103, as enacted by Laws of Utah 2018, Chapter
299     295)
300          26B-4-504, (Renumbered from 26-64-104, as enacted by Laws of Utah 2018, Chapter
301     295)
302          26B-4-505, (Renumbered from 26-64-105, as enacted by Laws of Utah 2018, Chapter
303     295)
304          26B-4-506, (Renumbered from 26-64-106, as enacted by Laws of Utah 2018, Chapter
305     295)
306          26B-4-507, (Renumbered from 26-64-107, as enacted by Laws of Utah 2018, Chapter

307     295)
308          26B-4-508, (Renumbered from 26-55-103, as enacted by Laws of Utah 2014, Chapter
309     130)
310          26B-4-509, (Renumbered from 26-55-104, as last amended by Laws of Utah 2017,
311     Chapters 181 and 392)
312          26B-4-510, (Renumbered from 26-55-105, as last amended by Laws of Utah 2022,
313     Chapter 415)
314          26B-4-511, (Renumbered from 26-55-106, as last amended by Laws of Utah 2017,
315     Chapter 392)
316          26B-4-512, (Renumbered from 26-55-107, as enacted by Laws of Utah 2016, Chapter
317     202 and last amended by Coordination Clause, Laws of Utah 2016, Chapter 207)
318          26B-4-513, (Renumbered from 26-55-108, as last amended by Laws of Utah 2022,
319     Chapter 415)
320          26B-4-514, (Renumbered from 26-55-109, as enacted by Laws of Utah 2018, Chapter
321     145)
322          26B-4-601, (Renumbered from 26-67-102, as last amended by Laws of Utah 2022,
323     Chapter 255)
324          26B-4-602, (Renumbered from 26-67-201, as enacted by Laws of Utah 2020, Chapter
325     169)
326          26B-4-603, (Renumbered from 26-67-203, as enacted by Laws of Utah 2020, Chapter
327     169)
328          26B-4-604, (Renumbered from 26-67-204, as last amended by Laws of Utah 2020,
329     Fifth Special Session, Chapter 4)
330          26B-4-701, (Renumbered from 26-46a-102, as last amended by Laws of Utah 2018,
331     Chapter 330)
332          26B-4-702, (Renumbered from 26-46-102, as last amended by Laws of Utah 2020,
333     Chapter 56)
334          26B-4-703, (Renumbered from 26-46a-103, as enacted by Laws of Utah 2015, Chapter
335     136)
336          26B-4-704, (Renumbered from 26-60-103, as last amended by Laws of Utah 2021,
337     Chapter 64)

338          26B-4-705, (Renumbered from 26-69-301, as enacted by Laws of Utah 2022, Chapter
339     224)
340          26B-4-706, (Renumbered from 26-69-402, as renumbered and amended by Laws of
341     Utah 2022, Chapter 224)
342          26B-4-707, (Renumbered from 26-69-403, as renumbered and amended by Laws of
343     Utah 2022, Chapter 224)
344          26B-4-708, (Renumbered from 26-69-404, as renumbered and amended by Laws of
345     Utah 2022, Chapter 224)
346          26B-4-709, (Renumbered from 26-69-405, as last amended by Laws of Utah 2022,
347     Chapter 415 and renumbered and amended by Laws of Utah 2022, Chapter 224 and
348     last amended by Coordination Clause, Laws of Utah 2022, Chapter 415)
349          26B-4-710, (Renumbered from 26-69-406, as renumbered and amended by Laws of
350     Utah 2022, Chapter 224)
351          26B-4-711, (Renumbered from 26-69-407, as enacted by Laws of Utah 2022, Chapter
352     154 and last amended by Coordination Clause, Laws of Utah 2022, Chapter 154)
353          26B-4-712, (Renumbered from 26-69-408, as enacted by Laws of Utah 2022, Chapter
354     154 and last amended by Coordination Clause, Laws of Utah 2022, Chapter 154)
355          26B-4-801, (Renumbered from 26-49-102, as last amended by Laws of Utah 2022,
356     Chapter 255)
357          26B-4-802, (Renumbered from 26-49-103, as last amended by Laws of Utah 2021,
358     Chapter 188)
359          26B-4-803, (Renumbered from 26-49-201, as last amended by Laws of Utah 2021,
360     Chapter 188)
361          26B-4-804, (Renumbered from 26-49-202, as last amended by Laws of Utah 2021,
362     Chapter 188)
363          26B-4-805, (Renumbered from 26-49-203, as last amended by Laws of Utah 2021,
364     Chapter 188)
365          26B-4-806, (Renumbered from 26-49-204, as last amended by Laws of Utah 2021,
366     Chapter 188)
367          26B-4-807, (Renumbered from 26-49-205, as last amended by Laws of Utah 2022,
368     Chapter 415)

369          26B-4-808, (Renumbered from 26-49-301, as enacted by Laws of Utah 2008, Chapter
370     242)
371          26B-4-809, (Renumbered from 26-49-401, as enacted by Laws of Utah 2008, Chapter
372     242)
373          26B-4-810, (Renumbered from 26-49-501, as enacted by Laws of Utah 2008, Chapter
374     242)
375          26B-4-811, (Renumbered from 26-49-601, as enacted by Laws of Utah 2008, Chapter
376     242)
377          26B-4-812, (Renumbered from 26-49-701, as last amended by Laws of Utah 2011,
378     Chapter 297)
379     REPEALS:
380          26-1-2, as last amended by Laws of Utah 2022, Chapter 255
381          26-1-7.5, as last amended by Laws of Utah 2011, Chapter 297
382          26-2-1, as last amended by Laws of Utah 1995, Chapter 202
383          26-2-2, as last amended by Laws of Utah 2022, Chapter 415
384          26-4-1, as enacted by Laws of Utah 1981, Chapter 126
385          26-5-2, as enacted by Laws of Utah 1981, Chapter 126
386          26-5-3, as last amended by Laws of Utah 2004, Chapter 197
387          26-5-4, as enacted by Laws of Utah 1981, Chapter 126
388          26-6-1, as enacted by Laws of Utah 1981, Chapter 126
389          26-6-12, as enacted by Laws of Utah 1981, Chapter 126
390          26-6-13, as enacted by Laws of Utah 1981, Chapter 126
391          26-6-14, as enacted by Laws of Utah 1981, Chapter 126
392          26-6b-2, as last amended by Laws of Utah 2006, Chapter 185
393          26-8a-101, as enacted by Laws of Utah 1999, Chapter 141
394          26-8a-102, as last amended by Laws of Utah 2022, Chapters 255, 351, and 404
395          26-8a-104, as last amended by Laws of Utah 2021, Chapters 237 and 265
396          26-8a-204, as enacted by Laws of Utah 1999, Chapter 141
397          26-8a-205, as enacted by Laws of Utah 1999, Chapter 141
398          26-8a-206, as last amended by Laws of Utah 2021, Chapter 208
399          26-8a-211, as enacted by Laws of Utah 2020, Chapter 215

400          26-8b-101, as enacted by Laws of Utah 2009, Chapter 22
401          26-8b-102, as last amended by Laws of Utah 2015, Chapter 411
402          26-8b-601, as enacted by Laws of Utah 2013, Chapter 99
403          26-8c-101, as enacted by Laws of Utah 2016, Chapter 97
404          26-8d-101, as enacted by Laws of Utah 2018, Chapter 104
405          26-9f-101, as last amended by Laws of Utah 2004, Chapter 33
406          26-9f-102, as last amended by Laws of Utah 2008, Chapter 46
407          26-9f-104, as last amended by Laws of Utah 2018, Chapter 125
408          26-10-1, as last amended by Laws of Utah 2019, Chapter 124
409          26-15-1, as last amended by Laws of Utah 2020, Chapter 311
410          26-15-5.1, as enacted by Laws of Utah 2014, Chapter 327
411          26-15-12, as last amended by Laws of Utah 1994, Chapter 281
412          26-15a-101, as enacted by Laws of Utah 1998, Chapter 345
413          26-15a-103, as enacted by Laws of Utah 1998, Chapter 345
414          26-15a-107, as enacted by Laws of Utah 1998, Chapter 345
415          26-15b-101, as enacted by Laws of Utah 2020, Chapter 189
416          26-15b-102, as last amended by Laws of Utah 2020, Fifth Special Session, Chapter 4
417          26-15b-103, as enacted by Laws of Utah 2020, Chapter 189
418          26-15b-104, as enacted by Laws of Utah 2020, Chapter 189
419          26-15c-101, as enacted by Laws of Utah 2021, Chapter 417
420          26-15c-102, as enacted by Laws of Utah 2021, Chapter 417
421          26-15c-103, as enacted by Laws of Utah 2021, Chapter 417
422          26-15c-104, as enacted by Laws of Utah 2021, Chapter 417
423          26-18-1, as enacted by Laws of Utah 1981, Chapter 126
424          26-18-2, as last amended by Laws of Utah 2019, Chapter 393
425          26-18-402.5, as last amended by Laws of Utah 2022, Chapter 40
426          26-18-501, as last amended by Laws of Utah 2019, Chapter 393
427          26-18-601, as enacted by Laws of Utah 2011, Chapter 362
428          26-18-602, as last amended by Laws of Utah 2015, Chapter 135
429          26-18-701, as enacted by Laws of Utah 2022, Chapter 334
430          26-18-702, as enacted by Laws of Utah 2022, Chapter 334

431          26-18a-1, as last amended by Laws of Utah 2010, Chapter 278
432          26-18a-3, as last amended by Laws of Utah 2013, Chapter 167
433          26-19-101, as renumbered and amended by Laws of Utah 2018, Chapter 443
434          26-20-1, as last amended by Laws of Utah 2007, Chapter 48
435          26-21-1, as last amended by Laws of Utah 1997, Chapter 209
436          26-21-4, as last amended by Laws of Utah 2010, Chapter 286
437          26-21-5, as last amended by Laws of Utah 2016, Chapter 74
438          26-21-100, as enacted by Laws of Utah 2012, Chapter 328
439          26-21-203, as enacted by Laws of Utah 2012, Chapter 328
440          26-21-205, as enacted by Laws of Utah 2012, Chapter 328
441          26-21-206, as enacted by Laws of Utah 2012, Chapter 328
442          26-21-207, as enacted by Laws of Utah 2012, Chapter 328
443          26-21-208, as enacted by Laws of Utah 2012, Chapter 328
444          26-21-210, as enacted by Laws of Utah 2012, Chapter 328
445          26-21-301, as last amended by Laws of Utah 2018, Chapter 220
446          26-21-302, as last amended by Laws of Utah 2018, Chapter 220
447          26-21-304, as enacted by Laws of Utah 2016, Chapter 141
448          26-21a-201, as enacted by Laws of Utah 1991, Chapter 126
449          26-21b-101, as enacted by Laws of Utah 2009, Chapter 266
450          26-21b-102, as last amended by Laws of Utah 2010, Chapter 140
451          26-21b-301, as enacted by Laws of Utah 2009, Chapter 266
452          26-21c-101, as enacted by Laws of Utah 2020, Chapter 406
453          26-21c-102, as enacted by Laws of Utah 2020, Chapter 406
454          26-21c-104, as enacted by Laws of Utah 2020, Chapter 406
455          26-23a-1, as last amended by Laws of Utah 1996, Chapter 23
456          26-23a-3, as enacted by Laws of Utah 1988, Chapter 238
457          26-23b-101, as enacted by Laws of Utah 2002, Chapter 155
458          26-25-2, as last amended by Laws of Utah 2008, Chapter 382
459          26-25-3, as last amended by Laws of Utah 1996, Chapter 201
460          26-25-4, as last amended by Laws of Utah 2003, Chapter 242
461          26-25-5, as last amended by Laws of Utah 2011, Chapter 297

462          26-26-1, as enacted by Laws of Utah 1981, Chapter 126
463          26-26-2, as enacted by Laws of Utah 1981, Chapter 126
464          26-26-4, as last amended by Laws of Utah 1989, Chapter 80
465          26-26-5, as enacted by Laws of Utah 1981, Chapter 126
466          26-26-6, as enacted by Laws of Utah 1981, Chapter 126
467          26-26-7, as last amended by Laws of Utah 1989, Chapter 80
468          26-28-101, as enacted by Laws of Utah 2007, Chapter 60
469          26-31-101, as enacted by Laws of Utah 2011, Chapter 90
470          26-31-102, as enacted by Laws of Utah 2011, Chapter 90
471          26-31-202, as enacted by Laws of Utah 2011, Chapter 90
472          26-33a-101, as enacted by Laws of Utah 1990, Chapter 305
473          26-33a-103, as last amended by Laws of Utah 2022, Chapter 255
474          26-34-1, as enacted by Laws of Utah 1989, Chapter 276
475          26-34-2, as last amended by Laws of Utah 2020, Chapter 353
476          26-35a-101, as enacted by Laws of Utah 2004, Chapter 284
477          26-36b-101, as enacted by Laws of Utah 2016, Chapter 279
478          26-36c-101, as enacted by Laws of Utah 2018, Chapter 468
479          26-36d-101, as repealed and reenacted by Laws of Utah 2019, Chapter 455
480          26-37a-101, as enacted by Laws of Utah 2015, Chapter 440
481          26-38-1, as enacted by Laws of Utah 1994, Chapter 281
482          26-38-2, as last amended by Laws of Utah 2020, Chapter 347
483          26-38-3.5, as enacted by Laws of Utah 1995, Chapter 125
484          26-38-6, as last amended by Laws of Utah 2007, Chapter 44
485          26-38-7, as last amended by Laws of Utah 2012, Chapter 171
486          26-38-8, as last amended by Laws of Utah 2010, Chapter 218
487          26-38-9, as last amended by Laws of Utah 2008, Chapter 382
488          26-39-101, as enacted by Laws of Utah 1997, Chapter 196
489          26-39-203, as last amended by Laws of Utah 2016, Chapter 74
490          26-40-101, as enacted by Laws of Utah 1998, Chapter 360
491          26-41-101, as last amended by Laws of Utah 2019, Chapter 236
492          26-41-102, as last amended by Laws of Utah 2020, Chapter 372

493          26-43-101, as enacted by Laws of Utah 1998, Chapter 73
494          26-43-103, as last amended by Laws of Utah 2008, Chapter 382
495          26-46-101, as last amended by Laws of Utah 2020, Chapter 56
496          26-46a-101, as enacted by Laws of Utah 2015, Chapter 136
497          26-47-101, as enacted by Laws of Utah 2005, Chapter 273
498          26-47-102, as last amended by Laws of Utah 2013, Chapter 167
499          26-47-103, as last amended by Laws of Utah 2017, Chapter 181
500          26-49-101, as enacted by Laws of Utah 2008, Chapter 242
501          26-50-101, as enacted by Laws of Utah 2008, Chapter 325
502          26-50-102, as enacted by Laws of Utah 2008, Chapter 325
503          26-51-101, as enacted by Laws of Utah 2008, Chapter 38
504          26-51-202, as enacted by Laws of Utah 2008, Chapter 38
505          26-53-101, as enacted by Laws of Utah 2011, Chapter 97
506          26-54-101, as last amended by Laws of Utah 2019, Chapter 405
507          26-55-101, as last amended by Laws of Utah 2016, Chapters 202, 207, and 208
508          26-55-102, as last amended by Laws of Utah 2017, Chapter 392
509          26-57-101, as last amended by Laws of Utah 2021, First Special Session, Chapter 12
510          26-57-102, as last amended by Laws of Utah 2021, First Special Session, Chapter 12
511          26-57-104, as enacted by Laws of Utah 2020, Chapter 347
512          26-58-101, as enacted by Laws of Utah 2016, Chapter 71
513          26-60-101, as enacted by Laws of Utah 2017, Chapter 241
514          26-60-102, as last amended by Laws of Utah 2020, Chapter 119
515          26-60-104, as last amended by Laws of Utah 2022, Chapters 255 and 415
516          26-60-105, as last amended by Laws of Utah 2019, Chapter 249
517          26-61-101, as enacted by Laws of Utah 2017, Chapter 398
518          26-61-102, as last amended by Laws of Utah 2022, Chapter 452
519          26-61-202, as last amended by Laws of Utah 2022, Chapter 415
520          26-61a-101, as renumbered and amended by Laws of Utah 2018, Third Special Session,
521     Chapter 1
522          26-62-101, as last amended by Laws of Utah 2020, Chapter 347
523          26-64-101, as enacted by Laws of Utah 2018, Chapter 295

524          26-66-101, as enacted by Laws of Utah 2019, Chapter 34
525          26-66-102, as enacted by Laws of Utah 2019, Chapter 34
526          26-66-201, as enacted by Laws of Utah 2019, Chapter 34
527          26-66-203, as enacted by Laws of Utah 2019, Chapter 34
528          26-67-101, as enacted by Laws of Utah 2020, Chapter 169
529          26-68-101, as enacted by Laws of Utah 2021, Chapter 182
530          26-69-101, as enacted by Laws of Utah 2022, Chapter 224
531          26-69-202, as enacted by Laws of Utah 2022, Chapter 224
532          26-69-203, as enacted by Laws of Utah 2022, Chapter 224
533          26-69-401, as renumbered and amended by Laws of Utah 2022, Chapter 224
534          26-70-101, as enacted by Laws of Utah 2022, Chapter 327
535          26A-1-101, as renumbered and amended by Laws of Utah 1991, Chapter 269
536          26B-1-201.1, as last amended by Laws of Utah 2022, Chapter 255
537          26B-1a-101, as enacted by Laws of Utah 2022, Chapter 245
538          26B-1a-102, as enacted by Laws of Utah 2022, Chapter 245
539          26B-1a-103, as enacted by Laws of Utah 2022, Chapter 245 and last amended by
540     Coordination Clause, Laws of Utah 2022, Chapter 245
541          26B-1a-107, as enacted by Laws of Utah 2022, Chapter 245
542          62A-1-104, as last amended by Laws of Utah 2022, Chapter 255
543          62A-1-123, as enacted by Laws of Utah 2022, Chapter 36
544          62A-1-201, as enacted by Laws of Utah 2014, Chapter 37
545          62A-2-101, as last amended by Laws of Utah 2022, Chapters 334 and 468
546          62A-3-101, as last amended by Laws of Utah 2005, Chapter 107
547          62A-4a-101.5, as enacted by Laws of Utah 2022, Chapter 334
548          62A-4a-210, as enacted by Laws of Utah 2014, Chapter 67
549          62A-5-206.8, as enacted by Laws of Utah 2018, Chapter 404
550          62A-5-401, as enacted by Laws of Utah 1991, Chapter 207
551          62A-5-403, as last amended by Laws of Utah 1996, Chapters 179 and 318
552          62A-5a-101, as enacted by Laws of Utah 1991, Chapter 207
553          62A-5a-102, as last amended by Laws of Utah 2019, Chapter 187
554          62A-5a-104, as last amended by Laws of Utah 2013, Chapters 167 and 413

555          62A-5a-105, as last amended by Laws of Utah 2019, Chapter 187
556          62A-5b-101, as last amended by Laws of Utah 2019, Chapter 190
557          62A-6-101, as last amended by Laws of Utah 2011, Chapter 366
558          62A-11-103, as last amended by Laws of Utah 2012, Chapter 41
559          62A-11-301, as last amended by Laws of Utah 2000, Chapter 161
560          62A-11-601, as enacted by Laws of Utah 2007, Chapter 338
561          62A-11-701, as enacted by Laws of Utah 2008, Chapter 73
562          62A-11-702, as enacted by Laws of Utah 2008, Chapter 73
563          62A-14-101, as enacted by Laws of Utah 1999, Chapter 69
564          62A-15-101, as last amended by Laws of Utah 2009, Chapter 75
565          62A-15-102, as last amended by Laws of Utah 2022, Chapter 255
566          62A-15-201, as renumbered and amended by Laws of Utah 2002, Fifth Special Session,
567     Chapter 8
568          62A-15-645, as renumbered and amended by Laws of Utah 2002, Fifth Special Session,
569     Chapter 8
570          62A-15-1001, as renumbered and amended by Laws of Utah 2002, Fifth Special
571     Session, Chapter 8
572          62A-15-1100, as enacted by Laws of Utah 2018, Chapter 414
573          62A-15-1301, as last amended by Laws of Utah 2020, Chapter 303
574          62A-15-1303, as last amended by Laws of Utah 2020, Chapter 303
575          62A-15-1401, as last amended by Laws of Utah 2020, Chapter 303
576          62A-15-1501, as last amended by Laws of Utah 2021, Chapter 277
577          62A-15-1601, as last amended by Laws of Utah 2021, Chapter 278
578          62A-15-1701, as enacted by Laws of Utah 2020, Chapter 358
579          62A-15-1801, as enacted by Laws of Utah 2020, Chapter 304
580          62A-16-101, as enacted by Laws of Utah 2010, Chapter 239
581          62A-17-101, as enacted by Laws of Utah 2013, Chapter 24
582          62A-18-101, as enacted by Laws of Utah 2019, Chapter 139
583          62A-18-102, as enacted by Laws of Utah 2019, Chapter 139
584          62A-18-103, as enacted by Laws of Utah 2019, Chapter 139
585          62A-18-104, as enacted by Laws of Utah 2019, Chapter 139

586     

587     Be it enacted by the Legislature of the state of Utah:
588          Section 1. Section 26B-4-101 is amended to read:
589     
CHAPTER 4. HEALTH CARE - DELIVERY AND ACCESS

590     
Part 1. Utah Emergency Medical Services System

591          26B-4-101. Definitions.
592          [Reserved]
593          As used in this part:
594          (1) (a) "911 ambulance or paramedic services" means:
595          (i) either:
596          (A) 911 ambulance service;
597          (B) 911 paramedic service; or
598          (C) both 911 ambulance and paramedic service; and
599          (ii) a response to a 911 call received by a designated dispatch center that receives 911
600     or E911 calls.
601          (b) "911 ambulance or paramedic services" does not mean a seven or 10 digit
602     telephone call received directly by an ambulance provider licensed under this part.
603          (2) "Ambulance" means a ground, air, or water vehicle that:
604          (a) transports patients and is used to provide emergency medical services; and
605          (b) is required to obtain a permit under Section 26-8a-304 to operate in the state.
606          (3) "Ambulance provider" means an emergency medical service provider that:
607          (a) transports and provides emergency medical care to patients; and
608          (b) is required to obtain a license under Part 4, Ambulance and Paramedic Providers.
609          (4) (a) "Behavioral emergency services" means delivering a behavioral health
610     intervention to a patient in an emergency context within a scope and in accordance with
611     guidelines established by the department.
612          (b) "Behavioral emergency services" does not include engaging in the:
613          (i) practice of mental health therapy as defined in Section 58-60-102;
614          (ii) practice of psychology as defined in Section 58-61-102;
615          (iii) practice of clinical social work as defined in Section 58-60-202;
616          (iv) practice of certified social work as defined in Section 58-60-202;

617          (v) practice of marriage and family therapy as defined in Section 58-60-302;
618          (vi) practice of clinical mental health counseling as defined in Section 58-60-402; or
619          (vii) practice as a substance use disorder counselor as defined in Section 58-60-502.
620          (5) "Committee" means the State Emergency Medical Services Committee created by
621     Section 26B-1-204.
622          (6) "Community paramedicine" means medical care:
623          (a) provided by emergency medical service personnel; and
624          (b) provided to a patient who is not:
625          (i) in need of ambulance transportation; or
626          (ii) located in a health care facility as defined in Section 26B-2-201.
627          (7) "Direct medical observation" means in-person observation of a patient by a
628     physician, registered nurse, physician's assistant, or individual licensed under Section 26B-4-
629     116
.
630          (8) "Emergency medical condition" means:
631          (a) a medical condition that manifests itself by symptoms of sufficient severity,
632     including severe pain, that a prudent layperson, who possesses an average knowledge of health
633     and medicine, could reasonably expect the absence of immediate medical attention to result in:
634          (i) placing the individual's health in serious jeopardy;
635          (ii) serious impairment to bodily functions; or
636          (iii) serious dysfunction of any bodily organ or part; or
637          (b) a medical condition that in the opinion of a physician or the physician's designee
638     requires direct medical observation during transport or may require the intervention of an
639     individual licensed under Section 26B-4-116 during transport.
640          (9) (a) "Emergency medical service personnel" means an individual who provides
641     emergency medical services or behavioral emergency services to a patient and is required to be
642     licensed or certified under Section 26B-4-116.
643          (b) "Emergency medical service personnel" includes a paramedic, medical director of a
644     licensed emergency medical service provider, emergency medical service instructor, behavioral
645     emergency services technician, other categories established by the committee, and a certified
646     emergency medical dispatcher.
647          (10) "Emergency medical service providers" means:

648          (a) licensed ambulance providers and paramedic providers;
649          (b) a facility or provider that is required to be designated under Subsection 26B-4-
650     117
(1)(a); and
651          (c) emergency medical service personnel.
652          (11) "Emergency medical services" means:
653          (a) medical services;
654          (b) transportation services;
655          (c) behavioral emergency services; or
656          (d) any combination of the services described in Subsections (11)(a) through (c).
657          (12) "Emergency medical service vehicle" means a land, air, or water vehicle that is:
658          (a) maintained and used for the transportation of emergency medical personnel,
659     equipment, and supplies to the scene of a medical emergency; and
660          (b) required to be permitted under Section 26B-4-118.
661          (13) "Governing body":
662          (a) means the same as that term is defined in Section 11-42-102; and
663          (b) for purposes of a "special service district" under Section 11-42-102, means a
664     special service district that has been delegated the authority to select a provider under this part
665     by the special service district's legislative body or administrative control board.
666          (14) "Interested party" means:
667          (a) a licensed or designated emergency medical services provider that provides
668     emergency medical services within or in an area that abuts an exclusive geographic service area
669     that is the subject of an application submitted pursuant to Sections 26B-4-150 through 26B-4-
670     170
;
671          (b) any municipality, county, or fire district that lies within or abuts a geographic
672     service area that is the subject of an application submitted pursuant to Sections 26B-4-150
673     through 26B-4-170; or
674          (c) the department when acting in the interest of the public.
675          (15) "Level of service" means the level at which an ambulance provider type of service
676     is licensed as:
677          (a) emergency medical technician;
678          (b) advanced emergency medical technician; or

679          (c) paramedic.
680          (16) "Medical control" means a person who provides medical supervision to an
681     emergency medical service provider.
682          (17) "Non-911 service" means transport of a patient that is not 911 transport under
683     Subsection (1).
684          (18) "Nonemergency secured behavioral health transport" means an entity that:
685          (a) provides nonemergency secure transportation services for an individual who:
686          (i) is not required to be transported by an ambulance under Section 26B-4-119; and
687          (ii) requires behavioral health observation during transport between any of the
688     following facilities:
689          (A) a licensed acute care hospital;
690          (B) an emergency patient receiving facility;
691          (C) a licensed mental health facility; and
692          (D) the office of a licensed health care provider; and
693          (b) is required to be designated under Section 26B-4-117.
694          (19) "Paramedic provider" means an entity that:
695          (a) employs emergency medical service personnel; and
696          (b) is required to obtain a license under Sections 26B-4-150 through 26B-4-170.
697          (20) "Patient" means an individual who, as the result of illness, injury, or a behavioral
698     emergency condition, meets any of the criteria in Section 26B-4-119.
699          (21) "Political subdivision" means:
700          (a) a city, town, or metro township;
701          (b) a county;
702          (c) a special service district created under Title 17D, Chapter 1, Special Service
703     District Act, for the purpose of providing fire protection services under Subsection
704     17D-1-201(9);
705          (d) a local district created under Title 17B, Limited Purpose Local Government Entities
706     - Local Districts, for the purpose of providing fire protection, paramedic, and emergency
707     services;
708          (e) areas coming together as described in Subsection 26B-4-156(2)(b)(ii); or
709          (f) an interlocal entity under Title 11, Chapter 13, Interlocal Cooperation Act.

710          (22) "Trauma" means an injury requiring immediate medical or surgical intervention.
711          (23) "Trauma system" means a single, statewide system that:
712          (a) organizes and coordinates the delivery of trauma care within defined geographic
713     areas from the time of injury through transport and rehabilitative care; and
714          (b) is inclusive of all prehospital providers, hospitals, and rehabilitative facilities in
715     delivering care for trauma patients, regardless of severity.
716          (24) "Triage" means the sorting of patients in terms of disposition, destination, or
717     priority. For prehospital trauma victims, triage requires a determination of injury severity to
718     assess the appropriate level of care according to established patient care protocols.
719          (25) "Triage, treatment, transportation, and transfer guidelines" means written
720     procedures that:
721          (a) direct the care of patients; and
722          (b) are adopted by the medical staff of an emergency patient receiving facility, trauma
723     center, or an emergency medical service provider.
724          (26) "Type of service" means the category at which an ambulance provider is licensed
725     as:
726          (a) ground ambulance transport;
727          (b) ground ambulance interfacility transport; or
728          (c) both ground ambulance transport and ground ambulance interfacility transport.
729          Section 2. Section 26B-4-102, which is renumbered from Section 26-8a-105 is
730     renumbered and amended to read:
731          [26-8a-105].      26B-4-102. Department powers.
732          The department shall:
733          (1) coordinate the emergency medical services within the state;
734          (2) administer this [chapter] part and the rules established pursuant to it;
735          (3) establish a voluntary task force representing a diversity of emergency medical
736     service providers to advise the department and the committee on rules;
737          (4) establish an emergency medical service personnel peer review board to advise the
738     department concerning discipline of emergency medical service personnel under this [chapter]
739     part; [and]
740          (5) adopt rules in accordance with Title 63G, Chapter 3, Utah Administrative

741     Rulemaking Act, to:
742          (a) license ambulance providers and paramedic providers;
743          (b) permit ambulances, emergency medical response vehicles, and nonemergency
744     secured behavioral health transport vehicles, including approving an emergency vehicle
745     operator's course in accordance with Section [26-8a-304] 26B-4-118;
746          (c) establish:
747          (i) the qualifications for membership of the peer review board created by this section;
748          (ii) a process for placing restrictions on a license while an investigation is pending;
749          (iii) the process for the investigation and recommendation by the peer review board;
750     and
751          (iv) the process for determining the status of a license while a peer review board
752     investigation is pending;
753          (d) establish application, submission, and procedural requirements for licenses,
754     designations, and permits; and
755          (e) establish and implement the programs, plans, and responsibilities as specified in
756     other sections of this [chapter.] part;
757          (6) develop and implement, in cooperation with state, federal, and local agencies
758     empowered to oversee disaster response activities, plans to provide emergency medical
759     services during times of disaster or emergency;
760          (7) establish a pediatric quality improvement resource program; and
761          (8) develop and implement a statewide program to provide support and counseling for
762     personnel who have been exposed to one or more stressful incidents in the course of providing
763     emergency services which shall include:
764          (a) ongoing training for agencies providing emergency services and counseling
765     program volunteers;
766          (b) critical incident stress debriefing for personnel at no cost to the emergency
767     provider; and
768          (c) advising the department on training requirements for licensure as a behavioral
769     emergency services technician.
770          Section 3. Section 26B-4-103, which is renumbered from Section 26-8a-106 is
771     renumbered and amended to read:

772          [26-8a-106].      26B-4-103. Waiver of rules and education and licensing
773     requirements.
774          (1) Upon application, the department, or the committee with the concurrence of the
775     department, may waive the requirements of a rule the department, or the committee with the
776     concurrence of the department, has adopted if:
777          (a) the person applying for the waiver satisfactorily demonstrates that:
778          (i) the waiver is necessary for a pilot project to be undertaken by the applicant;
779          (ii) in the particular situation, the requirement serves no beneficial public purpose; or
780          (iii) circumstances warrant that waiver of the requirement outweighs the public benefit
781     to be gained by adherence to the rule; and
782          (b) for a waiver granted under Subsection (1)(a)(ii) or (iii):
783          (i) the committee or department extends the waiver to similarly situated persons upon
784     application; or
785          (ii) the department, or the committee with the concurrence of the department, amends
786     the rule to be consistent with the waiver.
787          (2) A waiver of education or licensing requirements may be granted to a veteran, as
788     defined in Section 68-3-12.5, if the veteran:
789          (a) provides to the committee or department documentation showing military education
790     and training in the field in which licensure is sought; and
791          (b) successfully passes any examination required.
792          (3) No waiver may be granted under this section that is inconsistent with the provisions
793     of this [chapter] part.
794          Section 4. Section 26B-4-104, which is renumbered from Section 26-8a-201 is
795     renumbered and amended to read:
796          [26-8a-201].      26B-4-104. Public awareness efforts.
797          The department may:
798          (1) develop programs to inform the public of the emergency medical service system;
799     and
800          (2) develop and disseminate emergency medical training programs for the public,
801     which emphasize the prevention and treatment of injuries and illnesses.
802          Section 5. Section 26B-4-105, which is renumbered from Section 26-8a-202 is

803     renumbered and amended to read:
804          [26-8a-202].      26B-4-105. Emergency medical communications.
805          Consistent with federal law, the department is the lead agency for coordinating the
806     statewide emergency medical service communication systems under which emergency medical
807     personnel, dispatch centers, and treatment facilities provide medical control and coordination
808     between emergency medical service providers.
809          Section 6. Section 26B-4-106, which is renumbered from Section 26-8a-203 is
810     renumbered and amended to read:
811          [26-8a-203].      26B-4-106. Data collection.
812          (1) The committee shall specify the information that shall be collected for the
813     emergency medical services data system established pursuant to Subsection (2).
814          (2) (a) The department shall establish an emergency medical services data system,
815     which shall provide for the collection of information, as defined by the committee, relating to
816     the treatment and care of patients who use or have used the emergency medical services
817     system.
818          (b) The committee shall coordinate with the Health Data Authority created in Chapter
819     [33a] 8, Part 5, Utah Health Data Authority [Act], to create a report of data collected by the
820     Health Data Committee under Section [26-33a-106.1] 26B-8-504 regarding:
821          (i) appropriate analytical methods;
822          (ii) the total amount of air ambulance flight charges in the state for a one-year period;
823     and
824          (iii) of the total number of flights in a one-year period under Subsection (2)(b)(ii):
825          (A) the number of flights for which a patient had no personal responsibility for paying
826     part of the flight charges;
827          (B) the number of flights for which a patient had personal responsibility to pay all or
828     part of the flight charges;
829          (C) the range of flight charges for which patients had personal responsibility under
830     Subsection (2)(b)(iii)(B), including the median amount for paid patient personal responsibility;
831     and
832          (D) the name of any air ambulance provider that received a median paid amount for
833     patient responsibility in excess of the median amount for all paid patient personal responsibility

834     during the reporting year.
835          (c) The department may share, with the Department of Public Safety, information from
836     the emergency medical services data system that:
837          (i) relates to traffic incidents;
838          (ii) is for the improvement of traffic safety;
839          (iii) may not be used for the prosecution of criminal matters; and
840          (iv) may not include any personally identifiable information.
841          (3) (a) On or before October 1, the department shall make the information in Subsection
842     (2)(b) public and send the information in Subsection (2)(b) to public safety dispatchers and first
843     responders in the state.
844          (b) Before making the information in Subsection (2)(b) public, the committee shall
845     provide the air ambulance providers named in the report with the opportunity to respond to the
846     accuracy of the information in the report under Section [26-33a-107] 26B-8-506.
847          (4) Persons providing emergency medical services:
848          (a) shall provide information to the department for the emergency medical services
849     data system established pursuant to Subsection (2)(a);
850          (b) are not required to provide information to the department under Subsection (2)(b);
851     and
852          (c) may provide information to the department under Subsection (2)(b) or (3)(b).
853          Section 7. Section 26B-4-107, which is renumbered from Section 26-8a-207 is
854     renumbered and amended to read:
855          [26-8a-207].      26B-4-107. Emergency Medical Services Grant Program.
856          (1) Funds appropriated to the department for the Emergency Medical Services Grant
857     Program shall be used for improvement of delivery of emergency medical services and
858     administrative costs as described in Subsection (2)(a).
859          (2) From the total amount of funds appropriated to the department under Subsection
860     (1), the department shall use:
861          (a) an amount equal to 50% of the funds:
862          (i) to provide staff support; and
863          (ii) for other expenses incurred in:
864          (A) administration of grant funds; and

865          (B) other department administrative costs under this [chapter] part; and
866          (b) an amount equal to 50% of the funds to provide emergency medical services grants
867     in accordance with Subsection (3).
868          (3) (a) A recipient of a grant under this section shall actively provide emergency
869     medical services within the state.
870          (b) (i) From the total amount of funds used to provide grants under Subsection (3), the
871     department shall distribute an amount equal to 21% as per capita block grants for use
872     specifically related to the provision of emergency medical services to nonprofit prehospital
873     emergency medical services providers that are either licensed or designated and to emergency
874     medical services that are the primary emergency medical services for a service area.
875          (ii) The department shall determine the grant amounts by prorating available funds on a
876     per capita basis by county as described in department rule.
877          (c) Subject to Subsections (3)(d) through (f), the committee shall use the remaining
878     grant funds to award competitive grants to licensed emergency medical services providers that
879     provide emergency medical services within counties of the third through sixth class, in
880     accordance with rules made by the committee.
881          (d) A grant awarded under Subsection (3)(c) shall be used:
882          (i) for the purchase of equipment, subject to Subsection (3)(e); or
883          (ii) for the recruitment, training, or retention of licensed emergency medical services
884     providers.
885          (e) A recipient of a grant under Subsection (3)(c) may not use more than $100,000 in
886     grant proceeds for the purchase of vehicles.
887          (f) A grant awarded for the purpose described in Subsection (3)(d)(ii) is ongoing for a
888     period of up to three years.
889          (g) (i) If, after providing grants under Subsections (3)(c) through (f), any grant funds
890     are unallocated at the end of the fiscal year, the committee shall distribute the unallocated grant
891     funds as per capita block grants as described in Subsection (3)(b).
892          (ii) Any grant funds distributed as per capita grants under Subsection (3)(g)(i) are in
893     addition to the amount described in Subsection (3)(b).
894          Section 8. Section 26B-4-108, which is renumbered from Section 26-8a-208 is
895     renumbered and amended to read:

896          [26-8a-208].      26B-4-108. Fees for training equipment rental, testing, and
897     quality assurance reviews.
898          (1) The department may charge fees, established [pursuant to] in accordance with
899     Section 26B-1-209:
900          (a) for the use of department-owned training equipment;
901          (b) to administer tests and conduct quality assurance reviews; and
902          (c) to process an application for a designation, permit, or license.
903          (2) (a) Fees collected under Subsections (1)(a) and (b) shall be separate dedicated
904     credits.
905          (b) Fees under Subsection (1)(a) may be used to purchase training equipment.
906          (c) Fees under Subsection (1)(b) may be used to administer tests and conduct quality
907     assurance reviews.
908          Section 9. Section 26B-4-109, which is renumbered from Section 26-8a-210 is
909     renumbered and amended to read:
910          [26-8a-210].      26B-4-109. Regional Emergency Medical Services Liaisons --
911     Qualifications -- Duties.
912          (1) As used in this section:
913          (a) "Liaison" means a regional emergency medical services liaison hired under this
914     section.
915          (b) "Rural county" means a county of the third, fourth, fifth, or sixth class.
916          (2) The department shall hire five individuals to serve as regional emergency medical
917     services liaisons to:
918          (a) serve the needs of rural counties in providing emergency medical services in
919     accordance with this [chapter] part;
920          (b) act as a liaison between the department and individuals or entities responsible for
921     emergency medical services in rural counties, including:
922          (i) emergency medical services providers;
923          (ii) local officials; and
924          (iii) local health departments or agencies;
925          (c) provide support and training to emergency medical services providers in rural
926     counties;

927          (d) assist rural counties in utilizing state and federal grant programs for financing
928     emergency medical services; and
929          (e) serve as emergency medical service personnel to assist licensed providers with
930     ambulance staffing needs within rural counties.
931          (3) Each liaison hired under Subsection (2):
932          (a) shall reside in a rural county; and
933          (b) shall be licensed as:
934          (i) an advanced emergency medical technician as defined in Section [26-8c-102]
935     26B-4-137; or
936          (ii) a paramedic as defined in Section [26-8c-102] 26B-4-137.
937          (4) The department shall provide each liaison with a vehicle and other equipment in
938     accordance with rules established by the department.
939          Section 10. Section 26B-4-110, which is renumbered from Section 26-8a-212 is
940     renumbered and amended to read:
941          [26-8a-212].      26B-4-110. Community paramedicine program.
942          (1) A ground ambulance provider or a designated quick response provider, as
943     designated in accordance with Section [26-8a-303] 26B-4-117, may develop and implement a
944     community paramedicine program.
945          (2) (a) Before providing services, a community paramedicine program shall:
946          (i) implement training requirements as determined by the committee; and
947          (ii) submit a written community paramedicine operational plan to the department that
948     meets requirements established by the committee.
949          (b) A community paramedicine program shall report data, as determined by the
950     committee, related to community paramedicine to the department.
951          (3) A service provided as part of a community paramedicine program may not be billed
952     to an individual or a health benefit plan as defined in Section 31A-1-301 unless:
953          (a) the service is provided in partnership with a health care facility as defined in
954     Section [26-21-2] 26B-2-201; and
955          (b) the partnering health care facility is the person that bills the individual or health
956     benefit plan.
957          (4) Nothing in this section affects any billing authorized under Section [26-8a-403]

958     26B-4-152.
959          (5) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, the
960     committee shall make rules to implement this section.
961          Section 11. Section 26B-4-111, which is renumbered from Section 26-8a-250 is
962     renumbered and amended to read:
963          [26-8a-250].      26B-4-111. Establishment of statewide trauma system.
964          The department shall establish and actively supervise a statewide trauma system to:
965          (1) promote optimal care for trauma patients;
966          (2) alleviate unnecessary death and disability from trauma and emergency illness;
967          (3) inform health care providers about trauma system capabilities;
968          (4) encourage the efficient and effective continuum of patient care, including
969     prevention, prehospital care, hospital care, and rehabilitative care; and
970          (5) minimize the overall cost of trauma care.
971          Section 12. Section 26B-4-112, which is renumbered from Section 26-8a-252 is
972     renumbered and amended to read:
973          [26-8a-252].      26B-4-112. Statewide trauma system -- Department duties.
974          In connection with the statewide trauma system established in Section [26-8a-250]
975     26B-4-111, the department shall:
976          (1) establish a statewide trauma system plan that:
977          (a) identifies statewide trauma care needs, objectives, and priorities;
978          (b) identifies the equipment, facilities, personnel training, and other things necessary to
979     create and maintain a statewide trauma system; and
980          (c) organizes and coordinates trauma care within defined geographic areas;
981          (2) support the statewide trauma system by:
982          (a) facilitating the coordination of prehospital, acute care, and rehabilitation services
983     and providers through state regulation and oversight;
984          (b) facilitating the ongoing evaluation and refinement of the statewide trauma system;
985          (c) providing educational programs;
986          (d) encouraging cooperation between community organizations, health care facilities,
987     public health officials, emergency medical service providers, and rehabilitation facilities for the
988     development of a statewide trauma system;

989          (e) implementing a quality assurance program using information from the statewide
990     trauma registry established pursuant to Section [26-8a-253] 26B-4-113;
991          (f) establishing trauma center designation requirements in accordance with Section
992     [26-8a-254] 26B-4-114; and
993          (g) developing standards so that:
994          (i) trauma centers are categorized according to their capability to provide care;
995          (ii) trauma victims are triaged at the initial point of patient contact; and
996          (iii) trauma patients are sent to appropriate health care facilities.
997          Section 13. Section 26B-4-113, which is renumbered from Section 26-8a-253 is
998     renumbered and amended to read:
999          [26-8a-253].      26B-4-113. Statewide trauma system -- Registry and quality
1000     assurance program.
1001          (1) The department shall:
1002          (a) establish and fund a statewide trauma registry to collect and analyze information on
1003     the incidence, severity, causes, and outcomes of trauma;
1004          (b) establish, by rule, the data elements, the medical care providers that shall report,
1005     and the time frame and format for reporting;
1006          (c) use the data collected to:
1007          (i) improve the availability and delivery of prehospital and hospital trauma care;
1008          (ii) assess trauma care delivery, patient care outcomes, and compliance with the
1009     requirements of this [chapter] part and applicable department rules; and
1010          (iii) regularly produce and disseminate reports to data providers, state government, and
1011     the public; and
1012          (d) support data collection and abstraction by providing:
1013          (i) a data collection system and technical assistance to each hospital that submits data;
1014     and
1015          (ii) funding or, at the discretion of the department, personnel for collection and
1016     abstraction for each hospital not designated as a trauma center under the standards established
1017     pursuant to Section [26-8a-254] 26B-4-114.
1018          (2) (a) Each hospital shall submit trauma data in accordance with rules established
1019     under Subsection (1).

1020          (b) A hospital designated as a trauma center shall submit data as part of the ongoing
1021     quality assurance program established in Section [26-8a-252] 26B-4-112.
1022          (3) The department shall assess:
1023          (a) the effectiveness of the data collected pursuant to Subsection (1); and
1024          (b) the impact of the statewide trauma system on the provision of trauma care.
1025          (4) Data collected under this section shall be subject to Chapter [3] 8, Part 4, Health
1026     Statistics.
1027          (5) No person may be held civilly liable for having provided data to the department in
1028     accordance with this section.
1029          Section 14. Section 26B-4-114, which is renumbered from Section 26-8a-254 is
1030     renumbered and amended to read:
1031          [26-8a-254].      26B-4-114. Statewide trauma system -- Trauma center
1032     designations and guidelines.
1033          (1) The department, after seeking the advice of the trauma system advisory committee,
1034     shall establish by rule:
1035          (a) trauma center designation requirements; and
1036          (b) model state guidelines for triage, treatment, transportation, and transfer of trauma
1037     patients to the most appropriate health care facility.
1038          (2) The department shall designate as a trauma center each hospital that:
1039          (a) voluntarily requests a trauma center designation; and
1040          (b) meets the applicable requirements established pursuant to Subsection (1).
1041          Section 15. Section 26B-4-115, which is renumbered from Section 26-8a-301 is
1042     renumbered and amended to read:
1043          [26-8a-301].      26B-4-115. Certificates, Designations, Permits, and Licenses
1044     -- General requirement.
1045          (1) Except as provided in Section [26-8a-308 or 26-8b-201] 26B-4-104 or 26B-4-122:
1046          (a) an individual may not provide emergency medical services without a license or
1047     certification issued under Section [26-8a-302] 26B-4-116;
1048          (b) a facility or provider may not hold itself out as a designated emergency medical
1049     service provider or nonemergency secured behavioral health transport provider without a
1050     designation issued under Section [26-8a-303] 26B-4-117;

1051          (c) a vehicle may not operate as an ambulance, emergency response vehicle, or
1052     nonemergency secured behavioral health transport vehicle without a permit issued under
1053     Section [26-8a-304] 26B-4-118; and
1054          (d) an entity may not respond as an ambulance or paramedic provider without the
1055     appropriate license issued under [Part 4, Ambulance and Paramedic Providers] Sections 26B-4-
1056     150
through 26B-4-170 for ambulance and paramedic providers.
1057          (2) Section [26-8a-502] 26B-4-127 applies to violations of this section.
1058          Section 16. Section 26B-4-116, which is renumbered from Section 26-8a-302 is
1059     renumbered and amended to read:
1060          [26-8a-302].      26B-4-116. Licensure of emergency medical service
1061     personnel.
1062          (1) To promote the availability of comprehensive emergency medical services
1063     throughout the state, the committee shall establish:
1064          (a) initial and ongoing licensure and training requirements for emergency medical
1065     service personnel in the following categories:
1066          (i) paramedic;
1067          (ii) advanced emergency medical services technician;
1068          (iii) emergency medical services technician;
1069          (iv) behavioral emergency services technician; and
1070          (v) advanced behavioral emergency services technician;
1071          (b) a method to monitor the certification status and continuing medical education hours
1072     for emergency medical dispatchers; and
1073          (c) guidelines for giving credit for out-of-state training and experience.
1074          (2) The department shall, based on the requirements established in Subsection (1):
1075          (a) develop, conduct, and authorize training and testing for emergency medical service
1076     personnel;
1077          (b) issue a license and license renewals to emergency medical service personnel other
1078     than emergency medical dispatchers; and
1079          (c) verify the certification of emergency medical dispatchers.
1080          (3) The department shall coordinate with local mental health authorities described in
1081     Section 17-43-301 to develop and authorize initial and ongoing licensure and training

1082     requirements for licensure as a:
1083          (a) behavioral emergency services technician; and
1084          (b) advanced behavioral emergency services technician.
1085          (4) As provided in Section [26-8a-502] 26B-4-127, an individual issued a license or
1086     certified under this section may only provide emergency medical services to the extent allowed
1087     by the license or certification.
1088          (5) An individual may not be issued or retain a license under this section unless the
1089     individual obtains and retains background clearance under Section [26-8a-310] 26B-4-124.
1090          (6) An individual may not be issued or retain a certification under this section unless
1091     the individual obtains and retains background clearance in accordance with Section
1092     [26-8a-310.5] 26B-4-125.
1093          Section 17. Section 26B-4-117, which is renumbered from Section 26-8a-303 is
1094     renumbered and amended to read:
1095          [26-8a-303].      26B-4-117. Designation of emergency medical service
1096     providers and nonemergency secured behavioral health transport providers.
1097          (1) To ensure quality emergency medical services, the committee shall establish
1098     designation requirements for:
1099          (a) emergency medical service providers in the following categories:
1100          (i) quick response provider;
1101          (ii) resource hospital for emergency medical providers;
1102          (iii) emergency medical service dispatch center;
1103          (iv) emergency patient receiving facilities; and
1104          (v) other types of emergency medical service providers as the committee considers
1105     necessary; and
1106          (b) nonemergency secured behavioral health transport providers.
1107          (2) The department shall, based on the requirements in Subsection (1), issue
1108     designations to emergency medical service providers and nonemergency secured behavioral
1109     health transport providers listed in Subsection (1).
1110          (3) As provided in Section [26-8a-502] 26B-4-127, an entity issued a designation under
1111     Subsection (2) may only function and hold itself out in accordance with its designation.
1112          Section 18. Section 26B-4-118, which is renumbered from Section 26-8a-304 is

1113     renumbered and amended to read:
1114          [26-8a-304].      26B-4-118. Permits for emergency medical service vehicles
1115     and nonemergency secured behavioral health transport vehicles.
1116          (1) (a) To ensure that emergency medical service vehicles and nonemergency secured
1117     behavioral health transport vehicles are adequately staffed, safe, maintained, properly
1118     equipped, and safely operated, the committee shall establish permit requirements at levels it
1119     considers appropriate in the following categories:
1120          (i) ambulance;
1121          (ii) emergency medical response vehicle; and
1122          (iii) nonemergency secured behavioral health transport vehicle.
1123          (b) The permit requirements under Subsections (1)(a)(i) and (ii) shall include a
1124     requirement that beginning on or after January 31, 2014, every operator of an ambulance or
1125     emergency medical response vehicle annually provide proof of the successful completion of an
1126     emergency vehicle operator's course approved by the department for all ambulances and
1127     emergency medical response vehicle operators.
1128          (2) The department shall, based on the requirements established in Subsection (1),
1129     issue permits to emergency medical service vehicles and nonemergency secured behavioral
1130     health transport vehicles.
1131          Section 19. Section 26B-4-119, which is renumbered from Section 26-8a-305 is
1132     renumbered and amended to read:
1133          [26-8a-305].      26B-4-119. Ambulance license required for emergency
1134     medical transport.
1135          Except as provided in Section [26-8a-308] 26B-4-122, only an ambulance operating
1136     under a permit issued under Section [26-8a-304] 26B-4-118 may transport an individual who:
1137          (1) is in an emergency medical condition;
1138          (2) is medically or mentally unstable, requiring direct medical observation during
1139     transport;
1140          (3) is physically incapacitated because of illness or injury and in need of immediate
1141     transport by emergency medical service personnel;
1142          (4) is likely to require medical attention during transport;
1143          (5) is being maintained on any type of emergency medical electronic monitoring;

1144          (6) is receiving or has recently received medications that could cause a sudden change
1145     in medical condition that might require emergency medical services;
1146          (7) requires IV administration or maintenance, oxygen that is not patient-operated, or
1147     other emergency medical services during transport;
1148          (8) needs to be immobilized during transport to a hospital, an emergency patient
1149     receiving facility, or mental health facility due to a mental or physical condition, unless the
1150     individual is in the custody of a peace officer and the primary purpose of the restraint is to
1151     prevent escape;
1152          (9) needs to be immobilized due to a fracture, possible fracture, or other medical
1153     condition; or
1154          (10) otherwise requires or has the potential to require a level of medical care that the
1155     committee establishes as requiring direct medical observation.
1156          Section 20. Section 26B-4-120, which is renumbered from Section 26-8a-306 is
1157     renumbered and amended to read:
1158          [26-8a-306].      26B-4-120. Medical control.
1159          (1) The committee shall establish requirements for the coordination of emergency
1160     medical services rendered by emergency medical service providers, including the coordination
1161     between prehospital providers, hospitals, emergency patient receiving facilities, and other
1162     appropriate destinations.
1163          (2) The committee shall establish requirements for the medical supervision of
1164     emergency medical service providers to assure adequate physician oversight of emergency
1165     medical services and quality improvement.
1166          Section 21. Section 26B-4-121, which is renumbered from Section 26-8a-307 is
1167     renumbered and amended to read:
1168          [26-8a-307].      26B-4-121. Patient destination.
1169          (1) If an individual being transported by a ground or air ambulance is in a critical or
1170     unstable medical condition, the ground or air ambulance shall transport the patient to the
1171     trauma center or closest emergency patient receiving facility appropriate to adequately treat the
1172     patient.
1173          (2) If the patient's condition is not critical or unstable as determined by medical
1174     control, the ground or air ambulance may transport the patient to the:

1175          (a) hospital, emergency patient receiving facility, licensed mental health facility, or
1176     other medical provider chosen by the patient and approved by medical control as appropriate
1177     for the patient's condition and needs; or
1178          (b) nearest hospital, emergency patient receiving facility, licensed mental health
1179     facility, or other medical provider approved by medical control as appropriate for the patient's
1180     condition and needs if the patient expresses no preference.
1181          Section 22. Section 26B-4-122, which is renumbered from Section 26-8a-308 is
1182     renumbered and amended to read:
1183          [26-8a-308].      26B-4-122. Exemptions.
1184          (1) The following persons may provide emergency medical services to a patient
1185     without being licensed under this [chapter] part:
1186          (a) out-of-state emergency medical service personnel and providers in time of disaster;
1187          (b) an individual who gratuitously acts as a Good Samaritan;
1188          (c) a family member;
1189          (d) a private business if emergency medical services are provided only to employees at
1190     the place of business and during transport;
1191          (e) an agency of the United States government if compliance with this [chapter] part
1192     would be inconsistent with federal law; and
1193          (f) police, fire, and other public service personnel if:
1194          (i) emergency medical services are rendered in the normal course of the person's duties;
1195     and
1196          (ii) medical control, after being apprised of the circumstances, directs immediate
1197     transport.
1198          (2) An ambulance or emergency response vehicle may operate without a permit issued
1199     under Section [26-8a-304] 26B-4-118 in time of disaster.
1200          (3) Nothing in this [chapter] part or Title 58, Occupations and Professions, may be
1201     construed as requiring a license for an individual to administer cardiopulmonary resuscitation
1202     or to use a fully automated external defibrillator under Section [26-8b-201] 26B-4-302.
1203          (4) Nothing in this [chapter] part may be construed as requiring a license, permit, or
1204     designation for an acute care hospital, medical clinic, physician's office, or other fixed medical
1205     facility that:

1206          (a) is staffed by a physician, physician's assistant, nurse practitioner, or registered
1207     nurse; and
1208          (b) treats an individual who has presented himself or was transported to the hospital,
1209     clinic, office, or facility.
1210          Section 23. Section 26B-4-123, which is renumbered from Section 26-8a-309 is
1211     renumbered and amended to read:
1212          [26-8a-309].      26B-4-123. Out-of-state vehicles.
1213          (1) An ambulance or emergency response vehicle from another state may not pick up a
1214     patient in Utah to transport that patient to another location in Utah or to another state without a
1215     permit issued under Section [26-8a-304] 26B-2-318 and, in the case of an ambulance, a license
1216     issued under [Part 4, Ambulance and Paramedic Providers] this part for ambulance and
1217     paramedic providers.
1218          (2) Notwithstanding Subsection (1), an ambulance or emergency response vehicle from
1219     another state may, without a permit or license:
1220          (a) transport a patient into Utah; and
1221          (b) provide assistance in time of disaster.
1222          (3) The department may enter into agreements with ambulance and paramedic
1223     providers and their respective licensing agencies from other states to assure the expeditious
1224     delivery of emergency medical services beyond what may be reasonably provided by licensed
1225     ambulance and paramedic providers, including the transportation of patients between states.
1226          Section 24. Section 26B-4-124, which is renumbered from Section 26-8a-310 is
1227     renumbered and amended to read:
1228          [26-8a-310].      26B-4-124. Background clearance for emergency medical
1229     service personnel.
1230          (1) Subject to Section [26-8a-310.5] 26B-4-125, the department shall determine
1231     whether to grant background clearance for an individual seeking licensure or certification under
1232     Section [26-8a-302] 26B-4-116 from whom the department receives:
1233          (a) the individual's social security number, fingerprints, and other personal
1234     identification information specified by the department under Subsection (4); and
1235          (b) any fees established by the department under Subsection (10).
1236          (2) The department shall determine whether to deny or revoke background clearance

1237     for individuals for whom the department has previously granted background clearance.
1238          (3) The department shall determine whether to grant, deny, or revoke background
1239     clearance for an individual based on an initial and ongoing evaluation of information the
1240     department obtains under Subsections (5) and (11), which, at a minimum, shall include an
1241     initial criminal background check of state, regional, and national databases using the
1242     individual's fingerprints.
1243          (4) The department shall make rules, in accordance with Title 63G, Chapter 3, Utah
1244     Administrative Rulemaking Act, that specify:
1245          (a) the criteria the department will use under Subsection (3) to determine whether to
1246     grant, deny, or revoke background clearance; and
1247          (b) the other personal identification information an individual seeking licensure or
1248     certification under Section [26-8a-302] 26B-4-116 must submit under Subsection (1).
1249          (5) To determine whether to grant, deny, or revoke background clearance, the
1250     department may access and evaluate any of the following:
1251          (a) Department of Public Safety arrest, conviction, and disposition records described in
1252     Title 53, Chapter 10, Criminal Investigations and Technical Services Act, including
1253     information in state, regional, and national records files;
1254          (b) adjudications by a juvenile court of committing an act that if committed by an adult
1255     would be a felony or misdemeanor, if:
1256          (i) the applicant is under 28 years old; or
1257          (ii) the applicant:
1258          (A) is over 28 years old; and
1259          (B) has been convicted of, has pleaded no contest to, or is currently subject to a plea in
1260     abeyance or diversion agreement for a felony or misdemeanor;
1261          (c) juvenile court arrest, adjudication, and disposition records, other than those under
1262     Subsection (5)(b), as allowed under Section 78A-6-209;
1263          (d) child abuse or neglect findings described in Section 80-3-404;
1264          (e) the department's Licensing Information System described in Section 80-2-1002;
1265          (f) the department's database of reports of vulnerable adult abuse, neglect, or
1266     exploitation, described in Section [62A-3-311.1] 26B-6-210;
1267          (g) Division of Professional Licensing records of licensing and certification under Title

1268     58, Occupations and Professions;
1269          (h) records in other federal criminal background databases available to the state; and
1270          (i) any other records of arrests, warrants for arrest, convictions, pleas in abeyance,
1271     pending diversion agreements, or dispositions.
1272          (6) Except for the Department of Public Safety, an agency may not charge the
1273     department for information accessed under Subsection (5).
1274          (7) When evaluating information under Subsection (3), the department shall classify a
1275     crime committed in another state according to the closest matching crime under Utah law,
1276     regardless of how the crime is classified in the state where the crime was committed.
1277          (8) The department shall adopt measures to protect the security of information the
1278     department accesses under Subsection (5), which shall include limiting access by department
1279     employees to those responsible for acquiring, evaluating, or otherwise processing the
1280     information.
1281          (9) The department may disclose personal identification information the department
1282     receives under Subsection (1) to the department to verify that the subject of the information is
1283     not identified as a perpetrator or offender in the information sources described in Subsections
1284     (5)(d) through (f).
1285          (10) The department may charge fees, in accordance with Section 63J-1-504, to pay
1286     for:
1287          (a) the cost of obtaining, storing, and evaluating information needed under Subsection
1288     (3), both initially and on an ongoing basis, to determine whether to grant, deny, or revoke
1289     background clearance; and
1290          (b) other department costs related to granting, denying, or revoking background
1291     clearance.
1292          (11) The Criminal Investigations and Technical Services Division within the
1293     Department of Public Safety shall:
1294          (a) retain, separate from other division records, personal information under Subsection
1295     (1), including any fingerprints sent to it by the department; and
1296          (b) notify the department upon receiving notice that an individual for whom personal
1297     information has been retained is the subject of:
1298          (i) a warrant for arrest;

1299          (ii) an arrest;
1300          (iii) a conviction, including a plea in abeyance; or
1301          (iv) a pending diversion agreement.
1302          (12) The department shall use the Direct Access Clearance System database created
1303     under Section [26-21-209] 26B-2-241 to manage information about the background clearance
1304     status of each individual for whom the department is required to make a determination under
1305     Subsection (1).
1306          (13) Clearance granted for an individual licensed or certified under Section
1307     [26-8a-302] 26B-4-123 is valid until two years after the day on which the individual is no
1308     longer licensed or certified in Utah as emergency medical service personnel.
1309          Section 25. Section 26B-4-125, which is renumbered from Section 26-8a-310.5 is
1310     renumbered and amended to read:
1311          [26-8a-310.5].      26B-4-125. Background check requirements for emergency
1312     medical dispatchers.
1313          An emergency medical dispatcher seeking certification under Section [26-8a-302] 26B-
1314     4-116
shall undergo the background clearance process described in Section [26-8a-310] 26B-4-
1315     124
unless the emergency medical dispatcher can demonstrate that the emergency medical
1316     dispatcher has received and currently holds an approved Department of Public Safety
1317     background clearance.
1318          Section 26. Section 26B-4-126, which is renumbered from Section 26-8a-501 is
1319     renumbered and amended to read:
1320          [26-8a-501].      26B-4-126. Discrimination prohibited.
1321          (1) No person licensed or designated pursuant to this [chapter] part may discriminate in
1322     the provision of emergency medical services on the basis of race, sex, color, creed, or prior
1323     inquiry as to ability to pay.
1324          (2) This [chapter] part does not authorize or require medical assistance or
1325     transportation over the objection of an individual on religious grounds.
1326          Section 27. Section 26B-4-127, which is renumbered from Section 26-8a-502 is
1327     renumbered and amended to read:
1328          [26-8a-502].      26B-4-127. Illegal activity.
1329          (1) Except as provided in Section [26-8a-308 or 26-8b-201] 26B-4-104 or 26B-4-122,

1330     a person may not:
1331          (a) practice or engage in the practice, represent that the person is practicing or engaging
1332     in the practice, or attempt to practice or engage in the practice of any activity that requires a
1333     license, certification, or designation under this [chapter] part unless that person is licensed,
1334     certified, or designated under this [chapter] part; or
1335          (b) offer an emergency medical service that requires a license, certification, or
1336     designation under this [chapter] part unless the person is licensed, certified, or designated
1337     under this [chapter] part.
1338          (2) A person may not advertise or represent that the person holds a license,
1339     certification, or designation required under this [chapter] part, unless that person holds the
1340     license, certification, or designation under this [chapter] part.
1341          (3) A person may not employ or permit any employee to perform any service for which
1342     a license or certification is required by this [chapter] part, unless the person performing the
1343     service possesses the required license or certification under this [chapter] part.
1344          (4) A person may not wear, display, sell, reproduce, or otherwise use any Utah
1345     Emergency Medical Services insignia without authorization from the department.
1346          (5) A person may not reproduce or otherwise use materials developed by the
1347     department for licensure or certification testing or examination without authorization from the
1348     department.
1349          (6) A person may not willfully summon an ambulance or emergency response vehicle
1350     or report that one is needed when the person knows that the ambulance or emergency response
1351     vehicle is not needed.
1352          (7) A person who violates this section is subject to Section [26-23-6] 26B-1-224.
1353          Section 28. Section 26B-4-128, which is renumbered from Section 26-8a-502.1 is
1354     renumbered and amended to read:
1355          [26-8a-502.1].      26B-4-128. Prohibition on the use of "911".
1356          (1) As used in this section:
1357          (a) "Emergency services" means services provided by a person in response to an
1358     emergency.
1359          (b) "Emergency services" includes:
1360          (i) fire protection services;

1361          (ii) paramedic services;
1362          (iii) law enforcement services;
1363          (iv) 911 ambulance or paramedic services[, as defined in Section 26-8a-102]; and
1364          (v) any other emergency services.
1365          (2) A person may not use "911" or other similar sequence of numbers in the person's
1366     name with the purpose to deceive the public that the person operates or represents emergency
1367     services, unless the person is authorized to provide emergency services.
1368          (3) A violation of Subsection (2) is:
1369          (a) a class C misdemeanor; and
1370          (b) subject to a fine of up to $500 per violation.
1371          Section 29. Section 26B-4-129, which is renumbered from Section 26-8a-503 is
1372     renumbered and amended to read:
1373          [26-8a-503].      26B-4-129. Discipline of emergency medical services
1374     personnel.
1375          (1) The department may refuse to issue a license or renewal, or revoke, suspend,
1376     restrict, or place on probation an individual's license if:
1377          (a) the individual does not meet the qualifications for licensure under Section
1378     [26-8a-302] 26B-4-116;
1379          (b) the individual has engaged in conduct, as defined by committee rule, that:
1380          (i) is unprofessional;
1381          (ii) is adverse to the public health, safety, morals, or welfare; or
1382          (iii) would adversely affect public trust in the emergency medical service system;
1383          (c) the individual has violated Section [26-8a-502] 26B-4-127 or other provision of this
1384     [chapter] part;
1385          (d) the individual has violated Section 58-1-509;
1386          (e) a court of competent jurisdiction has determined the individual to be mentally
1387     incompetent for any reason; or
1388          (f) the individual is unable to provide emergency medical services with reasonable skill
1389     and safety because of illness, drunkenness, use of drugs, narcotics, chemicals, or any other type
1390     of material, or as a result of any other mental or physical condition, when the individual's
1391     condition demonstrates a clear and unjustifiable threat or potential threat to oneself, coworkers,

1392     or the public health, safety, or welfare that cannot be reasonably mitigated.
1393          (2) (a) An action to revoke, suspend, restrict, or place a license on probation shall be
1394     done in:
1395          (i) consultation with the peer review board created in Section [26-8a-105] 26B-4-102;
1396     and
1397          (ii) accordance with Title 63G, Chapter 4, Administrative Procedures Act.
1398          (b) Notwithstanding Subsection (2)(a), the department may issue a cease and desist
1399     order under Section [26-8a-507] 26B-4-133 to immediately suspend an individual's license
1400     pending an administrative proceeding to be held within 30 days if there is evidence to show
1401     that the individual poses a clear, immediate, and unjustifiable threat or potential threat to the
1402     public health, safety, or welfare.
1403          (3) An individual whose license has been suspended, revoked, or restricted may apply
1404     for reinstatement of the license at reasonable intervals and upon compliance with any
1405     conditions imposed upon the license by statute, committee rule, or the terms of the suspension,
1406     revocation, or restriction.
1407          (4) In addition to taking disciplinary action under Subsection (1), the department may
1408     impose sanctions in accordance with Section [26-23-6] 26B-1-224.
1409          Section 30. Section 26B-4-130, which is renumbered from Section 26-8a-504 is
1410     renumbered and amended to read:
1411          [26-8a-504].      26B-4-130. Discipline of designated and licensed providers.
1412          (1) The department may refuse to issue a license or designation or a renewal, or revoke,
1413     suspend, restrict, or place on probation, an emergency medical service provider's license or
1414     designation if the provider has:
1415          (a) failed to abide by terms of the license or designation;
1416          (b) violated statute or rule;
1417          (c) failed to provide services at the level or in the exclusive geographic service area
1418     required by the license or designation;
1419          (d) failed to submit a renewal application in a timely fashion as required by department
1420     rule;
1421          (e) failed to follow operational standards established by the committee; or
1422          (f) committed an act in the performance of a professional duty that endangered the

1423     public or constituted gross negligence.
1424          (2) (a) An action to revoke, suspend, restrict, or place a license or designation on
1425     probation shall be done in accordance with Title 63G, Chapter 4, Administrative Procedures
1426     Act.
1427          (b) Notwithstanding Subsection (2)(a), the department may issue a cease and desist
1428     order under Section [26-8a-507] 26B-4-133 to immediately suspend a license or designation
1429     pending an administrative proceeding to be held within 30 days if there is evidence to show
1430     that the provider or facility poses a clear, immediate, and unjustifiable threat or potential threat
1431     to the public health, safety, or welfare.
1432          (3) In addition to taking disciplinary action under Subsection (1), the department may
1433     impose sanctions in accordance with Section [26-23-6] 26B-1-224.
1434          Section 31. Section 26B-4-131, which is renumbered from Section 26-8a-505 is
1435     renumbered and amended to read:
1436          [26-8a-505].      26B-4-131. Service interruption or cessation -- Receivership
1437     -- Default coverage -- Notice.
1438          (1) Acting in the public interest, the department may petition the district court where an
1439     ambulance or paramedic provider operates or the district court with jurisdiction in Salt Lake
1440     County to appoint the department or an independent receiver to continue the operations of a
1441     provider upon any one of the following conditions:
1442          (a) the provider ceases or intends to cease operations;
1443          (b) the provider becomes insolvent;
1444          (c) the department has initiated proceedings to revoke the provider's license and has
1445     determined that the lives, health, safety, or welfare of the population served within the
1446     provider's exclusive geographic service area are endangered because of the provider's action or
1447     inaction pending a full hearing on the license revocation; or
1448          (d) the department has revoked the provider's license and has been unable to adequately
1449     arrange for another provider to take over the provider's exclusive geographic service area.
1450          (2) If a licensed or designated provider ceases operations or is otherwise unable to
1451     provide services, the department may arrange for another licensed provider to provide services
1452     on a temporary basis until a license is issued.
1453          (3) A licensed provider shall give the department 30 days notice of its intent to cease

1454     operations.
1455          Section 32. Section 26B-4-132, which is renumbered from Section 26-8a-506 is
1456     renumbered and amended to read:
1457          [26-8a-506].      26B-4-132. Investigations for enforcement of part.
1458          (1) The department may, for the purpose of ascertaining compliance with the
1459     provisions of this [chapter] part, enter and inspect on a routine basis the business premises and
1460     equipment of a person:
1461          (a) with a designation, permit, or license; or
1462          (b) who holds himself out to the general public as providing a service for which a
1463     designation, permit, or license is required under Section [26-8a-301] 26B-4-115.
1464          (2) Before conducting an inspection under Subsection (1), the department shall, after
1465     identifying the person in charge:
1466          (a) give proper identification;
1467          (b) describe the nature and purpose of the inspection; and
1468          (c) if necessary, explain the authority of the department to conduct the inspection.
1469          (3) In conducting an inspection under Subsection (1), the department may, after
1470     meeting the requirements of Subsection (2):
1471          (a) inspect records, equipment, and vehicles; and
1472          (b) interview personnel.
1473          (4) An inspection conducted under Subsection (1) shall be during regular operational
1474     hours.
1475          Section 33. Section 26B-4-133, which is renumbered from Section 26-8a-507 is
1476     renumbered and amended to read:
1477          [26-8a-507].      26B-4-133. Cease and desist orders.
1478          The department may issue a cease and desist order to any person who:
1479          (1) may be disciplined under Section [26-8a-503 or 26-8a-504] 26B-4-129 or
1480     26B-4-130; or
1481          (2) otherwise violates this [chapter] part or any rules adopted under this [chapter] part.
1482          Section 34. Section 26B-4-134, which is renumbered from Section 26-8a-601 is
1483     renumbered and amended to read:
1484          [26-8a-601].      26B-4-134. Persons and activities exempt from civil liability.

1485          (1) (a) Except as provided in Subsection (1)(b), a licensed physician, physician's
1486     assistant, or licensed registered nurse who, gratuitously and in good faith, gives oral or written
1487     instructions to any of the following is not liable for any civil damages as a result of issuing the
1488     instructions:
1489          (i) an individual licensed or certified under Section [26-8a-302] 26B-4-116;
1490          (ii) an individual who uses a fully automated external defibrillator, as defined in Section
1491     [26-8b-102] 26B-4-301; or
1492          (iii) an individual who administers CPR, as defined in Section [26-8b-102] 26B-4-301.
1493          (b) The liability protection described in Subsection (1)(a) does not apply if the
1494     instructions given were the result of gross negligence or willful misconduct.
1495          (2) An individual licensed or certified under Section [26-8a-302] 26B-4-116, during
1496     either training or after licensure or certification, a licensed physician, a physician assistant, or a
1497     registered nurse who, gratuitously and in good faith, provides emergency medical instructions
1498     or renders emergency medical care authorized by this [chapter] part is not liable for any civil
1499     damages as a result of any act or omission in providing the emergency medical instructions or
1500     medical care, unless the act or omission is the result of gross negligence or willful misconduct.
1501          (3) An individual licensed or certified under Section [26-8a-302] 26B-4-116 is not
1502     subject to civil liability for failure to obtain consent in rendering emergency medical services
1503     authorized by this [chapter] part to any individual who is unable to give his consent, regardless
1504     of the individual's age, where there is no other person present legally authorized to consent to
1505     emergency medical care, provided that the licensed individual acted in good faith.
1506          (4) A principal, agent, contractor, employee, or representative of an agency,
1507     organization, institution, corporation, or entity of state or local government that sponsors,
1508     authorizes, supports, finances, or supervises any functions of an individual licensed or certified
1509     under Section [26-8a-302] 26B-4-116 is not liable for any civil damages for any act or
1510     omission in connection with the sponsorship, authorization, support, finance, or supervision of
1511     the licensed or certified individual where the act or omission occurs in connection with the
1512     licensed or certified individual's training or occurs outside a hospital where the life of a patient
1513     is in immediate danger, unless the act or omission is inconsistent with the training of the
1514     licensed or certified individual, and unless the act or omission is the result of gross negligence
1515     or willful misconduct.

1516          (5) A physician or physician assistant who gratuitously and in good faith arranges for,
1517     requests, recommends, or initiates the transfer of a patient from a hospital to a critical care unit
1518     in another hospital is not liable for any civil damages as a result of such transfer where:
1519          (a) sound medical judgment indicates that the patient's medical condition is beyond the
1520     care capability of the transferring hospital or the medical community in which that hospital is
1521     located; and
1522          (b) the physician or physician assistant has secured an agreement from the receiving
1523     facility to accept and render necessary treatment to the patient.
1524          (6) An individual who is a registered member of the National Ski Patrol System (NSPS)
1525     or a member of a ski patrol who has completed a course in winter emergency care offered by
1526     the NSPS combined with CPR for medical technicians offered by the American Red Cross or
1527     American Heart Association, or an equivalent course of instruction, and who in good faith
1528     renders emergency care in the course of ski patrol duties is not liable for civil damages as a
1529     result of any act or omission in rendering the emergency care, unless the act or omission is the
1530     result of gross negligence or willful misconduct.
1531          (7) An emergency medical service provider who, in good faith, transports an individual
1532     against his will but at the direction of a law enforcement officer pursuant to Section
1533     [62A-15-629] 26B-5-331 is not liable for civil damages for transporting the individual.
1534          Section 35. Section 26B-4-135, which is renumbered from Section 26-8a-602 is
1535     renumbered and amended to read:
1536          [26-8a-602].      26B-4-135. Notification of air ambulance policies and
1537     charges.
1538          (1) For any patient who is in need of air medical transport provider services, an
1539     emergency medical service provider shall:
1540          (a) provide the patient or the patient's representative with the information described in
1541     Subsection [26-8a-107] 26B-1-405(7)(a) before contacting an air medical transport provider;
1542     and
1543          (b) if multiple air medical transport providers are capable of providing the patient with
1544     services, provide the patient or the patient's representative an opportunity to choose the air
1545     medical transport provider.
1546          (2) Subsection (1) does not apply if the patient:

1547          (a) is unconscious and the patient's representative is not physically present with the
1548     patient; or
1549          (b) is unable, due to a medical condition, to make an informed decision about the
1550     choice of an air medical transport provider, and the patient's representative is not physically
1551     present with the patient.
1552          Section 36. Section 26B-4-136, which is renumbered from Section 26-8a-603 is
1553     renumbered and amended to read:
1554          [26-8a-603].      26B-4-136. Volunteer Emergency Medical Service Personnel
1555     Health Insurance Program -- Creation -- Administration -- Eligibility -- Benefits --
1556     Rulemaking -- Advisory board.
1557          (1) As used in this section:
1558          (a) "Health benefit plan" means the same as that term is defined in Section 31A-1-301.
1559          (b) "Local government entity" means a political subdivision that:
1560          (i) is licensed as a ground ambulance provider under Part 4, Ambulance and Paramedic
1561     Providers; and
1562          (ii) as of January 1, 2022, does not offer health insurance benefits to volunteer
1563     emergency medical service personnel.
1564          (c) "PEHP" means the Public Employees' Benefit and Insurance Program created in
1565     Section 49-20-103.
1566          (d) "Political subdivision" means a county, a municipality, a limited purpose
1567     government entity described in Title 17B, Limited Purpose Local Government Entities - Local
1568     Districts, or Title 17D, Limited Purpose Local Government Entities - Other Entities, or an
1569     entity created by an interlocal agreement under Title 11, Chapter 13, Interlocal Cooperation
1570     Act.
1571          (e) "Qualifying association" means an association that represents two or more political
1572     subdivisions in the state.
1573          (2) The Volunteer Emergency Medical Service Personnel Health Insurance Program
1574     shall promote recruitment and retention of volunteer emergency medical service personnel by
1575     making health insurance available to volunteer emergency medical service personnel.
1576          (3) The department shall contract with a qualifying association to create, implement,
1577     and administer the Volunteer Emergency Medical Service Personnel Health Insurance Program

1578     described in this section.
1579          (4) Participation in the program is limited to emergency medical service personnel
1580     who:
1581          (a) are licensed under Section [26-8a-302] 26B-4-116 and are able to perform all
1582     necessary functions associated with the license;
1583          (b) provide emergency medical services under the direction of a local governmental
1584     entity:
1585          (i) by responding to 20% of calls for emergency medical services in a rolling
1586     twelve-month period;
1587          (ii) within a county of the third, fourth, fifth, or sixth class; and
1588          (iii) as a volunteer under the Fair Labor Standards Act, in accordance with 29 C.F.R.
1589     Sec. 553.106;
1590          (c) are not eligible for a health benefit plan through an employer or a spouse's
1591     employer;
1592          (d) are not eligible for medical coverage under a government sponsored healthcare
1593     program; and
1594          (e) reside in the state.
1595          (5) (a) A participant in the program is eligible to participate in PEHP in accordance
1596     with Subsection (5)(b) and Subsection 49-20-201(3).
1597          (b) Benefits available to program participants under PEHP are limited to health
1598     insurance that:
1599          (i) covers the program participant and the program participant's eligible dependents on
1600     a July 1 plan year;
1601          (ii) accepts enrollment during an open enrollment period or for a special enrollment
1602     event, including the initial eligibility of a program participant;
1603          (iii) if the program participant is no longer eligible for benefits, terminates on the last
1604     day of the last month for which the individual is a participant in the Volunteer Emergency
1605     Medical Service Personnel Health Insurance Program; and
1606          (iv) is not subject to continuation rights under state or federal law.
1607          (6) (a) The department may make rules in accordance with Title 63G, Chapter 3, Utah
1608     Administrative Rulemaking Act, to define additional criteria regarding benefit design and

1609     eligibility for the program.
1610          (b) The department shall convene an advisory board:
1611          (i) to advise the department on making rules under Subsection (6)(a); and
1612          (ii) that includes representation from at least the following entities:
1613          (A) the qualifying association that receives the contract under Subsection (3); and
1614          (B) PEHP.
1615          (7) For purposes of this section, the qualifying association that receives the contract
1616     under Subsection (3) shall be considered the public agency for whom the program participant is
1617     volunteering under 29 C.F.R. Sec. 553.101.
1618          Section 37. Section 26B-4-137, which is renumbered from Section 26-8c-102 is
1619     renumbered and amended to read:
1620          [26-8c-102].      26B-4-137. EMS Personnel Licensure Interstate Compact.
1621     
EMS PERSONNEL LICENSURE INTERSTATE COMPACT

1622     
SECTION 1. PURPOSE

1623          In order to protect the public through verification of competency and ensure
1624     accountability for patient care related activities all states license emergency medical services
1625     (EMS) personnel, such as emergency medical technicians (EMTs), advanced EMTs and
1626     paramedics. This Compact is intended to facilitate the day to day movement of EMS personnel
1627     across state boundaries in the performance of their EMS duties as assigned by an appropriate
1628     authority and authorize state EMS offices to afford immediate legal recognition to EMS
1629     personnel licensed in a member state. This Compact recognizes that states have a vested
1630     interest in protecting the public's health and safety through their licensing and regulation of
1631     EMS personnel and that such state regulation shared among the member states will best protect
1632     public health and safety. This Compact is designed to achieve the following purposes and
1633     objectives:
1634          1. Increase public access to EMS personnel;
1635          2. Enhance the states' ability to protect the public's health and safety, especially patient
1636     safety;
1637          3. Encourage the cooperation of member states in the areas of EMS personnel licensure
1638     and regulation;
1639          4. Support licensing of military members who are separating from an active duty tour

1640     and their spouses;
1641          5. Facilitate the exchange of information between member states regarding EMS
1642     personnel licensure, adverse action and significant investigatory information;
1643          6. Promote compliance with the laws governing EMS personnel practice in each
1644     member state; and
1645          7. Invest all member states with the authority to hold EMS personnel accountable
1646     through the mutual recognition of member state licenses.
1647     
SECTION 2. DEFINITIONS

1648          In this compact:
1649          A. "Advanced Emergency Medical Technician (AEMT)" means: an individual licensed
1650     with cognitive knowledge and a scope of practice that corresponds to that level in the National
1651     EMS Education Standards and National EMS Scope of Practice Model.
1652          B. "Adverse Action" means: any administrative, civil, equitable or criminal action
1653     permitted by a state's laws which may be imposed against licensed EMS personnel by a state
1654     EMS authority or state court, including, but not limited to, actions against an individual's
1655     license such as revocation, suspension, probation, consent agreement, monitoring or other
1656     limitation or encumbrance on the individual's practice, letters of reprimand or admonition,
1657     fines, criminal convictions and state court judgments enforcing adverse actions by the state
1658     EMS authority.
1659          C. "Alternative program" means: a voluntary, non-disciplinary substance abuse
1660     recovery program approved by a state EMS authority.
1661          D. "Certification" means: the successful verification of entry-level cognitive and
1662     psychomotor competency using a reliable, validated, and legally defensible examination.
1663          E. "Commission" means: the national administrative body of which all states that have
1664     enacted the compact are members.
1665          F. "Emergency Medical Technician (EMT)" means: an individual licensed with
1666     cognitive knowledge and a scope of practice that corresponds to that level in the National EMS
1667     Education Standards and National EMS Scope of Practice Model.
1668          G. "Home State" means: a member state where an individual is licensed to practice
1669     emergency medical services.
1670          H. "License" means: the authorization by a state for an individual to practice as an

1671     EMT, AEMT, paramedic, or a level in between EMT and paramedic.
1672          I. "Medical Director" means: a physician licensed in a member state who is
1673     accountable for the care delivered by EMS personnel.
1674          J. "Member State" means: a state that has enacted this compact.
1675          K. "Privilege to Practice" means: an individual's authority to deliver emergency
1676     medical services in remote states as authorized under this compact.
1677          L. "Paramedic" means: an individual licensed with cognitive knowledge and a scope of
1678     practice that corresponds to that level in the National EMS Education Standards and National
1679     EMS Scope of Practice Model.
1680          M. "Remote State" means: a member state in which an individual is not licensed.
1681          N. "Restricted" means: the outcome of an adverse action that limits a license or the
1682     privilege to practice.
1683          O. "Rule" means: a written statement by the interstate Commission promulgated
1684     pursuant to Section 12 of this compact that is of general applicability; implements, interprets,
1685     or prescribes a policy or provision of the compact; or is an organizational, procedural, or
1686     practice requirement of the Commission and has the force and effect of statutory law in a
1687     member state and includes the amendment, repeal, or suspension of an existing rule.
1688          P. "Scope of Practice" means: defined parameters of various duties or services that may
1689     be provided by an individual with specific credentials. Whether regulated by rule, statute, or
1690     court decision, it tends to represent the limits of services an individual may perform.
1691          Q. "Significant Investigatory Information" means:
1692          1. investigative information that a state EMS authority, after a preliminary inquiry that
1693     includes notification and an opportunity to respond if required by state law, has reason to
1694     believe, if proved true, would result in the imposition of an adverse action on a license or
1695     privilege to practice; or
1696          2. investigative information that indicates that the individual represents an immediate
1697     threat to public health and safety regardless of whether the individual has been notified and had
1698     an opportunity to respond.
1699          R. "State" means: means any state, commonwealth, district, or territory of the United
1700     States.
1701          S. "State EMS Authority" means: the board, office, or other agency with the legislative

1702     mandate to license EMS personnel.
1703     
SECTION 3. HOME STATE LICENSURE

1704          A. Any member state in which an individual holds a current license shall be deemed a
1705     home state for purposes of this compact.
1706          B. Any member state may require an individual to obtain and retain a license to be
1707     authorized to practice in the member state under circumstances not authorized by the privilege
1708     to practice under the terms of this compact.
1709          C. A home state's license authorizes an individual to practice in a remote state under
1710     the privilege to practice only if the home state:
1711          1. Currently requires the use of the National Registry of Emergency Medical
1712     Technicians (NREMT) examination as a condition of issuing initial licenses at the EMT and
1713     paramedic levels;
1714          2. Has a mechanism in place for receiving and investigating complaints about
1715     individuals;
1716          3. Notifies the Commission, in compliance with the terms herein, of any adverse action
1717     or significant investigatory information regarding an individual;
1718          4. No later than five years after activation of the Compact, requires a criminal
1719     background check of all applicants for initial licensure, including the use of the results of
1720     fingerprint or other biometric data checks compliant with the requirements of the Federal
1721     Bureau of Investigation with the exception of federal employees who have suitability
1722     determination in accordance with 5 C.F.R. Sec. 731.202 and submit documentation of such as
1723     promulgated in the rules of the Commission; and
1724          5. Complies with the rules of the Commission.
1725     
SECTION 4. COMPACT PRIVILEGE TO PRACTICE

1726          A. Member states shall recognize the privilege to practice of an individual licensed in
1727     another member state that is in conformance with Section 3.
1728          B. To exercise the privilege to practice under the terms and provisions of this compact,
1729     an individual must:
1730          1. Be at least 18 years of age;
1731          2. Possess a current unrestricted license in a member state as an EMT, AEMT,
1732     paramedic, or state recognized and licensed level with a scope of practice and authority

1733     between EMT and paramedic; and
1734          3. Practice under the supervision of a medical director.
1735          C. An individual providing patient care in a remote state under the privilege to practice
1736     shall function within the scope of practice authorized by the home state unless and until
1737     modified by an appropriate authority in the remote state as may be defined in the rules of the
1738     commission.
1739          D. Except as provided in Section 4 subsection C, an individual practicing in a remote
1740     state will be subject to the remote state's authority and laws. A remote state may, in accordance
1741     with due process and that state's laws, restrict, suspend, or revoke an individual's privilege to
1742     practice in the remote state and may take any other necessary actions to protect the health and
1743     safety of its citizens. If a remote state takes action it shall promptly notify the home state and
1744     the Commission.
1745          E. If an individual's license in any home state is restricted or suspended, the individual
1746     shall not be eligible to practice in a remote state under the privilege to practice until the
1747     individual's home state license is restored.
1748          F. If an individual's privilege to practice in any remote state is restricted, suspended, or
1749     revoked the individual shall not be eligible to practice in any remote state until the individual's
1750     privilege to practice is restored.
1751     
SECTION 5. CONDITIONS OF PRACTICE IN A REMOTE STATE

1752          An individual may practice in a remote state under a privilege to practice only in the
1753     performance of the individual's EMS duties as assigned by an appropriate authority, as defined
1754     in the rules of the Commission, and under the following circumstances:
1755          1. The individual originates a patient transport in a home state and transports the
1756     patient to a remote state;
1757          2. The individual originates in the home state and enters a remote state to pick up a
1758     patient and provide care and transport of the patient to the home state;
1759          3. The individual enters a remote state to provide patient care and/or transport within
1760     that remote state;
1761          4. The individual enters a remote state to pick up a patient and provide care and
1762     transport to a third member state;
1763          5. Other conditions as determined by rules promulgated by the commission.

1764     
SECTION 6. RELATIONSHIP TO EMERGENCY

1765     
MANAGEMENT ASSISTANCE COMPACT

1766          Upon a member state's governor's declaration of a state of emergency or disaster that
1767     activates the Emergency Management Assistance Compact (EMAC), all relevant terms and
1768     provisions of EMAC shall apply and to the extent any terms or provisions of this Compact
1769     conflicts with EMAC, the terms of EMAC shall prevail with respect to any individual
1770     practicing in the remote state in response to such declaration.
1771     
SECTION 7. VETERANS, SERVICE MEMBERS SEPARATING

1772     
FROM ACTIVE DUTY MILITARY, AND THEIR SPOUSES

1773          A. Member states shall consider a veteran, active military service member, and
1774     member of the National Guard and Reserves separating from an active duty tour, and a spouse
1775     thereof, who holds a current valid and unrestricted NREMT certification at or above the level
1776     of the state license being sought as satisfying the minimum training and examination
1777     requirements for such licensure.
1778          B. Member states shall expedite the processing of licensure applications submitted by
1779     veterans, active military service members, and members of the National Guard and Reserves
1780     separating from an active duty tour, and their spouses.
1781          C. All individuals functioning with a privilege to practice under this Section remain
1782     subject to the Adverse Actions provisions of Section VIII.
1783     
SECTION 8. ADVERSE ACTIONS

1784          A. A home state shall have exclusive power to impose adverse action against an
1785     individual's license issued by the home state.
1786          B. If an individual's license in any home state is restricted or suspended, the individual
1787     shall not be eligible to practice in a remote state under the privilege to practice until the
1788     individual's home state license is restored.
1789          1. All home state adverse action orders shall include a statement that the individual's
1790     compact privileges are inactive. The order may allow the individual to practice in remote states
1791     with prior written authorization from both the home state and remote state's EMS authority.
1792          2. An individual currently subject to adverse action in the home state shall not practice
1793     in any remote state without prior written authorization from both the home state and remote
1794     state's EMS authority.

1795          C. A member state shall report adverse actions and any occurrences that the
1796     individual's compact privileges are restricted, suspended, or revoked to the Commission in
1797     accordance with the rules of the Commission.
1798          D. A remote state may take adverse action on an individual's privilege to practice
1799     within that state.
1800          E. Any member state may take adverse action against an individual's privilege to
1801     practice in that state based on the factual findings of another member state, so long as each
1802     state follows its own procedures for imposing such adverse action.
1803          F. A home state's EMS authority shall investigate and take appropriate action with
1804     respect to reported conduct in a remote state as it would if such conduct had occurred within
1805     the home state. In such cases, the home state's law shall control in determining the appropriate
1806     adverse action.
1807          G. Nothing in this Compact shall override a member state's decision that participation
1808     in an alternative program may be used in lieu of adverse action and that such participation shall
1809     remain non-public if required by the member state's laws. Member states must require
1810     individuals who enter any alternative programs to agree not to practice in any other member
1811     state during the term of the alternative program without prior authorization from such other
1812     member state.
1813     
SECTION 9. ADDITIONAL POWERS INVESTED

1814     
IN A MEMBER STATE'S EMS AUTHORITY

1815          A member state's EMS authority, in addition to any other powers granted under state
1816     law, is authorized under this compact to:
1817          1. Issue subpoenas for both hearings and investigations that require the attendance and
1818     testimony of witnesses and the production of evidence. Subpoenas issued by a member state's
1819     EMS authority for the attendance and testimony of witnesses, and/or the production of
1820     evidence from another member state, shall be enforced in the remote state by any court of
1821     competent jurisdiction, according to that court's practice and procedure in considering
1822     subpoenas issued in its own proceedings. The issuing state EMS authority shall pay any
1823     witness fees, travel expenses, mileage, and other fees required by the service statutes of the
1824     state where the witnesses and/or evidence are located; and
1825          2. Issue cease and desist orders to restrict, suspend, or revoke an individual's privilege

1826     to practice in the state.
1827     
SECTION 10. ESTABLISHMENT OF THE INTERSTATE

1828     
COMMISSION FOR EMS PERSONNEL PRACTICE

1829          A. The Compact states hereby create and establish a joint public agency known as the
1830     Interstate Commission for EMS Personnel Practice.
1831          1. The Commission is a body politic and an instrumentality of the Compact states.
1832          2. Venue is proper and judicial proceedings by or against the Commission shall be
1833     brought solely and exclusively in a court of competent jurisdiction where the principal office of
1834     the Commission is located. The Commission may waive venue and jurisdictional defenses to
1835     the extent it adopts or consents to participate in alternative dispute resolution proceedings.
1836          3. Nothing in this Compact shall be construed to be a waiver of sovereign immunity.
1837          B. Membership, Voting, and Meetings
1838          1. Each member state shall have and be limited to one (1) delegate. The responsible
1839     official of the state EMS authority or his designee shall be the delegate to this Compact for
1840     each member state. Any delegate may be removed or suspended from office as provided by the
1841     law of the state from which the delegate is appointed. Any vacancy occurring in the
1842     Commission shall be filled in accordance with the laws of the member state in which the
1843     vacancy exists. In the event that more than one board, office, or other agency with the
1844     legislative mandate to license EMS personnel at and above the level of EMT exists, the
1845     Governor of the state will determine which entity will be responsible for assigning the delegate.
1846          2. Each delegate shall be entitled to one (1) vote with regard to the promulgation of
1847     rules and creation of bylaws and shall otherwise have an opportunity to participate in the
1848     business and affairs of the Commission. A delegate shall vote in person or by such other
1849     means as provided in the bylaws. The bylaws may provide for delegates' participation in
1850     meetings by telephone or other means of communication.
1851          3. The Commission shall meet at least once during each calendar year. Additional
1852     meetings shall be held as set forth in the bylaws.
1853          4. All meetings shall be open to the public, and public notice of meetings shall be
1854     given in the same manner as required under the rulemaking provisions in Section XII.
1855          5. The Commission may convene in a closed, non-public meeting if the Commission
1856     must discuss:

1857          a. Non-compliance of a member state with its obligations under the Compact;
1858          b. The employment, compensation, discipline or other personnel matters, practices or
1859     procedures related to specific employees or other matters related to the Commission's internal
1860     personnel practices and procedures;
1861          c. Current, threatened, or reasonably anticipated litigation;
1862          d. Negotiation of contracts for the purchase or sale of goods, services, or real estate;
1863          e. Accusing any person of a crime or formally censuring any person;
1864          f. Disclosure of trade secrets or commercial or financial information that is privileged
1865     or confidential;
1866          g. Disclosure of information of a personal nature where disclosure would constitute a
1867     clearly unwarranted invasion of personal privacy;
1868          h. Disclosure of investigatory records compiled for law enforcement purposes;
1869          i. Disclosure of information related to any investigatory reports prepared by or on
1870     behalf of or for use of the Commission or other committee charged with responsibility of
1871     investigation or determination of compliance issues pursuant to the compact; or
1872          j. Matters specifically exempted from disclosure by federal or member state statute.
1873          6. If a meeting, or portion of a meeting, is closed pursuant to this provision, the
1874     Commission's legal counsel or designee shall certify that the meeting may be closed and shall
1875     reference each relevant exempting provision. The Commission shall keep minutes that fully
1876     and clearly describe all matters discussed in a meeting and shall provide a full and accurate
1877     summary of actions taken, and the reasons therefore, including a description of the views
1878     expressed. All documents considered in connection with an action shall be identified in such
1879     minutes. All minutes and documents of a closed meeting shall remain under seal, subject to
1880     release by a majority vote of the Commission or order of a court of competent jurisdiction.
1881          C. The Commission shall, by a majority vote of the delegates, prescribe bylaws and/or
1882     rules to govern its conduct as may be necessary or appropriate to carry out the purposes and
1883     exercise the powers of the compact, including but not limited to:
1884          1. Establishing the fiscal year of the Commission;
1885          2. Providing reasonable standards and procedures:
1886          a. for the establishment and meetings of other committees; and
1887          b. governing any general or specific delegation of any authority or function of the

1888     Commission;
1889          3. Providing reasonable procedures for calling and conducting meetings of the
1890     Commission, ensuring reasonable advance notice of all meetings, and providing an opportunity
1891     for attendance of such meetings by interested parties, with enumerated exceptions designed to
1892     protect the public's interest, the privacy of individuals, and proprietary information, including
1893     trade secrets. The Commission may meet in closed session only after a majority of the
1894     membership votes to close a meeting in whole or in part. As soon as practicable, the
1895     Commission must make public a copy of the vote to close the meeting revealing the vote of
1896     each member with no proxy votes allowed;
1897          4. Establishing the titles, duties and authority, and reasonable procedures for the
1898     election of the officers of the Commission;
1899          5. Providing reasonable standards and procedures for the establishment of the
1900     personnel policies and programs of the Commission. Notwithstanding any civil service or
1901     other similar laws of any member state, the bylaws shall exclusively govern the personnel
1902     policies and programs of the Commission;
1903          6. Promulgating a code of ethics to address permissible and prohibited activities of
1904     Commission members and employees;
1905          7. Providing a mechanism for winding up the operations of the Commission and the
1906     equitable disposition of any surplus funds that may exist after the termination of the Compact
1907     after the payment and/or reserving of all of its debts and obligations;
1908          8. The Commission shall publish its bylaws and file a copy thereof, and a copy of any
1909     amendment thereto, with the appropriate agency or officer in each of the member states, if any.
1910          9. The Commission shall maintain its financial records in accordance with the bylaws.
1911          10. The Commission shall meet and take such actions as are consistent with the
1912     provisions of this Compact and the bylaws.
1913          D. The Commission shall have the following powers:
1914          1. The authority to promulgate uniform rules to facilitate and coordinate
1915     implementation and administration of this Compact. The rules shall have the force and effect
1916     of law and shall be binding in all member states;
1917          2. To bring and prosecute legal proceedings or actions in the name of the Commission,
1918     provided that the standing of any state EMS authority or other regulatory body responsible for

1919     EMS personnel licensure to sue or be sued under applicable law shall not be affected;
1920          3. To purchase and maintain insurance and bonds;
1921          4. To borrow, accept, or contract for services of personnel, including, but not limited
1922     to, employees of a member state;
1923          5. To hire employees, elect or appoint officers, fix compensation, define duties, grant
1924     such individuals appropriate authority to carry out the purposes of the compact, and to establish
1925     the Commission's personnel policies and programs relating to conflicts of interest,
1926     qualifications of personnel, and other related personnel matters;
1927          6. To accept any and all appropriate donations and grants of money, equipment,
1928     supplies, materials and services, and to receive, utilize and dispose of the same; provided that
1929     at all times the Commission shall strive to avoid any appearance of impropriety and/or conflict
1930     of interest;
1931          7. To lease, purchase, accept appropriate gifts or donations of, or otherwise to own,
1932     hold, improve or use, any property, real, personal or mixed; provided that at all times the
1933     Commission shall strive to avoid any appearance of impropriety;
1934          8. To sell convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of
1935     any property real, personal, or mixed;
1936          9. To establish a budget and make expenditures;
1937          10. To borrow money;
1938          11. To appoint committees, including advisory committees comprised of members,
1939     state regulators, state legislators or their representatives, and consumer representatives, and
1940     such other interested persons as may be designated in this compact and the bylaws;
1941          12. To provide and receive information from, and to cooperate with, law enforcement
1942     agencies;
1943          13. To adopt and use an official seal; and
1944          14. To perform such other functions as may be necessary or appropriate to achieve the
1945     purposes of this Compact consistent with the state regulation of EMS personnel licensure and
1946     practice.
1947          E. Financing of the Commission
1948          1. The Commission shall pay, or provide for the payment of, the reasonable expenses
1949     of its establishment, organization, and ongoing activities.

1950          2. The Commission may accept any and all appropriate revenue sources, donations, and
1951     grants of money, equipment, supplies, materials, and services.
1952          3. The Commission may levy on and collect an annual assessment from each member
1953     state or impose fees on other parties to cover the cost of the operations and activities of the
1954     Commission and its staff, which must be in a total amount sufficient to cover its annual budget
1955     as approved each year for which revenue is not provided by other sources. The aggregate
1956     annual assessment amount shall be allocated based upon a formula to be determined by the
1957     Commission, which shall promulgate a rule binding upon all member states.
1958          4. The Commission shall not incur obligations of any kind prior to securing the funds
1959     adequate to meet the same; nor shall the Commission pledge the credit of any of the member
1960     states, except by and with the authority of the member state.
1961          5. The Commission shall keep accurate accounts of all receipts and disbursements.
1962     The receipts and disbursements of the Commission shall be subject to the audit and accounting
1963     procedures established under its bylaws. However, all receipts and disbursements of funds
1964     handled by the Commission shall be audited yearly by a certified or licensed public accountant,
1965     and the report of the audit shall be included in and become part of the annual report of the
1966     Commission.
1967          F. Qualified Immunity, Defense, and Indemnification
1968          1. The members, officers, executive director, employees and representatives of the
1969     Commission shall be immune from suit and liability, either personally or in their official
1970     capacity, for any claim for damage to or loss of property or personal injury or other civil
1971     liability caused by or arising out of any actual or alleged act, error or omission that occurred, or
1972     that the person against whom the claim is made had a reasonable basis for believing occurred
1973     within the scope of Commission employment, duties or responsibilities; provided that nothing
1974     in this paragraph shall be construed to protect any such person from suit and/or liability for any
1975     damage, loss, injury, or liability caused by the intentional or willful or wanton misconduct of
1976     that person.
1977          2. The Commission shall defend any member, officer, executive director, employee or
1978     representative of the Commission in any civil action seeking to impose liability arising out of
1979     any actual or alleged act, error, or omission that occurred within the scope of Commission
1980     employment, duties, or responsibilities, or that the person against whom the claim is made had

1981     a reasonable basis for believing occurred within the scope of Commission employment, duties,
1982     or responsibilities; provided that nothing herein shall be construed to prohibit that person from
1983     retaining his or her own counsel; and provided further, that the actual or alleged act, error, or
1984     omission did not result from that person's intentional or willful or wanton misconduct.
1985          3. The Commission shall indemnify and hold harmless any member, officer, executive
1986     director, employee, or representative of the Commission for the amount of any settlement or
1987     judgment obtained against that person arising out of any actual or alleged act, error or omission
1988     that occurred within the scope of Commission employment, duties, or responsibilities, or that
1989     such person had a reasonable basis for believing occurred within the scope of Commission
1990     employment, duties, or responsibilities, provided that the actual or alleged act, error, or
1991     omission did not result from the intentional or willful or wanton misconduct of that person.
1992     
SECTION 11. COORDINATED DATABASE

1993          A. The Commission shall provide for the development and maintenance of a
1994     coordinated database and reporting system containing licensure, adverse action, and significant
1995     investigatory information on all licensed individuals in member states.
1996          B. Notwithstanding any other provision of state law to the contrary, a member state
1997     shall submit a uniform data set to the coordinated database on all individuals to whom this
1998     compact is applicable as required by the rules of the Commission, including:
1999          1. Identifying information;
2000          2. Licensure data;
2001          3. Significant investigatory information;
2002          4. Adverse actions against an individual's license;
2003          5. An indicator that an individual's privilege to practice is restricted, suspended or
2004     revoked;
2005          6. Non-confidential information related to alternative program participation;
2006          7. Any denial of application for licensure, and the reason(s) for such denial; and
2007          8. Other information that may facilitate the administration of this Compact, as
2008     determined by the rules of the Commission.
2009          C. The coordinated database administrator shall promptly notify all member states of
2010     any adverse action taken against, or significant investigative information on, any individual in a
2011     member state.

2012          D. Member states contributing information to the coordinated database may designate
2013     information that may not be shared with the public without the express permission of the
2014     contributing state.
2015          E. Any information submitted to the coordinated database that is subsequently required
2016     to be expunged by the laws of the member state contributing the information shall be removed
2017     from the coordinated database.
2018     
SECTION 12. RULEMAKING

2019          A. The Commission shall exercise its rulemaking powers pursuant to the criteria set
2020     forth in this Section and the rules adopted thereunder. Rules and amendments shall become
2021     binding as of the date specified in each rule or amendment.
2022          B. If a majority of the legislatures of the member states rejects a rule, by enactment of a
2023     statute or resolution in the same manner used to adopt the Compact, then such rule shall have
2024     no further force and effect in any member state.
2025          C. Rules or amendments to the rules shall be adopted at a regular or special meeting of
2026     the Commission.
2027          D. Prior to promulgation and adoption of a final rule or rules by the Commission, and
2028     at least sixty (60) days in advance of the meeting at which the rule will be considered and voted
2029     upon, the Commission shall file a Notice of Proposed Rulemaking:
2030          1. On the website of the Commission; and
2031          2. On the website of each member state EMS authority or the publication in which each
2032     state would otherwise publish proposed rules.
2033          E. The Notice of Proposed Rulemaking shall include:
2034          1. The proposed time, date, and location of the meeting in which the rule will be
2035     considered and voted upon;
2036          2. The text of the proposed rule or amendment and the reason for the proposed rule;
2037          3. A request for comments on the proposed rule from any interested person; and
2038          4. The manner in which interested persons may submit notice to the Commission of
2039     their intention to attend the public hearing and any written comments.
2040          F. Prior to adoption of a proposed rule, the Commission shall allow persons to submit
2041     written data, facts, opinions, and arguments, which shall be made available to the public.
2042          G. The Commission shall grant an opportunity for a public hearing before it adopts a

2043     rule or amendment if a hearing is requested by:
2044          1. At least twenty-five (25) persons;
2045          2. A governmental subdivision or agency; or
2046          3. An association having at least twenty-five (25) members.
2047          H. If a hearing is held on the proposed rule or amendment, the Commission shall
2048     publish the place, time, and date of the scheduled public hearing.
2049          1. All persons wishing to be heard at the hearing shall notify the executive director of
2050     the Commission or other designated member in writing of their desire to appear and testify at
2051     the hearing not less than five (5) business days before the scheduled date of the hearing.
2052          2. Hearings shall be conducted in a manner providing each person who wishes to
2053     comment a fair and reasonable opportunity to comment orally or in writing.
2054          3. No transcript of the hearing is required, unless a written request for a transcript is
2055     made, in which case the person requesting the transcript shall bear the cost of producing the
2056     transcript. A recording may be made in lieu of a transcript under the same terms and
2057     conditions as a transcript. This subsection shall not preclude the Commission from making a
2058     transcript or recording of the hearing if it so chooses.
2059          4. Nothing in this section shall be construed as requiring a separate hearing on each
2060     rule. Rules may be grouped for the convenience of the Commission at hearings required by
2061     this section.
2062          I. Following the scheduled hearing date, or by the close of business on the scheduled
2063     hearing date if the hearing was not held, the Commission shall consider all written and oral
2064     comments received.
2065          J. The Commission shall, by majority vote of all members, take final action on the
2066     proposed rule and shall determine the effective date of the rule, if any, based on the rulemaking
2067     record and the full text of the rule.
2068          K. If no written notice of intent to attend the public hearing by interested parties is
2069     received, the Commission may proceed with promulgation of the proposed rule without a
2070     public hearing.
2071          L. Upon determination that an emergency exists, the Commission may consider and
2072     adopt an emergency rule without prior notice, opportunity for comment, or hearing, provided
2073     that the usual rulemaking procedures provided in the Compact and in this section shall be

2074     retroactively applied to the rule as soon as reasonably possible, in no event later than ninety
2075     (90) days after the effective date of the rule. For the purposes of this provision, an emergency
2076     rule is one that must be adopted immediately in order to:
2077          1. Meet an imminent threat to public health, safety, or welfare;
2078          2. Prevent a loss of Commission or member state funds;
2079          3. Meet a deadline for the promulgation of an administrative rule that is established by
2080     federal law or rule; or
2081          4. Protect public health and safety.
2082          M. The Commission or an authorized committee of the Commission may direct
2083     revisions to a previously adopted rule or amendment for purposes of correcting typographical
2084     errors, errors in format, errors in consistency, or grammatical errors. Public notice of any
2085     revisions shall be posted on the website of the Commission. The revision shall be subject to
2086     challenge by any person for a period of thirty (30) days after posting. The revision may be
2087     challenged only on grounds that the revision results in a material change to a rule. A challenge
2088     shall be made in writing, and delivered to the chair of the Commission prior to the end of the
2089     notice period. If no challenge is made, the revision will take effect without further action. If
2090     the revision is challenged, the revision may not take effect without the approval of the
2091     Commission.
2092     
SECTION 13. OVERSIGHT, DISPUTE RESOLUTION, AND ENFORCEMENT

2093          A. Oversight
2094          1. The executive, legislative, and judicial branches of state government in each
2095     member state shall enforce this compact and take all actions necessary and appropriate to
2096     effectuate the compact's purposes and intent. The provisions of this compact and the rules
2097     promulgated hereunder shall have standing as statutory law.
2098          2. All courts shall take judicial notice of the compact and the rules in any judicial or
2099     administrative proceeding in a member state pertaining to the subject matter of this compact
2100     which may affect the powers, responsibilities or actions of the Commission.
2101          3. The Commission shall be entitled to receive service of process in any such
2102     proceeding, and shall have standing to intervene in such a proceeding for all purposes. Failure
2103     to provide service of process to the Commission shall render a judgment or order void as to the
2104     Commission, this Compact, or promulgated rules.

2105          B. Default, Technical Assistance, and Termination
2106          1. If the Commission determines that a member state has defaulted in the performance
2107     of its obligations or responsibilities under this compact or the promulgated rules, the
2108     Commission shall:
2109          a. Provide written notice to the defaulting state and other member states of the nature
2110     of the default, the proposed means of curing the default and/or any other action to be taken by
2111     the Commission; and
2112          b. Provide remedial training and specific technical assistance regarding the default.
2113          2. If a state in default fails to cure the default, the defaulting state may be terminated
2114     from the Compact upon an affirmative vote of a majority of the member states, and all rights,
2115     privileges and benefits conferred by this compact may be terminated on the effective date of
2116     termination. A cure of the default does not relieve the offending state of obligations or
2117     liabilities incurred during the period of default.
2118          3. Termination of membership in the compact shall be imposed only after all other
2119     means of securing compliance have been exhausted. Notice of intent to suspend or terminate
2120     shall be given by the Commission to the governor, the majority and minority leaders of the
2121     defaulting state's legislature, and each of the member states.
2122          4. A state that has been terminated is responsible for all assessments, obligations, and
2123     liabilities incurred through the effective date of termination, including obligations that extend
2124     beyond the effective date of termination.
2125          5. The Commission shall not bear any costs related to a state that is found to be in
2126     default or that has been terminated from the compact, unless agreed upon in writing between
2127     the Commission and the defaulting state.
2128          6. The defaulting state may appeal the action of the Commission by petitioning the
2129     U.S. District Court for the District of Columbia or the federal district where the Commission
2130     has its principal offices. The prevailing member shall be awarded all costs of such litigation,
2131     including reasonable attorney's fees.
2132          C. Dispute Resolution
2133          1. Upon request by a member state, the Commission shall attempt to resolve disputes
2134     related to the compact that arise among member states and between member and non-member
2135     states.

2136          2. The Commission shall promulgate a rule providing for both mediation and binding
2137     dispute resolution for disputes as appropriate.
2138          D. Enforcement
2139          1. The Commission, in the reasonable exercise of its discretion, shall enforce the
2140     provisions and rules of this compact.
2141          2. By majority vote, the Commission may initiate legal action in the United States
2142     District Court for the District of Columbia or the federal district where the Commission has its
2143     principal offices against a member state in default to enforce compliance with the provisions of
2144     the compact and its promulgated rules and bylaws. The relief sought may include both
2145     injunctive relief and damages. In the event judicial enforcement is necessary, the prevailing
2146     member shall be awarded all costs of such litigation, including reasonable attorney's fees.
2147          3. The remedies herein shall not be the exclusive remedies of the Commission. The
2148     Commission may pursue any other remedies available under federal or state law.
2149     
SECTION 14. DATE OF IMPLEMENTATION OF THE INTERSTATE

2150     
COMMISSION FOR EMS PERSONNEL PRACTICE AND

2151     
ASSOCIATED RULES, WITHDRAWAL, AND AMENDMENT

2152          A. The compact shall come into effect on the date on which the compact statute is
2153     enacted into law in the tenth member state. The provisions, which become effective at that
2154     time, shall be limited to the powers granted to the Commission relating to assembly and the
2155     promulgation of rules. Thereafter, the Commission shall meet and exercise rulemaking powers
2156     necessary to the implementation and administration of the compact.
2157          B. Any state that joins the compact subsequent to the Commission's initial adoption of
2158     the rules shall be subject to the rules as they exist on the date on which the compact becomes
2159     law in that state. Any rule that has been previously adopted by the Commission shall have the
2160     full force and effect of law on the day the compact becomes law in that state.
2161          C. Any member state may withdraw from this compact by enacting a statute repealing
2162     the same.
2163          1. A member state's withdrawal shall not take effect until six (6) months after
2164     enactment of the repealing statute.
2165          2. Withdrawal shall not affect the continuing requirement of the withdrawing state's
2166     EMS authority to comply with the investigative and adverse action reporting requirements of

2167     this act prior to the effective date of withdrawal.
2168          D. Nothing contained in this compact shall be construed to invalidate or prevent any
2169     EMS personnel licensure agreement or other cooperative arrangement between a member state
2170     and a non-member state that does not conflict with the provisions of this compact.
2171          E. This Compact may be amended by the member states. No amendment to this
2172     Compact shall become effective and binding upon any member state until it is enacted into the
2173     laws of all member states.
2174     
SECTION 15. CONSTRUCTION AND SEVERABILITY

2175          This Compact shall be liberally construed so as to effectuate the purposes thereof. If
2176     this compact shall be held contrary to the constitution of any state member thereto, the compact
2177     shall remain in full force and effect as to the remaining member states. Nothing in this
2178     compact supersedes state law or rules related to licensure of EMS agencies.
2179          Section 38. Section 26B-4-150, which is renumbered from Section 26-8a-401 is
2180     renumbered and amended to read:
2181          [26-8a-401].      26B-4-150. State regulation of emergency medical services
2182     market -- License term.
2183          (1) To ensure emergency medical service quality and minimize unnecessary
2184     duplication, the department shall regulate the emergency medical services market by creating
2185     and operating a statewide system that:
2186          (a) consists of exclusive geographic service areas as provided in Section [26-8a-402]
2187     26B-4-151; and
2188          (b) establishes maximum rates as provided in Section [26-8a-403] 26B-4-152.
2189          (2) A license issued or renewed under this part is valid for four years.
2190          Section 39. Section 26B-4-151, which is renumbered from Section 26-8a-402 is
2191     renumbered and amended to read:
2192          [26-8a-402].      26B-4-151. Exclusive geographic service areas.
2193          (1) Each ground ambulance provider license issued under this part shall be for an
2194     exclusive geographic service area as described in the license. Only the licensed ground
2195     ambulance provider may respond to an ambulance request that originates within the provider's
2196     exclusive geographic service area, except as provided in Subsection (5) and Section
2197     [26-8a-416] 26B-4-170.

2198          (2) Each paramedic provider license issued under this part shall be for an exclusive
2199     geographic service area as described in the license. Only the licensed paramedic provider may
2200     respond to a paramedic request that originates within the exclusive geographic service area,
2201     except as provided in Subsection (6) and Section [26-8a-416] 26B-4-170.
2202          (3) Nothing in this section may be construed as either requiring or prohibiting that the
2203     formation of boundaries in a given location be the same for a licensed paramedic provider and
2204     a licensed ambulance provider.
2205          (4) (a) A licensed ground ambulance or paramedic provider may, as necessary, enter
2206     into a mutual aid agreement to allow another licensed provider to give assistance in times of
2207     unusual demand, as that term is defined by the committee in rule.
2208          (b) A mutual aid agreement shall include a formal written plan detailing the type of
2209     assistance and the circumstances under which it would be given.
2210          (c) The parties to a mutual aid agreement shall submit a copy of the agreement to the
2211     department.
2212          (d) Notwithstanding this Subsection (4), a licensed provider may not subcontract with
2213     another entity to provide services in the licensed provider's exclusive geographic service area.
2214          (5) Notwithstanding Subsection (1), a licensed ground ambulance provider may
2215     respond to an ambulance request that originates from the exclusive geographic area of another
2216     provider:
2217          (a) pursuant to a mutual aid agreement;
2218          (b) to render assistance on a case-by-case basis to that provider; and
2219          (c) as necessary to meet needs in time of disaster or other major emergency.
2220          (6) Notwithstanding Subsection (2), a licensed paramedic provider may respond to a
2221     paramedic request that originates from the exclusive geographic area of another provider:
2222          (a) pursuant to a mutual aid agreement;
2223          (b) to render assistance on a case-by-case basis to that provider; and
2224          (c) as necessary to meet needs in time of disaster or other major emergency.
2225          (7) The department may, upon the renewal of a license, align the boundaries of an
2226     exclusive geographic area with the boundaries of a political subdivision:
2227          (a) if the alignment is practical and in the public interest;
2228          (b) if each licensed provider that would be affected by the alignment agrees to the

2229     alignment; and
2230          (c) taking into consideration the requirements of:
2231          (i) Section 11-48-103; and
2232          (ii) Section [26-8a-408] 26B-4-162.
2233          Section 40. Section 26B-4-152, which is renumbered from Section 26-8a-403 is
2234     renumbered and amended to read:
2235          [26-8a-403].      26B-4-152. Establishment of maximum rates.
2236          (1) The department shall, after receiving recommendations under Subsection (2),
2237     establish maximum rates for ground ambulance providers and paramedic providers that are just
2238     and reasonable.
2239          (2) The committee may make recommendations to the department on the maximum
2240     rates that should be set under Subsection (1).
2241          (3) (a) The department shall prohibit ground ambulance providers and paramedic
2242     providers from charging fees for transporting a patient when the provider does not transport the
2243     patient.
2244          (b) The provisions of Subsection (3)(a) do not apply to ambulance providers or
2245     paramedic providers in a geographic service area which contains a town as defined in
2246     Subsection 10-2-301(2)(f).
2247          Section 41. Section 26B-4-153, which is renumbered from Section 26-8a-404 is
2248     renumbered and amended to read:
2249          [26-8a-404].      26B-4-153. Ground ambulance and paramedic licenses --
2250     Application and department review.
2251          (1) Except as provided in Section [26-8a-413] 26B-4-167, an applicant for a ground
2252     ambulance or paramedic license shall apply to the department for a license only by:
2253          (a) submitting a completed application;
2254          (b) providing information in the format required by the department; and
2255          (c) paying the required fees, including the cost of the hearing officer.
2256          (2) The department shall make rules establishing minimum qualifications and
2257     requirements for:
2258          (a) personnel;
2259          (b) capital reserves;

2260          (c) equipment;
2261          (d) a business plan;
2262          (e) operational procedures;
2263          (f) medical direction agreements;
2264          (g) management and control; and
2265          (h) other matters that may be relevant to an applicant's ability to provide ground
2266     ambulance or paramedic service.
2267          (3) An application for a license to provide ground ambulance service or paramedic
2268     service shall be for all ground ambulance services or paramedic services arising within the
2269     geographic service area, except that an applicant may apply for a license for less than all
2270     ground ambulance services or all paramedic services arising within an exclusive geographic
2271     area if it can demonstrate how the remainder of that area will be served.
2272          (4) (a) A ground ambulance service licensee may apply to the department for a license
2273     to provide a higher level of service as defined by department rule if the application includes:
2274          (i) a copy of the new treatment protocols for the higher level of service approved by the
2275     off-line medical director;
2276          (ii) an assessment of field performance by the applicant's off-line director; and
2277          (iii) an updated plan of operation demonstrating the ability of the applicant to provide
2278     the higher level of service.
2279          (b) If the department determines that the applicant has demonstrated the ability to
2280     provide the higher level of service in accordance with Subsection (4)(a), the department shall
2281     issue a revised license reflecting the higher level of service and the requirements of Section
2282     [26-8a-408] 26B-4-162 do not apply.
2283          (c) A revised license issued under Subsection (4)(b):
2284          (i) may only affect the level of service that the licensee may provide; and
2285          (ii) may not affect any other terms, conditions, or limitations of the original license.
2286          (5) Upon receiving a completed application and the required fees, the department shall
2287     review the application and determine whether the application meets the minimum
2288     qualifications and requirements for licensure.
2289          (6) The department may deny an application if it finds that it contains any materially
2290     false or misleading information, is incomplete, or if the application demonstrates that the

2291     applicant fails to meet the minimum qualifications and requirements for licensure under
2292     Subsection (2).
2293          (7) If the department denies an application, it shall notify the applicant in writing
2294     setting forth the grounds for the denial. A denial may be appealed under Title 63G, Chapter 4,
2295     Administrative Procedures Act.
2296          Section 42. Section 26B-4-154, which is renumbered from Section 26-8a-405 is
2297     renumbered and amended to read:
2298          [26-8a-405].      26B-4-154. Ground ambulance and paramedic licenses --
2299     Agency notice of approval.
2300          (1) Beginning January 1, 2004, if the department determines that the application meets
2301     the minimum requirements for licensure under Section [26-8a-404] 26B-4-153, the department
2302     shall issue a notice of the approved application to the applicant.
2303          (2) A current license holder responding to a request for proposal under Section
2304     [26-8a-405.2] 26B-4-156 is considered an approved applicant for purposes of Section
2305     [26-8a-405.2] 26B-4-156 if the current license holder, prior to responding to the request for
2306     proposal, submits the following to the department:
2307          (a) the information described in Subsections [26-8a-404] 26B-4-153(4)(a)(i) through
2308     (iii); and
2309          (b) (i) if the license holder is a private entity, a financial statement, a pro forma budget
2310     and necessary letters of credit demonstrating a financial ability to expand service to a new
2311     service area; or
2312          (ii) if the license holder is a governmental entity, a letter from the governmental entity's
2313     governing body demonstrating the governing body's willingness to financially support the
2314     application.
2315          Section 43. Section 26B-4-155, which is renumbered from Section 26-8a-405.1 is
2316     renumbered and amended to read:
2317          [26-8a-405.1].      26B-4-155. Selection of provider by political subdivision.
2318          (1) (a) Only an applicant approved under Section [26-8a-405] 26B-4-154 may respond
2319     to a request for a proposal issued in accordance with Section [26-8a-405.2] 26B-4-156 or
2320     Section [26-8a-405.4] 26B-4-158 by a political subdivision.
2321          (b) A response to a request for proposal is subject to the maximum rates established by

2322     the department under Section [26-8a-403] 26B-4-152.
2323          (c) A political subdivision may award a contract to an applicant in response to a
2324     request for proposal:
2325          (i) in accordance with Section [26-8a-405.2] 26B-4-156; and
2326          (ii) subject to Subsections (2) and (3).
2327          (2) (a) The department shall issue a license to an applicant selected by a political
2328     subdivision under Subsection (1) unless the department finds that issuing a license to that
2329     applicant would jeopardize the health, safety, and welfare of the citizens of the geographic
2330     service area.
2331          (b) A license issued under this Subsection (2):
2332          (i) is for the exclusive geographic service area approved by the department in
2333     accordance with Subsection [26-8a-405.2] 26B-4-156(2);
2334          (ii) is valid for four years;
2335          (iii) is not subject to a request for license from another applicant under the provisions
2336     of Sections [26-8a-406 through 26-8a-409] 26B-4-160 through 26B-4-163 during the four-year
2337     term, unless the applicant's license is revoked under Section [26-8a-504] 26B-4-130;
2338          (iv) is subject to revocation or revision under Subsection (3)(d); and
2339          (v) is subject to supervision by the department under Sections [26-8a-503 and
2340     26-8a-504] 26B-4-129 and 26B-4-130.
2341          (3) Notwithstanding Subsection (2)(b), a political subdivision may terminate a contract
2342     described in Subsection (1)(c), with or without cause, if:
2343          (a) the contract:
2344          (i) is entered into on or after May 5, 2021; and
2345          (ii) allows an applicant to provide 911 ambulance services;
2346          (b) the political subdivision provides written notice to the applicant described in
2347     Subsection (3)(a)(ii) and the department:
2348          (i) at least 18 months before the day on which the contract is terminated; or
2349          (ii) within a period of time shorter than 18 months before the day on which the contract
2350     is terminated, if otherwise agreed to by the applicant and the department;
2351          (c) the political subdivision selects another applicant to provide 911 ambulance
2352     services for the political subdivision in accordance with Section [26-8a-405.2] 26B-4-156;

2353          (d) the department:
2354          (i) revokes the license of the applicant described in Subsection (3)(a)(ii), or issues a
2355     new or revised license for the applicant described in Subsection (3)(a)(ii):
2356          (A) in order to remove the area that is subject to the contract from the applicant's
2357     exclusive geographic service area; and
2358          (B) to take effect the day on which the contract is terminated; and
2359          (ii) issues a new or revised license for the applicant described in Subsection (3)(c):
2360          (A) in order to allow the applicant to provide 911 ambulance services for the area
2361     described in Subsection (3)(d)(i)(A); and
2362          (B) to take effect the day on which the contract is terminated; and
2363          (e) the termination does not create an orphaned area.
2364          (4) Except as provided in Subsection [26-8a-405.3] 26B-4-157(4)(a), the provisions of
2365     Sections [26-8a-406 through 26-8a-409] 26B-4-160 through 26B-4-163 do not apply to a
2366     license issued under this section.
2367          Section 44. Section 26B-4-156, which is renumbered from Section 26-8a-405.2 is
2368     renumbered and amended to read:
2369          [26-8a-405.2].      26B-4-156. Selection of provider -- Request for competitive
2370     sealed proposal -- Public convenience and necessity.
2371          (1) (a) A political subdivision may contract with an applicant approved under Section
2372     [26-8a-404] 26B-4-153 to provide services for the geographic service area that is approved by
2373     the department in accordance with Subsection (2), if:
2374          (i) the political subdivision complies with the provisions of this section and Section
2375     [26-8a-405.3] 26B-4-157 if the contract is for 911 ambulance or paramedic services; or
2376          (ii) the political subdivision complies with Sections [26-8a-405.3 and 26-8a-405.4]
2377     26B-4-157 and 26B-4-158, if the contract is for non-911 services.
2378          (b) (i) The provisions of this section and Sections [26-8a-405.1, 26-8a-405.3, and
2379     26-8a-405.4] 26B-4-155, 26B-4-157, and 26B-4-158 do not require a political subdivision to
2380     issue a request for proposal for ambulance or paramedic services or non-911 services.
2381          (ii) If a political subdivision does not contract with an applicant in accordance with this
2382     section and Section [26-8a-405.3] 26B-4-157, the provisions of Sections [26-8a-406 through
2383     26-8a-409] 26B-4-160 through 26B-4-163 apply to the issuance of a license for ambulance or

2384     paramedic services in the geographic service area that is within the boundaries of the political
2385     subdivision.
2386          (iii) If a political subdivision does not contract with an applicant in accordance with
2387     this section, Section [26-8a-405.3] 26B-4-157 and Section [26-8a-405.4] 26B-4-158, a license
2388     for the non-911 services in the geographic service area that is within the boundaries of the
2389     political subdivision may be issued:
2390          (A) under the public convenience and necessity provisions of Sections [26-8a-406
2391     through 26-8a-409] 26B-4-160 through 26B-4-163; or
2392          (B) by a request for proposal issued by the department under Section [26-8a-405.5]
2393     26B-4-159.
2394          (c) (i) [For purposes of] As used in this Subsection (1)(c):
2395          (A) "Fire district" means a local district under Title 17B, Limited Purpose Local
2396     Government Entities - Local Districts, that:
2397          (I) is located in a county of the first or second class; and
2398          (II) provides fire protection, paramedic, and emergency services.
2399          (B) "Participating municipality" means a city or town whose area is partly or entirely
2400     included within a county service area or fire district.
2401          (C) "Participating county" means a county whose unincorporated area is partly or
2402     entirely included within a fire district.
2403          (ii) A participating municipality or participating county may as provided in this section
2404     and Section [26-8a-405.3] 26B-4-157, contract with a provider for 911 ambulance or
2405     paramedic service.
2406          (iii) If the participating municipality or participating county contracts with a provider
2407     for services under this section and Section [26-8a-405.3] 26B-4-157:
2408          (A) the fire district is not obligated to provide the services that are included in the
2409     contract between the participating municipality or the participating county and the provider;
2410          (B) the fire district may impose taxes and obligations within the fire district in the same
2411     manner as if the participating municipality or participating county were receiving all services
2412     offered by the fire district; and
2413          (C) the participating municipality's and participating county's obligations to the fire
2414     district are not diminished.

2415          (2) (a) The political subdivision shall submit the request for proposal and the exclusive
2416     geographic service area to be included in a request for proposal issued under Subsections
2417     (1)(a)(i) or (ii) to the department for approval prior to issuing the request for proposal. The
2418     department shall approve the request for proposal and the exclusive geographic service area:
2419          (i) unless the geographic service area creates an orphaned area; and
2420          (ii) in accordance with Subsections (2)(b) and (c).
2421          (b) The exclusive geographic service area may:
2422          (i) include the entire geographic service area that is within the political subdivision's
2423     boundaries;
2424          (ii) include islands within or adjacent to other peripheral areas not included in the
2425     political subdivision that governs the geographic service area; or
2426          (iii) exclude portions of the geographic service area within the political subdivision's
2427     boundaries if another political subdivision or licensed provider agrees to include the excluded
2428     area within their license.
2429          (c) The proposed geographic service area for 911 ambulance or paramedic service shall
2430     demonstrate that non-911 ambulance or paramedic service will be provided in the geographic
2431     service area, either by the current provider, the applicant, or some other method acceptable to
2432     the department. The department may consider the effect of the proposed geographic service
2433     area on the costs to the non-911 provider and that provider's ability to provide only non-911
2434     services in the proposed area.
2435          Section 45. Section 26B-4-157, which is renumbered from Section 26-8a-405.3 is
2436     renumbered and amended to read:
2437          [26-8a-405.3].      26B-4-157. Use of competitive sealed proposals -- Procedure
2438     -- Appeal rights.
2439          (1) (a) Competitive sealed proposals for paramedic or 911 ambulance services under
2440     Section [26-8a-405.2] 26B-4-156, or for non-911 services under Section [26-8a-405.4]
2441     26B-4-158, shall be solicited through a request for proposal and the provisions of this section.
2442          (b) The governing body of the political subdivision shall approve the request for
2443     proposal prior to the notice of the request for proposals under Subsection (1)(c).
2444          (c) Notice of the request for proposals shall be published:
2445          (i) by posting the notice for at least 20 days in at least five public places in the county;

2446     and
2447          (ii) by posting the notice on the Utah Public Notice Website, created in Section
2448     63A-16-601, for at least 20 days.
2449          (2) (a) Proposals shall be opened so as to avoid disclosure of contents to competing
2450     offerors during the process of negotiations.
2451          (b) (i) Subsequent to the published notice, and prior to selecting an applicant, the
2452     political subdivision shall hold a presubmission conference with interested applicants for the
2453     purpose of assuring full understanding of, and responsiveness to, solicitation requirements.
2454          (ii) A political subdivision shall allow at least 90 days from the presubmission
2455     conference for the proposers to submit proposals.
2456          (c) Subsequent to the presubmission conference, the political subdivision may issue
2457     addenda to the request for proposals. An addenda to a request for proposal shall be finalized
2458     and posted by the political subdivision at least 45 days before the day on which the proposal
2459     must be submitted.
2460          (d) Offerors to the request for proposals shall be accorded fair and equal treatment with
2461     respect to any opportunity for discussion and revisions of proposals, and revisions may be
2462     permitted after submission and before a contract is awarded for the purpose of obtaining best
2463     and final offers.
2464          (e) In conducting discussions, there shall be no disclosures of any information derived
2465     from proposals submitted by competing offerors.
2466          (3) (a) (i) A political subdivision may select an applicant approved by the department
2467     under Section [26-8a-404] 26B-4-153 to provide 911 ambulance or paramedic services by
2468     contract to the most responsible offeror as defined in Section 63G-6a-103.
2469          (ii) An award under Subsection (3)(a)(i) shall be made to the responsible offeror whose
2470     proposal is determined in writing to be the most advantageous to the political subdivision,
2471     taking into consideration price and the evaluation factors set forth in the request for proposal.
2472          (b) The applicants who are approved under Section [26-8a-405] 26B-4-154 and who
2473     are selected under this section may be the political subdivision issuing the request for
2474     competitive sealed proposals, or any other public entity or entities, any private person or entity,
2475     or any combination thereof.
2476          (c) A political subdivision may reject all of the competitive proposals.

2477          (4) In seeking competitive sealed proposals and awarding contracts under this section,
2478     a political subdivision:
2479          (a) shall apply the public convenience and necessity factors listed in Subsections
2480     [26-8a-408] 26B-4-162(2) through (6);
2481          (b) shall require the applicant responding to the proposal to disclose how the applicant
2482     will meet performance standards in the request for proposal;
2483          (c) may not require or restrict an applicant to a certain method of meeting the
2484     performance standards, including:
2485          (i) requiring ambulance medical personnel to also be a firefighter; or
2486          (ii) mandating that offerors use fire stations or dispatch services of the political
2487     subdivision;
2488          (d) shall require an applicant to submit the proposal:
2489          (i) based on full cost accounting in accordance with generally accepted accounting
2490     principals; and
2491          (ii) if the applicant is a governmental entity, in addition to the requirements of
2492     Subsection (4)(e)(i), in accordance with generally accepted government auditing standards and
2493     in compliance with the State of Utah Legal Compliance Audit Guide; and
2494          (e) shall set forth in the request for proposal:
2495          (i) the method for determining full cost accounting in accordance with generally
2496     accepted accounting principles, and require an applicant to submit the proposal based on such
2497     full cost accounting principles;
2498          (ii) guidelines established to further competition and provider accountability; and
2499          (iii) a list of the factors that will be considered by the political subdivision in the award
2500     of the contract, including by percentage, the relative weight of the factors established under this
2501     Subsection (4)(e), which may include such things as:
2502          (A) response times;
2503          (B) staging locations;
2504          (C) experience;
2505          (D) quality of care; and
2506          (E) cost, consistent with the cost accounting method in Subsection (4)(e)(i).
2507          (5) (a) Notwithstanding any provision of Title 63G, Chapter 6a, Utah Procurement

2508     Code, to the contrary, the provisions of Title 63G, Chapter 6a, Utah Procurement Code, apply
2509     to the procurement process required by this section, except as provided in Subsection (5)(c).
2510          (b) A procurement appeals panel described in Section 63G-6a-1702 shall have
2511     jurisdiction to review and determine an appeal of an offeror under this section.
2512          (c) (i) An offeror may appeal the solicitation or award as provided by the political
2513     subdivision's procedures. After all political subdivision appeal rights are exhausted, the offeror
2514     may appeal under the provisions of Subsections (5)(a) and (b).
2515          (ii) A procurement appeals panel described in Section 63G-6a-1702 shall determine
2516     whether the solicitation or award was made in accordance with the procedures set forth in this
2517     section and Section [26-8a-405.2] 26B-4-156.
2518          (d) The determination of an issue of fact by the appeals board shall be final and
2519     conclusive unless arbitrary and capricious or clearly erroneous as provided in Section
2520     63G-6a-1705.
2521          Section 46. Section 26B-4-158, which is renumbered from Section 26-8a-405.4 is
2522     renumbered and amended to read:
2523          [26-8a-405.4].      26B-4-158. Non-911 provider -- Finding of meritorious
2524     complaint -- Request for proposals.
2525          (1) (a) This section applies to a non-911 provider license under this [chapter] part.
2526          (b) The department shall, in accordance with Subsections (3) and (4):
2527          (i) receive a complaint about a non-911 provider;
2528          (ii) determine whether the complaint has merit;
2529          (iii) issue a finding of:
2530          (A) a meritorious complaint; or
2531          (B) a non-meritorious complaint; and
2532          (iv) forward a finding of a meritorious complaint to the governing body of the political
2533     subdivision:
2534          (A) in which the non-911 provider is licensed; or
2535          (B) that provides the non-911 services, if different from Subsection (1)(b)(iv)(A).
2536          (2) (a) A political subdivision that receives a finding of a meritorious complaint from
2537     the department:
2538          (i) shall take corrective action that the political subdivision determines is appropriate;

2539     and
2540          (ii) shall, if the political subdivision determines corrective action will not resolve the
2541     complaint or is not appropriate:
2542          (A) issue a request for proposal for non-911 service in the geographic service area if
2543     the political subdivision will not respond to the request for proposal; or
2544          (B) (I) make a finding that a request for proposal for non-911 services is appropriate
2545     and the political subdivision intends to respond to a request for proposal; and
2546          (II) submit the political subdivision's findings to the department with a request that the
2547     department issue a request for proposal in accordance with Section [26-8a-405.5] 26B-4-159.
2548          (b) (i) If Subsection (2)(a)(ii)(A) applies, the political subdivision shall issue the
2549     request for proposal in accordance with Sections [26-8a-405.1 through 26-8a-405.3] 26B-4-155
2550     through 26B-4-157.
2551          (ii) If Subsection (2)(a)(ii)(B) applies, the department shall issue a request for proposal
2552     for non-911 services in accordance with Section [26-8a-405.5] 26B-4-159.
2553          (3) The department shall make a determination under Subsection (1)(b) if:
2554          (a) the department receives a written complaint from any of the following in the
2555     geographic service area:
2556          (i) a hospital;
2557          (ii) a health care facility;
2558          (iii) a political subdivision; or
2559          (iv) an individual; and
2560          (b) the department determines, in accordance with Subsection (1)(b), that the complaint
2561     has merit.
2562          (4) (a) If the department receives a complaint under Subsection (1)(b), the department
2563     shall request a written response from the non-911 provider concerning the complaint.
2564          (b) The department shall make a determination under Subsection (1)(b) based on:
2565          (i) the written response from the non-911 provider; and
2566          (ii) other information that the department may have concerning the quality of service of
2567     the non-911 provider.
2568          (c) (i) The department's determination under Subsection (1)(b) is not subject to an
2569     adjudicative proceeding under Title 63G, Chapter 4, Administrative Procedures Act.

2570          (ii) The department shall adopt administrative rules in accordance with Title 63G,
2571     Chapter 3, Utah Administrative Rulemaking Act, to implement the provisions of Subsection
2572     (1)(b).
2573          Section 47. Section 26B-4-159, which is renumbered from Section 26-8a-405.5 is
2574     renumbered and amended to read:
2575          [26-8a-405.5].      26B-4-159. Use of competitive sealed proposals -- Procedure
2576     -- Appeal rights.
2577          (1) (a) The department shall issue a request for proposal for non-911 services in a
2578     geographic service area if the department receives a request from a political subdivision under
2579     Subsection [26-8a-405.4] 26B-4-158(2)(a)(ii)(B) to issue a request for proposal for non-911
2580     services.
2581          (b) Competitive sealed proposals for non-911 services under Subsection (1)(a) shall be
2582     solicited through a request for proposal and the provisions of this section.
2583          (c) (i) Notice of the request for proposals shall be published:
2584          (A) at least once a week for three consecutive weeks in a newspaper of general
2585     circulation published in the county; or
2586          (B) if there is no such newspaper, then notice shall be posted for at least 20 days in at
2587     least five public places in the county; and
2588          (ii) in accordance with Section 45-1-101 for at least 20 days.
2589          (2) (a) Proposals shall be opened so as to avoid disclosure of contents to competing
2590     offerors during the process of negotiations.
2591          (b) (i) Subsequent to the published notice, and prior to selecting an applicant, the
2592     department shall hold a presubmission conference with interested applicants for the purpose of
2593     assuring full understanding of, and responsiveness to, solicitation requirements.
2594          (ii) The department shall allow at least 90 days from the presubmission conference for
2595     the proposers to submit proposals.
2596          (c) Subsequent to the presubmission conference, the department may issue addenda to
2597     the request for proposals. An addenda to a request for proposal shall be finalized and posted by
2598     the department at least 45 days before the day on which the proposal must be submitted.
2599          (d) Offerors to the request for proposals shall be accorded fair and equal treatment with
2600     respect to any opportunity for discussion and revisions of proposals, and revisions may be

2601     permitted after submission and before a contract is awarded for the purpose of obtaining best
2602     and final offers.
2603          (e) In conducting discussions, there shall be no disclosures of any information derived
2604     from proposals submitted by competing offerors.
2605          (3) (a) (i) The department may select an applicant approved by the department under
2606     Section [26-8a-404] 26B-4-153 to provide non-911 services by contract to the most responsible
2607     offeror as defined in Section 63G-6a-103.
2608          (ii) An award under Subsection (3)(a)(i) shall be made to the responsible offeror whose
2609     proposal is determined in writing to be the most advantageous to the public, taking into
2610     consideration price and the evaluation factors set forth in the request for proposal.
2611          (b) The applicants who are approved under Section [26-8a-405] 26B-4-154 and who
2612     are selected under this section may be the political subdivision responding to the request for
2613     competitive sealed proposals, or any other public entity or entities, any private person or entity,
2614     or any combination thereof.
2615          (c) The department may reject all of the competitive proposals.
2616          (4) In seeking competitive sealed proposals and awarding contracts under this section,
2617     the department:
2618          (a) shall consider the public convenience and necessity factors listed in Subsections
2619     [26-8a-408] 26B-4-162(2) through (6);
2620          (b) shall require the applicant responding to the proposal to disclose how the applicant
2621     will meet performance standards in the request for proposal;
2622          (c) may not require or restrict an applicant to a certain method of meeting the
2623     performance standards, including:
2624          (i) requiring ambulance medical personnel to also be a firefighter; or
2625          (ii) mandating that offerors use fire stations or dispatch services of the political
2626     subdivision;
2627          (d) shall require an applicant to submit the proposal:
2628          (i) based on full cost accounting in accordance with generally accepted accounting
2629     principals; and
2630          (ii) if the applicant is a governmental entity, in addition to the requirements of
2631     Subsection (4)(e)(i), in accordance with generally accepted government auditing standards and

2632     in compliance with the State of Utah Legal Compliance Audit Guide; and
2633          (e) shall set forth in the request for proposal:
2634          (i) the method for determining full cost accounting in accordance with generally
2635     accepted accounting principles, and require an applicant to submit the proposal based on such
2636     full cost accounting principles;
2637          (ii) guidelines established to further competition and provider accountability; and
2638          (iii) a list of the factors that will be considered by the department in the award of the
2639     contract, including by percentage, the relative weight of the factors established under this
2640     Subsection (4)(e), which may include:
2641          (A) response times;
2642          (B) staging locations;
2643          (C) experience;
2644          (D) quality of care; and
2645          (E) cost, consistent with the cost accounting method in Subsection (4)(e)(i).
2646          (5) A license issued under this section:
2647          (a) is for the exclusive geographic service area approved by the department;
2648          (b) is valid for four years;
2649          (c) is not subject to a request for license from another applicant under the provisions of
2650     Sections [26-8a-406 through 26-8a-409] 26B-4-160 through 26B-4-163 during the four-year
2651     term, unless the applicant's license is revoked under Section [26-8a-504] 26B-4-130;
2652          (d) is subject to supervision by the department under Sections [26-8a-503 and
2653     26-8a-504] 26B-4-129 and 26B-4-130; and
2654          (e) except as provided in Subsection (4)(a), is not subject to the provisions of Sections
2655     [26-8a-406 through 26-8a-409] 26B-4-160 through 26B-4-163.
2656          Section 48. Section 26B-4-160, which is renumbered from Section 26-8a-406 is
2657     renumbered and amended to read:
2658          [26-8a-406].      26B-4-160. Ground ambulance and paramedic licenses --
2659     Parties.
2660          (1) When an applicant approved under Section [26-8a-404] 26B-4-153 seeks licensure
2661     under the provisions of Sections [26-8a-406 through 26-8a-409] 26B-4-160 through
2662     26B-4-163, the department shall:

2663          (a) issue a notice of agency action to the applicant to commence an informal
2664     administrative proceeding;
2665          (b) provide notice of the application to all interested parties; and
2666          (c) publish notice of the application, at the applicant's expense:
2667          (i) once a week for four consecutive weeks, in a newspaper of general circulation in the
2668     geographic service area that is the subject of the application; and
2669          (ii) in accordance with Section 45-1-101 for four weeks.
2670          (2) An interested party has 30 days to object to an application.
2671          (3) If an interested party objects, the presiding officer shall join the interested party as
2672     an indispensable party to the proceeding.
2673          (4) The department may join the proceeding as a party to represent the public interest.
2674          (5) Others who may be affected by the grant of a license to the applicant may join the
2675     proceeding, if the presiding officer determines that they meet the requirement of legal standing.
2676          Section 49. Section 26B-4-161, which is renumbered from Section 26-8a-407 is
2677     renumbered and amended to read:
2678          [26-8a-407].      26B-4-161. Ground ambulance and paramedic licenses --
2679     Proceedings.
2680          (1) The presiding officer shall:
2681          (a) commence an informal adjudicative proceeding within 120 days of receiving a
2682     completed application;
2683          (b) meet with the applicant and objecting interested parties and provide no less than
2684     120 days for a negotiated resolution, consistent with the criteria in Section [26-8a-408]
2685     26B-4-162;
2686          (c) set aside a separate time during the proceedings to accept public comment on the
2687     application; and
2688          (d) present a written decision to the executive director if a resolution has been reached
2689     that satisfies the criteria in Section [26-8a-408] 26B-4-162.
2690          (2) At any time during an informal adjudicative proceeding under Subsection (1), any
2691     party may request conversion of the informal adjudicative proceeding to a formal adjudicative
2692     proceeding in accordance with Section 63G-4-202.
2693          (3) Upon conversion to a formal adjudicative proceeding, a hearing officer shall be

2694     assigned to the application as provided in Section [26-8a-409] 26B-4-163. The hearing office
2695     shall:
2696          (a) set aside a separate time during the proceedings to accept public comment on the
2697     application;
2698          (b) apply the criteria established in Section [26-8a-408] 26B-4-162; and
2699          (c) present a recommended decision to the executive director in writing.
2700          (4) The executive director may, as set forth in a final written order, accept, modify,
2701     reject, or remand the decision of a presiding or hearing officer after:
2702          (a) reviewing the record;
2703          (b) giving due deference to the officer's decision; and
2704          (c) determining whether the criteria in Section [26-8a-408] 26B-4-162 have been
2705     satisfied.
2706          Section 50. Section 26B-4-162, which is renumbered from Section 26-8a-408 is
2707     renumbered and amended to read:
2708          [26-8a-408].      26B-4-162. Criteria for determining public convenience and
2709     necessity.
2710          (1) The criteria for determining public convenience and necessity is set forth in
2711     Subsections (2) through (6).
2712          (2) Access to emergency medical services shall be maintained or improved. The
2713     officer shall consider the impact on existing services, including the impact on response times,
2714     call volumes, populations and exclusive geographic service areas served, and the ability of
2715     surrounding licensed providers to service their exclusive geographic service areas. The
2716     issuance or amendment of a license may not create an orphaned area.
2717          (3) The quality of service in the area shall be maintained or improved. The officer
2718     shall consider the:
2719          (a) staffing and equipment standards of the current licensed provider and the applicant;
2720          (b) training and licensure levels of the current licensed provider's staff and the
2721     applicant's staff;
2722          (c) continuing medical education provided by the current licensed provider and the
2723     applicant;
2724          (d) levels of care as defined by department rule;

2725          (e) plan of medical control; and
2726          (f) the negative or beneficial impact on the regional emergency medical service system
2727     to provide service to the public.
2728          (4) The cost to the public shall be justified. The officer shall consider:
2729          (a) the financial solvency of the applicant;
2730          (b) the applicant's ability to provide services within the rates established under Section
2731     [26-8a-403] 26B-4-152;
2732          (c) the applicant's ability to comply with cost reporting requirements;
2733          (d) the cost efficiency of the applicant; and
2734          (e) the cost effect of the application on the public, interested parties, and the emergency
2735     medical services system.
2736          (5) Local desires concerning cost, quality, and access shall be considered. The officer
2737     shall assess and consider:
2738          (a) the existing provider's record of providing services and the applicant's record and
2739     ability to provide similar or improved services;
2740          (b) locally established emergency medical services goals, including those established in
2741     Subsection (7);
2742          (c) comment by local governments on the applicant's business and operations plans;
2743          (d) comment by interested parties that are providers on the impact of the application on
2744     the parties' ability to provide emergency medical services;
2745          (e) comment by interested parties that are local governments on the impact of the
2746     application on the citizens it represents; and
2747          (f) public comment on any aspect of the application or proposed license.
2748          (6) Other related criteria:
2749          (a) the officer considers necessary; or
2750          (b) established by department rule.
2751          (7) Local governments shall establish cost, quality, and access goals for the ground
2752     ambulance and paramedic services that serve their areas.
2753          (8) In a formal adjudicative proceeding, the applicant bears the burden of establishing
2754     that public convenience and necessity require the approval of the application for all or part of
2755     the exclusive geographic service area requested.

2756          Section 51. Section 26B-4-163, which is renumbered from Section 26-8a-409 is
2757     renumbered and amended to read:
2758          [26-8a-409].      26B-4-163. Ground ambulance and paramedic licenses --
2759     Hearing and presiding officers.
2760          (1) The department shall set training standards for hearing officers and presiding
2761     officers.
2762          (2) At a minimum, a presiding officer shall:
2763          (a) be familiar with the theory and application of public convenience and necessity; and
2764          (b) have a working knowledge of the emergency medical service system in the state.
2765          (3) In addition to the requirements in Subsection (2), a hearing officer shall also be
2766     licensed to practice law in the state.
2767          (4) The department shall provide training for hearing officer and presiding officer
2768     candidates in the theory and application of public convenience and necessity and on the
2769     emergency medical system in the state.
2770          (5) The department shall maintain a roster of no less than five individuals who meet
2771     the minimum qualifications for both presiding and hearing officers and the standards set by the
2772     department.
2773          (6) The parties may mutually select an officer from the roster if the officer is available.
2774          (7) If the parties cannot agree upon an officer under Subsection (4), the department
2775     shall randomly select an officer from the roster or from a smaller group of the roster agreed
2776     upon by the applicant and the objecting interested parties.
2777          Section 52. Section 26B-4-164, which is renumbered from Section 26-8a-410 is
2778     renumbered and amended to read:
2779          [26-8a-410].      26B-4-164. Local approvals.
2780          (1) Licensed ambulance providers and paramedic providers shall meet all local zoning
2781     and business licensing standards generally applicable to businesses operating within the
2782     jurisdiction.
2783          (2) Publicly subsidized providers shall demonstrate approval of the taxing authority
2784     that will provide the subsidy.
2785          (3) A publicly operated service shall demonstrate that the governing body has approved
2786     the provision of services to the entire exclusive geographic service area that is the subject of

2787     the license, including those areas that may lie outside the territorial or jurisdictional boundaries
2788     of the governing body.
2789          Section 53. Section 26B-4-165, which is renumbered from Section 26-8a-411 is
2790     renumbered and amended to read:
2791          [26-8a-411].      26B-4-165. Limitation on repetitive applications.
2792          A person who has previously applied for a license under Sections [26-8a-406 through
2793     26-8a-409] 26B-4-160 through 26B-4-163 may not apply for a license for the same service that
2794     covers any exclusive geographic service area that was the subject of the prior application
2795     unless:
2796          (1) one year has passed from the date of the issuance of a final decision under Section
2797     [26-8a-407] 26B-4-161; or
2798          (2) all interested parties and the department agree that a new application is in the public
2799     interest.
2800          Section 54. Section 26B-4-166, which is renumbered from Section 26-8a-412 is
2801     renumbered and amended to read:
2802          [26-8a-412].      26B-4-166. License for air ambulance providers.
2803          (1) An applicant for an air ambulance provider shall apply to the department for a
2804     license only by:
2805          (a) submitting a complete application;
2806          (b) providing information in the format required by the department; and
2807          (c) paying the required fees.
2808          (2) The department may make rules establishing minimum qualifications and
2809     requirements for:
2810          (a) personnel;
2811          (b) capital reserves;
2812          (c) equipment;
2813          (d) business plan;
2814          (e) operational procedures;
2815          (f) resource hospital and medical direction agreements;
2816          (g) management and control qualifications and requirements; and
2817          (h) other matters that may be relevant to an applicant's ability to provide air ambulance

2818     services.
2819          (3) Upon receiving a completed application and the required fees, the department shall
2820     review the application and determine whether the application meets the minimum requirements
2821     for licensure.
2822          (4) The department may deny an application for an air ambulance if:
2823          (a) the department finds that the application contains any materially false or misleading
2824     information or is incomplete;
2825          (b) the application demonstrates that the applicant fails to meet the minimum
2826     requirements for licensure; or
2827          (c) the department finds after inspection that the applicant does not meet the minimum
2828     requirements for licensure.
2829          (5) If the department denies an application under this section, it shall notify the
2830     applicant in writing setting forth the grounds for the denial.
2831          Section 55. Section 26B-4-167, which is renumbered from Section 26-8a-413 is
2832     renumbered and amended to read:
2833          [26-8a-413].      26B-4-167. License renewals.
2834          (1) A licensed provider desiring to renew its license shall meet the renewal
2835     requirements established by department rule.
2836          (2) The department shall issue a renewal license for a ground ambulance provider or a
2837     paramedic provider upon the licensee's application for a renewal and without a public hearing
2838     if:
2839          (a) the applicant was licensed under the provisions of Sections [26-8a-406 through
2840     26-8a-409] 26B-4-160 through 26B-4-163; and
2841          (b) there has been:
2842          (i) no change in controlling interest in the ownership of the licensee as defined in
2843     Section [26-8a-415] 26B-4-169;
2844          (ii) no serious, substantiated public complaints filed with the department against the
2845     licensee during the term of the previous license;
2846          (iii) no material or substantial change in the basis upon which the license was
2847     originally granted;
2848          (iv) no reasoned objection from the committee or the department; and

2849          (v) no change to the license type.
2850          (3) (a) (i) The provisions of this Subsection (3) apply to a provider licensed under the
2851     provisions of Sections [26-8a-405.1 and 26-8a-405.2] 26B-4-155 and 26B-4-156.
2852          (ii) A provider may renew its license if the provisions of Subsections (1) and (2) and
2853     this Subsection (3) are met.
2854          (b) (i) The department shall issue a renewal license to a provider upon the provider's
2855     application for renewal for one additional four-year term if the political subdivision certifies to
2856     the department that the provider has met all of the specifications of the original bid.
2857          (ii) If the political subdivision does not certify to the department that the provider has
2858     met all of the specifications of the original bid, the department may not issue a renewal license
2859     and the political subdivision shall enter into a public bid process under Sections [26-8a-405.1
2860     and 26-8a-405.2] 26B-4-155 and 26B-4-156.
2861          (c) (i) The department shall issue an additional renewal license to a provider who has
2862     already been issued a one-time renewal license under the provisions of Subsection (3)(b)(i) if
2863     the department and the political subdivision do not receive, prior to the expiration of the
2864     provider's license, written notice from an approved applicant informing the political
2865     subdivision of the approved applicant's desire to submit a bid for ambulance or paramedic
2866     service.
2867          (ii) If the department and the political subdivision receive the notice in accordance with
2868     Subsection (3)(c)(i), the department may not issue a renewal license and the political
2869     subdivision shall enter into a public bid process under Sections [26-8a-405.1 and 26-8a-405.2]
2870     26B-4-155 and 26B-4-156.
2871          (4) The department shall issue a renewal license for an air ambulance provider upon
2872     the licensee's application for renewal and completion of the renewal requirements established
2873     by department rule.
2874          Section 56. Section 26B-4-168, which is renumbered from Section 26-8a-414 is
2875     renumbered and amended to read:
2876          [26-8a-414].      26B-4-168. Annexations.
2877          (1) A municipality shall comply with the provisions of this section if the municipality
2878     is licensed under this [chapter] part and desires to provide service to an area that is:
2879          (a) included in a petition for annexation under Title 10, Chapter 2, Part 4, Annexation;

2880     and
2881          (b) currently serviced by another provider licensed under this [chapter] part.
2882          (2) (a) (i) At least 45 days prior to approving a petition for annexation, the municipality
2883     shall certify to the department that by the time of the approval of the annexation the
2884     municipality can meet or exceed the current level of service provided by the existing licensee
2885     for the annexed area by meeting the requirements of Subsections (2)(b)(ii)(A) through (D); and
2886          (ii) no later than three business days after the municipality files a petition for
2887     annexation in accordance with Section 10-2-403, provide written notice of the petition for
2888     annexation to:
2889          (A) the existing licensee providing service to the area included in the petition of
2890     annexation; and
2891          (B) the department.
2892          (b) (i) After receiving a certification under Subsection (2)(a), but prior to the
2893     municipality approving a petition for annexation, the department may audit the municipality
2894     only to verify the requirements of Subsections (2)(b)(ii)(A) through (D).
2895          (ii) If the department elects to conduct an audit, the department shall make a finding
2896     that the municipality can meet or exceed the current level of service provided by the existing
2897     licensee for the annexed area if the department finds that the municipality has or will have by
2898     the time of the approval of the annexation:
2899          (A) adequate trained personnel to deliver basic and advanced life support services;
2900          (B) adequate apparatus and equipment to deliver emergency medical services;
2901          (C) adequate funding for personnel and equipment; and
2902          (D) appropriate medical controls, such as a medical director and base hospital.
2903          (iii) The department shall submit the results of the audit in writing to the municipal
2904     legislative body.
2905          (3) (a) If the department audit finds that the municipality meets the requirements of
2906     Subsection (2)(b)(ii), the department shall issue an amended license to the municipality and all
2907     other affected licensees to reflect the municipality's new boundaries after the department
2908     receives notice of the approval of the petition for annexation from the municipality in
2909     accordance with Section 10-2-425.
2910          (b) (i) Notwithstanding the provisions of Subsection 63G-4-102(2)(k), if the

2911     department audit finds that the municipality fails to meet the requirements of Subsection
2912     (2)(b)(ii), the municipality may request an adjudicative proceeding under the provisions of
2913     Title 63G, Chapter 4, Administrative Procedures Act. The municipality may approve the
2914     petition for annexation while an adjudicative proceeding requested under this Subsection
2915     (3)(b)(i) is pending.
2916          (ii) The department shall conduct an adjudicative proceeding when requested under
2917     Subsection (3)(b)(i).
2918          (iii) Notwithstanding the provisions of Sections [26-8a-404 through 26-8a-409]
2919     26B-4-153 through 26B-4-163, in any adjudicative proceeding held under the provisions of
2920     Subsection (3)(b)(i), the department bears the burden of establishing that the municipality
2921     cannot, by the time of the approval of the annexation, meet the requirements of Subsection
2922     (2)(b)(ii).
2923          (c) If, at the time of the approval of the annexation, an adjudicative proceeding is
2924     pending under the provisions of Subsection (3)(b)(i), the department shall issue amended
2925     licenses if the municipality prevails in the adjudicative proceeding.
2926          Section 57. Section 26B-4-169, which is renumbered from Section 26-8a-415 is
2927     renumbered and amended to read:
2928          [26-8a-415].      26B-4-169. Changes in ownership.
2929          (1) A licensed provider whose ownership or controlling ownership interest has changed
2930     shall submit information to the department, as required by department rule:
2931          (a) to establish whether the new owner or new controlling party meets minimum
2932     requirements for licensure; and
2933          (b) except as provided in Subsection (2), to commence an administrative proceeding to
2934     determine whether the new owner meets the requirement of public convenience and necessity
2935     under Section [26-8a-408] 26B-4-162.
2936          (2) An administrative proceeding is not required under Subsection (1)(b) if:
2937          (a) the change in ownership interest is among existing owners of a closely held
2938     corporation and the change does not result in a change in the management of the licensee or in
2939     the name of the licensee;
2940          (b) the change in ownership in a closely held corporation results in the introduction of
2941     new owners, provided that:

2942          (i) the new owners are limited to individuals who would be entitled to the equity in the
2943     closely held corporation by the laws of intestate succession had the transferor died intestate at
2944     the time of the transfer;
2945          (ii) the majority owners on January 1, 1999, have been disclosed to the department by
2946     October 1, 1999, and the majority owners on January 1, 1999, retain a majority interest in the
2947     closely held corporation; and
2948          (iii) the name of the licensed provider remains the same;
2949          (c) the change in ownership is the result of one or more owners transferring their
2950     interests to a trust, limited liability company, partnership, or closely held corporation so long as
2951     the transferors retain control over the receiving entity;
2952          (d) the change in ownership is the result of a distribution of an estate or a trust upon the
2953     death of the testator or the trustor and the recipients are limited to individuals who would be
2954     entitled to the interest by the laws of intestate succession had the transferor died intestate at the
2955     time of the transfer; or
2956          (e) other similar changes that the department establishes, by rule, as having no
2957     significant impact on the cost, quality, or access to emergency medical services.
2958          Section 58. Section 26B-4-170, which is renumbered from Section 26-8a-416 is
2959     renumbered and amended to read:
2960          [26-8a-416].      26B-4-170. Overlapping licenses.
2961          (1) As used in this section:
2962          (a) "Overlap" means two ground ambulance interfacility transport providers that are
2963     licensed at the same level of service in all or part of a single geographic service area.
2964          (b) "Overlay" means two ground ambulance interfacility transport providers that are
2965     licensed at a different level of service in all or part of a single geographic service area.
2966          (2) Notwithstanding the exclusive geographic service requirement of Section
2967     [26-8a-402] 26B-4-151, the department shall recognize overlap and overlay ground ambulance
2968     interfacility transport licenses that existed on or before May 4, 2022.
2969          (3) The department may, without an adjudicative proceeding but with at least 30 days
2970     notice to providers in the same geographic service area, amend an existing overlay ground
2971     ambulance interfacility transport license solely to convert an overlay into an overlap if the
2972     existing ground ambulance interfacility transport licensed provider meets the requirements

2973     described in Subsection [26-8a-404] 26B-4-153(4).
2974          (4) An amendment of a license under this section may not alter:
2975          (a) other terms of the original license, including the applicable geographic service area;
2976     or
2977          (b) the license of other providers that provide interfacility transport services in the
2978     geographic service area.
2979          (5) Notwithstanding Subsection (2), any license for an overlap area terminates upon:
2980          (a) relinquishment by the provider; or
2981          (b) revocation by the department.
2982          Section 59. Section 26B-4-201, which is renumbered from Section 26-61a-102 is
2983     renumbered and amended to read:
2984     
Part 2. Cannabinoid Research and Medical Cannabis

2985          [26-61a-102].      26B-4-201. Definitions.
2986          As used in this [chapter] part:
2987          (1) "Active tetrahydrocannabinol" means THC, any THC analog, and
2988     tetrahydrocannabinolic acid.
2989          (2) " Cannabis Research Review Board" means the Cannabis Research Review Board
2990     created in Section 26-61-201.
2991          (3) "Cannabis" means marijuana.
2992          (4) "Cannabis cultivation facility" means the same as that term is defined in Section
2993     4-41a-102.
2994          (5) "Cannabis processing facility" means the same as that term is defined in Section
2995     4-41a-102.
2996          (6) "Cannabis product" means a product that:
2997          (a) is intended for human use; and
2998          (b) contains cannabis or any tetrahydrocannabinol or THC analog in a total
2999     concentration of 0.3% or greater on a dry weight basis.
3000          (7) "Cannabis production establishment" means the same as that term is defined in
3001     Section 4-41a-102.
3002          (8) "Cannabis production establishment agent" means the same as that term is defined
3003     in Section 4-41a-102.

3004          (9) "Cannabis production establishment agent registration card" means the same as that
3005     term is defined in Section 4-41a-102.
3006          (10) "Community location" means a public or private elementary or secondary school,
3007     a church, a public library, a public playground, or a public park.
3008          (11) "Conditional medical cannabis card" means an electronic medical cannabis card
3009     that the department issues in accordance with Subsection [26-61a-201] 26B-4-213(1)(b) to
3010     allow an applicant for a medical cannabis card to access medical cannabis during the
3011     department's review of the application.
3012          (12) "Controlled substance database" means the controlled substance database created
3013     in Section 58-37f-201.
3014          (13) "Department" means the Department of Health.
3015          (14) "Designated caregiver" means:
3016          (a) an individual:
3017          (i) whom an individual with a medical cannabis patient card or a medical cannabis
3018     guardian card designates as the patient's caregiver; and
3019          (ii) who registers with the department under Section [26-61a-202] 26B-4-214; or
3020          (b) (i) a facility that an individual designates as a designated caregiver in accordance
3021     with Subsection [26-61a-202] 26B-4-214(1)(b); or
3022          (ii) an assigned employee of the facility described in Subsection [26-61a-202] 26B-4-
3023     214
(1)(b)(ii).
3024          (15) "Directions of use" means recommended routes of administration for a medical
3025     cannabis treatment and suggested usage guidelines.
3026          (16) "Dosing guidelines" means a quantity range and frequency of administration for a
3027     recommended treatment of medical cannabis.
3028          (17) "Financial institution" means a bank, trust company, savings institution, or credit
3029     union, chartered and supervised under state or federal law.
3030          (18) "Home delivery medical cannabis pharmacy" means a medical cannabis pharmacy
3031     that the department authorizes, as part of the pharmacy's license, to deliver medical cannabis
3032     shipments to a medical cannabis cardholder's home address to fulfill electronic orders that the
3033     state central patient portal facilitates.
3034          (19) "Inventory control system" means the system described in Section 4-41a-103.

3035          (20) "Legal dosage limit" means an amount that:
3036          (a) is sufficient to provide 30 days of treatment based on the dosing guidelines that the
3037     relevant recommending medical provider or the state central patient portal or pharmacy
3038     medical provider, in accordance with Subsection [26-61a-502] 26B-4-230(4) or (5),
3039     recommends; and
3040          (b) may not exceed:
3041          (i) for unprocessed cannabis in a medicinal dosage form, 113 grams by weight; and
3042          (ii) for a cannabis product in a medicinal dosage form, a quantity that contains, in total,
3043     greater than 20 grams of active tetrahydrocannabinol.
3044          (21) "Legal use termination date" means a date on the label of a container of
3045     unprocessed cannabis flower:
3046          (a) that is 60 days after the date of purchase of the cannabis; and
3047          (b) after which, the cannabis is no longer in a medicinal dosage form outside of the
3048     primary residence of the relevant medical cannabis patient cardholder.
3049          (22) "Limited medical provider" means an individual who:
3050          (a) meets the recommending qualifications; and
3051          (b) has no more than 15 patients with a valid medical cannabis patient card or
3052     provisional patient card as a result of the individual's recommendation, in accordance with
3053     Subsection [26-61a-106] 26B-4-204(1)(b).
3054          (23) "Marijuana" means the same as that term is defined in Section 58-37-2.
3055          (24) "Medical cannabis" means cannabis in a medicinal dosage form or a cannabis
3056     product in a medicinal dosage form.
3057          (25) "Medical cannabis card" means a medical cannabis patient card, a medical
3058     cannabis guardian card, a medical cannabis caregiver card, or a conditional medical cannabis
3059     card.
3060          (26) "Medical cannabis cardholder" means:
3061          (a) a holder of a medical cannabis card; or
3062          (b) a facility or assigned employee, described in Subsection(14)(b), only:
3063          (i) within the scope of the facility's or assigned employee's performance of the role of a
3064     medical cannabis patient cardholder's caregiver designation under Subsection [26-61a-202]
3065     26B-4-214(1)(b); and

3066          (ii) while in possession of documentation that establishes:
3067          (A) a caregiver designation described in Subsection [26-61a-202] 26B-4-214(1)(b);
3068          (B) the identity of the individual presenting the documentation; and
3069          (C) the relation of the individual presenting the documentation to the caregiver
3070     designation.
3071          (27) "Medical cannabis caregiver card" means an electronic document that a cardholder
3072     may print or store on an electronic device or a physical card or document that:
3073          (a) the department issues to an individual whom a medical cannabis patient cardholder
3074     or a medical cannabis guardian cardholder designates as a designated caregiver; and
3075          (b) is connected to the electronic verification system.
3076          (28) "Medical cannabis courier" means a courier that:
3077          (a) the department licenses in accordance with Section [26-61a-604] 26B-4-239; and
3078          (b) contracts with a home delivery medical cannabis pharmacy to deliver medical
3079     cannabis shipments to fulfill electronic orders that the state central patient portal facilitates.
3080          (29) "Medical cannabis courier agent" means an individual who:
3081          (a) is an employee of a medical cannabis courier; and
3082          (b) who holds a valid medical cannabis courier agent registration card.
3083          (30) (a) "Medical cannabis device" means a device that an individual uses to ingest or
3084     inhale cannabis in a medicinal dosage form or a cannabis product in a medicinal dosage form.
3085          (b) "Medical cannabis device" does not include a device that:
3086          (i) facilitates cannabis combustion; or
3087          (ii) an individual uses to ingest substances other than cannabis.
3088          (31) "Medical cannabis guardian card" means an electronic document that a cardholder
3089     may print or store on an electronic device or a physical card or document that:
3090          (a) the department issues to the parent or legal guardian of a minor with a qualifying
3091     condition; and
3092          (b) is connected to the electronic verification system.
3093          (32) "Medical cannabis patient card" means an electronic document that a cardholder
3094     may print or store on an electronic device or a physical card or document that:
3095          (a) the department issues to an individual with a qualifying condition; and
3096          (b) is connected to the electronic verification system.

3097          (33) "Medical cannabis pharmacy" means a person that:
3098          (a) (i) acquires or intends to acquire medical cannabis or a cannabis product in a
3099     medicinal dosage form from a cannabis processing facility or another medical cannabis
3100     pharmacy or a medical cannabis device; or
3101          (ii) possesses medical cannabis or a medical cannabis device; and
3102          (b) sells or intends to sell medical cannabis or a medical cannabis device to a medical
3103     cannabis cardholder.
3104          (34) "Medical cannabis pharmacy agent" means an individual who:
3105          (a) is an employee of a medical cannabis pharmacy; and
3106          (b) who holds a valid medical cannabis pharmacy agent registration card.
3107          (35) "Medical cannabis pharmacy agent registration card" means a registration card
3108     issued by the department that authorizes an individual to act as a medical cannabis pharmacy
3109     agent.
3110          (36) "Medical cannabis shipment" means a shipment of medical cannabis or a medical
3111     cannabis product that a home delivery medical cannabis pharmacy or a medical cannabis
3112     courier delivers to a medical cannabis cardholder's home address to fulfill an electronic medical
3113     cannabis order that the state central patient portal facilitates.
3114          (37) "Medical cannabis treatment" means cannabis in a medicinal dosage form, a
3115     cannabis product in a medicinal dosage form, or a medical cannabis device.
3116          (38) (a) "Medicinal dosage form" means:
3117          (i) for processed medical cannabis or a medical cannabis product, the following with a
3118     specific and consistent cannabinoid content:
3119          (A) a tablet;
3120          (B) a capsule;
3121          (C) a concentrated liquid or viscous oil;
3122          (D) a liquid suspension that, after December 1, 2022, does not exceed 30 ml;
3123          (E) a topical preparation;
3124          (F) a transdermal preparation;
3125          (G) a sublingual preparation;
3126          (H) a gelatinous cube, gelatinous rectangular cuboid, or lozenge in a cube or
3127     rectangular cuboid shape;

3128          (I) a resin or wax; or
3129          (J) an aerosol; or
3130          (ii) for unprocessed cannabis flower, a container described in Section 4-41a-602 that:
3131          (A) contains cannabis flowers in a quantity that varies by no more than 10% from the
3132     stated weight at the time of packaging;
3133          (B) at any time the medical cannabis cardholder transports or possesses the container in
3134     public, is contained within an opaque bag or box that the medical cannabis pharmacy provides;
3135     and
3136          (C) is labeled with the container's content and weight, the date of purchase, the legal
3137     use termination date, and after December 31, 2020, a barcode that provides information
3138     connected to an inventory control system; and
3139          (iii) a form measured in grams, milligrams, or milliliters.
3140          (b) "Medicinal dosage form" includes a portion of unprocessed cannabis flower that:
3141          (i) the medical cannabis cardholder has recently removed from the container described
3142     in Subsection (38)(a)(ii) for use; and
3143          (ii) does not exceed the quantity described in Subsection (38)(a)(ii).
3144          (c) "Medicinal dosage form" does not include:
3145          (i) any unprocessed cannabis flower outside of the container described in Subsection
3146     (38)(a)(ii), except as provided in Subsection (38)(b);
3147          (ii) any unprocessed cannabis flower in a container described in Subsection (38)(a)(ii)
3148     after the legal use termination date;
3149          (iii) a process of vaporizing and inhaling concentrated cannabis by placing the cannabis
3150     on a nail or other metal object that is heated by a flame, including a blowtorch; or
3151          (iv) a liquid suspension that is branded as a beverage.
3152          (39) "Nonresident patient" means an individual who:
3153          (a) is not a resident of Utah or has been a resident of Utah for less than 45 days;
3154          (b) has a currently valid medical cannabis card or the equivalent of a medical cannabis
3155     card under the laws of another state, district, territory, commonwealth, or insular possession of
3156     the United States; and
3157          (c) has been diagnosed with a qualifying condition as described in Section
3158     [26-61a-104] 26B-4-203.

3159          (40) "Payment provider" means an entity that contracts with a cannabis production
3160     establishment or medical cannabis pharmacy to facilitate transfers of funds between the
3161     establishment or pharmacy and other businesses or individuals.
3162          (41) "Pharmacy medical provider" means the medical provider required to be on site at
3163     a medical cannabis pharmacy under Section [26-61a-403] 26B-4-219.
3164          (42) "Provisional patient card" means a card that:
3165          (a) the department issues to a minor with a qualifying condition for whom:
3166          (i) a recommending medical provider has recommended a medical cannabis treatment;
3167     and
3168          (ii) the department issues a medical cannabis guardian card to the minor's parent or
3169     legal guardian; and
3170          (b) is connected to the electronic verification system.
3171          (43) "Qualified medical provider" means an individual:
3172          (a) who meets the recommending qualifications; and
3173          (b) whom the department registers to recommend treatment with cannabis in a
3174     medicinal dosage form under Section [26-61a-106] 26B-4-204.
3175          (44) "Qualified Patient Enterprise Fund" means the enterprise fund created in Section
3176     [26-61a-109] 26B-1-310.
3177          (45) "Qualifying condition" means a condition described in Section [26-61a-104] 26B-
3178     4-203
.
3179          (46) "Recommend" or "recommendation" means, for a recommending medical
3180     provider, the act of suggesting the use of medical cannabis treatment, which:
3181          (a) certifies the patient's eligibility for a medical cannabis card; and
3182          (b) may include, at the recommending medical provider's discretion, directions of use,
3183     with or without dosing guidelines.
3184          (47) "Recommending medical provider" means a qualified medical provider or a
3185     limited medical provider.
3186          (48) "Recommending qualifications" means that an individual:
3187          (a) (i) has the authority to write a prescription;
3188          (ii) is licensed to prescribe a controlled substance under Title 58, Chapter 37, Utah
3189     Controlled Substances Act; and

3190          (iii) possesses the authority, in accordance with the individual's scope of practice, to
3191     prescribe a Schedule II controlled substance; and
3192          (b) is licensed as:
3193          (i) a podiatrist under Title 58, Chapter 5a, Podiatric Physician Licensing Act;
3194          (ii) an advanced practice registered nurse under Title 58, Chapter 31b, Nurse Practice
3195     Act;
3196          (iii) a physician under Title 58, Chapter 67, Utah Medical Practice Act, or Title 58,
3197     Chapter 68, Utah Osteopathic Medical Practice Act; or
3198          (iv) a physician assistant under Title 58, Chapter 70a, Utah Physician Assistant Act.
3199          (49) "State central patient portal" means the website the department creates, in
3200     accordance with Section [26-61a-601] 26B-4-236, to facilitate patient safety, education, and an
3201     electronic medical cannabis order.
3202          (50) "State central patient portal medical provider" means a physician or pharmacist
3203     that the department employs in relation to the state central patient portal to consult with
3204     medical cannabis cardholders in accordance with Section [26-61a-602] 26B-4-237.
3205          (51) "State electronic verification system" means the system described in Section
3206     [26-61a-103] 26B-4-202.
3207          (52) "Tetrahydrocannabinol" or "THC" means a substance derived from cannabis or a
3208     synthetic equivalent as described in Subsection 58-37-4(2)(a)(iii)(AA).
3209          (53) "THC analog" means the same as that term is defined in Section 4-41-102.
3210          (54) "Valid form of photo identification" means any of the following forms of
3211     identification that is either current or has expired within the previous six months:
3212          (a) a valid state-issued driver license or identification card;
3213          (b) a valid United States federal-issued photo identification, including:
3214          (i) a United States passport;
3215          (ii) a United States passport card;
3216          (iii) a United States military identification card; or
3217          (iv) a permanent resident card or alien registration receipt card; or
3218          (c) a passport that another country issued.
3219          Section 60. Section 26B-4-202, which is renumbered from Section 26-61a-103 is
3220     renumbered and amended to read:

3221          [26-61a-103].      26B-4-202. Electronic verification system.
3222          (1) The Department of Agriculture and Food, the department, the Department of Public
3223     Safety, and the Division of Technology Services shall:
3224          (a) enter into a memorandum of understanding in order to determine the function and
3225     operation of the state electronic verification system in accordance with Subsection (2);
3226          (b) coordinate with the Division of Purchasing, under Title 63G, Chapter 6a, Utah
3227     Procurement Code, to develop a request for proposals for a third-party provider to develop and
3228     maintain the state electronic verification system in coordination with the Division of
3229     Technology Services; and
3230          (c) select a third-party provider who:
3231          (i) meets the requirements contained in the request for proposals issued under
3232     Subsection (1)(b); and
3233          (ii) may not have any commercial or ownership interest in a cannabis production
3234     establishment or a medical cannabis pharmacy.
3235          (2) The Department of Agriculture and Food, the department, the Department of Public
3236     Safety, and the Division of Technology Services shall ensure that, on or before March 1, 2020,
3237     the state electronic verification system described in Subsection (1):
3238          (a) allows an individual to apply for a medical cannabis patient card or, if applicable, a
3239     medical cannabis guardian card, provided that the card may not become active until:
3240          (i) the relevant qualified medical provider completes the associated medical cannabis
3241     recommendation; or
3242          (ii) for a medical cannabis card related to a limited medical provider's
3243     recommendation, the medical cannabis pharmacy completes the recording described in
3244     Subsection (2)(d);
3245          (b) allows an individual to apply to renew a medical cannabis patient card or a medical
3246     cannabis guardian card in accordance with Section [26-61a-201] 26B-4-213;
3247          (c) allows a qualified medical provider, or an employee described in Subsection (3)
3248     acting on behalf of the qualified medical provider, to:
3249          (i) access dispensing and card status information regarding a patient:
3250          (A) with whom the qualified medical provider has a provider-patient relationship; and
3251          (B) for whom the qualified medical provider has recommended or is considering

3252     recommending a medical cannabis card;
3253          (ii) electronically recommend, after an initial face-to-face visit with a patient described
3254     in Subsection [26-61a-201] 26B-4-213(4)(a)(iii), treatment with cannabis in a medicinal
3255     dosage form or a cannabis product in a medicinal dosage form and optionally recommend
3256     dosing guidelines; and
3257          (iii) electronically renew a recommendation to a medical cannabis patient cardholder or
3258     medical cannabis guardian cardholder:
3259          (A) using telehealth services, for the qualified medical provider who originally
3260     recommended a medical cannabis treatment during a face-to-face visit with the patient; or
3261          (B) during a face-to-face visit with the patient, for a qualified medical provider who
3262     did not originally recommend the medical cannabis treatment during a face-to-face visit.
3263          (d) beginning on the earlier of September 1, 2021, or the date on which the electronic
3264     verification system is functionally capable of facility medical cannabis pharmacy recording,
3265     allows a medical cannabis pharmacy medical provider or medical cannabis pharmacy agent, in
3266     accordance with Subsection [26-61a-501] 26B-4-229(10)(a), to:
3267          (i) access the electronic verification system to review the history within the system of a
3268     patient with whom the provider or agent is interacting, limited to read-only access for medical
3269     cannabis pharmacy agents unless the medical cannabis pharmacy's pharmacist in charge
3270     authorizes add and edit access;
3271          (ii) record a patient's recommendation from a limited medical provider, including any
3272     directions of use, dosing guidelines, or caregiver indications from the limited medical provider;
3273     and
3274          (iii) record a limited medical provider's renewal of the provider's previous
3275     recommendation;
3276          (e) connects with:
3277          (i) an inventory control system that a medical cannabis pharmacy uses to track in real
3278     time and archive purchases of any cannabis in a medicinal dosage form, cannabis product in a
3279     medicinal dosage form, or a medical cannabis device, including:
3280          (A) the time and date of each purchase;
3281          (B) the quantity and type of cannabis, cannabis product, or medical cannabis device
3282     purchased;

3283          (C) any cannabis production establishment, any medical cannabis pharmacy, or any
3284     medical cannabis courier associated with the cannabis, cannabis product, or medical cannabis
3285     device; and
3286          (D) the personally identifiable information of the medical cannabis cardholder who
3287     made the purchase; and
3288          (ii) any commercially available inventory control system that a cannabis production
3289     establishment utilizes in accordance with Section 4-41a-103 to use data that the Department of
3290     Agriculture and Food requires by rule, in accordance with Title 63G, Chapter 3, Utah
3291     Administrative Rulemaking Act, from the inventory tracking system that a licensee uses to
3292     track and confirm compliance;
3293          (f) provides access to:
3294          (i) the department to the extent necessary to carry out the department's functions and
3295     responsibilities under this [chapter] part;
3296          (ii) the Department of Agriculture and Food to the extent necessary to carry out the
3297     functions and responsibilities of the Department of Agriculture and Food under Title 4, Chapter
3298     41a, Cannabis Production Establishments; and
3299          (iii) the Division of Professional Licensing to the extent necessary to carry out the
3300     functions and responsibilities related to the participation of the following in the
3301     recommendation and dispensing of medical cannabis:
3302          (A) a podiatrist licensed under Title 58, Chapter 5a, Podiatric Physician Licensing Act;
3303          (B) a pharmacist licensed under Title 58, Chapter 17b, Pharmacy Practice Act;
3304          (C) an advanced practice registered nurse licensed under Title 58, Chapter 31b, Nurse
3305     Practice Act;
3306          (D) a physician licensed under Title 58, Chapter 67, Utah Medical Practice Act, or
3307     Title 58, Chapter 68, Utah Osteopathic Medical Practice Act; or
3308          (E) a physician assistant licensed under Title 58, Chapter 70a, Utah Physician Assistant
3309     Act;
3310          (g) provides access to and interaction with the state central patient portal;
3311          (h) communicates dispensing information from a record that a medical cannabis
3312     pharmacy submits to the state electronic verification system under Subsection [26-61a-502]
3313     26B-4-230(6)(a)(ii) to the controlled substance database;

3314          (i) provides access to state or local law enforcement:
3315          (i) during a law enforcement encounter, without a warrant, using the individual's driver
3316     license or state ID, only for the purpose of determining if the individual subject to the law
3317     enforcement encounter has a valid medical cannabis card; or
3318          (ii) after obtaining a warrant; and
3319          (j) creates a record each time a person accesses the system that identifies the person
3320     who accesses the system and the individual whose records the person accesses.
3321          (3) (a) Beginning on the earlier of September 1, 2021, or the date on which the
3322     electronic verification system is functionally capable of allowing employee access under this
3323     Subsection (3), an employee of a qualified medical provider may access the electronic
3324     verification system for a purpose described in Subsection (2)(c) on behalf of the qualified
3325     medical provider if:
3326          (i) the qualified medical provider has designated the employee as an individual
3327     authorized to access the electronic verification system on behalf of the qualified medical
3328     provider;
3329          (ii) the qualified medical provider provides written notice to the department of the
3330     employee's identity and the designation described in Subsection (3)(a)(i); and
3331          (iii) the department grants to the employee access to the electronic verification system.
3332          (b) An employee of a business that employs a qualified medical provider may access
3333     the electronic verification system for a purpose described in Subsection (2)(c) on behalf of the
3334     qualified medical provider if:
3335          (i) the qualified medical provider has designated the employee as an individual
3336     authorized to access the electronic verification system on behalf of the qualified medical
3337     provider;
3338          (ii) the qualified medical provider and the employing business jointly provide written
3339     notice to the department of the employee's identity and the designation described in Subsection
3340     (3)(b)(i); and
3341          (iii) the department grants to the employee access to the electronic verification system.
3342          (4) (a) As used in this Subsection (4), "prescribing provider" means:
3343          (i) a podiatrist licensed under Title 58, Chapter 5a, Podiatric Physician Licensing Act;
3344          (ii) an advanced practice registered nurse licensed under Title 58, Chapter 31b, Nurse

3345     Practice Act;
3346          (iii) a physician licensed under Title 58, Chapter 67, Utah Medical Practice Act, or
3347     Title 58, Chapter 68, Utah Osteopathic Medical Practice Act; or
3348          (iv) a physician assistant licensed under Title 58, Chapter 70a, Utah Physician
3349     Assistant Act.
3350          (b) Beginning on the earlier of September 1, 2021, or the date on which the electronic
3351     verification system is functionally capable of allowing provider access under this Subsection
3352     (4), a prescribing provider may access information in the electronic verification system
3353     regarding a patient the prescribing provider treats.
3354          (5) The department may release limited data that the system collects for the purpose of:
3355          (a) conducting medical and other department approved research;
3356          (b) providing the report required by Section [26-61a-703] 26B-4-222; and
3357          (c) other official department purposes.
3358          (6) The department shall make rules, in accordance with Title 63G, Chapter 3, Utah
3359     Administrative Rulemaking Act, to establish:
3360          (a) the limitations on access to the data in the state electronic verification system as
3361     described in this section; and
3362          (b) standards and procedures to ensure accurate identification of an individual
3363     requesting information or receiving information in this section.
3364          (7) (a) Any person who knowingly and intentionally releases any information in the
3365     state electronic verification system in violation of this section is guilty of a third degree felony.
3366          (b) Any person who negligently or recklessly releases any information in the state
3367     electronic verification system in violation of this section is guilty of a class C misdemeanor.
3368          (8) (a) Any person who obtains or attempts to obtain information from the state
3369     electronic verification system by misrepresentation or fraud is guilty of a third degree felony.
3370          (b) Any person who obtains or attempts to obtain information from the state electronic
3371     verification system for a purpose other than a purpose this [chapter] part authorizes is guilty of
3372     a third degree felony.
3373          (9) (a) Except as provided in Subsection (9)(e), a person may not knowingly and
3374     intentionally use, release, publish, or otherwise make available to any other person information
3375     obtained from the state electronic verification system for any purpose other than a purpose

3376     specified in this section.
3377          (b) Each separate violation of this Subsection (9) is:
3378          (i) a third degree felony; and
3379          (ii) subject to a civil penalty not to exceed $5,000.
3380          (c) The department shall determine a civil violation of this Subsection (9) in
3381     accordance with Title 63G, Chapter 4, Administrative Procedures Act.
3382          (d) Civil penalties assessed under this Subsection (9) shall be deposited into the
3383     General Fund.
3384          (e) This Subsection (9) does not prohibit a person who obtains information from the
3385     state electronic verification system under Subsection (2)(a), (c), or (f) from:
3386          (i) including the information in the person's medical chart or file for access by a person
3387     authorized to review the medical chart or file;
3388          (ii) providing the information to a person in accordance with the requirements of the
3389     Health Insurance Portability and Accountability Act of 1996; or
3390          (iii) discussing or sharing that information about the patient with the patient.
3391          Section 61. Section 26B-4-203, which is renumbered from Section 26-61a-104 is
3392     renumbered and amended to read:
3393          [26-61a-104].      26B-4-203. Qualifying condition.
3394          (1) By designating a particular condition under Subsection (2) for which the use of
3395     medical cannabis to treat symptoms is decriminalized, the Legislature does not conclusively
3396     state that:
3397          (a) current scientific evidence clearly supports the efficacy of a medical cannabis
3398     treatment for the condition; or
3399          (b) a medical cannabis treatment will treat, cure, or positively affect the condition.
3400          (2) For the purposes of this [chapter] part, each of the following conditions is a
3401     qualifying condition:
3402          (a) HIV or acquired immune deficiency syndrome;
3403          (b) Alzheimer's disease;
3404          (c) amyotrophic lateral sclerosis;
3405          (d) cancer;
3406          (e) cachexia;

3407          (f) persistent nausea that is not significantly responsive to traditional treatment, except
3408     for nausea related to:
3409          (i) pregnancy;
3410          (ii) cannabis-induced cyclical vomiting syndrome; or
3411          (iii) cannabinoid hyperemesis syndrome;
3412          (g) Crohn's disease or ulcerative colitis;
3413          (h) epilepsy or debilitating seizures;
3414          (i) multiple sclerosis or persistent and debilitating muscle spasms;
3415          (j) post-traumatic stress disorder that is being treated and monitored by a licensed
3416     mental health therapist, as that term is defined in Section 58-60-102, and that:
3417          (i) has been diagnosed by a healthcare provider or mental health provider employed or
3418     contracted by the United States Veterans Administration, evidenced by copies of medical
3419     records from the United States Veterans Administration that are included as part of the
3420     qualified medical provider's pre-treatment assessment and medical record documentation; or
3421          (ii) has been diagnosed or confirmed, through face-to-face or telehealth evaluation of
3422     the patient, by a provider who is:
3423          (A) a licensed board-eligible or board-certified psychiatrist;
3424          (B) a licensed psychologist with a master's-level degree;
3425          (C) a licensed clinical social worker with a master's-level degree; or
3426          (D) a licensed advanced practice registered nurse who is qualified to practice within
3427     the psychiatric mental health nursing specialty and who has completed the clinical practice
3428     requirements in psychiatric mental health nursing, including in psychotherapy, in accordance
3429     with Subsection 58-31b-302(5)(g);
3430          (k) autism;
3431          (l) a terminal illness when the patient's remaining life expectancy is less than six
3432     months;
3433          (m) a condition resulting in the individual receiving hospice care;
3434          (n) a rare condition or disease that:
3435          (i) affects less than 200,000 individuals in the United States, as defined in Section 526
3436     of the Federal Food, Drug, and Cosmetic Act; and
3437          (ii) is not adequately managed despite treatment attempts using:

3438          (A) conventional medications other than opioids or opiates; or
3439          (B) physical interventions;
3440          (o) pain lasting longer than two weeks that is not adequately managed, in the qualified
3441     medical provider's opinion, despite treatment attempts using:
3442          (i) conventional medications other than opioids or opiates; or
3443          (ii) physical interventions;
3444          (p) pain that is expected to last for two weeks or longer for an acute condition,
3445     including a surgical procedure, for which a medical professional may generally prescribe
3446     opioids for a limited duration, subject to Subsection [26-61a-201] 26B-4-213(5)(c); and
3447          (q) a condition that the Compassionate Use Board approves under Section
3448     [26-61a-105] 26B-1-421, on an individual, case-by-case basis.
3449          Section 62. Section 26B-4-204, which is renumbered from Section 26-61a-106 is
3450     renumbered and amended to read:
3451          [26-61a-106].      26B-4-204. Qualified medical provider registration --
3452     Continuing education -- Treatment recommendation -- Limited medical provider.
3453          (1) (a) (i) Except as provided in Subsection (1)(b), an individual may not recommend a
3454     medical cannabis treatment unless the department registers the individual as a qualified
3455     medical provider in accordance with this section.
3456          (ii) Notwithstanding Subsection (1)(a)(i), a qualified medical provider who is podiatrist
3457     licensed under Title 58, Chapter 5a, Podiatric Physician Licensing Act, may not recommend a
3458     medical cannabis treatment except within the course and scope of a practice of podiatry, as that
3459     term is defined in Section 58-5a-102.
3460          (b) Beginning on the earlier of September 1, 2021, or the date on which the department
3461     gives notice that the electronic verification system is functionally capable as described in
3462     Subsection [26-61a-103] 26B-4-202(2)(d), an individual who meets the recommending
3463     qualifications may recommend a medical cannabis treatment as a limited medical provider
3464     without registering under Subsection (1)(a) if:
3465          (i) the individual recommends the use of medical cannabis to the patient through an
3466     order described in Subsection (1)(c) after:
3467          (A) a face-to-face visit for an initial recommendation or the renewal of a
3468     recommendation for a patient for whom the limited medical provider did not make the patient's

3469     original recommendation; or
3470          (B) a visit using telehealth services for a renewal of a recommendation for a patient for
3471     whom the limited medical provider made the patient's original recommendation; and
3472          (ii) the individual's recommendation or renewal would not cause the total number of
3473     the individual's patients who have a valid medical cannabis patient card or provisional patient
3474     card resulting from the individual's recommendation to exceed 15.
3475          (c) The individual described in Subsection (1)(b) shall communicate the individual's
3476     recommendation through an order for the medical cannabis pharmacy to record the individual's
3477     recommendation or renewal in the state electronic verification system under the individual's
3478     recommendation that:
3479          (i) (A) that the individual or the individual's employee sends electronically to a medical
3480     cannabis pharmacy; or
3481          (B) that the individual gives to the patient in writing for the patient to deliver to a
3482     medical cannabis pharmacy; and
3483          (ii) may include:
3484          (A) directions of use or dosing guidelines; and
3485          (B) an indication of a need for a caregiver in accordance with Subsection [26-61a-201]
3486     26B-4-213(3)(c).
3487          (d) If the limited medical provider gives the patient a written recommendation to
3488     deliver to a medical cannabis pharmacy under Subsection (1)(c)(i)(B), the limited medical
3489     provider shall ensure that the document includes all of the information that is included on a
3490     prescription the provider would issue for a controlled substance, including:
3491          (i) the date of issuance;
3492          (ii) the provider's name, address and contact information, controlled substance license
3493     information, and signature; and
3494          (iii) the patient's name, address and contact information, age, and diagnosed qualifying
3495     condition.
3496          (e) In considering making a recommendation as a limited medical provider, an
3497     individual may consult information that the department makes available on the department's
3498     website for recommending providers.
3499          (2) (a) The department shall, within 15 days after the day on which the department

3500     receives an application from an individual, register and issue a qualified medical provider
3501     registration card to the individual if the individual:
3502          (i) provides to the department the individual's name and address;
3503          (ii) provides to the department a report detailing the individual's completion of the
3504     applicable continuing education requirement described in Subsection (3);
3505          (iii) provides to the department evidence that the individual meets the recommending
3506     qualifications;
3507          (iv) for an applicant on or after November 1, 2021, provides to the department the
3508     information described in Subsection (10)(a); and
3509          (v) pays the department a fee in an amount that:
3510          (A) the department sets, in accordance with Section 63J-1-504; and
3511          (B) does not exceed $300 for an initial registration.
3512          (b) The department may not register an individual as a qualified medical provider if the
3513     individual is:
3514          (i) a pharmacy medical provider; or
3515          (ii) an owner, officer, director, board member, employee, or agent of a cannabis
3516     production establishment, a medical cannabis pharmacy, or a medical cannabis courier.
3517          (3) (a) An individual shall complete the continuing education described in this
3518     Subsection (3) in the following amounts:
3519          (i) for an individual as a condition precedent to registration, four hours; and
3520          (ii) for a qualified medical provider as a condition precedent to renewal, four hours
3521     every two years.
3522          (b) In accordance with Subsection (3)(a), a qualified medical provider shall:
3523          (i) complete continuing education:
3524          (A) regarding the topics described in Subsection (3)(d); and
3525          (B) offered by the department under Subsection (3)(c) or an accredited or approved
3526     continuing education provider that the department recognizes as offering continuing education
3527     appropriate for the recommendation of cannabis to patients; and
3528          (ii) make a continuing education report to the department in accordance with a process
3529     that the department establishes by rule, in accordance with Title 63G, Chapter 3, Utah
3530     Administrative Rulemaking Act, and in collaboration with the Division of Professional

3531     Licensing and:
3532          (A) for a podiatrist licensed under Title 58, Chapter 5a, Podiatric Physician Licensing
3533     Act, the Podiatric Physician Board;
3534          (B) for an advanced practice registered nurse licensed under Title 58, Chapter 31b,
3535     Nurse Practice Act, the Board of Nursing;
3536          (C) for a qualified medical provider licensed under Title 58, Chapter 67, Utah Medical
3537     Practice Act, the Physicians Licensing Board;
3538          (D) for a qualified medical provider licensed under Title 58, Chapter 68, Utah
3539     Osteopathic Medical Practice Act, the Osteopathic Physician and Surgeon's Licensing Board;
3540     and
3541          (E) for a physician assistant licensed under Title 58, Chapter 70a, Utah Physician
3542     Assistant Act, the Physician Assistant Licensing Board.
3543          (c) The department may, in consultation with the Division of Professional Licensing,
3544     develop the continuing education described in this Subsection (3).
3545          (d) The continuing education described in this Subsection (3) may discuss:
3546          (i) the provisions of this [chapter] part;
3547          (ii) general information about medical cannabis under federal and state law;
3548          (iii) the latest scientific research on the endocannabinoid system and medical cannabis,
3549     including risks and benefits;
3550          (iv) recommendations for medical cannabis as it relates to the continuing care of a
3551     patient in pain management, risk management, potential addiction, or palliative care; and
3552          (v) best practices for recommending the form and dosage of medical cannabis products
3553     based on the qualifying condition underlying a medical cannabis recommendation.
3554          (4) (a) Except as provided in Subsection (4)(b), a qualified medical provider may not
3555     recommend a medical cannabis treatment to more than 275 of the qualified medical provider's
3556     patients at the same time, as determined by the number of medical cannabis cards under the
3557     qualified medical provider's name in the state electronic verification system.
3558          (b) A qualified medical provider may recommend a medical cannabis treatment to up to
3559     600 of the qualified medical provider's patients at any given time, as determined by the number
3560     of medical cannabis cards under the qualified medical provider's name in the state electronic
3561     verification system, if:

3562          (i) the appropriate American medical board has certified the qualified medical provider
3563     in the specialty of anesthesiology, gastroenterology, neurology, oncology, pain, hospice and
3564     palliative medicine, physical medicine and rehabilitation, rheumatology, endocrinology, or
3565     psychiatry; or
3566          (ii) a licensed business employs or contracts with the qualified medical provider for the
3567     specific purpose of providing hospice and palliative care.
3568          (5) A recommending medical provider may recommend medical cannabis to an
3569     individual under this [chapter] part only in the course of a provider-patient relationship after
3570     the recommending medical provider has completed and documented in the patient's medical
3571     record a thorough assessment of the patient's condition and medical history based on the
3572     appropriate standard of care for the patient's condition.
3573          (6) (a) Except as provided in Subsection (6)(b), an individual may not advertise that the
3574     individual recommends a medical cannabis treatment.
3575          (b) Notwithstanding Subsection (6)(a) and subject to Section [26-61a-116] 26B-4-223,
3576     a qualified medical provider or clinic or office that employs a qualified medical provider may
3577     advertise the following:
3578          (i) a green cross;
3579          (ii) the provider's or clinic's name and logo;
3580          (iii) a qualifying condition that the individual treats;
3581          (iv) that the individual is registered as a qualified medical provider and recommends
3582     medical cannabis; or
3583          (v) a scientific study regarding medical cannabis use.
3584          (7) (a) A qualified medical provider registration card expires two years after the day on
3585     which the department issues the card.
3586          (b) The department shall renew a qualified medical provider's registration card if the
3587     provider:
3588          (i) applies for renewal;
3589          (ii) is eligible for a qualified medical provider registration card under this section,
3590     including maintaining an unrestricted license under the recommending qualifications;
3591          (iii) certifies to the department in a renewal application that the information in
3592     Subsection (2)(a) is accurate or updates the information;

3593          (iv) submits a report detailing the completion of the continuing education requirement
3594     described in Subsection (3); and
3595          (v) pays the department a fee in an amount that:
3596          (A) the department sets, in accordance with Section 63J-1-504; and
3597          (B) does not exceed $50 for a registration renewal.
3598          (8) The department may revoke the registration of a qualified medical provider who
3599     fails to maintain compliance with the requirements of this section.
3600          (9) A recommending medical provider may not receive any compensation or benefit for
3601     the qualified medical provider's medical cannabis treatment recommendation from:
3602          (a) a cannabis production establishment or an owner, officer, director, board member,
3603     employee, or agent of a cannabis production establishment;
3604          (b) a medical cannabis pharmacy or an owner, officer, director, board member,
3605     employee, or agent of a medical cannabis pharmacy; or
3606          (c) a recommending medical provider or pharmacy medical provider.
3607          (10) (a) On or before November 1, 2021, a qualified medical provider shall report to
3608     the department, in a manner designated by the department:
3609          (i) if applicable, that the qualified medical provider or the entity that employs the
3610     qualified medical provider represents online or on printed material that the qualified medical
3611     provider is a qualified medical provider or offers medical cannabis recommendations to
3612     patients; and
3613          (ii) the fee amount that the qualified medical provider or the entity that employs the
3614     qualified medical provider charges a patient for a medical cannabis recommendation, either as
3615     an actual cash rate or, if the provider or entity bills insurance, an average cash rate.
3616          (b) The department shall:
3617          (i) ensure that the following information related to qualified medical providers and
3618     entities described in Subsection (10)(a)(i) is available on the department's website or on the
3619     health care price transparency tool under Subsection (10)(b)(ii):
3620          (A) the name of the qualified medical provider and, if applicable, the name of the
3621     entity that employs the qualified medical provider;
3622          (B) the address of the qualified medical provider's office or, if applicable, the entity
3623     that employs the qualified medical provider; and

3624          (C) the fee amount described in Subsection (10)(a)(ii); and
3625          (ii) share data collected under this Subsection (10) with the state auditor for use in the
3626     health care price transparency tool described in Section 67-3-11.
3627          Section 63. Section 26B-4-205, which is renumbered from Section 26-61a-107 is
3628     renumbered and amended to read:
3629          [26-61a-107].      26B-4-205. Standard of care -- Physicians and pharmacists
3630     not liable -- No private right of action.
3631          (1) An individual described in Subsection (2) is not subject to the following solely for
3632     violating a federal law or regulation that would otherwise prohibit recommending, prescribing,
3633     or dispensing medical cannabis, a medical cannabis product, or a cannabis-based drug that the
3634     United States Food and Drug Administration has not approved:
3635          (a) civil or criminal liability; or
3636          (b) licensure sanctions under Title 58, Chapter 17b, Pharmacy Practice Act, Title 58,
3637     Chapter 31b, Nurse Practice Act, Title 58, Chapter 67, Utah Medical Practice Act, Title 58,
3638     Chapter 68, Utah Osteopathic Medical Practice Act, or Title 58, Chapter 70a, Utah Physician
3639     Assistant Act.
3640          (2) The limitations of liability described in Subsection (1) apply to:
3641          (a) a podiatrist licensed under Title 58, Chapter 5a, Podiatric Physician Licensing Act,
3642     an advanced practice registered nurse licensed under Title 58, Chapter 31b, Nurse Practice Act,
3643     a physician licensed under Title 58, Chapter 67, Utah Medical Practice Act, or Title 58,
3644     Chapter 68, Utah Osteopathic Medical Practice Act, or a physician assistant licensed under
3645     Title 58, Chapter 70a, Utah Physician Assistant Act:
3646          (i) (A) whom the department has registered as a qualified medical provider; or
3647          (B) who makes a recommendation as a limited medical provider; and
3648          (ii) who recommends treatment with cannabis in a medicinal dosage form or a cannabis
3649     product in a medicinal dosage form to a patient in accordance with this [chapter] part; and
3650          (b) a pharmacist licensed under Title 58, Chapter 17b, Pharmacy Practice Act:
3651          (i) whom the department has registered as a pharmacy medical provider; and
3652          (ii) who dispenses, in a medical cannabis pharmacy, treatment with cannabis in a
3653     medicinal dosage form or a cannabis product in a medicinal dosage form to a medical cannabis
3654     cardholder in accordance with this [chapter] part.

3655          (3) Nothing in this section or [chapter] part reduces or in any way negates the duty of
3656     an individual described in Subsection (2) to use reasonable and ordinary care in the treatment
3657     of a patient:
3658          (a) who may have a qualifying condition; and
3659          (b) (i) for whom the individual described in Subsection (2)(a)(i) or (ii) has
3660     recommended or might consider recommending a treatment with cannabis or a cannabis
3661     product; or
3662          (ii) with whom the pharmacist described in Subsection (2)(b) has interacted in the
3663     dosing or dispensing of cannabis or a cannabis product.
3664          (4) (a) As used in this Subsection (4), "healthcare facility" means [the same as that
3665     term] health care facility as is defined in Section [26-21-2] 26B-2-201.
3666          (b) A healthcare facility may adopt restrictions on the possession, use, and storage of
3667     medical cannabis on the premises of the healthcare facility by a medical cannabis cardholder
3668     who resides at or is actively receiving treatment or care at the healthcare facility.
3669          (c) An employee or agent of a healthcare facility described in this Subsection (4) is not
3670     subject to civil or criminal liability for carrying out employment duties, including:
3671          (i) providing or supervising care to a medical cannabis cardholder; or
3672          (ii) in accordance with a caregiver designation under Section [26-61a-202] 26B-4-214
3673     for a medical cannabis cardholder residing at the healthcare facility, purchasing, transporting,
3674     or possessing medical cannabis for the relevant patient and in accordance with the designation.
3675          (d) Nothing in this section requires a healthcare facility to adopt a restriction under
3676     Subsection (4)(b).
3677          Section 64. Section 26B-4-206, which is renumbered from Section 26-61a-108 is
3678     renumbered and amended to read:
3679          [26-61a-108].      26B-4-206. Agreement with a tribe.
3680          (1) As used in this section, "tribe" means a federally recognized Indian tribe or Indian
3681     band.
3682          (2) (a) In accordance with this section, the governor may enter into an agreement with a
3683     tribe to allow for the operation of a medical cannabis pharmacy on tribal land located within
3684     the state.
3685          (b) An agreement described in Subsection (2)(a) may not exempt any person from the

3686     requirements of this [chapter] part.
3687          (c) The governor shall ensure that an agreement described in Subsection (2)(a):
3688          (i) is in writing;
3689          (ii) is signed by:
3690          (A) the governor; and
3691          (B) the governing body of the tribe that the tribe designates and has the authority to
3692     bind the tribe to the terms of the agreement;
3693          (iii) states the effective date of the agreement;
3694          (iv) provides that the governor shall renegotiate the agreement if the agreement is or
3695     becomes inconsistent with a state statute; and
3696          (v) includes any accommodation that the tribe makes:
3697          (A) to which the tribe agrees; and
3698          (B) that is reasonably related to the agreement.
3699          (d) Before executing an agreement under this Subsection (2), the governor shall consult
3700     with the department.
3701          (e) At least 30 days before the execution of an agreement described in this Subsection
3702     (2), the governor or the governor's designee shall provide a copy of the agreement in the form
3703     in which the agreement will be executed to:
3704          (i) the chairs of the Native American Legislative Liaison Committee; and
3705          (ii) the Office of Legislative Research and General Counsel.
3706          Section 65. Section 26B-4-207, which is renumbered from Section 26-61a-111 is
3707     renumbered and amended to read:
3708          [26-61a-111].      26B-4-207. Nondiscrimination for medical care or
3709     government employment -- Notice to prospective and current public employees -- No
3710     effect on private employers.
3711          (1) For purposes of medical care, including an organ or tissue transplant, a patient's
3712     use, in accordance with this [chapter] part, of cannabis in a medicinal dosage form or a
3713     cannabis product in a medicinal dosage form:
3714          (a) is considered the equivalent of the authorized use of any other medication used at
3715     the discretion of a physician; and
3716          (b) does not constitute the use of an illicit substance or otherwise disqualify an

3717     individual from needed medical care.
3718          (2) (a) Notwithstanding any other provision of law and except as provided in
3719     Subsection (2)(b), the state or any political subdivision shall treat:
3720          (i) an employee's use of medical cannabis in accordance with this [chapter] part or
3721     Section 58-37-3.7 in the same way the state or political subdivision treats employee use of any
3722     prescribed controlled substance; and
3723          (ii) an employee's status as a medical cannabis cardholder or an employee's medical
3724     cannabis recommendation from a qualified medical provider or limited provider in the same
3725     way the state or political subdivision treats an employee's prescriptions for any prescribed
3726     controlled substance.
3727          (b) A state or political subdivision employee who has a valid medical cannabis card is
3728     not subject to retaliatory action, as that term is defined in Section 67-19a-101, for failing a drug
3729     test due to marijuana or tetrahydrocannabinol without evidence that the employee was impaired
3730     or otherwise adversely affected in the employee's job performance due to the use of medical
3731     cannabis.
3732          (c) Subsections (2)(a) and (b) do not apply:
3733          (i) where the application of Subsection (2)(a) or (b) would jeopardize federal funding, a
3734     federal security clearance, or any other federal background determination required for the
3735     employee's position;
3736          (ii) if the employee's position is dependent on a license or peace officer certification
3737     that is subject to federal regulations, including 18 U.S.C. Sec. 922(g)(3); or
3738          (iii) if an employee described in Subsections 34A-2-102(1)(h)(ii) through (vi) uses
3739     medical cannabis during the 12 hours immediately preceding the employee's shift or during the
3740     employee's shift.
3741          (3) (a) (i) A state employer or a political subdivision employer shall take the action
3742     described in Subsection (3)(a)(ii) before:
3743          (A) giving to a current employee an assignment or duty that arises from or directly
3744     relates to an obligation under this [chapter] part; or
3745          (B) hiring a prospective employee whose assignments or duties would include an
3746     assignment or duty that arises from or directly relates to an obligation under this [chapter] part.
3747          (ii) The employer described in Subsection (3)(a)(i) shall give the employee or

3748     prospective employee described in Subsection (3)(a)(i) a written notice that notifies the
3749     employee or prospective employee:
3750          (A) that the employee's or prospective employee's job duties may require the employee
3751     or prospective employee to engage in conduct which is in violation of the criminal laws of the
3752     United States; and
3753          (B) that in accepting a job or undertaking a duty described in Subsection (3)(a)(i),
3754     although the employee or prospective employee is entitled to the protections of Title 67,
3755     Chapter 21, Utah Protection of Public Employees Act, the employee may not object or refuse to
3756     carry out an assignment or duty that may be a violation of the criminal laws of the United
3757     States with respect to the manufacture, sale, or distribution of cannabis.
3758          (b) The Division of Human Resource Management shall create, revise, and publish the
3759     form of the notice described in Subsection (3)(a).
3760          (c) Notwithstanding Subsection 67-21-3(3), an employee who has signed the notice
3761     described in Subsection (3)(a) may not:
3762          (i) claim in good faith that the employee's actions violate or potentially violate the laws
3763     of the United States with respect to the manufacture, sale, or distribution of cannabis; or
3764          (ii) refuse to carry out a directive that the employee reasonably believes violates the
3765     criminal laws of the United States with respect to the manufacture, sale, or distribution of
3766     cannabis.
3767          (d) An employer may not take retaliatory action as defined in Section 67-19a-101
3768     against a current employee who refuses to sign the notice described in Subsection (3)(a).
3769          (4) Nothing in this section requires a private employer to accommodate the use of
3770     medical cannabis or affects the ability of a private employer to have policies restricting the use
3771     of medical cannabis by applicants or employees.
3772          Section 66. Section 26B-4-208, which is renumbered from Section 26-61a-112 is
3773     renumbered and amended to read:
3774          [26-61a-112].      26B-4-208. No insurance requirement.
3775          Nothing in this [chapter] part requires an insurer, a third-party administrator, or an
3776     employer to pay or reimburse for cannabis, a cannabis product, or a medical cannabis device.
3777          Section 67. Section 26B-4-209, which is renumbered from Section 26-61a-113 is
3778     renumbered and amended to read:

3779          [26-61a-113].      26B-4-209. No effect on use of hemp extract -- Cannabidiol --
3780     Approved drugs.
3781          (1) Nothing in this [chapter] part prohibits an individual from purchasing, selling,
3782     possessing, or using a cannabinoid product in accordance with Section 4-41-402.
3783          (2) Nothing in this [chapter] part restricts or otherwise affects the prescription,
3784     distribution, or dispensing of a product that the United States Food and Drug Administration
3785     has approved.
3786          Section 68. Section 26B-4-210, which is renumbered from Section 26-61a-114 is
3787     renumbered and amended to read:
3788          [26-61a-114].      26B-4-210. Severability clause.
3789          (1) If any provision of this title or Laws of Utah 2018, Third Special Session, Chapter 1
3790     or the application of any provision of this title or Laws of Utah 2018, Third Special Session,
3791     Chapter 1 to any person or circumstance is held invalid by a final decision of a court of
3792     competent jurisdiction, the remaining provisions of this title and Laws of Utah 2018, Third
3793     Special Session, Chapter 1 remain effective without the invalidated provision or application.
3794          (2) The provisions of this title and Laws of Utah 2018, Third Special Session, Chapter
3795     1 are severable.
3796          Section 69. Section 26B-4-211, which is renumbered from Section 26-61a-115 is
3797     renumbered and amended to read:
3798          [26-61a-115].      26B-4-211. Analogous to prescribed controlled substances.
3799          When an employee, officer, or agent of the state or a political subdivision makes a
3800     finding, determination, or otherwise considers an individual's possession or use of cannabis, a
3801     cannabis product, or a medical cannabis device, the employee, officer, or agent may not
3802     consider the individual's possession or use any differently than the lawful possession or use of
3803     any prescribed controlled substance, if the individual's possession or use complies with:
3804          (1) this [chapter] part;
3805          (2) Title 4, Chapter 41a, Cannabis Production Establishments; or
3806          (3) Subsection 58-37-3.7(2) or (3).
3807          Section 70. Section 26B-4-212, which is renumbered from Section 26-61-103 is
3808     renumbered and amended to read:
3809          [26-61-103].      26B-4-212. Institutional review board -- Approved study of

3810     cannabis, a cannabinoid product, or an expanded cannabinoid product.
3811          (1) As used in this section:
3812          (a) "Approved study" means a medical research study:
3813          (i) the purpose of which is to investigate the medical benefits and risks of cannabinoid
3814     products; and
3815          (ii) that is approved by an IRB.
3816          (b) "Board" means the Cannabis Research Review Board created in Section 26B-1-
3817     420
.
3818          (c) "Cannabinoid product" means the same as that term is defined in Section 58-37-3.6.
3819          (d) "Cannabis" means the same as that term is defined in Section 58-37-3.6.
3820          (e) "Expanded cannabinoid product" means the same as that term is defined in Section
3821     58-37-3.6.
3822          (f) "Institutional review board" or "IRB" means an institutional review board that is
3823     registered for human subject research by the United States Department of Health and Human
3824     Services.
3825          [(1)] (2) A person conducting an approved study may, for the purposes of the study:
3826          (a) process a cannabinoid product or an expanded cannabinoid product;
3827          (b) possess a cannabinoid product or an expanded cannabinoid product; and
3828          (c) administer a cannabinoid product, or an expanded cannabinoid product to an
3829     individual in accordance with the approved study.
3830          [(2)] (3) A person conducting an approved study may:
3831          (a) import cannabis, a cannabinoid product, or an expanded cannabinoid product from
3832     another state if:
3833          (i) the importation complies with federal law; and
3834          (ii) the person uses the cannabis, cannabinoid product, or expanded cannabinoid
3835     product in accordance with the approved study; or
3836          (b) obtain cannabis, a cannabinoid product, or an expanded cannabinoid product from
3837     the National Institute on Drug Abuse.
3838          [(3)] (4) A person conducting an approved study may distribute cannabis, a
3839     cannabinoid product, or an expanded cannabinoid product outside the state if:
3840          (a) the distribution complies with federal law; and

3841          (b) the distribution is for the purposes of, and in accordance with, the approved study.
3842          Section 71. Section 26B-4-213, which is renumbered from Section 26-61a-201 is
3843     renumbered and amended to read:
3844          [26-61a-201].      26B-4-213. Medical cannabis patient card -- Medical
3845     cannabis guardian card -- Conditional medical cannabis card -- Application -- Fees --
3846     Studies.
3847          (1) (a) The department shall, within 15 days after the day on which an individual who
3848     satisfies the eligibility criteria in this section or Section [26-61a-202] 26B-4-214 submits an
3849     application in accordance with this section or Section [26-61a-202] 26B-4-214:
3850          (i) issue a medical cannabis patient card to an individual described in Subsection
3851     (2)(a);
3852          (ii) issue a medical cannabis guardian card to an individual described in Subsection
3853     (2)(b);
3854          (iii) issue a provisional patient card to a minor described in Subsection (2)(c); and
3855          (iv) issue a medical cannabis caregiver card to an individual described in Subsection
3856     [26-61a-202] 26B-4-214(4).
3857          (b) (i) Beginning on the earlier of September 1, 2021, or the date on which the
3858     electronic verification system is functionally capable of facilitating a conditional medical
3859     cannabis card under this Subsection (1)(b), upon the entry of a recommending medical
3860     provider's medical cannabis recommendation for a patient in the state electronic verification
3861     system, either by the provider or the provider's employee or by a medical cannabis pharmacy
3862     medical provider or medical cannabis pharmacy in accordance with Subsection [26-61a-501]
3863     26B-4-229(10)(a), the department shall issue to the patient an electronic conditional medical
3864     cannabis card, in accordance with this Subsection (1)(b).
3865          (ii) A conditional medical cannabis card is valid for the lesser of:
3866          (A) 60 days; or
3867          (B) the day on which the department completes the department's review and issues a
3868     medical cannabis card under Subsection (1)(a), denies the patient's medical cannabis card
3869     application, or revokes the conditional medical cannabis card under Subsection (8).
3870          (iii) The department may issue a conditional medical cannabis card to an individual
3871     applying for a medical cannabis patient card for which approval of the Compassionate Use

3872     Board is not required.
3873          (iv) An individual described in Subsection (1)(b)(iii) has the rights, restrictions, and
3874     obligations under law applicable to a holder of the medical cannabis card for which the
3875     individual applies and for which the department issues the conditional medical cannabis card.
3876          (2) (a) An individual is eligible for a medical cannabis patient card if:
3877          (i) (A) the individual is at least 21 years old; or
3878          (B) the individual is 18, 19, or 20 years old, the individual petitions the Compassionate
3879     Use Board under Section [26-61a-105] 26B-1-421, and the Compassionate Use Board
3880     recommends department approval of the petition;
3881          (ii) the individual is a Utah resident;
3882          (iii) the individual's recommending medical provider recommends treatment with
3883     medical cannabis in accordance with Subsection (4);
3884          (iv) the individual signs an acknowledgment stating that the individual received the
3885     information described in Subsection (9); and
3886          (v) the individual pays to the department a fee in an amount that, subject to Subsection
3887     [26-61a-109] 26B-1-310(5), the department sets in accordance with Section 63J-1-504.
3888          (b) (i) An individual is eligible for a medical cannabis guardian card if the individual:
3889          (A) is at least 18 years old;
3890          (B) is a Utah resident;
3891          (C) is the parent or legal guardian of a minor for whom the minor's qualified medical
3892     provider recommends a medical cannabis treatment, the individual petitions the Compassionate
3893     Use Board under Section [26-61a-105] 26B-1-421, and the Compassionate Use Board
3894     recommends department approval of the petition;
3895          (D) the individual signs an acknowledgment stating that the individual received the
3896     information described in Subsection (9);
3897          (E) pays to the department a fee in an amount that, subject to Subsection [26-61a-109]
3898     26B-1-310(5), the department sets in accordance with Section 63J-1-504, plus the cost of the
3899     criminal background check described in Section [26-61a-203] 26B-4-215; and
3900          (F) the individual has not been convicted of a misdemeanor or felony drug distribution
3901     offense under either state or federal law, unless the individual completed any imposed sentence
3902     six months or more before the day on which the individual applies for a medical cannabis

3903     guardian card.
3904          (ii) The department shall notify the Department of Public Safety of each individual that
3905     the department registers for a medical cannabis guardian card.
3906          (c) (i) A minor is eligible for a provisional patient card if:
3907          (A) the minor has a qualifying condition;
3908          (B) the minor's qualified medical provider recommends a medical cannabis treatment
3909     to address the minor's qualifying condition;
3910          (C) one of the minor's parents or legal guardians petitions the Compassionate Use
3911     Board under Section 26-61a-105, and the Compassionate Use Board recommends department
3912     approval of the petition; and
3913          (D) the minor's parent or legal guardian is eligible for a medical cannabis guardian card
3914     under Subsection (2)(b) or designates a caregiver under Subsection (2)(d) who is eligible for a
3915     medical cannabis caregiver card under Section [26-61a-202] 26B-4-214.
3916          (ii) The department shall automatically issue a provisional patient card to the minor
3917     described in Subsection (2)(c)(i) at the same time the department issues a medical cannabis
3918     guardian card to the minor's parent or legal guardian.
3919          (d) Beginning on the earlier of September 1, 2021, or the date on which the electronic
3920     verification system is functionally capable of servicing the designation, if the parent or legal
3921     guardian of a minor described in Subsections (2)(c)(i)(A) through (C) does not qualify for a
3922     medical cannabis guardian card under Subsection (2)(b), the parent or legal guardian may
3923     designate up to two caregivers in accordance with Subsection [26-61a-202] 26B-4-214(1)(c) to
3924     ensure that the minor has adequate and safe access to the recommended medical cannabis
3925     treatment.
3926          (3) (a) An individual who is eligible for a medical cannabis card described in
3927     Subsection (2)(a) or (b) shall submit an application for a medical cannabis card to the
3928     department:
3929          (i) through an electronic application connected to the state electronic verification
3930     system;
3931          (ii) with the recommending medical provider; and
3932          (iii) with information including:
3933          (A) the applicant's name, gender, age, and address;

3934          (B) the number of the applicant's valid form of photo identification;
3935          (C) for a medical cannabis guardian card, the name, gender, and age of the minor
3936     receiving a medical cannabis treatment under the cardholder's medical cannabis guardian card;
3937     and
3938          (D) for a provisional patient card, the name of the minor's parent or legal guardian who
3939     holds the associated medical cannabis guardian card.
3940          (b) The department shall ensure that a medical cannabis card the department issues
3941     under this section contains the information described in Subsection (3)(a)(iii).
3942          (c) (i) If a recommending medical provider determines that, because of age, illness, or
3943     disability, a medical cannabis patient cardholder requires assistance in administering the
3944     medical cannabis treatment that the recommending medical provider recommends, the
3945     recommending medical provider may indicate the cardholder's need in the state electronic
3946     verification system, either directly or, for a limited medical provider, through the order
3947     described in Subsections [26-61a-106] 26B-4-204(1)(c) and (d).
3948          (ii) If a recommending medical provider makes the indication described in Subsection
3949     (3)(c)(i):
3950          (A) the department shall add a label to the relevant medical cannabis patient card
3951     indicating the cardholder's need for assistance;
3952          (B) any adult who is 18 years old or older and who is physically present with the
3953     cardholder at the time the cardholder needs to use the recommended medical cannabis
3954     treatment may handle the medical cannabis treatment and any associated medical cannabis
3955     device as needed to assist the cardholder in administering the recommended medical cannabis
3956     treatment; and
3957          (C) an individual of any age who is physically present with the cardholder in the event
3958     of an emergency medical condition, as that term is defined in Section 31A-1-301, may handle
3959     the medical cannabis treatment and any associated medical cannabis device as needed to assist
3960     the cardholder in administering the recommended medical cannabis treatment.
3961          (iii) A non-cardholding individual acting under Subsection (3)(c)(ii)(B) or (C) may not:
3962          (A) ingest or inhale medical cannabis;
3963          (B) possess, transport, or handle medical cannabis or a medical cannabis device outside
3964     of the immediate area where the cardholder is present or with an intent other than to provide

3965     assistance to the cardholder; or
3966          (C) possess, transport, or handle medical cannabis or a medical cannabis device when
3967     the cardholder is not in the process of being dosed with medical cannabis.
3968          (4) To recommend a medical cannabis treatment to a patient or to renew a
3969     recommendation, a recommending medical provider shall:
3970          (a) before recommending or renewing a recommendation for medical cannabis in a
3971     medicinal dosage form or a cannabis product in a medicinal dosage form:
3972          (i) verify the patient's and, for a minor patient, the minor patient's parent or legal
3973     guardian's valid form of identification described in Subsection (3)(a);
3974          (ii) review any record related to the patient and, for a minor patient, the patient's parent
3975     or legal guardian in:
3976          (A) for a qualified medical provider, the state electronic verification system; and
3977          (B) the controlled substance database created in Section 58-37f-201; and
3978          (iii) consider the recommendation in light of the patient's qualifying condition, history
3979     of substance use or opioid use disorder, and history of medical cannabis and controlled
3980     substance use during an initial face-to-face visit with the patient; and
3981          (b) state in the recommending medical provider's recommendation that the patient:
3982          (i) suffers from a qualifying condition, including the type of qualifying condition; and
3983          (ii) may benefit from treatment with cannabis in a medicinal dosage form or a cannabis
3984     product in a medicinal dosage form.
3985          (5) (a) Except as provided in Subsection (5)(b) or (c), a medical cannabis card that the
3986     department issues under this section is valid for the lesser of:
3987          (i) an amount of time that the recommending medical provider determines; or
3988          (ii) (A) six months for the first issuance, and, except as provided in Subsection
3989     (5)(a)(ii)(B), for a renewal; or
3990          (B) for a renewal, one year if, after at least one year following the issuance of the
3991     original medical cannabis card, the recommending medical provider determines that the patient
3992     has been stabilized on the medical cannabis treatment and a one-year renewal period is
3993     justified.
3994          (b) (i) A medical cannabis card that the department issues in relation to a terminal
3995     illness described in Section [26-61a-104] 26B-4-203 expires after one year.

3996          (ii) The recommending medical provider may revoke a recommendation that the
3997     provider made in relation to a terminal illness described in Section 26-61a-104 if the medical
3998     cannabis cardholder no longer has the terminal illness.
3999          (c) A medical cannabis card that the department issues in relation to acute pain as
4000     described in Section [26-61a-104] 26B-4-203 expires 30 days after the day on which the
4001     department first issues a conditional or full medical cannabis card.
4002          (6) (a) A medical cannabis patient card or a medical cannabis guardian card is
4003     renewable if:
4004          (i) at the time of renewal, the cardholder meets the requirements of Subsection (2)(a) or
4005     (b); or
4006          (ii) the cardholder received the medical cannabis card through the recommendation of
4007     the Compassionate Use Board under Section [26-61a-105] 26B-1-421.
4008          (b) The recommending medical provider who made the underlying recommendation for
4009     the card of a cardholder described in Subsection (6)(a) may renew the cardholder's card through
4010     phone or video conference with the cardholder, at the recommending medical provider's
4011     discretion.
4012          (c) Before having access to a renewed card, a cardholder under Subsection (2)(a) or (b)
4013     shall pay to the department a renewal fee in an amount that:
4014          (i) subject to Subsection [26-61a-109] 26B-1-310(5), the department sets in accordance
4015     with Section 63J-1-504; and
4016          (ii) may not exceed the cost of the relatively lower administrative burden of renewal in
4017     comparison to the original application process.
4018          (d) If a minor meets the requirements of Subsection (2)(c), the minor's provisional
4019     patient card renews automatically at the time the minor's parent or legal guardian renews the
4020     parent or legal guardian's associated medical cannabis guardian card.
4021          (7) (a) A cardholder under this section shall carry the cardholder's valid medical
4022     cannabis card with the patient's name.
4023          (b) (i) A medical cannabis patient cardholder or a provisional patient cardholder may
4024     purchase, in accordance with this [chapter] part and the recommendation underlying the card,
4025     cannabis in a medicinal dosage form, a cannabis product in a medicinal dosage form, or a
4026     medical cannabis device.

4027          (ii) A cardholder under this section may possess or transport, in accordance with this
4028     [chapter] part and the recommendation underlying the card, cannabis in a medicinal dosage
4029     form, a cannabis product in a medicinal dosage form, or a medical cannabis device.
4030          (iii) To address the qualifying condition underlying the medical cannabis treatment
4031     recommendation:
4032          (A) a medical cannabis patient cardholder or a provisional patient cardholder may use
4033     cannabis in a medicinal dosage form, a medical cannabis product in a medicinal dosage form,
4034     or a medical cannabis device; and
4035          (B) a medical cannabis guardian cardholder may assist the associated provisional
4036     patient cardholder with the use of cannabis in a medicinal dosage form, a medical cannabis
4037     product in a medicinal dosage form, or a medical cannabis device.
4038          (8) The department may revoke a medical cannabis card that the department issues
4039     under this section if the cardholder:
4040          (a) violates this [chapter] part; or
4041          (b) is convicted under state or federal law of, after March 17, 2021, a drug distribution
4042     offense.
4043          (9) The department shall establish by rule, in accordance with Title 63G, Chapter 3,
4044     Utah Administrative Rulemaking Act, a process to provide information regarding the following
4045     to an individual receiving a medical cannabis card:
4046          (a) risks associated with medical cannabis treatment;
4047          (b) the fact that a condition's listing as a qualifying condition does not suggest that
4048     medical cannabis treatment is an effective treatment or cure for that condition, as described in
4049     Subsection [26-61a-104] 26B-4-203(1); and
4050          (c) other relevant warnings and safety information that the department determines.
4051          (10) The department may establish procedures by rule, in accordance with Title 63G,
4052     Chapter 3, Utah Administrative Rulemaking Act, to implement the application and issuance
4053     provisions of this section.
4054          (11) (a) On or before September 1, 2021, the department shall establish by rule, in
4055     accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, a process to allow
4056     an individual from another state to register with the department in order to purchase medical
4057     cannabis or a medical cannabis device from a medical cannabis pharmacy while the individual

4058     is visiting the state.
4059          (b) The department may only provide the registration process described in Subsection
4060     (11)(a):
4061          (i) to a nonresident patient; and
4062          (ii) for no more than two visitation periods per calendar year of up to 21 calendar days
4063     per visitation period.
4064          (12) (a) A person may submit to the department a request to conduct a research study
4065     using medical cannabis cardholder data that the state electronic verification system contains.
4066          (b) The department shall review a request described in Subsection (12)(a) to determine
4067     whether an institutional review board, as that term is defined in Section [26-61-102] 26B-4-
4068     201
, could approve the research study.
4069          (c) At the time an individual applies for a medical cannabis card, the department shall
4070     notify the individual:
4071          (i) of how the individual's information will be used as a cardholder;
4072          (ii) that by applying for a medical cannabis card, unless the individual withdraws
4073     consent under Subsection (12)(d), the individual consents to the use of the individual's
4074     information for external research; and
4075          (iii) that the individual may withdraw consent for the use of the individual's
4076     information for external research at any time, including at the time of application.
4077          (d) An applicant may, through the medical cannabis card application, and a medical
4078     cannabis cardholder may, through the state central patient portal, withdraw the applicant's or
4079     cardholder's consent to participate in external research at any time.
4080          (e) The department may release, for the purposes of a study described in this
4081     Subsection (12), information about a cardholder under this section who consents to participate
4082     under Subsection (12)(c).
4083          (f) If an individual withdraws consent under Subsection (12)(d), the withdrawal of
4084     consent:
4085          (i) applies to external research that is initiated after the withdrawal of consent; and
4086          (ii) does not apply to research that was initiated before the withdrawal of consent.
4087          (g) The department may establish standards for a medical research study's validity, by
4088     rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.

4089          (13) The department shall record the issuance or revocation of a medical cannabis card
4090     under this section in the controlled substance database.
4091          Section 72. Section 26B-4-214, which is renumbered from Section 26-61a-202 is
4092     renumbered and amended to read:
4093          [26-61a-202].      26B-4-214. Medical cannabis caregiver card -- Registration
4094     -- Renewal -- Revocation.
4095          (1) (a) A cardholder described in Section 26-61a-201 may designate, through the state
4096     central patient portal, up to two individuals, or an individual and a facility in accordance with
4097     Subsection (1)(b), to serve as a designated caregiver for the cardholder.
4098          (b) (i) Beginning on the earlier of September 1, 2021, or the date on which the
4099     electronic verification system is functionally capable of servicing the designation, a cardholder
4100     described in Section 26-61a-201 may designate one of the following types of facilities as one of
4101     the caregivers described in Subsection (1)(a):
4102          (A) for a patient or resident, an assisted living facility, as that term is defined in Section
4103     26-21-2;
4104          (B) for a patient or resident, a nursing care facility, as that term is defined in Section
4105     26-21-2; or
4106          (C) for a patient, a general acute hospital, as that term is defined in Section 26-21-2.
4107          (ii) A facility may:
4108          (A) assign one or more employees to assist patients with medical cannabis treatment
4109     under the caregiver designation described in this Subsection (1)(b); and
4110          (B) receive a medical cannabis shipment from a medical cannabis pharmacy or a
4111     medical cannabis courier on behalf of the medical cannabis cardholder within the facility who
4112     designated the facility as a caregiver.
4113          (iii) The department shall make rules to regulate the practice of facilities and facility
4114     employees serving as designated caregivers under this Subsection (1)(b).
4115          (c) A parent or legal guardian described in Subsection 26-61a-201(2)(d), in
4116     consultation with the minor and the minor's qualified medical provider, may designate, through
4117     the state central patient portal, up to two individuals to serve as a designated caregiver for the
4118     minor, if the department determines that the parent or legal guardian is not eligible for a
4119     medical cannabis guardian card under Section 26-61a-201.

4120          (d) (i) Beginning on the earlier of September 1, 2022, or the date on which the
4121     electronic verification system is functionally capable of facilitating a conditional medical
4122     cannabis caregiver card under this Subsection (1)(d), upon the entry of a caregiver designation
4123     under Subsection (1) by a patient with a terminal illness described in Section 26-61a-104, the
4124     department shall issue to the designated caregiver an electronic conditional medical cannabis
4125     caregiver card, in accordance with this Subsection (1)(d).
4126          (ii) A conditional medical cannabis caregiver card is valid for the lesser of:
4127          (A) 60 days; or
4128          (B) the day on which the department completes the department's review and issues a
4129     medical cannabis caregiver card under Subsection (1)(a), denies the patient's medical cannabis
4130     caregiver card application, or revokes the conditional medical cannabis caregiver card under
4131     Subsection (8).
4132          (iii) The department may issue a conditional medical cannabis card to an individual
4133     applying for a medical cannabis patient card for which approval of the Compassionate Use
4134     Board is not required.
4135          (iv) An individual described in Subsection (1)(b)(iii) has the rights, restrictions, and
4136     obligations under law applicable to a holder of the medical cannabis card for which the
4137     individual applies and for which the department issues the conditional medical cannabis card.
4138          (2) An individual that the department registers as a designated caregiver under this
4139     section and a facility described in Subsection (1)(b):
4140          (a) for an individual designated caregiver, may carry a valid medical cannabis caregiver
4141     card;
4142          (b) in accordance with this [chapter] part, may purchase, possess, transport, or assist
4143     the patient in the use of cannabis in a medicinal dosage form, a cannabis product in a medicinal
4144     dosage form, or a medical cannabis device on behalf of the designating medical cannabis
4145     cardholder;
4146          (c) may not charge a fee to an individual to act as the individual's designated caregiver
4147     or for a service that the designated caregiver provides in relation to the role as a designated
4148     caregiver; and
4149          (d) may accept reimbursement from the designating medical cannabis cardholder for
4150     direct costs the designated caregiver incurs for assisting with the designating cardholder's

4151     medicinal use of cannabis.
4152          (3) (a) The department shall:
4153          (i) within 15 days after the day on which an individual submits an application in
4154     compliance with this section, issue a medical cannabis card to the applicant if the applicant:
4155          (A) is designated as a caregiver under Subsection (1);
4156          (B) is eligible for a medical cannabis caregiver card under Subsection (4); and
4157          (C) complies with this section; and
4158          (ii) notify the Department of Public Safety of each individual that the department
4159     registers as a designated caregiver.
4160          (b) The department shall ensure that a medical cannabis caregiver card contains the
4161     information described in Subsections (5)(b) and (3)(c)(i).
4162          (c) If a cardholder described in Section 26-61a-201 designates an individual as a
4163     caregiver who already holds a medical cannabis caregiver card, the individual with the medical
4164     cannabis caregiver card:
4165          (i) shall report to the department the information required of applicants under
4166     Subsection (5)(b) regarding the new designation;
4167          (ii) if the individual makes the report described in Subsection (3)(c)(i), is not required
4168     to file an application for another medical cannabis caregiver card;
4169          (iii) may receive an additional medical cannabis caregiver card in relation to each
4170     additional medical cannabis patient who designates the caregiver; and
4171          (iv) is not subject to an additional background check.
4172          (4) An individual is eligible for a medical cannabis caregiver card if the individual:
4173          (a) is at least 21 years old;
4174          (b) is a Utah resident;
4175          (c) pays to the department a fee in an amount that, subject to Subsection
4176     26-61a-109(5), the department sets in accordance with Section 63J-1-504, plus the cost of the
4177     criminal background check described in Section 26-61a-203;
4178          (d) signs an acknowledgment stating that the applicant received the information
4179     described in Subsection 26-61a-201(9); and
4180          (e) has not been convicted of a misdemeanor or felony drug distribution offense that is
4181     a felony under either state or federal law, unless the individual completes any imposed sentence

4182     two or more years before the day on which the individual submits the application.
4183          (5) An eligible applicant for a medical cannabis caregiver card shall:
4184          (a) submit an application for a medical cannabis caregiver card to the department
4185     through an electronic application connected to the state electronic verification system; and
4186          (b) submit the following information in the application described in Subsection (5)(a):
4187          (i) the applicant's name, gender, age, and address;
4188          (ii) the name, gender, age, and address of the cardholder described in Section
4189     26-61a-201 who designated the applicant;
4190          (iii) if a medical cannabis guardian cardholder designated the caregiver, the name,
4191     gender, and age of the minor receiving a medical cannabis treatment in relation to the medical
4192     cannabis guardian cardholder; and
4193          (iv) any additional information that the department requests to assist in matching the
4194     application with the designating medical cannabis patient.
4195          (6) Except as provided in Subsection (6)(b), a medical cannabis caregiver card that the
4196     department issues under this section is valid for the lesser of:
4197          (a) an amount of time that the cardholder described in Section 26-61a-201 who
4198     designated the caregiver determines; or
4199          (b) the amount of time remaining before the card of the cardholder described in Section
4200     26-61a-201 expires.
4201          (7) (a) If a designated caregiver meets the requirements of Subsection (4), the
4202     designated caregiver's medical cannabis caregiver card renews automatically at the time the
4203     cardholder described in Section 26-61a-201 who designated the caregiver:
4204          (i) renews the cardholder's card; and
4205          (ii) renews the caregiver's designation, in accordance with Subsection (7)(b).
4206          (b) The department shall provide a method in the card renewal process to allow a
4207     cardholder described in Section 26-61a-201 who has designated a caregiver to:
4208          (i) signify that the cardholder renews the caregiver's designation;
4209          (ii) remove a caregiver's designation; or
4210          (iii) designate a new caregiver.
4211          (8) The department may revoke a medical cannabis caregiver card if the designated
4212     caregiver:

4213          (a) violates this [chapter] part; or
4214          (b) is convicted under state or federal law of:
4215          (i) a felony drug distribution offense; or
4216          (ii) after December 3, 2018, a misdemeanor drug distribution offense.
4217          (9) The department shall record the issuance or revocation of a medical cannabis card
4218     under this section in the controlled substance database.
4219          Section 73. Section 26B-4-215, which is renumbered from Section 26-61a-203 is
4220     renumbered and amended to read:
4221          [26-61a-203].      26B-4-215. Designated caregiver -- Guardian -- Criminal
4222     background check.
4223          (1) Except for an applicant reapplying for a medical cannabis card within less than one
4224     year after the expiration of the applicant's previous medical cannabis card, each applicant for a
4225     medical cannabis guardian card under Section [26-61a-201] 26B-4-213 or a medical cannabis
4226     caregiver card under Section [26-61a-202] 26B-4-214 shall:
4227          (a) submit to the department, at the time of application:
4228          (i) a fingerprint card in a form acceptable to the Department of Public Safety; and
4229          (ii) a signed waiver in accordance with Subsection 53-10-108(4) acknowledging the
4230     registration of the applicant's fingerprints in the Federal Bureau of Investigation Next
4231     Generation Identification System's Rap Back Service; and
4232          (b) consent to a fingerprint background check by:
4233          (i) the Bureau of Criminal Identification; and
4234          (ii) the Federal Bureau of Investigation.
4235          (2) The Bureau of Criminal Identification shall:
4236          (a) check the fingerprints the applicant submits under Subsection (1)(a) against the
4237     applicable state, regional, and national criminal records databases, including the Federal
4238     Bureau of Investigation Next Generation Identification System;
4239          (b) report the results of the background check to the department;
4240          (c) maintain a separate file of fingerprints that applicants submit under Subsection
4241     (1)(a) for search by future submissions to the local and regional criminal records databases,
4242     including latent prints;
4243          (d) request that the fingerprints be retained in the Federal Bureau of Investigation Next

4244     Generation Identification System's Rap Back Service for search by future submissions to
4245     national criminal records databases, including the Next Generation Identification System and
4246     latent prints; and
4247          (e) establish a privacy risk mitigation strategy to ensure that the department only
4248     receives notifications for an individual with whom the department maintains an authorizing
4249     relationship.
4250          (3) The department shall:
4251          (a) assess an applicant who submits fingerprints under Subsection (1)(a) a fee in an
4252     amount that the department sets in accordance with Section 63J-1-504 for the services that the
4253     Bureau of Criminal Identification or another authorized agency provides under this section; and
4254          (b) remit the fee described in Subsection (3)(a) to the Bureau of Criminal
4255     Identification.
4256          Section 74. Section 26B-4-216, which is renumbered from Section 26-61a-204 is
4257     renumbered and amended to read:
4258          [26-61a-204].      26B-4-216. Medical cannabis card -- Patient and designated
4259     caregiver requirements -- Rebuttable presumption.
4260          (1) (a) A medical cannabis cardholder who possesses medical cannabis that the
4261     cardholder purchased under this [chapter] part:
4262          (i) shall carry:
4263          (A) at all times the cardholder's medical cannabis card; and
4264          (B) with the medical cannabis, a label that identifies that the medical cannabis was sold
4265     from a licensed medical cannabis pharmacy and includes an identification number that links the
4266     medical cannabis to the inventory control system;
4267          (ii) may possess up to the legal dosage limit of:
4268          (A) unprocessed cannabis in medicinal dosage form; and
4269          (B) a cannabis product in medicinal dosage form;
4270          (iii) may not possess more medical cannabis than described in Subsection (1)(a)(ii);
4271          (iv) may only possess the medical cannabis in the container in which the cardholder
4272     received the medical cannabis from the medical cannabis pharmacy; and
4273          (v) may not alter or remove any label described in Section 4-41a-602 from the
4274     container described in Subsection (1)(a)(iv).

4275          (b) Except as provided in Subsection (1)(c) or (e), a medical cannabis cardholder who
4276     possesses medical cannabis in violation of Subsection (1)(a) is:
4277          (i) guilty of an infraction; and
4278          (ii) subject to a $100 fine.
4279          (c) A medical cannabis cardholder or a nonresident patient who possesses medical
4280     cannabis in an amount that is greater than the legal dosage limit and equal to or less than twice
4281     the legal dosage limit is:
4282          (i) for a first offense:
4283          (A) guilty of an infraction; and
4284          (B) subject to a fine of up to $100; and
4285          (ii) for a second or subsequent offense:
4286          (A) guilty of a class B misdemeanor; and
4287          (B) subject to a fine of $1,000.
4288          (d) An individual who is guilty of a violation described in Subsection (1)(b) or (c) is
4289     not guilty of a violation of Title 58, Chapter 37, Utah Controlled Substances Act, for the
4290     conduct underlying the penalty described in Subsection (1)(b) or (c).
4291          (e) A nonresident patient who possesses medical cannabis that is not in a medicinal
4292     dosage form is:
4293          (i) for a first offense:
4294          (A) guilty of an infraction; and
4295          (B) subject to a fine of up to $100; and
4296          (ii) for a second or subsequent offense, is subject to the penalties described in Title 58,
4297     Chapter 37, Utah Controlled Substances Act.
4298          (f) A medical cannabis cardholder or a nonresident patient who possesses medical
4299     cannabis in an amount that is greater than twice the legal dosage limit is subject to the penalties
4300     described in Title 58, Chapter 37, Utah Controlled Substances Act.
4301          (2) (a) As used in this Subsection (2), "emergency medical condition" means the same
4302     as that term is defined in Section 31A-1-301.
4303          (b) Except as described in Subsection (2)(c), a medical cannabis patient cardholder, a
4304     provisional patient cardholder, or a nonresident patient may not use, in public view, medical
4305     cannabis or a cannabis product.

4306          (c) In the event of an emergency medical condition, an individual described in
4307     Subsection (2)(b) may use, and the holder of a medical cannabis guardian card or a medical
4308     cannabis caregiver card may administer to the cardholder's charge, in public view, cannabis in a
4309     medicinal dosage form or a cannabis product in a medicinal dosage form.
4310          (d) An individual described in Subsection (2)(b) who violates Subsection (2)(b) is:
4311          (i) for a first offense:
4312          (A) guilty of an infraction; and
4313          (B) subject to a fine of up to $100; and
4314          (ii) for a second or subsequent offense:
4315          (A) guilty of a class B misdemeanor; and
4316          (B) subject to a fine of $1,000.
4317          (3) If a medical cannabis cardholder carrying the cardholder's card possesses cannabis
4318     in a medicinal dosage form or a cannabis product in compliance with Subsection (1), or a
4319     medical cannabis device that corresponds with the cannabis or cannabis product:
4320          (a) there is a rebuttable presumption that the cardholder possesses the cannabis,
4321     cannabis product, or medical cannabis device legally; and
4322          (b) there is no probable cause, based solely on the cardholder's possession of the
4323     cannabis in medicinal dosage form, cannabis product in medicinal dosage form, or medical
4324     cannabis device, to believe that the cardholder is engaging in illegal activity.
4325          (4) (a) If a law enforcement officer stops an individual who possesses cannabis in a
4326     medicinal dosage form, a cannabis product in a medicinal dosage form, or a medical cannabis
4327     device, and the individual represents to the law enforcement officer that the individual holds a
4328     valid medical cannabis card, but the individual does not have the medical cannabis card in the
4329     individual's possession at the time of the stop by the law enforcement officer, the law
4330     enforcement officer shall attempt to access the state electronic verification system to determine
4331     whether the individual holds a valid medical cannabis card.
4332          (b) If the law enforcement officer is able to verify that the individual described in
4333     Subsection (4)(a) is a valid medical cannabis cardholder, the law enforcement officer:
4334          (i) may not arrest or take the individual into custody for the sole reason that the
4335     individual is in possession of cannabis in a medicinal dosage form, a cannabis product in a
4336     medicinal dosage form, or a medical cannabis device; and

4337          (ii) may not seize the cannabis, cannabis product, or medical cannabis device.
4338          Section 75. Section 26B-4-217, which is renumbered from Section 26-61a-401 is
4339     renumbered and amended to read:
4340          [26-61a-401].      26B-4-217. Medical cannabis pharmacy agent --
4341     Registration.
4342          (1) An individual may not serve as a medical cannabis pharmacy agent of a medical
4343     cannabis pharmacy unless the department registers the individual as a medical cannabis
4344     pharmacy agent.
4345          (2) A recommending medical provider may not act as a medical cannabis pharmacy
4346     agent, have a financial or voting interest of 2% or greater in a medical cannabis pharmacy, or
4347     have the power to direct or cause the management or control of a medical cannabis pharmacy.
4348          (3) (a) The department shall, within 15 days after the day on which the department
4349     receives a complete application from a medical cannabis pharmacy on behalf of a prospective
4350     medical cannabis pharmacy agent, register and issue a medical cannabis pharmacy agent
4351     registration card to the prospective agent if the medical cannabis pharmacy:
4352          (i) provides to the department:
4353          (A) the prospective agent's name and address;
4354          (B) the name and location of the licensed medical cannabis pharmacy where the
4355     prospective agent seeks to act as the medical cannabis pharmacy agent; and
4356          (C) the submission required under Subsection (3)(b); and
4357          (ii) pays a fee to the department in an amount that, subject to Subsection [26-61a-109]
4358     26B-1-310(5), the department sets in accordance with Section 63J-1-504.
4359          (b) Except for an applicant reapplying for a medical cannabis pharmacy agent
4360     registration card within less than one year after the expiration of the applicant's previous
4361     medical cannabis pharmacy agent registration card, each prospective agent described in
4362     Subsection (3)(a) shall:
4363          (i) submit to the department:
4364          (A) a fingerprint card in a form acceptable to the Department of Public Safety; and
4365          (B) a signed waiver in accordance with Subsection 53-10-108(4) acknowledging the
4366     registration of the prospective agent's fingerprints in the Federal Bureau of Investigation Next
4367     Generation Identification System's Rap Back Service; and

4368          (ii) consent to a fingerprint background check by:
4369          (A) the Bureau of Criminal Identification; and
4370          (B) the Federal Bureau of Investigation.
4371          (c) The Bureau of Criminal Identification shall:
4372          (i) check the fingerprints the prospective agent submits under Subsection (3)(b) against
4373     the applicable state, regional, and national criminal records databases, including the Federal
4374     Bureau of Investigation Next Generation Identification System;
4375          (ii) report the results of the background check to the department;
4376          (iii) maintain a separate file of fingerprints that prospective agents submit under
4377     Subsection (3)(b) for search by future submissions to the local and regional criminal records
4378     databases, including latent prints;
4379          (iv) request that the fingerprints be retained in the Federal Bureau of Investigation Next
4380     Generation Identification System's Rap Back Service for search by future submissions to
4381     national criminal records databases, including the Next Generation Identification System and
4382     latent prints; and
4383          (v) establish a privacy risk mitigation strategy to ensure that the department only
4384     receives notifications for an individual with whom the department maintains an authorizing
4385     relationship.
4386          (d) The department shall:
4387          (i) assess an individual who submits fingerprints under Subsection (3)(b) a fee in an
4388     amount that the department sets in accordance with Section 63J-1-504 for the services that the
4389     Bureau of Criminal Identification or another authorized agency provides under this section; and
4390          (ii) remit the fee described in Subsection (3)(d)(i) to the Bureau of Criminal
4391     Identification.
4392          (4) The department shall designate, on an individual's medical cannabis pharmacy
4393     agent registration card the name of the medical cannabis pharmacy where the individual is
4394     registered as an agent.
4395          (5) A medical cannabis pharmacy agent shall comply with a certification standard that
4396     the department develops in collaboration with the Division of Professional Licensing and the
4397     Board of Pharmacy, or a third-party certification standard that the department designates by
4398     rule, in collaboration with the Division of Professional Licensing and the Board of Pharmacy

4399     and in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
4400          (6) The department shall ensure that the certification standard described in Subsection
4401     (5) includes training in:
4402          (a) Utah medical cannabis law; and
4403          (b) medical cannabis pharmacy best practices.
4404          (7) The department may revoke the medical cannabis pharmacy agent registration card
4405     of, or refuse to issue a medical cannabis pharmacy agent registration card to, an individual
4406     who:
4407          (a) violates the requirements of this [chapter] part; or
4408          (b) is convicted under state or federal law of:
4409          (i) a felony within the preceding 10 years; or
4410          (ii) after December 3, 2018, a misdemeanor for drug distribution.
4411          (8) (a) A medical cannabis pharmacy agent registration card expires two years after the
4412     day on which the department issues or renews the card.
4413          (b) A medical cannabis pharmacy agent may renew the agent's registration card if the
4414     agent:
4415          (i) is eligible for a medical cannabis pharmacy agent registration card under this
4416     section;
4417          (ii) certifies to the department in a renewal application that the information in
4418     Subsection (3)(a) is accurate or updates the information; and
4419          (iii) pays to the department a renewal fee in an amount that:
4420          (A) subject to Subsection [26-61a-109] 26B-1-310(5), the department sets in
4421     accordance with Section 63J-1-504; and
4422          (B) may not exceed the cost of the relatively lower administrative burden of renewal in
4423     comparison to the original application process.
4424          (9) (a) As a condition precedent to registration and renewal of a medical cannabis
4425     pharmacy agent registration card, a medical cannabis pharmacy agent shall:
4426          (i) complete at least one hour of continuing education regarding patient privacy and
4427     federal health information privacy laws that is offered by the department under Subsection
4428     (9)(b) or an accredited or approved continuing education provider that the department
4429     recognizes as offering continuing education appropriate for the medical cannabis pharmacy

4430     practice; and
4431          (ii) make a continuing education report to the department in accordance with a process
4432     that the department establishes by rule, in accordance with Title 63G, Chapter 3, Utah
4433     Administrative Rulemaking Act, and in collaboration with the Division of Professional
4434     Licensing and the Board of Pharmacy.
4435          (b) The department may, in consultation with the Division of Professional Licensing,
4436     develop the continuing education described in this Subsection (9).
4437          (c) The pharmacist-in-charge described in Section [26-61a-403] 26B-4-219 shall
4438     ensure that each medical cannabis pharmacy agent working in the medical cannabis pharmacy
4439     who has access to the state electronic verification system is in compliance with this Subsection
4440     (9).
4441          Section 76. Section 26B-4-218, which is renumbered from Section 26-61a-402 is
4442     renumbered and amended to read:
4443          [26-61a-402].      26B-4-218. Medical cannabis pharmacy agent registration
4444     card -- Rebuttable presumption.
4445          (1) A medical cannabis pharmacy agent shall carry the individual's medical cannabis
4446     pharmacy agent registration card with the individual at all times when:
4447          (a) the individual is on the premises of a medical cannabis pharmacy; and
4448          (b) the individual is transporting cannabis in a medicinal dosage form, a cannabis
4449     product in a medicinal dosage form, or a medical cannabis device between a cannabis
4450     production establishment and a medical cannabis pharmacy.
4451          (2) If an individual handling, at a medical cannabis pharmacy, cannabis in a medicinal
4452     dosage form, a cannabis product in a medicinal dosage form, or a medical cannabis device or
4453     transporting cannabis in a medicinal dosage form, a cannabis product in a medicinal dosage
4454     form, or a medical cannabis device, possesses the cannabis, cannabis product, or medical
4455     cannabis device in compliance with Subsection (1):
4456          (a) there is a rebuttable presumption that the individual possesses the cannabis,
4457     cannabis product, or medical cannabis device legally; and
4458          (b) there is no probable cause, based solely on the individual's possession of the
4459     cannabis in medicinal dosage form, cannabis product in medicinal dosage form, or medical
4460     cannabis device in compliance with Subsection (1), that the individual is engaging in illegal

4461     activity.
4462          (3) (a) A medical cannabis pharmacy agent who fails to carry the agent's medical
4463     cannabis pharmacy agent registration card in accordance with Subsection (1) is:
4464          (i) for a first or second offense in a two-year period:
4465          (A) guilty of an infraction; and
4466          (B) is subject to a $100 fine; or
4467          (ii) for a third or subsequent offense in a two-year period:
4468          (A) guilty of a class C misdemeanor; and
4469          (B) subject to a $750 fine.
4470          (b) (i) The prosecuting entity shall notify the department and the relevant medical
4471     cannabis pharmacy of each conviction under Subsection (3)(a).
4472          (ii) For each violation described in Subsection (3)(a)(ii), the department may assess the
4473     relevant medical cannabis pharmacy a fine of up to $5,000, in accordance with a fine schedule
4474     that the department establishes by rule in accordance with Title 63G, Chapter 3, Utah
4475     Administrative Rulemaking Act.
4476          (c) An individual who is guilty of a violation described in Subsection (3)(a) is not
4477     guilty of a violation of Title 58, Chapter 37, Utah Controlled Substances Act, for the conduct
4478     underlying the violation described in Subsection (3)(a).
4479          Section 77. Section 26B-4-219, which is renumbered from Section 26-61a-403 is
4480     renumbered and amended to read:
4481          [26-61a-403].      26B-4-219. Pharmacy medical providers -- Registration --
4482     Continuing education.
4483          (1) (a) A medical cannabis pharmacy:
4484          (i) shall employ a pharmacist who is licensed under Title 58, Chapter 17b, Pharmacy
4485     Practice Act, as a pharmacy medical provider;
4486          (ii) may employ a physician who has the authority to write a prescription and is
4487     licensed under Title 58, Chapter 67, Utah Medical Practice Act, or Title 58, Chapter 68, Utah
4488     Osteopathic Medical Practice Act, as a pharmacy medical provider;
4489          (iii) shall ensure that a pharmacy medical provider described in Subsection (1)(a)(i)
4490     works onsite during all business hours; and
4491          (iv) shall designate one pharmacy medical provider described in Subsection (1)(a)(i) as

4492     the pharmacist-in-charge to oversee the operation of and generally supervise the medical
4493     cannabis pharmacy.
4494          (b) An individual may not serve as a pharmacy medical provider unless the department
4495     registers the individual as a pharmacy medical provider in accordance with Subsection (2).
4496          (2) (a) The department shall, within 15 days after the day on which the department
4497     receives an application from a medical cannabis pharmacy on behalf of a prospective pharmacy
4498     medical provider, register and issue a pharmacy medical provider registration card to the
4499     prospective pharmacy medical provider if the medical cannabis pharmacy:
4500          (i) provides to the department:
4501          (A) the prospective pharmacy medical provider's name and address;
4502          (B) the name and location of the licensed medical cannabis pharmacy where the
4503     prospective pharmacy medical provider seeks to act as a pharmacy medical provider;
4504          (C) a report detailing the completion of the continuing education requirement described
4505     in Subsection (3); and
4506          (D) evidence that the prospective pharmacy medical provider is a pharmacist who is
4507     licensed under Title 58, Chapter 17b, Pharmacy Practice Act, or a physician who has the
4508     authority to write a prescription and is licensed under Title 58, Chapter 67, Utah Medical
4509     Practice Act, or Title 58, Chapter 68, Utah Osteopathic Medical Practice Act; and
4510          (ii) pays a fee to the department in an amount that, subject to Subsection [26-61a-109]
4511     26B-1-310(5), the department sets in accordance with Section 63J-1-504.
4512          (b) The department may not register a recommending medical provider or a state
4513     central patient portal medical provider as a pharmacy medical provider.
4514          (3) (a) A pharmacy medical provider shall complete the continuing education described
4515     in this Subsection (3) in the following amounts:
4516          (i) as a condition precedent to registration, four hours; and
4517          (ii) as a condition precedent to renewal of the registration, four hours every two years.
4518          (b) In accordance with Subsection (3)(a), the pharmacy medical provider shall:
4519          (i) complete continuing education:
4520          (A) regarding the topics described in Subsection (3)(d); and
4521          (B) offered by the department under Subsection (3)(c) or an accredited or approved
4522     continuing education provider that the department recognizes as offering continuing education

4523     appropriate for the medical cannabis pharmacy practice; and
4524          (ii) make a continuing education report to the department in accordance with a process
4525     that the department establishes by rule, in accordance with Title 63G, Chapter 3, Utah
4526     Administrative Rulemaking Act, and in collaboration with the Division of Professional
4527     Licensing and:
4528          (A) for a pharmacy medical provider who is licensed under Title 58, Chapter 17b,
4529     Pharmacy Practice Act, the Board of Pharmacy;
4530          (B) for a pharmacy medical provider licensed under Title 58, Chapter 67, Utah Medical
4531     Practice Act, the Physicians Licensing Board; and
4532          (C) for a pharmacy medical provider licensed under Title 58, Chapter 68, Utah
4533     Osteopathic Medical Practice Act, the Osteopathic Physician and Surgeon's Licensing Board.
4534          (c) The department may, in consultation with the Division of Professional Licensing,
4535     develop the continuing education described in this Subsection (3).
4536          (d) The continuing education described in this Subsection (3) may discuss:
4537          (i) the provisions of this [chapter] part;
4538          (ii) general information about medical cannabis under federal and state law;
4539          (iii) the latest scientific research on the endocannabinoid system and medical cannabis,
4540     including risks and benefits;
4541          (iv) recommendations for medical cannabis as it relates to the continuing care of a
4542     patient in pain management, risk management, potential addiction, and palliative care; or
4543          (v) best practices for recommending the form and dosage of a medical cannabis
4544     product based on the qualifying condition underlying a medical cannabis recommendation.
4545          (4) (a) A pharmacy medical provider registration card expires two years after the day
4546     on which the department issues or renews the card.
4547          (b) A pharmacy medical provider may renew the provider's registration card if the
4548     provider:
4549          (i) is eligible for a pharmacy medical provider registration card under this section;
4550          (ii) certifies to the department in a renewal application that the information in
4551     Subsection (2)(a) is accurate or updates the information;
4552          (iii) submits a report detailing the completion of the continuing education requirement
4553     described in Subsection (3); and

4554          (iv) pays to the department a renewal fee in an amount that:
4555          (A) subject to Subsection [26-61a-109] 26B-1-310(5), the department sets in
4556     accordance with Section 63J-1-504; and
4557          (B) may not exceed the cost of the relatively lower administrative burden of renewal in
4558     comparison to the original application process.
4559          (5) (a) Except as provided in Subsection (5)(b), a person may not advertise that the
4560     person or another person dispenses medical cannabis.
4561          (b) Notwithstanding Subsection (5)(a) and subject to Section [26-61a-116] 26B-4-223,
4562     a registered pharmacy medical provider may advertise the following:
4563          (i) a green cross;
4564          (ii) that the person is registered as a pharmacy medical provider and dispenses medical
4565     cannabis; or
4566          (iii) a scientific study regarding medical cannabis use.
4567          Section 78. Section 26B-4-220, which is renumbered from Section 26-61a-701 is
4568     renumbered and amended to read:
4569          [26-61a-701].      26B-4-220. Enforcement -- Misdemeanor.
4570          (1) Except as provided in Title 4, Chapter 41a, Cannabis Production Establishments,
4571     and Sections [26-61a-502, 26-61a-605, and 26-61a-607] 26B-4-230, 26B-4-240, and 26B-4-
4572     242
, it is unlawful for a medical cannabis cardholder to sell or otherwise give to another
4573     medical cannabis cardholder cannabis in a medicinal dosage form, a cannabis product in a
4574     medicinal dosage form, a medical cannabis device, or any cannabis residue remaining in or
4575     from a medical cannabis device.
4576          (2) (a) Except as provided in Subsection (2)(b), a medical cannabis cardholder who
4577     violates Subsection (1) is:
4578          (i) guilty of a class B misdemeanor; and
4579          (ii) subject to a $1,000 fine.
4580          (b) An individual is not guilty under Subsection (2)(a) if the individual:
4581          (i) (A) is a designated caregiver; and
4582          (B) gives the product described in Subsection (1) to the medical cannabis cardholder
4583     who designated the individual as a designated caregiver; or
4584          (ii) (A) is a medical cannabis guardian cardholder; and

4585          (B) gives the product described in Subsection (1) to the relevant provisional patient
4586     cardholder.
4587          (c) An individual who is guilty of a violation described in Subsection (2)(a) is not
4588     guilty of a violation of Title 58, Chapter 37, Utah Controlled Substances Act, for the conduct
4589     underlying the violation described in Subsection (2)(a).
4590          Section 79. Section 26B-4-221, which is renumbered from Section 26-61a-702 is
4591     renumbered and amended to read:
4592          [26-61a-702].      26B-4-221. Enforcement -- Fine -- Citation.
4593          (1) (a) The department may, for a medical cannabis pharmacy's or a medical cannabis
4594     courier's violation of this [chapter] part or an applicable administrative rule:
4595          (i) revoke the medical cannabis pharmacy or medical cannabis courier license;
4596          (ii) refuse to renew the medical cannabis pharmacy or medical cannabis courier
4597     license; or
4598          (iii) assess the medical cannabis pharmacy or medical cannabis courier an
4599     administrative penalty.
4600          (b) The department may, for a medical cannabis pharmacy agent's or medical cannabis
4601     courier agent's violation of this [chapter] part:
4602          (i) revoke the medical cannabis pharmacy agent or medical cannabis courier agent
4603     registration card;
4604          (ii) refuse to renew the medical cannabis pharmacy agent or medical cannabis courier
4605     agent registration card; or
4606          (iii) assess the medical cannabis pharmacy agent or medical cannabis courier agent an
4607     administrative penalty.
4608          (2) The department shall deposit an administrative penalty imposed under this section
4609     into the General Fund.
4610          (3) For a person subject to an uncontested citation, a stipulated settlement, or a finding
4611     of a violation in an adjudicative proceeding under this section, the department may:
4612          (a) for a fine amount not already specified in law, assess the person a fine of up to
4613     $5,000 per violation, in accordance with a fine schedule that the department establishes by rule
4614     in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act; or
4615          (b) order the person to cease and desist from the action that creates a violation.

4616          (4) The department may not revoke a medical cannabis pharmacy's license or a medical
4617     cannabis courier's license without first directing the medical cannabis pharmacy or the medical
4618     cannabis courier to appear before an adjudicative proceeding conducted under Title 63G,
4619     Chapter 4, Administrative Procedures Act.
4620          (5) If, within 20 calendar days after the day on which the department issues a citation
4621     for a violation of this chapter, the person that is the subject of the citation fails to request a
4622     hearing to contest the citation, the citation becomes the department's final order.
4623          (6) The department may, for a person who fails to comply with a citation under this
4624     section:
4625          (a) refuse to issue or renew the person's license or agent registration card; or
4626          (b) suspend, revoke, or place on probation the person's license or agent registration
4627     card.
4628          (7) (a) Except where a criminal penalty is expressly provided for a specific violation of
4629     this [chapter] part, if an individual violates a provision of this [chapter] part, the individual is:
4630          (i) guilty of an infraction; and
4631          (ii) subject to a $100 fine.
4632          (b) An individual who is guilty of a violation described in Subsection (7)(a) is not
4633     guilty of a violation of Title 58, Chapter 37, Utah Controlled Substances Act, for the conduct
4634     underlying the violation described in Subsection (7)(a).
4635          Section 80. Section 26B-4-222, which is renumbered from Section 26-61a-703 is
4636     renumbered and amended to read:
4637          [26-61a-703].      26B-4-222. Report.
4638          (1) By the November interim meeting each year beginning in 2020, the department
4639     shall report to the Health and Human Services Interim Committee on:
4640          (a) the number of applications and renewal applications filed for medical cannabis
4641     cards;
4642          (b) the number of qualifying patients and designated caregivers;
4643          (c) the nature of the debilitating medical conditions of the qualifying patients;
4644          (d) the age and county of residence of cardholders;
4645          (e) the number of medical cannabis cards revoked;
4646          (f) the number of practitioners providing recommendations for qualifying patients;

4647          (g) the number of license applications and renewal license applications received;
4648          (h) the number of licenses the department has issued in each county;
4649          (i) the number of licenses the department has revoked;
4650          (j) the quantity of medical cannabis shipments that the state central patient portal
4651     facilitates;
4652          (k) the number of overall purchases of medical cannabis and medical cannabis products
4653     from each medical cannabis pharmacy;
4654          (l) the expenses incurred and revenues generated from the medical cannabis program;
4655     and
4656          (m) an analysis of product availability in medical cannabis pharmacies.
4657          (2) The department may not include personally identifying information in the report
4658     described in this section.
4659          (3) During the 2022 legislative interim, the department shall report to the working
4660     group described in Section 36-12-8.2 as requested by the working group.
4661          Section 81. Section 26B-4-223, which is renumbered from Section 26-61a-116 is
4662     renumbered and amended to read:
4663          [26-61a-116].      26B-4-223. Advertising.
4664          (1) Except as provided in this [chapter] part, a person may not advertise regarding the
4665     recommendation, sale, dispensing, or transportation of medical cannabis.
4666          (2) Notwithstanding any authorization to advertise regarding medical cannabis under
4667     this [chapter] part, the person advertising may not advertise:
4668          (a) using promotional discounts or incentives;
4669          (b) a particular medical cannabis product, medical cannabis device, or medicinal
4670     dosage form; or
4671          (c) an assurance regarding an outcome related to medical cannabis treatment.
4672          (3) Notwithstanding Subsection (1):
4673          (a) a nonprofit organization that offers financial assistance for medical cannabis
4674     treatment to low-income patients may advertise the organization's assistance if the
4675     advertisement does not relate to a specific medical cannabis pharmacy or a specific medical
4676     cannabis product; and
4677          (b) a medical cannabis pharmacy may provide information regarding subsidies for the

4678     cost of medical cannabis treatment to patients who affirmatively accept receipt of the subsidy
4679     information.
4680          (4) To ensure that the name and logo of a licensee under this [chapter] part have a
4681     medical rather than a recreational disposition, the name and logo of the licensee:
4682          (a) may include terms and images associated with:
4683          (i) a medical disposition, including "medical," "medicinal," "medicine," "pharmacy,"
4684     "apothecary," "wellness," "therapeutic," "health," "care," "cannabis," "clinic," "compassionate,"
4685     "relief," "treatment," and "patient;" or
4686          (ii) the plant form of cannabis, including "leaf," "flower," and "bloom";
4687          (b) may not include:
4688          (i) any term, statement, design representation, picture, or illustration that is associated
4689     with a recreational disposition or that appeals to children;
4690          (ii) an emphasis on a psychoactive ingredient;
4691          (iii) a specific cannabis strain; or
4692          (iv) terms related to recreational marijuana, including "weed," "pot," "reefer," "grass,"
4693     "hash," "ganga," "Mary Jane," "high," "buzz," "haze," "stoned," "joint," "bud," "smoke,"
4694     "euphoria," "dank," "doobie," "kush," "frost," "cookies," "rec," "bake," "blunt," "combust,"
4695     "bong," "budtender," "dab," "blaze," "toke," or "420."
4696          (5) The department shall define standards for advertising authorized under this chapter,
4697     including names and logos in accordance with Subsection (4), to ensure a medical rather than
4698     recreational disposition.
4699          Section 82. Section 26B-4-224, which is renumbered from Section 26-61a-301 is
4700     renumbered and amended to read:
4701          [26-61a-301].      26B-4-224. Medical cannabis pharmacy -- License --
4702     Eligibility.
4703          (1) A person may not operate as a medical cannabis pharmacy without a license that
4704     the department issues under this part.
4705          (2) (a) (i) Subject to Subsections (4) and (5) and to Section [26-61a-305] 26B-4-228,
4706     the department shall issue a license to operate a medical cannabis pharmacy in accordance with
4707     Title 63G, Chapter 6a, Utah Procurement Code.
4708          (ii) The department may not issue a license to operate a medical cannabis pharmacy to

4709     an applicant who is not eligible for a license under this section.
4710          (b) An applicant is eligible for a license under this section if the applicant submits to
4711     the department:
4712          (i) subject to Subsection (2)(c), a proposed name and address where the applicant will
4713     operate the medical cannabis pharmacy;
4714          (ii) the name and address of an individual who:
4715          (A) for a publicly traded company, has a financial or voting interest of 2% or greater in
4716     the proposed medical cannabis pharmacy;
4717          (B) for a privately held company, a financial or voting interest in the proposed medical
4718     cannabis pharmacy; or
4719          (C) has the power to direct or cause the management or control of a proposed medical
4720     cannabis pharmacy;
4721          (iii) a statement that the applicant will obtain and maintain a performance bond that a
4722     surety authorized to transact surety business in the state issues in an amount of at least
4723     $100,000 for each application that the applicant submits to the department;
4724          (iv) an operating plan that:
4725          (A) complies with Section [26-61a-304] 26B-4-227;
4726          (B) includes operating procedures to comply with the operating requirements for a
4727     medical cannabis pharmacy described in this [chapter] part and with a relevant municipal or
4728     county law that is consistent with Section [26-61a-507] 26B-4-235; and
4729          (C) the department approves;
4730          (v) an application fee in an amount that, subject to Subsection [26-61a-109] 26B-1-
4731     310
(5), the department sets in accordance with Section 63J-1-504; and
4732          (vi) a description of any investigation or adverse action taken by any licensing
4733     jurisdiction, government agency, law enforcement agency, or court in any state for any
4734     violation or detrimental conduct in relation to any of the applicant's cannabis-related operations
4735     or businesses.
4736          (c) (i) A person may not locate a medical cannabis pharmacy:
4737          (A) within 200 feet of a community location; or
4738          (B) in or within 600 feet of a district that the relevant municipality or county has zoned
4739     as primarily residential.

4740          (ii) The proximity requirements described in Subsection (2)(c)(i) shall be measured
4741     from the nearest entrance to the medical cannabis pharmacy establishment by following the
4742     shortest route of ordinary pedestrian travel to the property boundary of the community location
4743     or residential area.
4744          (iii) The department may grant a waiver to reduce the proximity requirements in
4745     Subsection (2)(c)(i) by up to 20% if the department determines that it is not reasonably feasible
4746     for the applicant to site the proposed medical cannabis pharmacy without the waiver.
4747          (iv) An applicant for a license under this section shall provide evidence of compliance
4748     with the proximity requirements described in Subsection (2)(c)(i).
4749          (d) The department may not issue a license to an eligible applicant that the department
4750     has selected to receive a license until the selected eligible applicant obtains the performance
4751     bond described in Subsection (2)(b)(iii).
4752          (e) If the department receives more than one application for a medical cannabis
4753     pharmacy within the same city or town, the department shall consult with the local land use
4754     authority before approving any of the applications pertaining to that city or town.
4755          (3) If the department selects an applicant for a medical cannabis pharmacy license
4756     under this section, the department shall:
4757          (a) charge the applicant an initial license fee in an amount that, subject to Subsection
4758     [26-61a-109] 26B-1-310(5), the department sets in accordance with Section 63J-1-504;
4759          (b) notify the Department of Public Safety of the license approval and the names of
4760     each individual described in Subsection (2)(b)(ii); and
4761          (c) charge the licensee a fee in an amount that, subject to Subsection [26-61a-109]
4762     26B-1-310(5), the department sets in accordance with Section 63J-1-504, for any change in
4763     location, ownership, or company structure.
4764          (4) The department may not issue a license to operate a medical cannabis pharmacy to
4765     an applicant if an individual described in Subsection (2)(b)(ii):
4766          (a) has been convicted under state or federal law of:
4767          (i) a felony; or
4768          (ii) after December 3, 2018, a misdemeanor for drug distribution;
4769          (b) is younger than 21 years old; or
4770          (c) after September 23, 2019, until January 1, 2023, is actively serving as a legislator.

4771          (5) (a) If an applicant for a medical cannabis pharmacy license under this section holds
4772     a license under Title 4, Chapter 41, Hemp and Cannabinoid Act, the department may not give
4773     preference to the applicant based on the applicant's status as a holder of the license.
4774          (b) If an applicant for a medical cannabis pharmacy license under this section holds a
4775     license to operate a cannabis cultivation facility under Title 4, Chapter 41a, Cannabis
4776     Production Establishments, the department:
4777          (i) shall consult with the Department of Agriculture and Food regarding the applicant;
4778     and
4779          (ii) may give consideration to the applicant based on the applicant's status as a holder
4780     of a license to operate a cannabis cultivation facility if:
4781          (A) the applicant demonstrates that a decrease in costs to patients is more likely to
4782     result from the applicant's vertical integration than from a more competitive marketplace; and
4783          (B) the department finds multiple other factors, in addition to the existing license, that
4784     support granting the new license.
4785          (6) (a) The department may revoke a license under this part:
4786          (i) if the medical cannabis pharmacy does not begin operations within one year after
4787     the day on which the department issues an announcement of the department's intent to award a
4788     license to the medical cannabis pharmacy;
4789          (ii) after the third the same violation of this [chapter] part in any of the licensee's
4790     licensed cannabis production establishments or medical cannabis pharmacies;
4791          (iii) if an individual described in Subsection (2)(b)(ii) is convicted, while the license is
4792     active, under state or federal law of:
4793          (A) a felony; or
4794          (B) after December 3, 2018, a misdemeanor for drug distribution;
4795          (iv) if the licensee fails to provide the information described in Subsection (2)(b)(vi) at
4796     the time of application, or fails to supplement the information described in Subsection
4797     (2)(b)(vi) with any investigation or adverse action that occurs after the submission of the
4798     application within 14 calendar days after the licensee receives notice of the investigation or
4799     adverse action;
4800          (v) if the medical cannabis pharmacy demonstrates a willful or reckless disregard for
4801     the requirements of this [chapter] part or the rules the department makes in accordance with

4802     this [chapter] part; or
4803          (vi) if, after a change of ownership described in Subsection (11)(c), the department
4804     determines that the medical cannabis pharmacy no longer meets the minimum standards for
4805     licensure and operation of the medical cannabis pharmacy described in this [chapter] part.
4806          (b) The department shall rescind a notice of an intent to issue a license under this part
4807     to an applicant or revoke a license issued under this part if the associated medical cannabis
4808     pharmacy does not begin operation on or before June 1, 2021.
4809          (7) (a) A person who receives a medical cannabis pharmacy license under this [chapter]
4810     part, if the municipality or county where the licensed medical cannabis pharmacy will be
4811     located requires a local land use permit, shall submit to the department a copy of the licensee's
4812     approved application for the land use permit within 120 days after the day on which the
4813     department issues the license.
4814          (b) If a licensee fails to submit to the department a copy the licensee's approved land
4815     use permit application in accordance with Subsection (7)(a), the department may revoke the
4816     licensee's license.
4817          (8) The department shall deposit the proceeds of a fee imposed by this section into the
4818     Qualified Patient Enterprise Fund.
4819          (9) The department shall begin accepting applications under this part on or before
4820     March 1, 2020.
4821          (10) (a) The department's authority to issue a license under this section is plenary and is
4822     not subject to review.
4823          (b) Notwithstanding Subsection (2), the decision of the department to award a license
4824     to an applicant is not subject to:
4825          (i) Title 63G, Chapter 6a, Part 16, Protests; or
4826          (ii) Title 63G, Chapter 6a, Part 17, Procurement Appeals Board.
4827          (11) (a) A medical cannabis pharmacy license is not transferrable or assignable.
4828          (b) A medical cannabis pharmacy shall report in writing to the department no later than
4829     10 business days before the date of any change of ownership of the medical cannabis
4830     pharmacy.
4831          (c) If the ownership of a medical cannabis pharmacy changes by 50% or more:
4832          (i) concurrent with the report described in Subsection (11)(b), the medical cannabis

4833     pharmacy shall submit a new application described in Subsection (2)(b), subject to Subsection
4834     (2)(c);
4835          (ii) within 30 days of the submission of the application, the department shall:
4836          (A) conduct an application review; and
4837          (B) award a license to the medical cannabis pharmacy for the remainder of the term of
4838     the medical cannabis pharmacy's license before the ownership change if the medical cannabis
4839     pharmacy meets the minimum standards for licensure and operation of the medical cannabis
4840     pharmacy described in this [chapter] part; and
4841          (iii) if the department approves the license application, notwithstanding Subsection (3),
4842     the medical cannabis pharmacy shall pay a license fee that the department sets in accordance
4843     with Section 63J-1-504 in an amount that covers the board's cost of conducting the application
4844     review.
4845          Section 83. Section 26B-4-225, which is renumbered from Section 26-61a-302 is
4846     renumbered and amended to read:
4847          [26-61a-302].      26B-4-225. Medical cannabis pharmacy owners and
4848     directors -- Criminal background checks.
4849          (1) Each applicant to whom the department issues a notice of intent to award a license
4850     to operate as a medical cannabis pharmacy shall submit, before the department may award the
4851     license, from each individual who has a financial or voting interest of 2% or greater in the
4852     applicant or who has the power to direct or cause the management or control of the applicant:
4853          (a) a fingerprint card in a form acceptable to the Department of Public Safety;
4854          (b) a signed waiver in accordance with Subsection 53-10-108(4) acknowledging the
4855     registration of the individual's fingerprints in the Federal Bureau of Investigation Next
4856     Generation Identification System's Rap Back Service; and
4857          (c) consent to a fingerprint background check by:
4858          (i) the Bureau of Criminal Identification; and
4859          (ii) the Federal Bureau of Investigation.
4860          (2) The Bureau of Criminal Identification shall:
4861          (a) check the fingerprints the applicant submits under Subsection (1) against the
4862     applicable state, regional, and national criminal records databases, including the Federal
4863     Bureau of Investigation Next Generation Identification System;

4864          (b) report the results of the background check to the department;
4865          (c) maintain a separate file of fingerprints that applicants submit under Subsection (1)
4866     for search by future submissions to the local and regional criminal records databases, including
4867     latent prints;
4868          (d) request that the fingerprints be retained in the Federal Bureau of Investigation Next
4869     Generation Identification System's Rap Back Service for search by future submissions to
4870     national criminal records databases, including the Next Generation Identification System and
4871     latent prints; and
4872          (e) establish a privacy risk mitigation strategy to ensure that the department only
4873     receives notifications for an individual with whom the department maintains an authorizing
4874     relationship.
4875          (3) The department shall:
4876          (a) assess an individual who submits fingerprints under Subsection (1) a fee in an
4877     amount that the department sets in accordance with Section 63J-1-504 for the services that the
4878     Bureau of Criminal Identification or another authorized agency provides under this section; and
4879          (b) remit the fee described in Subsection (3)(a) to the Bureau of Criminal
4880     Identification.
4881          Section 84. Section 26B-4-226, which is renumbered from Section 26-61a-303 is
4882     renumbered and amended to read:
4883          [26-61a-303].      26B-4-226. Renewal.
4884          (1) The department shall renew a license under this part every year if, at the time of
4885     renewal:
4886          (a) the licensee meets the requirements of Section [26-61a-301] 26B-4-224;
4887          (b) the licensee pays the department a license renewal fee in an amount that, subject to
4888     Subsection [26-61a-109] 26B-1-310(5), the department sets in accordance with Section
4889     63J-1-504; and
4890          (c) if the medical cannabis pharmacy changes the operating plan described in Section
4891     [26-61a-304] 26B-4-227 that the department approved under Subsection [26-61a-301] 26B-4-
4892     224
(2)(b)(iv), the department approves the new operating plan.
4893          (2) (a) If a licensed medical cannabis pharmacy abandons the medical cannabis
4894     pharmacy's license, the department shall publish notice of an available license:

4895          (i) in a newspaper of general circulation for the geographic area in which the medical
4896     cannabis pharmacy license is available; or
4897          (ii) on the Utah Public Notice Website established in Section 63A-16-601.
4898          (b) The department may establish criteria, in collaboration with the Division of
4899     Professional Licensing and the Board of Pharmacy and in accordance with Title 63G, Chapter
4900     3, Utah Administrative Rulemaking Act, to identify the medical cannabis pharmacy actions that
4901     constitute abandonment of a medical cannabis pharmacy license.
4902          (3) If the department has not completed the necessary processes to make a
4903     determination on a license renewal under Subsections (1)(a) and (c) before the expiration of a
4904     license, the department may issue a conditional medical cannabis pharmacy license to a
4905     licensed medical cannabis pharmacy that has applied for license renewal under this section and
4906     paid the fee described in Subsection (1)(b).
4907          Section 85. Section 26B-4-227, which is renumbered from Section 26-61a-304 is
4908     renumbered and amended to read:
4909          [26-61a-304].      26B-4-227. Operating plan.
4910          A person applying for a medical cannabis pharmacy license shall submit to the
4911     department a proposed operation plan for the medical cannabis pharmacy that complies with
4912     this section and that includes:
4913          (1) a description of the physical characteristics of the proposed facility, including a
4914     floor plan and an architectural elevation;
4915          (2) a description of the credentials and experience of:
4916          (a) each officer, director, or owner of the proposed medical cannabis pharmacy; and
4917          (b) any highly skilled or experienced prospective employee;
4918          (3) the medical cannabis pharmacy's employee training standards;
4919          (4) a security plan;
4920          (5) a description of the medical cannabis pharmacy's inventory control system,
4921     including a plan to make the inventory control system compatible with the state electronic
4922     verification system;
4923          (6) storage protocols, both short- and long-term, to ensure that cannabis is stored in a
4924     manner that is sanitary and preserves the integrity of the cannabis; and
4925          (7) a description of the proposed medical cannabis pharmacy's strategic plan for

4926     opening the medical cannabis pharmacy, including gauging appropriate timing based on:
4927          (a) the supply of medical cannabis and medical cannabis products, in consultation with
4928     the Department of Agriculture and Food; and
4929          (b) the quantity and condition of the population of medical cannabis cardholders, in
4930     consultation with the department.
4931          Section 86. Section 26B-4-228, which is renumbered from Section 26-61a-305 is
4932     renumbered and amended to read:
4933          [26-61a-305].      26B-4-228. Maximum number of licenses -- Home delivery
4934     medical cannabis pharmacies.
4935          (1) (a) Except as provided in Subsections (1)(b) or (d), if a sufficient number of
4936     applicants apply, the department shall issue up to 15 medical cannabis pharmacy licenses in
4937     accordance with this section.
4938          (b) If an insufficient number of qualified applicants apply for the available number of
4939     medical cannabis pharmacy licenses, the department shall issue a medical cannabis pharmacy
4940     license to each qualified applicant.
4941          (c) The department may issue the licenses described in Subsection (1)(a) in accordance
4942     with this Subsection (1)(c).
4943          (i) Using one procurement process, the department may issue eight licenses to an initial
4944     group of medical cannabis pharmacies and six licenses to a second group of medical cannabis
4945     pharmacies.
4946          (ii) If the department issues licenses in two phases in accordance with Subsection
4947     (1)(c)(i), the department shall:
4948          (A) divide the state into no less than four geographic regions;
4949          (B) issue at least one license in each geographic region during each phase of issuing
4950     licenses; and
4951          (C) complete the process of issuing medical cannabis pharmacy licenses no later than
4952     July 1, 2020.
4953          (iii) In issuing a 15th license under Subsection (1), the department shall ensure that the
4954     license recipient will locate the medical cannabis pharmacy within Dagget, Duchesne, Uintah,
4955     Carbon, Sevier, Emery, Grand, or San Juan County.
4956          (d) (i) The department may issue licenses to operate a medical cannabis pharmacy in

4957     addition to the licenses described in Subsection (1)(a) if the department determines, in
4958     consultation with the Department of Agriculture and Food and after an annual or more frequent
4959     analysis of the current and anticipated market for medical cannabis, that each additional license
4960     is necessary to provide an adequate supply, quality, or variety of medical cannabis to medical
4961     cannabis cardholders.
4962          (ii) The department shall:
4963          (A) in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act,
4964     make rules to establish criteria and processes for the consultation, analysis, and application for
4965     a license described in Subsection (1)(d)(i); and
4966          (B) report to the Executive Appropriations Committee of the Legislature before each
4967     time the department issues an additional license under Subsection (1)(d)(i) regarding the results
4968     of the consultation and analysis described in Subsection (1)(d)(i) and the application of the
4969     criteria described in Subsection (1)(d)(ii)(A).
4970          (2) (a) If there are more qualified applicants than there are available licenses for
4971     medical cannabis pharmacies, the department shall:
4972          (i) evaluate each applicant and award the license to the applicant that best
4973     demonstrates:
4974          (A) experience with establishing and successfully operating a business that involves
4975     complying with a regulatory environment, tracking inventory, and training, evaluating, and
4976     monitoring employees;
4977          (B) an operating plan that will best ensure the safety and security of patrons and the
4978     community;
4979          (C) positive connections to the local community;
4980          (D) the suitability of the proposed location and the location's accessibility for
4981     qualifying patients;
4982          (E) the extent to which the applicant can increase efficiency and reduce the cost of
4983     medical cannabis for patients; and
4984          (F) a strategic plan described in Subsection [26-61a-304] 26B-4-227(7) that has a
4985     comparatively high likelihood of success; and
4986          (ii) ensure a geographic dispersal among licensees that is sufficient to reasonably
4987     maximize access to the largest number of medical cannabis cardholders.

4988          (b) In making the evaluation described in Subsection (2)(a), the department may give
4989     increased consideration to applicants who indicate a willingness to:
4990          (i) operate as a home delivery medical cannabis pharmacy that accepts electronic
4991     medical cannabis orders that the state central patient portal facilitates; and
4992          (ii) accept payments through:
4993          (A) a payment provider that the Division of Finance approves, in consultation with the
4994     state treasurer, in accordance with Section [26-61a-603] 26B-4-238; or
4995          (B) a financial institution in accordance with Subsection [26-61a-603] 26B-4-238(4).
4996          (3) The department may conduct a face-to-face interview with an applicant for a
4997     license that the department evaluates under Subsection (2).
4998          (4) (a) The department may designate a medical cannabis pharmacy as a home delivery
4999     medical cannabis pharmacy if the department determines that the medical cannabis pharmacy's
5000     operating plan demonstrates the functional and technical ability to:
5001          (i) safely conduct transactions for medical cannabis shipments;
5002          (ii) accept electronic medical cannabis orders that the state central patient portal
5003     facilitates; and
5004          (iii) accept payments through:
5005          (A) a payment provider that the Division of Finance approves, in consultation with the
5006     state treasurer, in accordance with Section [26-61a-603] 26B-4-238; or
5007          (B) a financial institution in accordance with Subsection [26-61a-603] 26B-4-238(4).
5008          (b) An applicant seeking a designation as a home delivery medical cannabis pharmacy
5009     shall identify in the applicant's operating plan any information relevant to the department's
5010     evaluation described in Subsection (4)(a), including:
5011          (i) the name and contact information of the payment provider;
5012          (ii) the nature of the relationship between the prospective licensee and the payment
5013     provider;
5014          (iii) the processes of the following to safely and reliably conduct transactions for
5015     medical cannabis shipments:
5016          (A) the prospective licensee; and
5017          (B) the electronic payment provider or the financial institution described in Subsection
5018     (4)(a)(iii); and

5019          (iv) the ability of the licensee to comply with the department's rules regarding the
5020     secure transportation and delivery of medical cannabis or medical cannabis product to a
5021     medical cannabis cardholder.
5022          (c) Notwithstanding any county or municipal ordinance, a medical cannabis pharmacy
5023     that the department designates as a home delivery medical cannabis pharmacy may deliver
5024     medical cannabis shipments in accordance with this [chapter] part.
5025          Section 87. Section 26B-4-229, which is renumbered from Section 26-61a-501 is
5026     renumbered and amended to read:
5027          [26-61a-501].      26B-4-229. Operating requirements -- General.
5028          (1) (a) A medical cannabis pharmacy shall operate:
5029          (i) at the physical address provided to the department under Section [26-61a-301] 26B-
5030     4-224
; and
5031          (ii) in accordance with the operating plan provided to the department under Section
5032     [26-61a-301] 26B-4-224 and, if applicable, Section [26-61a-304] 26B-4-227.
5033          (b) A medical cannabis pharmacy shall notify the department before a change in the
5034     medical cannabis pharmacy's physical address or operating plan.
5035          (2) An individual may not enter a medical cannabis pharmacy unless the individual:
5036          (a) is at least 18 years old or is an emancipated minor under Section 80-7-105; and
5037          (b) except as provided in Subsection (4):
5038          (i) possesses a valid:
5039          (A) medical cannabis pharmacy agent registration card;
5040          (B) pharmacy medical provider registration card; or
5041          (C) medical cannabis card;
5042          (ii) is an employee of the department or the Department of Agriculture and Food
5043     performing an inspection under Section [26-61a-504] 26B-4-232; or
5044          (iii) is another individual as the department provides.
5045          (3) A medical cannabis pharmacy may not employ an individual who is younger than
5046     21 years old.
5047          (4) Notwithstanding Subsection (2)(a), a medical cannabis pharmacy may authorize an
5048     individual who is not a medical cannabis pharmacy agent or pharmacy medical provider to
5049     access the medical cannabis pharmacy if the medical cannabis pharmacy tracks and monitors

5050     the individual at all times while the individual is at the medical cannabis pharmacy and
5051     maintains a record of the individual's access.
5052          (5) A medical cannabis pharmacy shall operate in a facility that has:
5053          (a) a single, secure public entrance;
5054          (b) a security system with a backup power source that:
5055          (i) detects and records entry into the medical cannabis pharmacy; and
5056          (ii) provides notice of an unauthorized entry to law enforcement when the medical
5057     cannabis pharmacy is closed; and
5058          (c) a lock on each area where the medical cannabis pharmacy stores cannabis or a
5059     cannabis product.
5060          (6) A medical cannabis pharmacy shall post, both clearly and conspicuously in the
5061     medical cannabis pharmacy, the limit on the purchase of cannabis described in Subsection
5062     [26-61a-502] 26B-4-230(2).
5063          (7) Except for an emergency situation described in Subsection [26-61a-201] 26B-4-
5064     213
(3)(c), a medical cannabis pharmacy may not allow any individual to consume cannabis on
5065     the property or premises of the medical cannabis pharmacy.
5066          (8) A medical cannabis pharmacy may not sell cannabis or a cannabis product without
5067     first indicating on the cannabis or cannabis product label the name of the medical cannabis
5068     pharmacy.
5069          (9) (a) Each medical cannabis pharmacy shall retain in the pharmacy's records the
5070     following information regarding each recommendation underlying a transaction:
5071          (i) the recommending medical provider's name, address, and telephone number;
5072          (ii) the patient's name and address;
5073          (iii) the date of issuance;
5074          (iv) directions of use and dosing guidelines or an indication that the recommending
5075     medical provider did not recommend specific directions of use or dosing guidelines; and
5076          (v) if the patient did not complete the transaction, the name of the medical cannabis
5077     cardholder who completed the transaction.
5078          (b) (i) Except as provided in Subsection (9)(b)(iii), a medical cannabis pharmacy may
5079     not sell medical cannabis unless the medical cannabis has a label securely affixed to the
5080     container indicating the following minimum information:

5081          (A) the name, address, and telephone number of the medical cannabis pharmacy;
5082          (B) the unique identification number that the medical cannabis pharmacy assigns;
5083          (C) the date of the sale;
5084          (D) the name of the patient;
5085          (E) the name of the recommending medical provider who recommended the medical
5086     cannabis treatment;
5087          (F) directions for use and cautionary statements, if any;
5088          (G) the amount dispensed and the cannabinoid content;
5089          (H) the suggested use date;
5090          (I) for unprocessed cannabis flower, the legal use termination date; and
5091          (J) any other requirements that the department determines, in consultation with the
5092     Division of Professional Licensing and the Board of Pharmacy.
5093          (ii) A medical cannabis pharmacy is exempt from the requirement to provide the
5094     following information under Subsection (9)(b)(i) if the information is already provided on the
5095     product label that a cannabis production establishment affixes:
5096          (A) a unique identification number;
5097          (B) directions for use and cautionary statements;
5098          (C) amount and cannabinoid content; and
5099          (D) a suggested use date.
5100          (iii) If the size of a medical cannabis container does not allow sufficient space to
5101     include the labeling requirements described in Subsection (9)(b)(i), the medical cannabis
5102     pharmacy may provide the following information described in Subsection (9)(b)(i) on a
5103     supplemental label attached to the container or an informational enclosure that accompanies the
5104     container:
5105          (A) the cannabinoid content;
5106          (B) the suggested use date; and
5107          (C) any other requirements that the department determines.
5108          (iv) A medical cannabis pharmacy may sell medical cannabis to another medical
5109     cannabis pharmacy without a label described in Subsection (9)(b)(i).
5110          (10) A pharmacy medical provider or medical cannabis pharmacy agent shall:
5111          (a) upon receipt of an order from a limited medical provider in accordance with

5112     Subsections [26-61a-106] 26B-4-204(1)(b) through (d):
5113          (i) for a written order or an electronic order under circumstances that the department
5114     determines, contact the limited medical provider or the limited medical provider's office to
5115     verify the validity of the recommendation; and
5116          (ii) for an order that the pharmacy medical provider or medical cannabis pharmacy
5117     agent verifies under Subsection (10)(a)(i) or an electronic order that is not subject to
5118     verification under Subsection (10)(a)(i), enter the limited medical provider's recommendation
5119     or renewal, including any associated directions of use, dosing guidelines, or caregiver
5120     indication, in the state electronic verification system;
5121          (b) in processing an order for a holder of a conditional medical cannabis card described
5122     in Subsection [26-61a-201] 26B-4-213(1)(b) that appears irregular or suspicious in the
5123     judgment of the pharmacy medical provider or medical cannabis pharmacy agent, contact the
5124     recommending medical provider or the recommending medical provider's office to verify the
5125     validity of the recommendation before processing the cardholder's order;
5126          (c) unless the medical cannabis cardholder has had a consultation under Subsection
5127     [26-61a-502] 26B-4-230(4) or (5), verbally offer to a medical cannabis cardholder at the time
5128     of a purchase of cannabis, a cannabis product, or a medical cannabis device, personal
5129     counseling with the pharmacy medical provider; and
5130          (d) provide a telephone number or website by which the cardholder may contact a
5131     pharmacy medical provider for counseling.
5132          (11) (a) A medical cannabis pharmacy may create a medical cannabis disposal program
5133     that allows an individual to deposit unused or excess medical cannabis, cannabis residue from a
5134     medical cannabis device, or medical cannabis product in a locked box or other secure
5135     receptacle within the medical cannabis pharmacy.
5136          (b) A medical cannabis pharmacy with a disposal program described in Subsection
5137     (11)(a) shall ensure that only a medical cannabis pharmacy agent or pharmacy medical provider
5138     can access deposited medical cannabis or medical cannabis products.
5139          (c) A medical cannabis pharmacy shall dispose of any deposited medical cannabis or
5140     medical cannabis products by:
5141          (i) rendering the deposited medical cannabis or medical cannabis products unusable
5142     and unrecognizable before transporting deposited medical cannabis or medical cannabis

5143     products from the medical cannabis pharmacy; and
5144          (ii) disposing of the deposited medical cannabis or medical cannabis products in
5145     accordance with:
5146          (A) federal and state law, rules, and regulations related to hazardous waste;
5147          (B) the Resource Conservation and Recovery Act, 42 U.S.C. Sec. 6991 et seq.;
5148          (C) Title 19, Chapter 6, Part 5, Solid Waste Management Act; and
5149          (D) other regulations that the department makes in accordance with Title 63G, Chapter
5150     3, Utah Administrative Rulemaking Act.
5151          (12) The department shall establish by rule, in accordance with Title 63G, Chapter 3,
5152     Utah Administrative Rulemaking Act, protocols for a recall of cannabis and cannabis products
5153     by a medical cannabis pharmacy.
5154          Section 88. Section 26B-4-230, which is renumbered from Section 26-61a-502 is
5155     renumbered and amended to read:
5156          [26-61a-502].      26B-4-230. Dispensing -- Amount a medical cannabis
5157     pharmacy may dispense -- Reporting -- Form of cannabis or cannabis product.
5158          (1) (a) A medical cannabis pharmacy may not sell a product other than, subject to this
5159     [chapter] part:
5160          (i) cannabis in a medicinal dosage form that the medical cannabis pharmacy acquired
5161     from another medical cannabis pharmacy or a cannabis processing facility that is licensed
5162     under Section 4-41a-201;
5163          (ii) a cannabis product in a medicinal dosage form that the medical cannabis pharmacy
5164     acquired from another medical cannabis pharmacy or a cannabis processing facility that is
5165     licensed under Section 4-41a-201;
5166          (iii) a medical cannabis device; or
5167          (iv) educational material related to the medical use of cannabis.
5168          (b) A medical cannabis pharmacy may only sell an item listed in Subsection (1)(a) to
5169     an individual with:
5170          (i) (A) a medical cannabis card;
5171          (B) a department registration described in [Section 26-61a-201] Subsection 26B-4-
5172     213
(10); and
5173          (ii) a corresponding valid form of photo identification.

5174          (c) Notwithstanding Subsection (1)(a), a medical cannabis pharmacy may not sell a
5175     cannabis-based drug that the United States Food and Drug Administration has approved.
5176          (d) Notwithstanding Subsection (1)(b), a medical cannabis pharmacy may not sell a
5177     medical cannabis device to an individual described in Subsection [26-61a-201] 26B-4-
5178     213
(2)(a)(i)(B) or to a minor described in Subsection [26-61a-201] 26B-4-213(2)(c) unless the
5179     individual or minor has the approval of the Compassionate Use Board in accordance with
5180     Subsection [26-61a-105] 26B-1-421(5).
5181          (2) A medical cannabis pharmacy:
5182          (a) may dispense to a medical cannabis cardholder, in any one 28-day period, up to the
5183     legal dosage limit of:
5184          (i) unprocessed cannabis that:
5185          (A) is in a medicinal dosage form; and
5186          (B) carries a label clearly displaying the amount of tetrahydrocannabinol and
5187     cannabidiol in the cannabis; and
5188          (ii) a cannabis product that is in a medicinal dosage form; and
5189          (b) may not dispense:
5190          (i) more medical cannabis than described in Subsection (2)(a); or
5191          (ii) to an individual whose recommending medical provider did not recommend
5192     directions of use and dosing guidelines, until the individual consults with the pharmacy
5193     medical provider in accordance with Subsection (4), any medical cannabis.
5194          (3) An individual with a medical cannabis card:
5195          (a) may purchase, in any one 28-day period, up to the legal dosage limit of:
5196          (i) unprocessed cannabis in a medicinal dosage form; and
5197          (ii) a cannabis product in a medicinal dosage form;
5198          (b) may not purchase:
5199          (i) more medical cannabis than described in Subsection (3)(a); or
5200          (ii) if the relevant recommending medical provider did not recommend directions of
5201     use and dosing guidelines, until the individual consults with the pharmacy medical provider in
5202     accordance with Subsection (4), any medical cannabis; and
5203          (c) may not use a route of administration that the relevant recommending medical
5204     provider or the pharmacy medical provider, in accordance with Subsection (4) or (5), has not

5205     recommended.
5206          (4) If a recommending medical provider recommends treatment with medical cannabis
5207     but wishes for the pharmacy medical provider to determine directions of use and dosing
5208     guidelines:
5209          (a) the recommending medical provider shall provide to the pharmacy medical
5210     provider, either through the state electronic verification system or through a medical cannabis
5211     pharmacy's recording of a recommendation under the order of a limited medical provider, any
5212     of the following information that the recommending medical provider feels would be needed to
5213     provide appropriate directions of use and dosing guidelines:
5214          (i) information regarding the qualifying condition underlying the recommendation;
5215          (ii) information regarding prior treatment attempts with medical cannabis; and
5216          (iii) portions of the patient's current medication list; and
5217          (b) before the relevant medical cannabis cardholder may obtain medical cannabis, the
5218     pharmacy medical provider shall:
5219          (i) review pertinent medical records, including the recommending medical provider
5220     documentation described in Subsection (4)(a); and
5221          (ii) unless the pertinent medical records show directions of use and dosing guidelines
5222     from a state central patient portal medical provider in accordance with Subsection (5), after
5223     completing the review described in Subsection (4)(b)(i) and consulting with the recommending
5224     medical provider as needed, determine the best course of treatment through consultation with
5225     the cardholder regarding:
5226          (A) the patient's qualifying condition underlying the recommendation from the
5227     recommending medical provider;
5228          (B) indications for available treatments;
5229          (C) directions of use and dosing guidelines; and
5230          (D) potential adverse reactions.
5231          (5) (a) A state central patient portal medical provider may provide the consultation and
5232     make the determination described in Subsection (4)(b) for a medical cannabis patient
5233     cardholder regarding an electronic order that the state central patient portal facilitates.
5234          (b) The state central patient portal medical provider described in Subsection (5)(a)
5235     shall document the directions of use and dosing guidelines, determined under Subsection (5)(a)

5236     in the pertinent medical records.
5237          (6) (a) A medical cannabis pharmacy shall:
5238          (i) (A) access the state electronic verification system before dispensing cannabis or a
5239     cannabis product to a medical cannabis cardholder in order to determine if the cardholder or,
5240     where applicable, the associated patient has met the maximum amount of medical cannabis
5241     described in Subsection (2); and
5242          (B) if the verification in Subsection (6)(a)(i) indicates that the individual has met the
5243     maximum amount described in Subsection (2), decline the sale, and notify the recommending
5244     medical provider who made the underlying recommendation;
5245          (ii) submit a record to the state electronic verification system each time the medical
5246     cannabis pharmacy dispenses medical cannabis to a medical cannabis cardholder;
5247          (iii) ensure that the pharmacy medical provider who is a licensed pharmacist reviews
5248     each medical cannabis transaction before dispensing the medical cannabis to the cardholder in
5249     accordance with pharmacy practice standards;
5250          (iv) package any medical cannabis that is in a container that:
5251          (A) complies with Subsection 4-41a-602(1)(b) or, if applicable, provisions related to a
5252     container for unprocessed cannabis flower in the definition of "medicinal dosage form" in
5253     Section [26-61a-102] 26B-4-201;
5254          (B) is tamper-resistant and tamper-evident; and
5255          (C) provides an opaque bag or box for the medical cannabis cardholder's use in
5256     transporting the container in public; and
5257          (v) for a product that is a cube that is designed for ingestion through chewing or
5258     holding in the mouth for slow dissolution, include a separate, off-label warning about the risks
5259     of over-consumption.
5260          (b) A medical cannabis cardholder transporting or possessing the container described
5261     in Subsection (6)(a)(iv) in public shall keep the container within the opaque bag or box that the
5262     medical cannabis pharmacist provides.
5263          (7) (a) Except as provided in Subsection (7)(b), a medical cannabis pharmacy may not
5264     sell medical cannabis in the form of a cigarette or a medical cannabis device that is
5265     intentionally designed or constructed to resemble a cigarette.
5266          (b) A medical cannabis pharmacy may sell a medical cannabis device that warms

5267     cannabis material into a vapor without the use of a flame and that delivers cannabis to an
5268     individual's respiratory system.
5269          (8) (a) A medical cannabis pharmacy may not give, at no cost, a product that the
5270     medical cannabis pharmacy is allowed to sell under Subsection (1)(a)(i), (ii), or (iii).
5271          (b) A medical cannabis pharmacy may give, at no cost, educational material related to
5272     the medical use of cannabis.
5273          (9) The department may impose a uniform fee on each medical cannabis transaction in
5274     a medical cannabis pharmacy in an amount that, subject to Subsection [26-61a-109] 26B-1-
5275     310
(5), the department sets in accordance with Section 63J-1-504.
5276          (10) A medical cannabis pharmacy may purchase and store medical cannabis devices
5277     regardless of whether the seller has a cannabis-related license under this title or Title 4, Chapter
5278     41a, Cannabis Production Establishments.
5279          Section 89. Section 26B-4-231, which is renumbered from Section 26-61a-503 is
5280     renumbered and amended to read:
5281          [26-61a-503].      26B-4-231. Partial filling.
5282          (1) As used in this section, "partially fill" means to provide less than the full amount of
5283     cannabis or cannabis product that the recommending medical provider recommends, if the
5284     recommending medical provider recommended specific dosing parameters.
5285          (2) A pharmacy medical provider may partially fill a recommendation for a medical
5286     cannabis treatment at the request of the recommending medical provider who issued the
5287     medical cannabis treatment recommendation or the medical cannabis cardholder.
5288          (3) The department shall make rules, in collaboration with the Division of Professional
5289     Licensing and the Board of Pharmacy and in accordance with Title 63G, Chapter 3, Utah
5290     Administrative Rulemaking Act, specifying how to record the date, quantity supplied, and
5291     quantity remaining of a partially filled medical cannabis treatment recommendation.
5292          (4) A pharmacy medical provider who is a pharmacist may, upon the request of a
5293     medical cannabis cardholder, determine different dosing parameters, subject to the dosing
5294     limits in Subsection [26-61a-502] 26B-4-230(2), to fill the quantity remaining of a partially
5295     filled medical cannabis treatment recommendation if:
5296          (a) the pharmacy medical provider determined dosing parameters for the partial fill
5297     under Subsection [26-61a-502] 26B-4-230(4) or (5); and

5298          (b) the medical cannabis cardholder reports that:
5299          (i) the partial fill did not substantially affect the qualifying condition underlying the
5300     medical cannabis recommendation; or
5301          (ii) the patient experienced an adverse reaction to the partial fill or was otherwise
5302     unable to successfully use the partial fill.
5303          Section 90. Section 26B-4-232, which is renumbered from Section 26-61a-504 is
5304     renumbered and amended to read:
5305          [26-61a-504].      26B-4-232. Inspections.
5306          (1) Each medical cannabis pharmacy shall maintain the pharmacy's medical cannabis
5307     treatment recommendation files and other records in accordance with this [chapter] part,
5308     department rules, and the federal Health Insurance Portability and Accountability Act of 1996,
5309     Pub. L. No. 104-191, 110 Stat. 1936, as amended.
5310          (2) The department or the Department of Agriculture and Food may inspect the
5311     records, facility, and inventory of a medical cannabis pharmacy at any time during business
5312     hours in order to determine if the medical cannabis pharmacy complies with this [chapter] part
5313     and Title 4, Chapter 41a, Cannabis Production Establishments.
5314          (3) An inspection under this section may include:
5315          (a) inspection of a site, facility, vehicle, book, record, paper, document, data, or other
5316     physical or electronic information, or any combination of the above;
5317          (b) questioning of any relevant individual;
5318          (c) inspection of equipment, an instrument, a tool, or machinery, including a container
5319     or label;
5320          (d) random sampling of medical cannabis by the Department of Agriculture and Food
5321     in accordance with rules described in Section 4-41a-701; or
5322          (e) seizure of medical cannabis, medical cannabis devices, or educational material as
5323     evidence in a department investigation or inspection or in instances of compliance failure.
5324          (4) In making an inspection under this section, the department or the Department of
5325     Agriculture and Food may freely access any area and review and make copies of a book,
5326     record, paper, document, data, or other physical or electronic information, including financial
5327     data, sales data, shipping data, pricing data, and employee data.
5328          (5) Failure to provide the department, the Department of Agriculture and Food, or the

5329     authorized agents of the department or the Department of Agriculture and Food immediate
5330     access to records and facilities during business hours in accordance with this section may result
5331     in:
5332          (a) the imposition of a civil monetary penalty that the department sets in accordance
5333     with Title 63G, Chapter 3, Utah Administrative Rulemaking Act;
5334          (b) license or registration suspension or revocation; or
5335          (c) an immediate cessation of operations under a cease and desist order that the
5336     department issues.
5337          (6) Notwithstanding any other provision of law, the department may temporarily store
5338     in any department facility the items the department seizes under Subsection (3)(e) until the
5339     department:
5340          (a) determines that sufficient compliance justifies the return of the seized items; or
5341          (b) disposes of the items in the same manner as a cannabis production establishment in
5342     accordance with Section 4-41a-405.
5343          Section 91. Section 26B-4-233, which is renumbered from Section 26-61a-505 is
5344     renumbered and amended to read:
5345          [26-61a-505].      26B-4-233. Advertising.
5346          (1) Except as provided in this section, a person may not advertise in any medium
5347     regarding a medical cannabis pharmacy or the dispensing of medical cannabis within the state.
5348          (2) Subject to Section 26-61a-116, a medical cannabis pharmacy may:
5349          (a) advertise an employment opportunity at the medical cannabis pharmacy;
5350          (b) notwithstanding any municipal or county ordinance prohibiting signage, use
5351     signage on the outside of the medical cannabis pharmacy that:
5352          (i) includes only:
5353          (A) in accordance with Subsection [26-61a-116] 26B-4-223(4), the medical cannabis
5354     pharmacy's name, logo, and hours of operation; and
5355          (B) a green cross; and
5356          (ii) complies with local ordinances regulating signage;
5357          (c) advertise in any medium:
5358          (i) the pharmacy's name and logo;
5359          (ii) the location and hours of operation of the medical cannabis pharmacy;

5360          (iii) a service available at the medical cannabis pharmacy;
5361          (iv) personnel affiliated with the medical cannabis pharmacy;
5362          (v) whether the medical cannabis pharmacy is licensed as a home delivery medical
5363     cannabis pharmacy;
5364          (vi) best practices that the medical cannabis pharmacy upholds; and
5365          (vii) educational material related to the medical use of cannabis, as defined by the
5366     department;
5367          (d) hold an educational event for the public or medical providers in accordance with
5368     Subsection (3) and the rules described in Subsection (4); and
5369          (e) maintain on the medical cannabis pharmacy's website non-promotional information
5370     regarding the medical cannabis pharmacy's inventory.
5371          (3) A medical cannabis pharmacy may not include in an educational event described in
5372     Subsection (2)(d):
5373          (a) any topic that conflicts with this chapter or Title 4, Chapter 41a, Cannabis
5374     Production Establishments;
5375          (b) any gift items or merchandise other than educational materials, as those terms are
5376     defined by the department;
5377          (c) any marketing for a specific product from the medical cannabis pharmacy or any
5378     other statement, claim, or information that would violate the federal Food, Drug, and Cosmetic
5379     Act, 21 U.S.C. Sec. 301, et seq.; or
5380          (d) a presenter other than the following:
5381          (i) a pharmacist licensed under Title 58, Chapter 17b, Pharmacy Practice Act;
5382          (ii) an advanced practice registered nurse licensed under Title 58, Chapter 31b, Nurse
5383     Practice Act;
5384          (iii) a physician licensed under Title 58, Chapter 67, Utah Medical Practice Act, or
5385     Title 58, Chapter 68, Utah Osteopathic Medical Practice Act;
5386          (iv) a physician assistant licensed under Title 58, Chapter 70a, Utah Physician
5387     Assistant Act;
5388          (v) a medical practitioner, similar to the practitioners described in this Subsection
5389     (3)(d)(v), who is licensed in another state or country;
5390          (vi) a state employee; or

5391          (vii) if the presentation relates to a cannabis topic other than medical treatment or
5392     medical conditions, an individual whom the department approves based on the individual's
5393     background and credentials in the presented topic.
5394          (4) The department shall make rules, in accordance with Title 63G, Chapter 3, Utah
5395     Administrative Rulemaking Act, to define:
5396          (a) the educational material described in Subsection (2)(c)(vii); and
5397          (b) the elements of and restrictions on the educational event described in Subsection
5398     (3), including:
5399          (i) a minimum age of 21 years old for attendees; and
5400          (ii) an exception to the minimum age for a medical cannabis patient cardholder who is
5401     at least 18 years old.
5402          Section 92. Section 26B-4-234, which is renumbered from Section 26-61a-506 is
5403     renumbered and amended to read:
5404          [26-61a-506].      26B-4-234. Medical cannabis transportation.
5405          (1) Only the following individuals may transport medical cannabis under this [chapter]
5406     part:
5407          (a) a registered medical cannabis pharmacy agent;
5408          (b) a registered medical cannabis courier agent;
5409          (c) a registered pharmacy medical provider; or
5410          (d) a medical cannabis cardholder who is transporting a medical cannabis treatment
5411     that the cardholder is authorized to transport.
5412          (2) Except for an individual with a valid medical cannabis card under this [chapter]
5413     part who is transporting a medical cannabis treatment that the cardholder is authorized to
5414     transport, an individual described in Subsection (1) shall possess a transportation manifest that:
5415          (a) includes a unique identifier that links the cannabis or cannabis product to a relevant
5416     inventory control system;
5417          (b) includes origin and destination information for the medical cannabis that the
5418     individual is transporting; and
5419          (c) identifies the departure and arrival times and locations of the individual
5420     transporting the medical cannabis.
5421          (3) (a) In addition to the requirements in Subsections (1) and (2), the department may

5422     establish by rule, in collaboration with the Division of Professional Licensing and the Board of
5423     Pharmacy and in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act,
5424     requirements for transporting medical cannabis to ensure that the medical cannabis remains
5425     safe for human consumption.
5426          (b) The transportation described in Subsection (1)(a) is limited to transportation
5427     between a medical cannabis pharmacy and:
5428          (i) another medical cannabis pharmacy; or
5429          (ii) for a medical cannabis shipment, a medical cannabis cardholder's home address.
5430          (4) (a) It is unlawful for an individual described in Subsection (1) to make a transport
5431     described in this section with a manifest that does not meet the requirements of this section.
5432          (b) Except as provided in Subsection (4)(d), an individual who violates Subsection
5433     (4)(a) is:
5434          (i) guilty of an infraction; and
5435          (ii) subject to a $100 fine.
5436          (c) An individual who is guilty of a violation described in Subsection (4)(b) is not
5437     guilty of a violation of Title 58, Chapter 37, Utah Controlled Substances Act, for the conduct
5438     underlying the violation described in Subsection (4)(b).
5439          (d) If the individual described in Subsection (4)(a) is transporting more medical
5440     cannabis than the manifest identifies, except for a de minimis administrative error:
5441          (i) this [chapter] part does not apply; and
5442          (ii) the individual is subject to penalties under Title 58, Chapter 37, Utah Controlled
5443     Substances Act.
5444          (5) An individual other than an individual described in Subsection (1) may transport a
5445     medical cannabis device within the state if the transport does not also contain medical
5446     cannabis.
5447          Section 93. Section 26B-4-235, which is renumbered from Section 26-61a-507 is
5448     renumbered and amended to read:
5449          [26-61a-507].      26B-4-235. Local control.
5450          (1) The operation of a medical cannabis pharmacy:
5451          (a) shall be a permitted use:
5452          (i) in any zone, overlay, or district within the municipality or county except for a

5453     primarily residential zone; and
5454          (ii) on land that the municipality or county has not zoned; and
5455          (b) is subject to the land use regulations, as defined in Sections [10-9a-103] 26B-7-506
5456     and 17-27a-103, that apply in the underlying zone.
5457          (2) A municipality or county may not:
5458          (a) on the sole basis that the applicant or medical cannabis pharmacy violates federal
5459     law regarding the legal status of cannabis, deny or revoke:
5460          (i) a land use permit, as that term is defined in Sections 10-9a-103 and 17-27a-103, to
5461     operate a medical cannabis pharmacy; or
5462          (ii) a business license to operate a medical cannabis pharmacy;
5463          (b) require a certain distance between a medical cannabis pharmacy and:
5464          (i) another medical cannabis pharmacy;
5465          (ii) a cannabis production establishment;
5466          (iii) a retail tobacco specialty business, as that term is defined in Section 26-62-103; or
5467          (iv) an outlet, as that term is defined in Section 32B-1-202; or
5468          (c) in accordance with Subsections 10-9a-509(1) and 17-27a-508(1), enforce a land use
5469     regulation against a medical cannabis pharmacy that was not in effect on the day on which the
5470     medical cannabis pharmacy submitted a complete land use application.
5471          (3) (a) A municipality or county may enact an ordinance that:
5472          (i) is not in conflict with this [chapter] part; and
5473          (ii) governs the time, place, or manner of medical cannabis pharmacy operations in the
5474     municipality or county.
5475          (b) An ordinance that a municipality or county enacts under Subsection (3)(a) may not
5476     restrict the hours of operation from 7 a.m. to 10 p.m.
5477          (4) An applicant for a land use permit to operate a medical cannabis pharmacy shall
5478     comply with the land use requirements and application process described in:
5479          (a) Title 10, Chapter 9a, Municipal Land Use, Development, and Management Act,
5480     including Section 10-9a-528; and
5481          (b) Title 17, Chapter 27a, County Land Use, Development, and Management Act,
5482     including Section 17-27a-525.
5483          Section 94. Section 26B-4-236, which is renumbered from Section 26-61a-601 is

5484     renumbered and amended to read:
5485          [26-61a-601].      26B-4-236. State central patient portal -- Department duties.
5486          (1) On or before July 1, 2020, the department shall establish or contract to establish, in
5487     accordance with Title 63G, Chapter 6a, Utah Procurement Code, a state central patient portal as
5488     described in this section.
5489          (2) The state central patient portal shall:
5490          (a) authenticate each user to ensure the user is a valid medical cannabis patient
5491     cardholder;
5492          (b) allow a medical cannabis patient cardholder to:
5493          (i) obtain and download the cardholder's medical cannabis card;
5494          (ii) review the cardholder's medical cannabis purchase history; and
5495          (iii) manage the cardholder's personal information, including withdrawing consent for
5496     the use of the cardholder's information for a study described in Subsection [26-61a-201] 26B-4-
5497     213
(12);
5498          (c) if the cardholder's recommending medical provider recommended the use of
5499     medical cannabis without providing directions of use and dosing guidelines and the cardholder
5500     has not yet received the counseling or consultation required in Subsection 26-61a-502(4):
5501          (i) alert the cardholder of the outstanding need for consultation; and
5502          (ii) provide the cardholder with access to the contact information for each state central
5503     patient portal medical provider and each pharmacy medical provider;
5504          (d) except as provided in Subsection (2)(e), facilitate an electronic medical cannabis
5505     order:
5506          (i) to a home delivery medical cannabis pharmacy for a medical cannabis shipment; or
5507          (ii) to a medical cannabis pharmacy for a medical cannabis cardholder to obtain in
5508     person from the pharmacy;
5509          (e) prohibit a patient from completing an electronic medical cannabis order described
5510     in Subsection (2)(d) if the purchase would exceed the limitations described in Subsection
5511     [26-61a-502] 26B-4-230(2)(a) or (b);
5512          (f) provide educational information to medical cannabis patient cardholders regarding
5513     the state's medical cannabis laws and regulatory programs and other relevant information
5514     regarding medical cannabis; and

5515          (g) allow the patient to designate up to two caregivers who may receive a medical
5516     cannabis caregiver card to purchase and transport medical cannabis on behalf of the patient in
5517     accordance with this [chapter] part.
5518          (3) The department may make rules in accordance with Title 63G, Chapter 3, Utah
5519     Administrative Rulemaking Act, to implement the state central patient portal.
5520          Section 95. Section 26B-4-237, which is renumbered from Section 26-61a-602 is
5521     renumbered and amended to read:
5522          [26-61a-602].      26B-4-237. State central patient portal medical provider.
5523          (1) In relation to the state central patient portal:
5524          (a) the department may only employ, as a state central patient portal medical provider:
5525          (i) a pharmacist who is licensed under Title 58, Chapter 17b, Pharmacy Practice Act; or
5526          (ii) a physician licensed under Title 58, Chapter 67, Utah Medical Practice Act, or Title
5527     58, Chapter 68, Utah Osteopathic Medical Practice Act; and
5528          (b) if the department employs a state central patient portal medical provider, the
5529     department shall ensure that a state central patient portal medical provider is available during
5530     normal business hours.
5531          (2) A state central patient portal medical provider may:
5532          (a) provide consultations to medical cannabis cardholders and qualified medical
5533     providers; and
5534          (b) determine dosing parameters in accordance with Subsection [26-61a-502] 26B-4-
5535     230
(5).
5536          Section 96. Section 26B-4-238, which is renumbered from Section 26-61a-603 is
5537     renumbered and amended to read:
5538          [26-61a-603].      26B-4-238. Payment provider for electronic medical
5539     cannabis transactions.
5540          (1) A cannabis production establishment, a medical cannabis pharmacy, or a
5541     prospective home delivery medical cannabis pharmacy seeking to use a payment provider shall
5542     submit to the Division of Finance and the state treasurer information regarding the payment
5543     provider the prospective licensee will use to conduct financial transactions related to medical
5544     cannabis, including:
5545          (a) the name and contact information of the payment provider;

5546          (b) the nature of the relationship between the establishment, pharmacy, or prospective
5547     pharmacy and the payment provider; and
5548          (c) for a prospective home delivery medical cannabis pharmacy, the processes the
5549     prospective licensee and the payment provider have in place to safely and reliably conduct
5550     financial transactions for medical cannabis shipments.
5551          (2) The Division of Finance shall, in consultation with the state treasurer:
5552          (a) in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act,
5553     make rules to establish standards for identifying payment providers that demonstrate the
5554     functional and technical ability to safely conduct financial transactions related to medical
5555     cannabis, including medical cannabis shipments;
5556          (b) review submissions the Division of Finance and the state treasurer receive under
5557     Subsection (1);
5558          (c) approve a payment provider that meets the standards described in Subsection (2)(a);
5559     and
5560          (d) establish a list of approved payment providers.
5561          (3) Any licensed cannabis production establishment, licensed medical cannabis
5562     pharmacy, or medical cannabis courier may use a payment provider that the Division of
5563     Finance approves, in consultation with the state treasurer, to conduct transactions related to the
5564     establishment's, pharmacy's, or courier's respective medical cannabis business.
5565          (4) If Congress passes legislation that allows a cannabis-related business to facilitate
5566     payments through or deposit funds in a financial institution, a cannabis production
5567     establishment or a medical cannabis pharmacy may facilitate payments through or deposit
5568     funds in a financial institution in addition to or instead of a payment provider that the Division
5569     of Finance approves, in consultation with the state treasurer, under this section.
5570          Section 97. Section 26B-4-239, which is renumbered from Section 26-61a-604 is
5571     renumbered and amended to read:
5572          [26-61a-604].      26B-4-239. Home delivery of medical cannabis shipments --
5573     Medical cannabis couriers -- License.
5574          (1) The department shall make rules, in accordance with Title 63G, Chapter 3, Utah
5575     Administrative Rulemaking Act, to ensure the safety, security, and efficiency of a home
5576     delivery medical cannabis pharmacy's fulfillment of electronic medical cannabis orders that the

5577     state central patient portal facilitates, including rules regarding the safe and controlled delivery
5578     of medical cannabis shipments.
5579          (2) A person may not operate as a medical cannabis courier without a license that the
5580     department issues under this section.
5581          (3) (a) Subject to Subsections (5) and (6), the department shall issue a license to
5582     operate as a medical cannabis courier to an applicant who is eligible for a license under this
5583     section.
5584          (b) An applicant is eligible for a license under this section if the applicant submits to
5585     the department:
5586          (i) the name and address of an individual who:
5587          (A) has a financial or voting interest of 2% or greater in the proposed medical cannabis
5588     pharmacy; or
5589          (B) has the power to direct or cause the management or control of a proposed cannabis
5590     production establishment;
5591          (ii) an operating plan that includes operating procedures to comply with the operating
5592     requirements for a medical cannabis courier described in this [chapter] part; and
5593          (iii) an application fee in an amount that, subject to Subsection [26-61a-109] 26B-1-
5594     310
(5), the department sets in accordance with Section 63J-1-504.
5595          (4) If the department determines that an applicant is eligible for a license under this
5596     section, the department shall:
5597          (a) charge the applicant an initial license fee in an amount that, subject to Subsection
5598     26-61a-109(5), the department sets in accordance with Section 63J-1-504; and
5599          (b) notify the Department of Public Safety of the license approval and the names of
5600     each individual described in Subsection (3)(b)(ii).
5601          (5) The department may not issue a license to operate as a medical cannabis courier to
5602     an applicant if an individual described in Subsection (3)(b)(ii):
5603          (a) has been convicted under state or federal law of:
5604          (i) a felony; or
5605          (ii) after September 23, 2019, a misdemeanor for drug distribution; or
5606          (b) is younger than 21 years old.
5607          (6) The department may revoke a license under this part if:

5608          (a) the medical cannabis courier does not begin operations within one year after the day
5609     on which the department issues the initial license;
5610          (b) the medical cannabis courier makes the same violation of this [chapter] part three
5611     times;
5612          (c) an individual described in Subsection (3)(b)(ii) is convicted, while the license is
5613     active, under state or federal law of:
5614          (i) a felony; or
5615          (ii) after September 23, 2019, a misdemeanor for drug distribution; or
5616          (d) after a change of ownership described in Subsection (15)(c), the department
5617     determines that the medical cannabis courier no longer meets the minimum standards for
5618     licensure and operation of the medical cannabis courier described in this [chapter] part.
5619          (7) The department shall deposit the proceeds of a fee imposed by this section in the
5620     Qualified Patient Enterprise Fund.
5621          (8) The department shall begin accepting applications under this section on or before
5622     July 1, 2020.
5623          (9) The department's authority to issue a license under this section is plenary and is not
5624     subject to review.
5625          (10) Each applicant for a license as a medical cannabis courier shall submit, at the time
5626     of application, from each individual who has a financial or voting interest of 2% or greater in
5627     the applicant or who has the power to direct or cause the management or control of the
5628     applicant:
5629          (a) a fingerprint card in a form acceptable to the Department of Public Safety;
5630          (b) a signed waiver in accordance with Subsection 53-10-108(4) acknowledging the
5631     registration of the individual's fingerprints in the Federal Bureau of Investigation Next
5632     Generation Identification System's Rap Back Service; and
5633          (c) consent to a fingerprint background check by:
5634          (i) the Bureau of Criminal Identification; and
5635          (ii) the Federal Bureau of Investigation.
5636          (11) The Bureau of Criminal Identification shall:
5637          (a) check the fingerprints the applicant submits under Subsection (10) against the
5638     applicable state, regional, and national criminal records databases, including the Federal

5639     Bureau of Investigation Next Generation Identification System;
5640          (b) report the results of the background check to the department;
5641          (c) maintain a separate file of fingerprints that applicants submit under Subsection (10)
5642     for search by future submissions to the local and regional criminal records databases, including
5643     latent prints;
5644          (d) request that the fingerprints be retained in the Federal Bureau of Investigation Next
5645     Generation Identification System's Rap Back Service for search by future submissions to
5646     national criminal records databases, including the Next Generation Identification System and
5647     latent prints; and
5648          (e) establish a privacy risk mitigation strategy to ensure that the department only
5649     receives notifications for an individual with whom the department maintains an authorizing
5650     relationship.
5651          (12) The department shall:
5652          (a) assess an individual who submits fingerprints under Subsection (10) a fee in an
5653     amount that the department sets in accordance with Section 63J-1-504 for the services that the
5654     Bureau of Criminal Identification or another authorized agency provides under this section; and
5655          (b) remit the fee described in Subsection (12)(a) to the Bureau of Criminal
5656     Identification.
5657          (13) The department shall renew a license under this section every year if, at the time
5658     of renewal:
5659          (a) the licensee meets the requirements of this section; and
5660          (b) the licensee pays the department a license renewal fee in an amount that, subject to
5661     Subsection [26-61a-109] 26B-1-310(5), the department sets in accordance with Section
5662     63J-1-504.
5663          (14) A person applying for a medical cannabis courier license shall submit to the
5664     department a proposed operating plan that complies with this section and that includes:
5665          (a) a description of the physical characteristics of any proposed facilities, including a
5666     floor plan and an architectural elevation, and delivery vehicles;
5667          (b) a description of the credentials and experience of each officer, director, or owner of
5668     the proposed medical cannabis courier;
5669          (c) the medical cannabis courier's employee training standards;

5670          (d) a security plan; and
5671          (e) storage and delivery protocols, both short and long term, to ensure that medical
5672     cannabis shipments are stored and delivered in a manner that is sanitary and preserves the
5673     integrity of the cannabis.
5674          (15) (a) A medical cannabis courier license is not transferrable or assignable.
5675          (b) A medical cannabis courier shall report in writing to the department no later than
5676     10 business days before the date of any change of ownership of the medical cannabis courier.
5677          (c) If the ownership of a medical cannabis courier changes by 50% or more:
5678          (i) concurrent with the report described in Subsection (15)(b), the medical cannabis
5679     courier shall submit a new application described in Subsection (3)(b);
5680          (ii) within 30 days of the submission of the application, the department shall:
5681          (A) conduct an application review; and
5682          (B) award a license to the medical cannabis courier for the remainder of the term of the
5683     medical cannabis courier's license before the ownership change if the medical cannabis courier
5684     meets the minimum standards for licensure and operation of the medical cannabis courier
5685     described in this [chapter] part; and
5686          (iii) if the department approves the license application, notwithstanding Subsection (4),
5687     the medical cannabis courier shall pay a license fee that the department sets in accordance with
5688     Section 63J-1-504 in an amount that covers the board's cost of conducting the application
5689     review.
5690          (16) (a) Except as provided in Subsection (15)(b), a person may not advertise regarding
5691     the transportation of medical cannabis.
5692          (b) Notwithstanding Subsection (15)(a) and subject to Section [26-61a-116] 26B-4-
5693     223
, a licensed home delivery medical cannabis pharmacy or a licensed medical cannabis
5694     courier may advertise:
5695          (i) a green cross;
5696          (ii) the pharmacy's or courier's name and logo; and
5697          (iii) that the pharmacy or courier is licensed to transport medical cannabis shipments.
5698          Section 98. Section 26B-4-240, which is renumbered from Section 26-61a-605 is
5699     renumbered and amended to read:
5700          [26-61a-605].      26B-4-240. Medical cannabis shipment transportation.

5701          (1) The department shall ensure that each home delivery medical cannabis pharmacy is
5702     capable of delivering, directly or through a medical cannabis courier, medical cannabis
5703     shipments in a secure manner.
5704          (2) (a) A home delivery medical cannabis pharmacy may contract with a licensed
5705     medical cannabis courier to deliver medical cannabis shipments to fulfill electronic medical
5706     cannabis orders that the state central patient portal facilitates.
5707          (b) If a home delivery medical cannabis pharmacy enters into a contract described in
5708     Subsection (2)(a), the pharmacy shall:
5709          (i) impose security and personnel requirements on the medical cannabis courier
5710     sufficient to ensure the security and safety of medical cannabis shipments; and
5711          (ii) provide regular oversight of the medical cannabis courier.
5712          (3) Except for an individual with a valid medical cannabis card who transports a
5713     shipment the individual receives, an individual may not transport a medical cannabis shipment
5714     unless the individual is:
5715          (a) a registered pharmacy medical provider;
5716          (b) a registered medical cannabis pharmacy agent; or
5717          (c) a registered agent of the medical cannabis courier described in Subsection (2).
5718          (4) An individual transporting a medical cannabis shipment under Subsection (3) shall
5719     possess a physical or electronic transportation manifest that:
5720          (a) includes a unique identifier that links the medical cannabis shipment to a relevant
5721     inventory control system;
5722          (b) includes origin and destination information for the medical cannabis shipment the
5723     individual is transporting; and
5724          (c) indicates the departure and estimated arrival times and locations of the individual
5725     transporting the medical cannabis shipment.
5726          (5) In addition to the requirements in Subsections (3) and (4), the department may
5727     establish by rule, in collaboration with the Division of Professional Licensing and the Board of
5728     Pharmacy and in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act,
5729     requirements for transporting medical cannabis shipments that are related to safety for human
5730     consumption of cannabis or a cannabis product.
5731          (6) (a) It is unlawful for an individual to transport a medical cannabis shipment with a

5732     manifest that does not meet the requirements of Subsection (4).
5733          (b) Except as provided in Subsection (6)(d), an individual who violates Subsection
5734     (6)(a) is:
5735          (i) guilty of an infraction; and
5736          (ii) subject to a $100 fine.
5737          (c) An individual who is guilty of a violation described in Subsection (6)(b) is not
5738     guilty of a violation of Title 58, Chapter 37, Utah Controlled Substances Act, for the conduct
5739     underlying the violation described in Subsection (6)(b).
5740          (d) If the individual described in Subsection (6)(a) is transporting more cannabis,
5741     cannabis product, or medical cannabis devices than the manifest identifies, except for a de
5742     minimis administrative error:
5743          (i) this [chapter] part does not apply; and
5744          (ii) the individual is subject to penalties under Title 58, Chapter 37, Utah Controlled
5745     Substances Act.
5746          Section 99. Section 26B-4-241, which is renumbered from Section 26-61a-606 is
5747     renumbered and amended to read:
5748          [26-61a-606].      26B-4-241. Medical cannabis courier agent -- Background
5749     check -- Registration card -- Rebuttable presumption.
5750          (1) An individual may not serve as a medical cannabis courier agent unless:
5751          (a) the individual is an employee of a licensed medical cannabis courier; and
5752          (b) the department registers the individual as a medical cannabis courier agent.
5753          (2) (a) The department shall, within 15 days after the day on which the department
5754     receives a complete application from a medical cannabis courier on behalf of a medical
5755     cannabis courier agent, register and issue a medical cannabis courier agent registration card to
5756     the prospective agent if the medical cannabis courier:
5757          (i) provides to the department:
5758          (A) the prospective agent's name and address;
5759          (B) the name and address of the medical cannabis courier;
5760          (C) the name and address of each home delivery medical cannabis pharmacy with
5761     which the medical cannabis courier contracts to deliver medical cannabis shipments; and
5762          (D) the submission required under Subsection (2)(b);

5763          (ii) as reported under Subsection (2)(c), has not been convicted under state or federal
5764     law of:
5765          (A) a felony; or
5766          (B) after December 3, 2018, a misdemeanor for drug distribution; and
5767          (iii) pays the department a fee in an amount that, subject to Subsection [26-61a-109]
5768     26B-1-310(5), the department sets in accordance with Section 63J-1-504.
5769          (b) Except for an applicant reapplying for a medical cannabis courier agent registration
5770     card within less than one year after the expiration of the applicant's previous medical cannabis
5771     courier agent registration card, each prospective agent described in Subsection (2)(a) shall:
5772          (i) submit to the department:
5773          (A) a fingerprint card in a form acceptable to the Department of Public Safety; and
5774          (B) a signed waiver in accordance with Subsection 53-10-108(4) acknowledging the
5775     registration of the prospective agent's fingerprints in the Federal Bureau of Investigation Next
5776     Generation Identification System's Rap Back Service; and
5777          (ii) consent to a fingerprint background check by:
5778          (A) the Bureau of Criminal Identification; and
5779          (B) the Federal Bureau of Investigation.
5780          (c) The Bureau of Criminal Identification shall:
5781          (i) check the fingerprints the prospective agent submits under Subsection (2)(b) against
5782     the applicable state, regional, and national criminal records databases, including the Federal
5783     Bureau of Investigation Next Generation Identification System;
5784          (ii) report the results of the background check to the department;
5785          (iii) maintain a separate file of fingerprints that prospective agents submit under
5786     Subsection (2)(b) for search by future submissions to the local and regional criminal records
5787     databases, including latent prints;
5788          (iv) request that the fingerprints be retained in the Federal Bureau of Investigation Next
5789     Generation Identification System's Rap Back Service for search by future submissions to
5790     national criminal records databases, including the Next Generation Identification System and
5791     latent prints; and
5792          (v) establish a privacy risk mitigation strategy to ensure that the department only
5793     receives notifications for an individual with whom the department maintains an authorizing

5794     relationship.
5795          (d) The department shall:
5796          (i) assess an individual who submits fingerprints under Subsection (2)(b) a fee in an
5797     amount that the department sets in accordance with Section 63J-1-504 for the services that the
5798     Bureau of Criminal Identification or another authorized agency provides under this section; and
5799          (ii) remit the fee described in Subsection (2)(d)(i) to the Bureau of Criminal
5800     Identification.
5801          (3) The department shall designate on an individual's medical cannabis courier agent
5802     registration card the name of the medical cannabis pharmacy where the individual is registered
5803     as an agent and each home delivery medical cannabis courier for which the medical cannabis
5804     courier delivers medical cannabis shipments.
5805          (4) (a) A medical cannabis courier agent shall comply with a certification standard that
5806     the department develops, in collaboration with the Division of Professional Licensing and the
5807     Board of Pharmacy, or a third-party certification standard that the department designates by
5808     rule in collaboration with the Division of Professional Licensing and the Board of Pharmacy
5809     and in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
5810          (b) The department shall ensure that the certification standard described in Subsection
5811     (4)(a) includes training in:
5812          (i) Utah medical cannabis law;
5813          (ii) the medical cannabis shipment process; and
5814          (iii) medical cannabis courier agent best practices.
5815          (5) (a) A medical cannabis courier agent registration card expires two years after the
5816     day on which the department issues or renews the card.
5817          (b) A medical cannabis courier agent may renew the agent's registration card if the
5818     agent:
5819          (i) is eligible for a medical cannabis courier agent registration card under this section;
5820          (ii) certifies to the department in a renewal application that the information in
5821     Subsection (2)(a) is accurate or updates the information; and
5822          (iii) pays to the department a renewal fee in an amount that:
5823          (A) subject to Subsection [26-61a-109] 26B-1-310(5), the department sets in
5824     accordance with Section 63J-1-504; and

5825          (B) may not exceed the cost of the relatively lower administrative burden of renewal in
5826     comparison to the original application process.
5827          (6) The department may revoke or refuse to issue or renew the medical cannabis
5828     courier agent registration card of an individual who:
5829          (a) violates the requirements of this [chapter] part; or
5830          (b) is convicted under state or federal law of:
5831          (i) a felony within the preceding 10 years; or
5832          (ii) after December 3, 2018, a misdemeanor for drug distribution.
5833          (7) A medical cannabis courier agent whom the department has registered under this
5834     section shall carry the agent's medical cannabis courier agent registration card with the agent at
5835     all times when:
5836          (a) the agent is on the premises of the medical cannabis courier, a medical cannabis
5837     pharmacy, or a medical cannabis cardholder's home address; and
5838          (b) the agent is handling a medical cannabis shipment.
5839          (8) If a medical cannabis courier agent handling a medical cannabis shipment possesses
5840     the shipment in compliance with Subsection (7):
5841          (a) there is a rebuttable presumption that the agent possesses the shipment legally; and
5842          (b) there is no probable cause, based solely on the agent's possession of the medical
5843     cannabis shipment that the agent is engaging in illegal activity.
5844          (9) (a) A medical cannabis courier agent who violates Subsection (7) is:
5845          (i) guilty of an infraction; and
5846          (ii) subject to a $100 fine.
5847          (b) An individual who is guilty of a violation described in Subsection (9)(a) is not
5848     guilty of a violation of Title 58, Chapter 37, Utah Controlled Substances Act, for the conduct
5849     underlying the violation described in Subsection (9)(a).
5850          Section 100. Section 26B-4-242, which is renumbered from Section 26-61a-607 is
5851     renumbered and amended to read:
5852          [26-61a-607].      26B-4-242. Home delivery of medical cannabis shipments.
5853          (1) An individual may not receive and a medical cannabis pharmacy agent or a medical
5854     cannabis courier agent may not deliver a medical cannabis shipment from a home delivery
5855     medical cannabis pharmacy unless:

5856          (a) the individual receiving the shipment presents:
5857          (i) a valid form of photo identification; and
5858          (ii) (A) a valid medical cannabis card under the same name that appears on the valid
5859     form of photo identification; or
5860          (B) for a facility that a medical cannabis cardholder has designated as a caregiver under
5861     Subsection [26-61a-202] 26B-4-214(1)(b), evidence of the facility caregiver designation; and
5862          (b) the delivery occurs at:
5863          (i) the medical cannabis cardholder's home address that is on file in the state electronic
5864     verification system; or
5865          (ii) the facility that the medical cannabis cardholder has designated as a caregiver under
5866     Subsection [26-61a-202] 26B-4-214(1)(b).
5867          (2) Before a medical cannabis pharmacy agent or a medical cannabis courier agent
5868     distributes a medical cannabis shipment to a medical cannabis cardholder, the agent shall:
5869          (a) verify the shipment information using the state electronic verification system;
5870          (b) ensure that the individual satisfies the identification requirements in Subsection (1);
5871          (c) verify that payment is complete; and
5872          (d) record the completion of the shipment transaction in a manner such that the
5873     delivery of the shipment will later be recorded within a reasonable period in the electronic
5874     verification system.
5875          (3) The medical cannabis courier shall:
5876          (a) (i) store each medical cannabis shipment in a secure manner until the recipient
5877     medical cannabis cardholder receives the shipment or the medical cannabis courier returns the
5878     shipment to the home delivery medical cannabis pharmacy in accordance with Subsection (4);
5879     and
5880          (ii) ensure that only a medical cannabis courier agent is able to access the medical
5881     cannabis shipment until the recipient medical cannabis cardholder receives the shipment;
5882          (b) return any undelivered medical cannabis shipment to the home delivery medical
5883     cannabis pharmacy, in accordance with Subsection (4), after the medical cannabis courier has
5884     possessed the shipment for 10 business days; and
5885          (c) return any medical cannabis shipment to the home delivery medical cannabis
5886     pharmacy, in accordance with Subsection (4), if a medical cannabis cardholder refuses to

5887     accept the shipment.
5888          (4) (a) If a medical cannabis courier or home delivery medical cannabis pharmacy
5889     agent returns an undelivered medical cannabis shipment that remains unopened, the home
5890     delivery medical cannabis pharmacy may repackage or otherwise reuse the shipment.
5891          (b) If a medical cannabis courier or home delivery medical cannabis pharmacy agent
5892     returns an undelivered or refused medical cannabis shipment under Subsection (3) that appears
5893     to be opened in any way, the home delivery medical cannabis pharmacy shall dispose of the
5894     shipment by:
5895          (i) rendering the shipment unusable and unrecognizable before transporting the
5896     shipment from the home delivery medical cannabis pharmacy; and
5897          (ii) disposing of the shipment in accordance with:
5898          (A) federal and state laws, rules, and regulations related to hazardous waste;
5899          (B) the Resource Conservation and Recovery Act, 42 U.S.C. Sec. 6991 et seq.;
5900          (C) Title 19, Chapter 6, Part 5, Solid Waste Management Act; and
5901          (D) other regulations that the department makes in accordance with Title 63G, Chapter
5902     3, Utah Administrative Rulemaking Act.
5903          Section 101. Section 26B-4-301, which is renumbered from Section 26-10b-101 is
5904     renumbered and amended to read:
5905     
Part 3. Health Care Access

5906          [26-10b-101].      26B-4-301. Definitions.
5907          As used in this [chapter] part:
5908          (1) "Account" means the Automatic External Defibrillator Restricted Account, created
5909     in Section 26B-1-307.
5910          (2) "Automatic external defibrillator" or "AED" means an automated or automatic
5911     computerized medical device that:
5912          (a) has received pre-market notification approval from the United States Food and
5913     Drug Administration, pursuant to 21 U.S.C. Sec. 360(k);
5914          (b) is capable of recognizing the presence or absence of ventricular fibrillation or rapid
5915     ventricular tachycardia;
5916          (c) is capable of determining, without intervention by an operator, whether
5917     defibrillation should be performed; and

5918          (d) upon determining that defibrillation should be performed, automatically charges,
5919     enabling delivery of, or automatically delivers, an electrical impulse through the chest wall and
5920     to a person's heart.
5921          (3) "Bureau" means the Bureau of Emergency Medical Services within the department.
5922          (4) "Cardiopulmonary resuscitation" or "CPR" means artificial ventilation or external
5923     chest compression applied to a person who is unresponsive and not breathing.
5924          [(1)] (5) "Committee" means the Primary Care Grant Committee described in Section
5925     [26-10b-106] 26B-1-410.
5926          [(2)] (6) "Community based organization":
5927          (a) means a private entity; and
5928          (b) includes for profit and not for profit entities.
5929          [(3)] (7) "Cultural competence" means a set of congruent behaviors, attitudes, and
5930     policies that come together in a system, agency, or profession and enables that system, agency,
5931     or profession to work effectively in cross-cultural situations.
5932          [(4) "Executive director" means the executive director of the department.]
5933          (8) "Emergency medical dispatch center" means a public safety answering point, as
5934     defined in Section 63H-7a-103, that is designated as an emergency medical dispatch center by
5935     the bureau.
5936          [(5)] (9) "Health literacy" means the degree to which an individual has the capacity to
5937     obtain, process, and understand health information and services needed to make appropriate
5938     health decisions.
5939          [(6)] (10) "Institutional capacity" means the ability of a community based organization
5940     to implement public and private contracts.
5941          [(7)] (11) "Medically underserved population" means the population of an urban or
5942     rural area or a population group that the committee determines has a shortage of primary health
5943     care.
5944          [(8)] (12) "Primary care grant" means a grant awarded by the department under
5945     Subsection [26-10b-102] 26B-4-310(1).
5946          [(9)] (13) (a) "Primary health care" means:
5947          (i) basic and general health care services given when a person seeks assistance to
5948     screen for or to prevent illness and disease, or for simple and common illnesses and injuries;

5949     and
5950          (ii) care given for the management of chronic diseases.
5951          (b) "Primary health care" includes:
5952          (i) services of physicians, nurses, physician's assistants, and dentists licensed to
5953     practice in this state under Title 58, Occupations and Professions;
5954          (ii) diagnostic and radiologic services;
5955          (iii) preventive health services including perinatal services, well-child services, and
5956     other services that seek to prevent disease or its consequences;
5957          (iv) emergency medical services;
5958          (v) preventive dental services; and
5959          (vi) pharmaceutical services.
5960          [(10) "Program" means the primary care grant program created under this chapter.]
5961          (14) "Sudden cardiac arrest" means a life-threatening condition that results when a
5962     person's heart stops or fails to produce a pulse.
5963          Section 102. Section 26B-4-302, which is renumbered from Section 26-8b-201 is
5964     renumbered and amended to read:
5965          [26-8b-201].      26B-4-302. Authority to administer CPR or use an AED.
5966          (1) A person may administer CPR on another person without a license, certificate, or
5967     other governmental authorization if the person reasonably believes that the other person is in
5968     sudden cardiac arrest.
5969          (2) A person may use an AED on another person without a license, certificate, or other
5970     governmental authorization if the person reasonably believes that the other person is in sudden
5971     cardiac arrest.
5972          Section 103. Section 26B-4-303, which is renumbered from Section 26-8b-202 is
5973     renumbered and amended to read:
5974          [26-8b-202].      26B-4-303. Immunity.
5975          (1) Except as provided in Subsection (3), the following persons are not subject to civil
5976     liability for any act or omission relating to preparing to care for, responding to care for, or
5977     providing care to, another person who reasonably appears to be in sudden cardiac arrest:
5978          (a) a person authorized, under Section [26-8b-201] 26B-4-302, to administer CPR,
5979     who:

5980          (i) gratuitously and in good faith attempts to administer or administers CPR to another
5981     person; or
5982          (ii) fails to administer CPR to another person;
5983          (b) a person authorized, under Section [26-8b-201] 26B-4-302, to use an AED who:
5984          (i) gratuitously and in good faith attempts to use or uses an AED; or
5985          (ii) fails to use an AED;
5986          (c) a person that teaches or provides a training course in administering CPR or using an
5987     AED;
5988          (d) a person that acquires an AED;
5989          (e) a person that owns, manages, or is otherwise responsible for the premises or
5990     conveyance where an AED is located;
5991          (f) a person who retrieves an AED in response to a perceived or potential sudden
5992     cardiac arrest;
5993          (g) a person that authorizes, directs, or supervises the installation or provision of an
5994     AED;
5995          (h) a person involved with, or responsible for, the design, management, or operation of
5996     a CPR or AED program;
5997          (i) a person involved with, or responsible for, reporting, receiving, recording, updating,
5998     giving, or distributing information relating to the ownership or location of an AED under [Part
5999     3, Automatic External Defibrillator Databases] Sections 26B-4-304 through 26B-4-306; or
6000          (j) a physician who gratuitously and in good faith:
6001          (i) provides medical oversight for a public AED program; or
6002          (ii) issues a prescription for a person to acquire or use an AED.
6003          (2) This section does not relieve a manufacturer, designer, developer, marketer, or
6004     commercial distributor of an AED, or an accessory for an AED, of any liability.
6005          (3) The liability protection described in Subsection (1) does not apply to an act or
6006     omission that constitutes gross negligence or willful misconduct.
6007          Section 104. Section 26B-4-304, which is renumbered from Section 26-8b-301 is
6008     renumbered and amended to read:
6009          [26-8b-301].      26B-4-304. Reporting location of automatic external
6010     defibrillators.

6011          (1) In accordance with Subsection (2) and except as provided in Subsection (3):
6012          (a) a person who owns or leases an AED shall report the person's name, address, and
6013     telephone number, and the exact location of the AED, in writing or by a web-based AED
6014     registration form, if available, to the emergency medical dispatch center that provides
6015     emergency dispatch services for the location where the AED is installed, if the person:
6016          (i) installs the AED;
6017          (ii) causes the AED to be installed; or
6018          (iii) allows the AED to be installed; and
6019          (b) a person who owns or leases an AED that is removed from a location where it is
6020     installed shall report the person's name, address, and telephone number, and the exact location
6021     from which the AED is removed, in writing or by a web-based AED registration form, if
6022     available, to the emergency medical dispatch center that provides emergency dispatch services
6023     for the location from which the AED is removed, if the person:
6024          (i) removes the AED;
6025          (ii) causes the AED to be removed; or
6026          (iii) allows the AED to be removed.
6027          (2) A report required under Subsection (1) shall be made within 14 days after the day
6028     on which the AED is installed or removed.
6029          (3) Subsection (1) does not apply to an AED:
6030          (a) at a private residence; or
6031          (b) in a vehicle or other mobile or temporary location.
6032          (4) A person who owns or leases an AED that is installed in, or removed from, a
6033     private residence may voluntarily report the location of, or removal of, the AED to the
6034     emergency medical dispatch center that provides emergency dispatch services for the location
6035     where the private residence is located.
6036          (5) The department may not impose a penalty on a person for failing to comply with
6037     the requirements of this section.
6038          Section 105. Section 26B-4-305, which is renumbered from Section 26-8b-302 is
6039     renumbered and amended to read:
6040          [26-8b-302].      26B-4-305. Distributors to notify of reporting requirements.
6041          A person in the business of selling or leasing an AED shall, at the time the person

6042     provides, sells, or leases an AED to another person, notify the other person, in writing, of the
6043     reporting requirements described in Section [26-8b-301] 26B-4-304.
6044          Section 106. Section 26B-4-306, which is renumbered from Section 26-8b-303 is
6045     renumbered and amended to read:
6046          [26-8b-303].      26B-4-306. Duties of emergency medical dispatch centers.
6047          An emergency medical dispatch center shall:
6048          (1) implement a system to receive and manage the information reported to the
6049     emergency medical dispatch center under Section [26-8b-301] 26B-4-304;
6050          (2) record in the system described in Subsection (1), all information received under
6051     Section [26-8b-301] 26B-4-304 within 14 days after the day on which the information is
6052     received;
6053          (3) inform a person who calls to report a potential incident of sudden cardiac arrest of
6054     the location of an AED located at the address of the potential sudden cardiac arrest;
6055          (4) provide verbal instructions to a person described in Subsection (3) to:
6056          (a) help a person determine if a patient is in cardiac arrest; and
6057          (b) if needed:
6058          (i) provide direction to start CPR;
6059          (ii) offer instructions on how to perform CPR; or
6060          (iii) offer instructions on how to use an AED, if one is available; and
6061          (5) provide the information contained in the system described in Subsection (1), upon
6062     request, to the bureau.
6063          Section 107. Section 26B-4-307, which is renumbered from Section 26-8b-401 is
6064     renumbered and amended to read:
6065          [26-8b-401].      26B-4-307. Education and training.
6066          (1) The bureau shall work in cooperation with federal, state, and local agencies and
6067     schools, to encourage individuals to complete courses on the administration of CPR and the use
6068     of an AED.
6069          (2) A person who owns or leases an AED shall encourage each person who is likely to
6070     use the AED to complete courses on the administration of CPR and the use of an AED.
6071          Section 108. Section 26B-4-308, which is renumbered from Section 26-8b-402 is
6072     renumbered and amended to read:

6073          [26-8b-402].      26B-4-308. AEDs for demonstration purposes.
6074          (1) Any AED used solely for demonstration or training purposes, which is not
6075     operational for emergency use is, except for the provisions of this section, exempt from the
6076     provisions of this [chapter] part.
6077          (2) The owner of an AED described in Subsection (1) shall clearly mark on the exterior
6078     of the AED that the AED is for demonstration or training use only.
6079          Section 109. Section 26B-4-309, which is renumbered from Section 26-8b-501 is
6080     renumbered and amended to read:
6081          [26-8b-501].      26B-4-309. Tampering with an AED prohibited -- Penalties.
6082          A person is guilty of a class C misdemeanor if the person removes, tampers with, or
6083     otherwise disturbs an AED, AED cabinet or enclosure, or AED sign, unless:
6084          (1) the person is authorized by the AED owner for the purpose of:
6085          (a) inspecting the AED or AED cabinet or enclosure; or
6086          (b) performing maintenance or repairs on the AED, the AED cabinet or enclosure, a
6087     wall or structure that the AED cabinet or enclosure is directly attached to, or an AED sign;
6088          (2) the person is responding to, or providing care to, a potential sudden cardiac arrest
6089     patient; or
6090          (3) the person acts in good faith with the intent to support, and not to violate, the
6091     recognized purposes of the AED.
6092          Section 110. Section 26B-4-310, which is renumbered from Section 26-10b-102 is
6093     renumbered and amended to read:
6094          [26-10b-102].      26B-4-310. Department to award grants -- Applications.
6095          (1) Within appropriations specified by the Legislature for this purpose, the department
6096     may, in accordance with the recommendation of the committee, award a grant to a public or
6097     nonprofit entity to provide primary health care to a medically underserved population.
6098          (2) When awarding a grant under Subsection (1), the department shall, in accordance
6099     with the committee's recommendation, consider:
6100          (a) the content of a grant application submitted to the department;
6101          (b) whether an application is submitted in the manner and form prescribed by the
6102     department; and
6103          (c) the criteria established in Section [26-10b-103] 26B-4-311.

6104          (3) The application for a grant under Subsection (2)(a) shall contain:
6105          (a) a requested award amount;
6106          (b) a budget; and
6107          (c) a narrative plan of the manner in which the applicant intends to provide the primary
6108     health care described in Subsection (1).
6109          Section 111. Section 26B-4-311, which is renumbered from Section 26-10b-103 is
6110     renumbered and amended to read:
6111          [26-10b-103].      26B-4-311. Content of grant applications.
6112          An applicant for a grant under [this chapter] Section 26B-4-310 shall include, in an
6113     application:
6114          (1) a statement of specific, measurable objectives, and the methods the applicant will
6115     use to assess the achievement of those objectives;
6116          (2) the precise boundaries of the area the applicant will serve, including a description
6117     of the medically underserved population the applicant will serve using the grant;
6118          (3) the results of a need assessment that demonstrates that the population the applicant
6119     will serve has a need for the services provided by the applicant;
6120          (4) a description of the personnel responsible for carrying out the activities of the grant
6121     along with a statement justifying the use of any grant funds for the personnel;
6122          (5) evidence that demonstrates the applicant's existing financial and professional
6123     assistance and any attempts by the applicant to obtain financial and professional assistance;
6124          (6) a list of services the applicant will provide;
6125          (7) the schedule of fees, if any, the applicant will charge;
6126          (8) the estimated number of individuals the applicant will serve with the grant award;
6127     and
6128          (9) any other information required by the department in consultation with the
6129     committee.
6130          Section 112. Section 26B-4-312, which is renumbered from Section 26-10b-104 is
6131     renumbered and amended to read:
6132          [26-10b-104].      26B-4-312. Process and criteria for awarding primary care
6133     grants.
6134          (1) The department shall review and rank applications based on the criteria in this

6135     section and transmit the applications to the committee for review.
6136          (2) The committee shall, after reviewing the applications transferred to the committee
6137     under Subsection (1), make recommendations to the executive director.
6138          (3) The executive director shall, in accordance with the committee's recommendations,
6139     decide which applications to award grants under Subsection [26-10b-102] 26B-4-310(1).
6140          (4) The department shall establish rules in accordance with Title 63G, Chapter 3, Utah
6141     Administrative Rulemaking Act, governing the application form, the process, and the criteria
6142     the department will use in reviewing, ranking, and awarding grants and contracts under this
6143     chapter.
6144          (5) When reviewing, ranking, and awarding a primary care grant under Subsection
6145     [26-10b-102] 26B-4-310(1), the department shall consider the extent to which an applicant:
6146          (a) demonstrates that the area or a population group the applicant will serve under the
6147     application has a shortage of primary health care and that the primary health care will be
6148     located so that it provides assistance to the greatest number of individuals in the population
6149     group;
6150          (b) utilizes other sources of funding, including private funding, to provide primary
6151     health care;
6152          (c) demonstrates the ability and expertise to serve a medically underserved population;
6153          (d) agrees to submit a report to the committee annually; and
6154          (e) meets other criteria determined by the department in consultation with the
6155     committee.
6156          (6) The department may use up to 5% of the funds appropriated by the Legislature to
6157     the primary care grant program [under this chapter] to pay the costs of administering the
6158     program.
6159          Section 113. Section 26B-4-313, which is renumbered from Section 26-10b-107 is
6160     renumbered and amended to read:
6161          [26-10b-107].      26B-4-313. Community education and outreach contracts.
6162          (1) The department may, as funding permits, contract with community based
6163     organizations for the purpose of developing culturally and linguistically appropriate programs
6164     and services for low income and medically underserved populations to accomplish one or more
6165     of the following:

6166          (a) to educate individuals:
6167          (i) to use private and public health care coverage programs, products, services, and
6168     resources in a timely, effective, and responsible manner;
6169          (ii) to pursue preventive health care, health screenings, and disease management; and
6170          (iii) to locate health care programs and services;
6171          (b) to assist individuals to develop:
6172          (i) personal health management;
6173          (ii) self-sufficiency in daily care; and
6174          (iii) life and disease management skills;
6175          (c) to support translation of health materials and information;
6176          (d) to facilitate an individual's access to primary care and providers, including mental
6177     health services; and
6178          (e) to measure and report empirical results of the pilot project.
6179          (2) When awarding a contract for community based services under Subsection (1), the
6180     department shall consider the extent to which the applicant:
6181          (a) demonstrates that the area or a population group to be served under the application
6182     is a medically underserved population and that the services will be located to provide
6183     assistance to the greatest number of individuals residing in the area or included in the
6184     population group;
6185          (b) utilizes other sources of funding, including private funding, to provide the services
6186     described in Subsection (1);
6187          (c) demonstrates the ability and expertise to serve medically underserved populations,
6188     including individuals with limited English-speaking ability, single heads of households, the
6189     elderly, individuals with low income, and individuals with a chronic disease;
6190          (d) meets other criteria determined by the department; and
6191          (e) demonstrates the ability to empirically measure and report the results of all contract
6192     supported activities.
6193          (3) The department may only award a contract under Subsection (1):
6194          (a) in accordance with Title 63G, Chapter 6a, Utah Procurement Code;
6195          (b) that contains the information described in Section [26-10b-103] 26B-4-311,
6196     relating to grants; and

6197          (c) that complies with Subsections (4) and (5).
6198          (4) An applicant under this chapter shall demonstrate to the department that the
6199     applicant will not deny services to a person because of the person's inability to pay for the
6200     services.
6201          (5) Subsection (4) does not preclude an applicant from seeking payment from the
6202     person receiving services, a third party, or a government agency if:
6203          (a) the applicant is authorized to charge for the services; and
6204          (b) the person, third party, or government agency is under legal obligation to pay for
6205     the services.
6206          (6) The department shall maximize the use of federal matching funds received for
6207     services under Subsection (1) to fund additional contracts under Subsection (1).
6208          Section 114. Section 26B-4-314, which is renumbered from Section 26-9-1 is
6209     renumbered and amended to read:
6210          [26-9-1].      26B-4-314. Assistance to rural communities by department.
6211          The department shall assist rural communities in dealing with primary health care needs
6212     relating to recruiting health professionals, planning, and technical assistance. The department
6213     shall assist the communities, at their request, at any stage of development of new or expanded
6214     primary health care services and shall work with them to improve primary health care by
6215     providing information to increase the effectiveness of their systems, to decrease duplication
6216     and fragmentation of services, and to maximize community use of private gifts, and local, state,
6217     and federal grants and contracts.
6218          Section 115. Section 26B-4-315, which is renumbered from Section 26-9-2 is
6219     renumbered and amended to read:
6220          [26-9-2].      26B-4-315. Responsibility of department for coordinating rural
6221     health programs.
6222          The department shall be the lead agency responsible for coordinating rural health
6223     programs and shall insure that resources available for rural health are efficiently and effectively
6224     used.
6225          Section 116. Section 26B-4-316, which is renumbered from Section 26-9-3 is
6226     renumbered and amended to read:
6227          [26-9-3].      26B-4-316. Rural health development initiatives.

6228          (1) (a) The University of Utah Health Science Center shall use any appropriations it
6229     receives for developing area health education centers to establish and maintain an area health
6230     education center program in accordance with this section.
6231          (b) Implementation and execution of the area health education center program is
6232     contingent upon appropriations from the Legislature.
6233          (2) (a) The area health education center program shall consist of a central program
6234     office at the University of Utah Health Science Center. The program office shall establish and
6235     operate a statewide, decentralized, regional program with emphasis on addressing rural health
6236     professions workforce education and training needs.
6237          (b) The area health education center program shall have five regional centers serving
6238     the following geographic areas:
6239          (i) the northern center serving Box Elder, Cache, Rich, Weber, and Morgan counties;
6240          (ii) the crossroads center serving Salt Lake, Wasatch, Summit, Tooele, Utah, and Davis
6241     counties;
6242          (iii) the central center serving Juab, Millard, Piute, Sanpete, Sevier, and Wayne
6243     counties;
6244          (iv) the eastern center serving Carbon, Daggett, Duchesne, Emery, Grand, San Juan,
6245     and Uintah counties; and
6246          (v) the southwest center serving Beaver, Garfield, Iron, Kane, and Washington
6247     counties.
6248          (3) The area health education center program shall attempt to acquire funding from
6249     state, local, federal, and private sources.
6250          (4) Each area health education center shall provide community-based health
6251     professions education programming for the geographic area described in Subsection (2)(b) of
6252     this section.
6253          Section 117. Section 26B-4-317, which is renumbered from Section 26-9-5 is
6254     renumbered and amended to read:
6255          [26-9-5].      26B-4-317. Rural County Health Care Special Service District
6256     Retirement Grant Program.
6257          (1) As used in this section:
6258          (a) "Participating employer" means an employer that was required to participate in the

6259     Utah State Retirement System under Section 49-12-201, 49-12-202, 49-13-201, or 49-13-202.
6260          (b) "Retirement liability" means an obligation in excess of $750,000 owed to the Utah
6261     State Retirement Office by a rural county health care special service district as a participating
6262     employer.
6263          (c) "Rural county health care special service district" means a special service district
6264     formed to provide health care in a third, fourth, fifth, or sixth class county as defined in Section
6265     17-50-501.
6266          (2) Because there is a compelling statewide public purpose in promoting health care in
6267     Utah's rural counties, and particularly in ensuring the continued existence and financial
6268     viability of hospital services provided by rural county health care special service districts, there
6269     is created a grant program to assist rural county health care special service districts in meeting a
6270     retirement liability.
6271          (3) (a) Subject to legislative appropriation and this Subsection (3), the department shall
6272     make grants to rural county health care special service districts.
6273          (b) To qualify for a grant, a rural county health care special service district shall:
6274          (i) file a grant application with the department detailing:
6275          (A) the name of the rural county health care special service district;
6276          (B) the estimated total amount of the retirement liability;
6277          (C) the grant amount that the rural county health care special service district is
6278     requesting; and
6279          (D) the amount of matching funds to be provided by the rural county health care
6280     special service district to help fund the retirement liability as required by Subsection (3)(d); and
6281          (ii) commit to provide matching funds as required by Subsection (3)(d).
6282          (c) The department shall review each grant application and, subject to legislative
6283     appropriation, award grants to each rural health care special service district that qualifies for a
6284     grant under Subsection (3)(b).
6285          (d) The department may not award a grant to a rural county health care special service
6286     district unless the rural county health care special service district commits to provide matching
6287     funds to the grant equal to at least 40% of the amount of the grant.
6288          Section 118. Section 26B-4-318, which is renumbered from Section 26-10-2 is
6289     renumbered and amended to read:

6290          [26-10-2].      26B-4-318. Maternal and child health provided by department.
6291          The department shall, as funding permits, provide for maternal and child health services
6292     and services for children with a disability if the individual needs the services and the individual
6293     cannot reasonably obtain the services from other sources.
6294          Section 119. Section 26B-4-319, which is renumbered from Section 26-10-6 is
6295     renumbered and amended to read:
6296          [26-10-6].      26B-4-319. Testing of newborn infants.
6297          (1) Except in the case where parents object on the grounds that they are members of a
6298     specified, well-recognized religious organization whose teachings are contrary to the tests
6299     required by this section, a newborn infant shall be tested for:
6300          (a) phenylketonuria (PKU);
6301          (b) other heritable disorders which may result in an intellectual or physical disability or
6302     death and for which:
6303          (i) a preventive measure or treatment is available; and
6304          (ii) there exists a reliable laboratory diagnostic test method;
6305          (c) (i) an infant born in a hospital with 100 or more live births annually, hearing loss;
6306     and
6307          (ii) an infant born in a setting other than a hospital with 100 or more live births
6308     annually, hearing loss; and
6309          (d) critical congenital heart defects using pulse oximetry.
6310          (2) In accordance with Section 26B-1-209, the department may charge fees for:
6311          (a) materials supplied by the department to conduct tests required under Subsection (1);
6312          (b) tests required under Subsection (1) conducted by the department;
6313          (c) laboratory analyses by the department of tests conducted under Subsection (1); and
6314          (d) the administrative cost of follow-up contacts with the parents or guardians of tested
6315     infants.
6316          (3) Tests for hearing loss described in Subsection (1) shall be based on one or more
6317     methods approved by the Newborn Hearing Screening Committee, including:
6318          (a) auditory brainstem response;
6319          (b) automated auditory brainstem response; and
6320          (c) evoked otoacoustic emissions.

6321          (4) Results of tests for hearing loss described in Subsection (1) shall be reported to:
6322          (a) the department; and
6323          (b) when results of tests for hearing loss under Subsection (1) suggest that additional
6324     diagnostic procedures or medical interventions are necessary:
6325          (i) a parent or guardian of the infant;
6326          (ii) an early intervention program administered by the department in accordance with
6327     Part C of the Individuals with Disabilities Education Act, 20 U.S.C. Sec. 1431 et seq.; and
6328          (iii) the Utah Schools for the Deaf and the Blind, created in Section 53E-8-201.
6329          [(5) (a) There is established the Newborn Hearing Screening Committee.]
6330          [(b) The committee shall advise the department on:]
6331          [(i) the validity and cost of newborn infant hearing loss testing procedures; and]
6332          [(ii) rules promulgated by the department to implement this section.]
6333          [(c) The committee shall be composed of at least 11 members appointed by the
6334     executive director, including:]
6335          [(i) one representative of the health insurance industry;]
6336          [(ii) one pediatrician;]
6337          [(iii) one family practitioner;]
6338          [(iv) one ear, nose, and throat specialist nominated by the Utah Medical Association;]
6339          [(v) two audiologists nominated by the Utah Speech-Language-Hearing Association;]
6340          [(vi) one representative of hospital neonatal nurseries;]
6341          [(vii) one representative of the Early Intervention Baby Watch Program administered
6342     by the department;]
6343          [(viii) one public health nurse;]
6344          [(ix) one consumer; and]
6345          [(x) the executive director or the executive director's designee.]
6346          [(d) Of the initial members of the committee, the executive director shall appoint as
6347     nearly as possible half to two-year terms and half to four-year terms. Thereafter, appointments
6348     shall be for four-year terms except:]
6349          [(i) for those members who have been appointed to complete an unexpired term; and]
6350          [(ii) as necessary to ensure that as nearly as possible the terms of half the appointments
6351     expire every two years.]

6352          [(e) A majority of the members constitute a quorum, and a vote of the majority of the
6353     members present constitutes an action of the committee.]
6354          [(f) The committee shall appoint a chairman from the committee's membership.]
6355          [(g) The committee shall meet at least quarterly.]
6356          [(h) A member may not receive compensation or benefits for the member's service, but
6357     may receive per diem and travel expenses in accordance with:]
6358          [(i) Section 63A-3-106;]
6359          [(ii) Section 63A-3-107; and]
6360          [(iii) rules made by the Division of Finance pursuant to Sections 63A-3-106 and
6361     63A-3-107.]
6362          [(i) The department shall provide staff for the committee.]
6363          [(6)] (5) Before implementing the test required by Subsection (1)(d), the department
6364     shall conduct a pilot program for testing newborns for critical congenital heart defects using
6365     pulse oximetry. The pilot program shall include the development of:
6366          (a) appropriate oxygen saturation levels that would indicate a need for further medical
6367     follow-up; and
6368          (b) the best methods for implementing the pulse oximetry screening in newborn care
6369     units.
6370          Section 120. Section 26B-4-320, which is renumbered from Section 26-10-7 is
6371     renumbered and amended to read:
6372          [26-10-7].      26B-4-320. Dental health programs -- Appointment of director.
6373          The department shall establish and promote programs to protect and improve the dental
6374     health of the public. The executive director shall appoint a director of the dental health program
6375     who shall be a dentist licensed in the state with at least one year of training in an accredited
6376     school of public health or not less than two years of experience in public health dentistry.
6377          Section 121. Section 26B-4-321, which is renumbered from Section 26-10-9 is
6378     renumbered and amended to read:
6379          [26-10-9].      26B-4-321. Immunizations -- Consent of minor to treatment.
6380          (1) This section:
6381          (a) is not intended to interfere with the integrity of the family or to minimize the rights
6382     of parents or children; and

6383          (b) applies to a minor, who at the time care is sought is:
6384          (i) married or has been married;
6385          (ii) emancipated as provided for in Section 80-7-105;
6386          (iii) a parent with custody of a minor child; or
6387          (iv) pregnant.
6388          (2) (a) A minor described in Subsections (1)(b)(i) and (ii) may consent to:
6389          (i) vaccinations against epidemic infections and communicable diseases as defined in
6390     Section [26-6-2] 26B-7-201; and
6391          (ii) examinations and vaccinations required to attend school as provided in Title 53G,
6392     Public Education System -- Local Administration.
6393          (b) A minor described in Subsections (1)(b)(iii) and (iv) may consent to the
6394     vaccinations described in Subsections (2)(a)(i) and (ii), and the vaccine for human
6395     papillomavirus only if:
6396          (i) the minor represents to the health care provider that the minor is an abandoned
6397     minor as defined in Section 76-5-109.3; and
6398          (ii) the health care provider makes a notation in the minor's chart that the minor
6399     represented to the health care provider that the minor is an abandoned minor under Section
6400     76-5-109.3.
6401          (c) Nothing in Subsection (2)(a) or (b) requires a health care provider to immunize a
6402     minor.
6403          (3) The consent of the minor pursuant to this section:
6404          (a) is not subject to later disaffirmance because of the minority of the person receiving
6405     the medical services;
6406          (b) is not voidable because of minority at the time the medical services were provided;
6407          (c) has the same legal effect upon the minor and the same legal obligations with regard
6408     to the giving of consent as consent given by a person of full age and capacity; and
6409          (d) does not require the consent of any other person or persons to authorize the medical
6410     services described in Subsections (2)(a) and (b).
6411          (4) A health care provider who provides medical services to a minor in accordance
6412     with the provisions of this section is not subject to civil or criminal liability for providing the
6413     services described in Subsections (2)(a) and (b) without obtaining the consent of another

6414     person prior to rendering the medical services.
6415          (5) This section does not remove the requirement for parental consent or notice when
6416     required by Section 76-7-304 or 76-7-304.5.
6417          (6) The parents, parent, or legal guardian of a minor who receives medical services
6418     pursuant to Subsections (2)(a) and (b) are not liable for the payment for those services unless
6419     the parents, parent, or legal guardian consented to the medical services.
6420          Section 122. Section 26B-4-322, which is renumbered from Section 26-10-11 is
6421     renumbered and amended to read:
6422          [26-10-11].      26B-4-322. Children's Hearing Aid Program -- Rulemaking.
6423          (1) The department shall offer a program to provide hearing aids to children who
6424     qualify under this section.
6425          (2) The department shall provide hearing aids to a child who:
6426          (a) is younger than six years old;
6427          (b) is a resident of Utah;
6428          (c) has been diagnosed with hearing loss by:
6429          (i) an audiologist with pediatric expertise; and
6430          (ii) a physician or physician assistant;
6431          (d) provides documentation from an audiologist with pediatric expertise certifying that
6432     the child needs hearing aids;
6433          (e) has obtained medical clearance by a medical provider for hearing aid fitting;
6434          (f) does not qualify to receive a contribution that equals the full cost of a hearing aid
6435     from the state's Medicaid program or the Utah Children's Health Insurance Program; and
6436          (g) meets the financial need qualification criteria established by the department by rule,
6437     made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, for
6438     participation in the program.
6439          [(3) (a) There is established the Children's Hearing Aid Advisory Committee.]
6440          [(b) The committee shall be composed of five members appointed by the executive
6441     director, and shall include:]
6442          [(i) one audiologist with pediatric expertise;]
6443          [(ii) one speech language pathologist;]
6444          [(iii) one teacher, certified under Title 53E, Public Education System -- State

6445     Administration, as a teacher of the deaf or a listening and spoken language therapist;]
6446          [(iv) one ear, nose, and throat specialist; and]
6447          [(v) one parent whose child:]
6448          [(A) is six years old or older; and]
6449          [(B) has hearing loss.]
6450          [(c) A majority of the members constitutes a quorum.]
6451          [(d) A vote of the majority of the members, with a quorum present, constitutes an
6452     action of the committee.]
6453          [(e) The committee shall elect a chair from its members.]
6454          [(f) The committee shall:]
6455          [(i) meet at least quarterly;]
6456          [(ii) recommend to the department medical criteria and procedures for selecting
6457     children who may qualify for assistance from the account; and]
6458          [(iii) review rules developed by the department.]
6459          [(g) A member may not receive compensation or benefits for the member's service, but
6460     may receive per diem and travel expenses in accordance with Sections 63A-3-106 and
6461     63A-3-107 and rules made by the Division of Finance, pursuant to Sections 63A-3-106 and
6462     63A-3-107.]
6463          [(h) The department shall provide staff to the committee.]
6464          [(4) (a) There is created within the General Fund a restricted account known as the
6465     "Children's Hearing Aid Program Restricted Account."]
6466          [(b) The Children's Hearing Aid Program Restricted Account shall consist of:]
6467          [(i) amounts appropriated to the account by the Legislature; and]
6468          [(ii) gifts, grants, devises, donations, and bequests of real property, personal property,
6469     or services, from any source, or any other conveyance that may be made to the account from
6470     private sources.]
6471          [(c) Upon appropriation, all actual and necessary operating expenses for the committee
6472     described in Subsection (3) shall be paid by the account.]
6473          [(d) Upon appropriation, no more than 9% of the account money may be used for the
6474     department's expenses.]
6475          [(e) If this account is repealed in accordance with Section 63I-1-226, any remaining

6476     assets in the account shall be deposited into the General Fund.]
6477          [(5)] (3) (a) For each child who receives a hearing aid under Subsection (2), the
6478     department shall maintain a record of the cost of providing services to the child under this
6479     section.
6480          (b) No more than six months after services are provided to a child under this section,
6481     the department shall send a letter to the family of the child who received services that includes
6482     information regarding:
6483          (i) the total amount paid by the department to provide services to the child under this
6484     section; and
6485          (ii) the process by which the family may donate all or part of the amount paid to
6486     provide services to the child to fund the Children's Hearing Aid Program.
6487          (c) All donations made under Subsection [(6)] (4)(c) shall be deposited into the
6488     Children's Hearing Aid Program Restricted Account created in [Subsection (4)(a)] Section
6489     26B-1-333.
6490          [(6)] (4) The department shall make rules, in accordance with Title 63G, Chapter 3,
6491     Utah Administrative Rulemaking Act, to establish procedures for:
6492          (a) identifying the children who are financially eligible to receive services under the
6493     program;
6494          (b) reviewing and paying for services provided to a child under the program; and
6495          (c) an individual to donate to the program all or part of the cost of providing services to
6496     a child under this section, without regard to whether the donation is made in response to the
6497     letter described in Subsection [(5)] (3)(b).
6498          Section 123. Section 26B-4-323, which is renumbered from Section 26-10-13 is
6499     renumbered and amended to read:
6500          [26-10-13].      26B-4-323. Reporting results of a test for hearing loss.
6501          (1) As used in this section, "health care provider" means the same as that term is
6502     defined in Section 78B-3-403.
6503          (2) Except as provided in Subsection (3), a health care provider shall report results of a
6504     test for hearing loss to the Utah Schools for the Deaf and the Blind if:
6505          (a) the results suggest that additional diagnostic procedures or medical interventions
6506     are necessary; and

6507          (b) the individual tested for hearing loss is under the age of 22.
6508          (3) A health care provider may not make the report of an individual's results described
6509     in Subsection (2) if the health care provider receives a request to not make the report from:
6510          (a) the individual, if the individual is not a minor; or
6511          (b) the individual's parent or guardian, if the individual is a minor.
6512          Section 124. Section 26B-4-401, which is renumbered from Section 26-53-102 is
6513     renumbered and amended to read:
6514     
Part 4. School Health

6515          [26-53-102].      26B-4-401. Definitions.
6516          As used in this [chapter] part:
6517          (1) "Agent" means a coach, teacher, employee, representative, or volunteer.
6518          (2) (a) "Amateur sports organization" means, except as provided in Subsection (2)(b):
6519          (i) a sports team;
6520          (ii) a public or private school;
6521          (iii) a public or private sports league;
6522          (iv) a public or private sports camp; or
6523          (v) any other public or private organization that organizes, manages, or sponsors a
6524     sporting event for its members, enrollees, or attendees.
6525          (b) "Amateur sports organization" does not include a professional:
6526          (i) team;
6527          (ii) league; or
6528          (iii) sporting event.
6529          (3) "Anaphylaxis" means a potentially life-threatening hypersensitivity to a substance.
6530          (a) Symptoms of anaphylaxis may include shortness of breath, wheezing, difficulty
6531     breathing, difficulty talking or swallowing, hives, itching, swelling, shock, or asthma.
6532          (b) Causes of anaphylaxis may include insect sting, food allergy, drug reaction, and
6533     exercise.
6534          (4) "Asthma action plan" means a written plan:
6535          (a) developed with a school nurse, a student's parent or guardian, and the student's
6536     health care provider to help control the student's asthma; and
6537          (b) signed by the student's:

6538          (i) parent or guardian; and
6539          (ii) health care provider.
6540          (5) "Asthma emergency" means an episode of respiratory distress that may include
6541     symptoms such as wheezing, shortness of breath, coughing, chest tightness, or breathing
6542     difficulty.
6543          [(3)] (6) "Child" means an individual who is under the age of 18.
6544          (7) "Epinephrine auto-injector" means a portable, disposable drug delivery device that
6545     contains a measured, single dose of epinephrine that is used to treat a person suffering a
6546     potentially fatal anaphylactic reaction.
6547          (8) "Health care provider" means an individual who is licensed as:
6548          (a) a physician under Title 58, Chapter 67, Utah Medical Practice Act;
6549          (b) a physician under Title 58, Chapter 68, Utah Osteopathic Medical Practice Act;
6550          (c) an advanced practice registered nurse under Section 58-31b-302; or
6551          (d) a physician assistant under Title 58, Chapter 70a, Utah Physician Assistant Act.
6552          (9) "Pharmacist" means the same as that term is defined in Section 58-17b-102.
6553          (10) "Pharmacy intern" means the same as that term is defined in Section 58-17b-102.
6554          (11) "Physician" means the same as that term is defined in Section 58-67-102.
6555          (12) "Qualified adult" means a person who:
6556          (a) is 18 years of age or older; and
6557          (b) (i) for purposes of administering an epinephrine auto-injector, has successfully
6558     completed the training program established in Section 26B-4-407; and
6559          (ii) for purposes of administering stock albuterol, has successfully completed the
6560     training program established in Section 26B-4-408.
6561          (13) "Qualified epinephrine auto-injector entity":
6562          (a) means a facility or organization that employs, contracts with, or has a similar
6563     relationship with a qualified adult who is likely to have contact with another person who may
6564     experience anaphylaxis; and
6565          (b) includes:
6566          (i) recreation camps;
6567          (ii) an education facility, school, or university;
6568          (iii) a day care facility;

6569          (iv) youth sports leagues;
6570          (v) amusement parks;
6571          (vi) food establishments;
6572          (vii) places of employment; and
6573          (viii) recreation areas.
6574          [(4)] (14) "Qualified health care provider" means a health care provider who:
6575          (a) is licensed under Title 58, Occupations and Professions; and
6576          (b) may evaluate and manage a concussion within the health care provider's scope of
6577     practice.
6578          (15) "Qualified stock albuterol entity" means a public or private school that employs,
6579     contracts with, or has a similar relationship with a qualified adult who is likely to have contact
6580     with another person who may experience an asthma emergency.
6581          [(5)] (16) (a) "Sporting event" means any of the following athletic activities that is
6582     organized, managed, or sponsored by an organization:
6583          (i) a game;
6584          (ii) a practice;
6585          (iii) a sports camp;
6586          (iv) a physical education class;
6587          (v) a competition; or
6588          (vi) a tryout.
6589          (b) "Sporting event" does not include:
6590          (i) the issuance of a lift ticket or pass by a ski resort, the use of the ticket or pass, or a
6591     ski or snowboarding class or school at a ski resort, unless the skiing or snowboarding is part of
6592     a camp, team, or competition that is organized, managed, or sponsored by the ski resort;
6593          (ii) as applied to a government entity, merely making available a field, facility, or other
6594     location owned, leased, or controlled by the government entity to an amateur sports
6595     organization or a child, regardless of whether the government entity charges a fee for the use;
6596     or
6597          (iii) free play or recess taking place during school hours.
6598          (17) "Stock albuterol" means a prescription inhaled medication:
6599          (a) used to treat asthma; and

6600          (b) that may be delivered through a device, including:
6601          (i) an inhaler; or
6602          (ii) a nebulizer with a mouthpiece or mask.
6603          (iii) free play or recess taking place during school hours.
6604          [(6)] (18) "Traumatic head injury" means an injury to the head arising from blunt
6605     trauma, an acceleration force, or a deceleration force, with one of the following observed or
6606     self-reported conditions attributable to the injury:
6607          (a) transient confusion, disorientation, or impaired consciousness;
6608          (b) dysfunction of memory;
6609          (c) loss of consciousness; or
6610          (d) signs of other neurological or neuropsychological dysfunction, including:
6611          (i) seizures;
6612          (ii) irritability;
6613          (iii) lethargy;
6614          (iv) vomiting;
6615          (v) headache;
6616          (vi) dizziness; or
6617          (vii) fatigue.
6618          Section 125. Section 26B-4-402, which is renumbered from Section 26-10-5 is
6619     renumbered and amended to read:
6620          [26-10-5].      26B-4-402. Plan for school health services.
6621          The department shall establish a plan for school health services for pupils in elementary
6622     and secondary schools. The department shall cooperate with the State Board of Education and
6623     local health departments in developing such plan and shall coordinate activities between these
6624     agencies. The plan may provide for the delivery of health services by and through intermediate
6625     and local school districts and local health departments.
6626          Section 126. Section 26B-4-403, which is renumbered from Section 26-53-201 is
6627     renumbered and amended to read:
6628          [26-53-201].      26B-4-403. Adoption and enforcement of concussion and
6629     head injury policy -- Notice of policy to parent or guardian.
6630          Each amateur sports organization shall:

6631          (1) adopt and enforce a concussion and head injury policy that:
6632          (a) is consistent with the requirements of Section [26-53-301] 26B-4-404; and
6633          (b) describes the nature and risk of:
6634          (i) a concussion or a traumatic head injury; and
6635          (ii) continuing to participate in a sporting event after sustaining a concussion or a
6636     traumatic head injury;
6637          (2) ensure that each agent of the amateur sports organization is familiar with, and has a
6638     copy of, the concussion and head injury policy; and
6639          (3) before permitting a child to participate in a sporting event of the amateur sports
6640     organization:
6641          (a) provide a written copy of the concussion and head injury policy to a parent or legal
6642     guardian of a child; and
6643          (b) obtain the signature of a parent or legal guardian of the child, acknowledging that
6644     the parent or legal guardian has read, understands, and agrees to abide by, the concussion and
6645     head injury policy.
6646          Section 127. Section 26B-4-404, which is renumbered from Section 26-53-301 is
6647     renumbered and amended to read:
6648          [26-53-301].      26B-4-404. Removal of child suspected of sustaining
6649     concussion or a traumatic head injury -- Medical clearance required before return to
6650     participation.
6651          (1) An amateur sports organization, and each agent of the amateur sports organization,
6652     shall:
6653          (a) immediately remove a child from participating in a sporting event of the amateur
6654     sports organization if the child is suspected of sustaining a concussion or a traumatic head
6655     injury; and
6656          (b) prohibit the child described in Subsection (1)(a) from participating in a sporting
6657     event of the amateur sports organization until the child:
6658          (i) is evaluated by a qualified health care provider who is trained in the evaluation and
6659     management of a concussion; and
6660          (ii) provides the amateur sports organization with a written statement from the
6661     qualified health care provider described in Subsection (1)(b)(i) stating that:

6662          (A) the qualified health care provider has, within three years before the day on which
6663     the written statement is made, successfully completed a continuing education course in the
6664     evaluation and management of a concussion; and
6665          (B) the child is cleared to resume participation in the sporting event of the amateur
6666     sports organization.
6667          (2) This section does not create a new cause of action.
6668          Section 128. Section 26B-4-405, which is renumbered from Section 26-53-401 is
6669     renumbered and amended to read:
6670          [26-53-401].      26B-4-405. School nurses evaluating student injuries.
6671          (1) A school nurse may assess a child who is suspected of sustaining a concussion or a
6672     traumatic head injury during school hours on school property regardless of whether the nurse
6673     has received specialized training in the evaluation and management of a concussion.
6674          (2) A school nurse who does not meet the requirements of Subsections [26-53-301]
6675     26B-4-404(1)(b)(i) and (1)(b)(ii)(A), but who assesses a child who is suspected of sustaining a
6676     concussion or traumatic head injury under Subsection (1):
6677          (a) shall refer the child to a qualified health care provider who is trained in the
6678     evaluation and management of a concussion; and
6679          (b) may not provide a written statement permitting the child to resume participation in
6680     free play or physical education class under Subsection [26-53-301] 26B-4-404(1)(b)(ii).
6681          (3) A school nurse shall undergo training in the evaluation and management of a
6682     concussion, as funding allows.
6683          Section 129. Section 26B-4-406, which is renumbered from Section 26-41-103 is
6684     renumbered and amended to read:
6685          [26-41-103].      26B-4-406. Voluntary participation.
6686          (1) [This chapter does] Sections 26B-4-406 through 26B-4-411 do not create a duty or
6687     standard of care for:
6688          (a) a person to be trained in the use and storage of epinephrine auto-injectors or stock
6689     albuterol; or
6690          (b) except as provided in Subsection (5), a qualified epinephrine auto-injector entity to
6691     store epinephrine auto-injectors or a qualified stock albuterol entity to store stock albuterol on
6692     its premises.

6693          (2) Except as provided in Subsections (3) and (5), a decision by a person to
6694     successfully complete a training program under Section [26-41-104 or 26-41-104.1] 26B-4-407
6695     or 26B-4-408 and to make emergency epinephrine auto-injectors or stock albuterol available
6696     under the provisions of this chapter is voluntary.
6697          (3) A school, school board, or school official may not prohibit or dissuade a teacher or
6698     other school employee at a primary or secondary school in the state, either public or private,
6699     from:
6700          (a) completing a training program under Section [26-41-104 or 26-41-104.1] 26B-4-
6701     407
or 26B-4-408;
6702          (b) possessing or storing an epinephrine auto-injector or stock albuterol on school
6703     property if:
6704          (i) the teacher or school employee is a qualified adult; and
6705          (ii) the possession and storage is in accordance with the training received under Section
6706     [26-41-104 or 26-41-104.1] 26B-4-407 or 26B-4-408; or
6707          (c) administering an epinephrine auto-injector or stock albuterol to any person, if:
6708          (i) the teacher or school employee is a qualified adult; and
6709          (ii) the administration is in accordance with the training received under Section
6710     [26-41-104 or 26-41-104.1] 26B-4-407 or 26B-4-408.
6711          (4) A school, school board, or school official may encourage a teacher or other school
6712     employee to volunteer to become a qualified adult.
6713          (5) (a) Each primary or secondary school in the state, both public and private, shall
6714     make an emergency epinephrine auto-injector available to any teacher or other school
6715     employee who:
6716          (i) is employed at the school; and
6717          (ii) is a qualified adult.
6718          (b) This section does not require a school described in Subsection (5)(a) to keep more
6719     than one emergency epinephrine auto-injector on the school premises, so long as it may be
6720     quickly accessed by a teacher or other school employee, who is a qualified adult, in the event of
6721     an emergency.
6722          (6) (a) Each primary or secondary school in the state, both public and private, may
6723     make stock albuterol available to any school employee who:

6724          (i) is employed at the school; and
6725          (ii) is a qualified adult.
6726          (b) A qualified adult may administer stock albuterol to a student who:
6727          (i) has a diagnosis of asthma by a health care provider;
6728          (ii) has a current asthma action plan on file with the school; and
6729          (iii) is showing symptoms of an asthma emergency as described in the student's asthma
6730     action plan.
6731          (c) This Subsection (6) may not be interpreted to relieve a student's parent or guardian
6732     of providing a student's medication or create an expectation that a school will have stock
6733     albuterol available.
6734          (7) No school, school board, or school official shall retaliate or otherwise take adverse
6735     action against a teacher or other school employee for:
6736          (a) volunteering under Subsection (2);
6737          (b) engaging in conduct described in Subsection (3); or
6738          (c) failing or refusing to become a qualified adult.
6739          Section 130. Section 26B-4-407, which is renumbered from Section 26-41-104 is
6740     renumbered and amended to read:
6741          [26-41-104].      26B-4-407. Training in use and storage of epinephrine
6742     auto-injector.
6743          (1) (a) Each primary and secondary school in the state, both public and private, shall
6744     make initial and annual refresher training, regarding the storage and emergency use of an
6745     epinephrine auto-injector, available to any teacher or other school employee who volunteers to
6746     become a qualified adult.
6747          (b) The training described in Subsection (1)(a) may be provided by the school nurse, or
6748     other person qualified to provide such training, designated by the school district physician, the
6749     medical director of the local health department, or the local emergency medical services
6750     director.
6751          (2) A person who provides training under Subsection (1) or (6) shall include in the
6752     training:
6753          (a) techniques for recognizing symptoms of anaphylaxis;
6754          (b) standards and procedures for the storage and emergency use of epinephrine

6755     auto-injectors;
6756          (c) emergency follow-up procedures, including calling the emergency 911 number and
6757     contacting, if possible, the student's parent and physician; and
6758          (d) written materials covering the information required under this Subsection (2).
6759          (3) A qualified adult shall retain for reference the written materials prepared in
6760     accordance with Subsection (2)(d).
6761          (4) A public school shall permit a student to possess an epinephrine auto-injector or
6762     possess and self-administer an epinephrine auto-injector if:
6763          (a) the student's parent or guardian signs a statement:
6764          (i) authorizing the student to possess or possess and self-administer an epinephrine
6765     auto-injector; and
6766          (ii) acknowledging that the student is responsible for, and capable of, possessing or
6767     possessing and self-administering an epinephrine auto-injector; and
6768          (b) the student's health care provider provides a written statement that states that:
6769          (i) it is medically appropriate for the student to possess or possess and self-administer
6770     an epinephrine auto-injector; and
6771          (ii) the student should be in possession of the epinephrine auto-injector at all times.
6772          (5) The department, in cooperation with the state superintendent of public instruction,
6773     shall design forms to be used by public and private schools for the parental and health care
6774     providers statements described in Subsection (4).
6775          (6) (a) The department:
6776          (i) shall approve educational programs conducted by other persons, to train:
6777          (A) people under Subsection (6)(b) of this section, regarding the proper use and storage
6778     of emergency epinephrine auto-injectors; and
6779          (B) a qualified epinephrine auto-injector entity regarding the proper storage and
6780     emergency use of epinephrine auto-injectors; and
6781          (ii) may, as funding is available, conduct educational programs to train people
6782     regarding the use of and storage of emergency epinephrine auto-injectors.
6783          (b) A person who volunteers to receive training as a qualified adult to administer an
6784     epinephrine auto-injector under the provisions of this Subsection (6) shall demonstrate a need
6785     for the training to the department, which may be based upon occupational, volunteer, or family

6786     circumstances, and shall include:
6787          (i) camp counselors;
6788          (ii) scout leaders;
6789          (iii) forest rangers;
6790          (iv) tour guides; and
6791          (v) other persons who have or reasonably expect to have contact with at least one other
6792     person as a result of the person's occupational or volunteer status.
6793          Section 131. Section 26B-4-408, which is renumbered from Section 26-41-104.1 is
6794     renumbered and amended to read:
6795          [26-41-104.1].      26B-4-408. Training in use and storage of stock albuterol.
6796          (1) (a) Each primary and secondary school in the state, both public and private, shall
6797     make initial and annual refresher training regarding the storage and emergency use of stock
6798     albuterol available to a teacher or school employee who volunteers to become a qualified adult.
6799          (b) The training described in Subsection (1)(a) shall be provided by the department.
6800          (2) A person who provides training under Subsection (1) or (6) shall include in the
6801     training:
6802          (a) techniques for recognizing symptoms of an asthma emergency;
6803          (b) standards and procedures for the storage and emergency use of stock albuterol;
6804          (c) emergency follow-up procedures, and contacting, if possible, the student's parent;
6805     and
6806          (d) written materials covering the information required under this Subsection (2).
6807          (3) A qualified adult shall retain for reference the written materials prepared in
6808     accordance with Subsection (2)(d).
6809          (4) (a) A public or private school shall permit a student to possess and self-administer
6810     asthma medication if:
6811          (i) the student's parent or guardian signs a statement:
6812          (A) authorizing the student to self-administer asthma medication; and
6813          (B) acknowledging that the student is responsible for, and capable of,
6814     self-administering the asthma medication; and
6815          (ii) the student's health care provider provides a written statement that states:
6816          (A) it is medically appropriate for the student to self-administer asthma medication and

6817     be in possession of asthma medication at all times; and
6818          (B) the name of the asthma medication prescribed or authorized for the student's use.
6819          (b) Section 53G-8-205 does not apply to the possession and self-administration of
6820     asthma medication in accordance with this section.
6821          (5) The department, in cooperation with the state superintendent of public instruction,
6822     shall design forms to be used by public and private schools for the parental and health care
6823     provider statements described in Subsection (4).
6824          (6) The department:
6825          (a) shall approve educational programs conducted by other persons to train:
6826          (i) people under Subsection (6)(b), regarding the proper use and storage of stock
6827     albuterol; and
6828          (ii) a qualified stock albuterol entity regarding the proper storage and emergency use of
6829     stock albuterol; and
6830          (b) may conduct educational programs to train people regarding the use of and storage
6831     of stock albuterol.
6832          Section 132. Section 26B-4-409, which is renumbered from Section 26-41-105 is
6833     renumbered and amended to read:
6834          [26-41-105].      26B-4-409. Authority to obtain and use an epinephrine
6835     auto-injector or stock albuterol.
6836          (1) A qualified adult who is a teacher or other school employee at a public or private
6837     primary or secondary school in the state, or a school nurse, may obtain from the school district
6838     physician, the medical director of the local health department, or the local emergency medical
6839     services director a prescription for:
6840          (a) epinephrine auto-injectors for use in accordance with this [chapter] part; or
6841          (b) stock albuterol for use in accordance with this [chapter] part.
6842          (2) (a) A qualified adult may obtain an epinephrine auto-injector for use in accordance
6843     with this [chapter] part that is dispensed by:
6844          (i) a pharmacist as provided under Section 58-17b-1004; or
6845          (ii) a pharmacy intern as provided under Section 58-17b-1004.
6846          (b) A qualified adult may obtain stock albuterol for use in accordance with this
6847     [chapter] part that is dispensed by:

6848          (i) a pharmacist as provided under Section 58-17b-1004; or
6849          (ii) a pharmacy intern as provided under Section 58-17b-1004.
6850          (3) A qualified adult:
6851          (a) may immediately administer an epinephrine auto-injector to a person exhibiting
6852     potentially life-threatening symptoms of anaphylaxis when a physician is not immediately
6853     available; and
6854          (b) shall initiate emergency medical services or other appropriate medical follow-up in
6855     accordance with the training materials retained under Section 26-41-104 after administering an
6856     epinephrine auto-injector.
6857          (4) If a school nurse is not immediately available, a qualified adult:
6858          (a) may immediately administer stock albuterol to an individual who:
6859          (i) has a diagnosis of asthma by a health care provider;
6860          (ii) has a current asthma action plan on file with the school; and
6861          (iii) is showing symptoms of an asthma emergency as described in the student's asthma
6862     action plan; and
6863          (b) shall initiate appropriate medical follow-up in accordance with the training
6864     materials retained under Section [26-41-104.1] 26B-4-408 after administering stock albuterol.
6865          (5) (a) A qualified entity that complies with Subsection (5)(b) or (c), may obtain a
6866     supply of epinephrine auto-injectors or stock albuterol, respectively, from a pharmacist under
6867     Section 58-17b-1004, or a pharmacy intern under Section 58-17b-1004 for:
6868          (i) storing:
6869          (A) the epinephrine auto-injectors on the qualified epinephrine auto-injector entity's
6870     premises; and
6871          (B) stock albuterol on the qualified stock albuterol entity's premises; and
6872          (ii) use by a qualified adult in accordance with Subsection (3) or (4).
6873          (b) A qualified epinephrine auto-injector entity shall:
6874          (i) designate an individual to complete an initial and annual refresher training program
6875     regarding the proper storage and emergency use of an epinephrine auto-injector available to a
6876     qualified adult; and
6877          (ii) store epinephrine auto-injectors in accordance with the standards established by the
6878     department in Section [26-41-107] 26B-4-411.

6879          (c) A qualified stock albuterol entity shall:
6880          (i) designate an individual to complete an initial and annual refresher training program
6881     regarding the proper storage and emergency use of stock albuterol available to a qualified
6882     adult; and
6883          (ii) store stock albuterol in accordance with the standards established by the department
6884     in Section [26-41-107] 26B-4-411.
6885          Section 133. Section 26B-4-410, which is renumbered from Section 26-41-106 is
6886     renumbered and amended to read:
6887          [26-41-106].      26B-4-410. Immunity from liability.
6888          (1) The following, if acting in good faith, are not liable in any civil or criminal action
6889     for any act taken or not taken under the authority of this chapter with respect to an anaphylactic
6890     reaction or asthma emergency:
6891          (a) a qualified adult;
6892          (b) a physician, pharmacist, or any other person or entity authorized to prescribe or
6893     dispense prescription drugs;
6894          (c) a person who conducts training described in Section [26-41-104 or 26-41-104.1]
6895     26B-4-407 or 26B-4-408
6896          (d) a qualified epinephrine auto-injector entity; and
6897          (e) a qualified stock albuterol entity.
6898          (2) Section 53G-9-502 does not apply to the administration of an epinephrine
6899     auto-injector or stock albuterol in accordance with this [chapter] part.
6900          (3) This section does not eliminate, limit, or reduce any other immunity from liability
6901     or defense against liability that may be available under state law.
6902          Section 134. Section 26B-4-411, which is renumbered from Section 26-41-107 is
6903     renumbered and amended to read:
6904          [26-41-107].      26B-4-411. Administrative rulemaking authority.
6905          The department shall adopt rules in accordance with Title 63G, Chapter 3, Utah
6906     Administrative Rulemaking Act, to:
6907          (1) establish and approve training programs in accordance with Sections [26-41-104
6908     and 26-41-104.1] 26B-4-407 and 26B-4-408;
6909          (2) establish a procedure for determining who is eligible for training as a qualified

6910     adult under Subsection [26-41-104] 26B-4-407(6)(b)(v); and
6911          (3) establish standards for storage of:
6912          (a) emergency auto-injectors by a qualified epinephrine auto-injector entity under
6913     Section [26-41-104] 26B-4-407; and
6914          (b) stock albuterol by a qualified stock albuterol entity under Section [26-41-104.1]
6915     26B-4-408.
6916          Section 135. Section 26B-4-501, which is renumbered from Section 26-64-102 is
6917     renumbered and amended to read:
6918     
Part 5. Treatment Access

6919          [26-64-102].      26B-4-501. Definitions.
6920          As used in this [chapter] part:
6921          (1) "Controlled substance" means the same as that term is defined in Title 58, Chapter
6922     37, Utah Controlled Substances Act.
6923          (2) "Critical access hospital" means a critical access hospital that meets the criteria of
6924     42 U.S.C. Sec. 1395i-4(c)(2) (1998).
6925          (3) "Designated facility" means:
6926          (a) a freestanding urgent care center;
6927          (b) a general acute hospital; or
6928          (c) a critical access hospital.
6929          [(1)] (4) "Dispense" means the same as that term is defined in Section 58-17b-102.
6930          [(2)] (5) "Division" means the Division of Professional Licensing created in Section
6931     58-1-103.
6932          [(3) "Local health department" means:]
6933          [(a) a local health department, as defined in Section 26A-1-102; or]
6934          [(b) a multicounty local health department, as defined in Section 26A-1-102.]
6935          (6) "Emergency contraception" means the use of a substance, approved by the United
6936     States Food and Drug Administration, to prevent pregnancy after sexual intercourse.
6937          (7) "Freestanding urgent care center" means the same as that term is defined in Section
6938     59-12-801.
6939          (8) "General acute hospital" means the same as that term is defined in Section 26B-2-
6940     201
.

6941          (9) "Health care facility" means a hospital, a hospice inpatient residence, a nursing
6942     facility, a dialysis treatment facility, an assisted living residence, an entity that provides home-
6943     and community-based services, a hospice or home health care agency, or another facility that
6944     provides or contracts to provide health care services, which facility is licensed under Chapter 2,
6945     Part 2, Health Care Facility Licensing and Inspection.
6946          (10) "Health care provider" means:
6947          (a) a physician, as defined in Section 58-67-102;
6948          (b) an advanced practice registered nurse, as defined in Section 58-31b-102;
6949          (c) a physician assistant, as defined in Section 58-70a-102; or
6950          (d) an individual licensed to engage in the practice of dentistry, as defined in Section
6951     58-69-102.
6952          (11) "Increased risk" means risk exceeding the risk typically experienced by an
6953     individual who is not using, and is not likely to use, an opiate.
6954          (12) "Opiate" means the same as that term is defined in Section 58-37-2.
6955          (13) "Opiate antagonist" means naloxone hydrochloride or any similarly acting drug
6956     that is not a controlled substance and that is approved by the federal Food and Drug
6957     Administration for the diagnosis or treatment of an opiate-related drug overdose.
6958          (14) "Opiate-related drug overdose event" means an acute condition, including a
6959     decreased level of consciousness or respiratory depression resulting from the consumption or
6960     use of a controlled substance, or another substance with which a controlled substance was
6961     combined, and that a person would reasonably believe to require medical assistance.
6962          (15) "Overdose outreach provider" means:
6963          (a) a law enforcement agency;
6964          (b) a fire department;
6965          (c) an emergency medical service provider, as defined in Section 26B-4-101;
6966          (d) emergency medical service personnel, as defined in Section 26B-4-101;
6967          (e) an organization providing treatment or recovery services for drug or alcohol use;
6968          (f) an organization providing support services for an individual, or a family of an
6969     individual, with a substance use disorder;
6970          (g) an organization providing substance use or mental health services under contract
6971     with a local substance abuse authority, as defined in Section 26B-5-101, or a local mental

6972     health authority, as defined in Section 26B-5-101;
6973          (h) an organization providing services to the homeless;
6974          (i) a local health department;
6975          (j) an individual licensed to practice pharmacy under Title 58, Chapter 17b, Pharmacy
6976     Practice Act; or
6977          (k) an individual.
6978          [(4)] (16) "Patient counseling" means the same as that term is defined in Section
6979     58-17b-102.
6980          [(5)] (17) "Pharmacist" means the same as that term is defined in Section 58-17b-102.
6981          [(6)] (18) "Pharmacy intern" means the same as that term is defined in Section
6982     58-17b-102.
6983          [(7)] (19) "Physician" means the same as that term is defined in Section 58-67-102.
6984          (20) "Practitioner" means:
6985          (a) a physician; or
6986          (b) any other person who is permitted by law to prescribe emergency contraception.
6987          [(8)] (21) "Prescribe" means the same as that term is defined in Section 58-17b-102.
6988          [(9)] (22) (a) "Self-administered hormonal contraceptive" means a self-administered
6989     hormonal contraceptive that is approved by the United States Food and Drug Administration to
6990     prevent pregnancy.
6991          (b) "Self-administered hormonal contraceptive" includes an oral hormonal
6992     contraceptive, a hormonal vaginal ring, and a hormonal contraceptive patch.
6993          (c) "Self-administered hormonal contraceptive" does not include any drug intended to
6994     induce an abortion, as that term is defined in Section 76-7-301.
6995          (23) "Sexual assault" means any criminal conduct described in Title 76, Chapter 5, Part
6996     4, Sexual Offenses, that may result in a pregnancy.
6997          (24) "Victim of sexual assault" means any person who presents to receive, or receives,
6998     medical care in consequence of being subjected to sexual assault.
6999          Section 136. Section 26B-4-502, which is renumbered from Section 26-21b-201 is
7000     renumbered and amended to read:
7001          [26-21b-201].      26B-4-502. Emergency contraception services for a victim of
7002     sexual assault.

7003          (1) Except as provided in Subsection (2), a designated facility shall provide the
7004     following services to a victim of sexual assault:
7005          (a) provide the victim with written and oral medical information regarding emergency
7006     contraception that is unbiased, accurate, and generally accepted by the medical community as
7007     being scientifically valid;
7008          (b) orally inform the victim of sexual assault that the victim may obtain emergency
7009     contraception at the designated facility;
7010          (c) offer a complete regimen of emergency contraception to a victim of sexual assault;
7011          (d) provide, at the designated facility, emergency contraception to the victim of sexual
7012     assault upon her request;
7013          (e) maintain a protocol, prepared by a physician, for the administration of emergency
7014     contraception at the designated facility to a victim of sexual assault; and
7015          (f) develop and implement a written policy to ensure that a person is present at the
7016     designated facility, or on-call, who:
7017          (i) has authority to dispense or prescribe emergency contraception, independently, or
7018     under the protocol described in Subsection (1)(e), to a victim of sexual assault; and
7019          (ii) is trained to comply with the requirements of this section.
7020          (2) A freestanding urgent care center is exempt from the requirements of Subsection
7021     (1) if:
7022          (a) there is a general acute hospital or a critical access hospital within 30 miles of the
7023     freestanding urgent care center; and
7024          (b) an employee of the freestanding urgent care center provides the victim with:
7025          (i) written and oral medical information regarding emergency contraception that is
7026     unbiased, accurate, and generally accepted by the medical community as being scientifically
7027     valid; and
7028          (ii) the name and address of the general acute hospital or critical access hospital
7029     described in Subsection (2)(a).
7030          (3) A practitioner shall comply with Subsection (4) with regard to a person who is a
7031     victim of sexual assault, if the person presents to receive medical care, or receives medical
7032     care, from the practitioner at a location that is not a designated facility.
7033          (4) A practitioner described in Subsection (3) shall:

7034          (a) provide the victim with written and oral medical information regarding emergency
7035     contraception that is unbiased, accurate, and generally accepted by the medical community as
7036     being scientifically valid; and
7037          (b) (i) (A) orally inform the victim of sexual assault that the victim may obtain
7038     emergency contraception at the facility where the practitioner is located; and
7039          (B) provide emergency contraception to the victim of sexual assault, if she requests
7040     emergency contraception; or
7041          (ii) inform the victim of sexual assault of the nearest location where she may obtain
7042     emergency contraception.
7043          (5) (a) The department may make rules, in accordance with Title 63G, Chapter 3, Utah
7044     Administrative Rulemaking Act, to enforce the provisions of this section.
7045          (b) The department shall, in an expeditious manner, investigate any complaint received
7046     by the department regarding the failure of a health care facility to comply with a requirement of
7047     this section.
7048          (c) If the department finds a violation of this section or any rules adopted under this
7049     section, the department may take one or more of the actions described in Section 26-21-11.
7050          Section 137. Section 26B-4-503, which is renumbered from Section 26-64-103 is
7051     renumbered and amended to read:
7052          [26-64-103].      26B-4-503. Voluntary participation.
7053          [This chapter does] Sections 26B-4-504 through 26B-4-507 do not create a duty or
7054     standard of care for a person to prescribe or dispense a self-administered hormonal
7055     contraceptive.
7056          Section 138. Section 26B-4-504, which is renumbered from Section 26-64-104 is
7057     renumbered and amended to read:
7058          [26-64-104].      26B-4-504. Authorization to dispense self-administered
7059     hormonal contraceptives.
7060          Notwithstanding Title 58, Chapter 17b, Pharmacy Practice Act, a person licensed under
7061     Title 58, Chapter 17b, Pharmacy Practice Act, to dispense a self-administered hormonal
7062     contraceptive may dispense the self-administered hormonal contraceptive:
7063          (1) to a patient who is 18 years old or older;
7064          (2) pursuant to a standing prescription drug order made in accordance with Section

7065     [26-64-105] 26B-4-505;
7066          (3) without any other prescription drug order from a person licensed to prescribe a
7067     self-administered hormonal contraceptive; and
7068          (4) in accordance with the dispensing guidelines in Section [26-64-106] 26B-4-506.
7069          Section 139. Section 26B-4-505, which is renumbered from Section 26-64-105 is
7070     renumbered and amended to read:
7071          [26-64-105].      26B-4-505. Standing prescription drug orders for a
7072     self-administered hormonal contraceptive.
7073          A physician who is licensed to prescribe a self-administered hormonal contraceptive,
7074     including a physician acting in the physician's capacity as an employee of the department, or a
7075     medical director of a local health department, may issue a standing prescription drug order
7076     authorizing the dispensing of the self-administered hormonal contraceptive under Section
7077     [26-64-104] 26B-4-504 in accordance with a protocol that:
7078          (1) requires the physician to specify the persons, by professional license number,
7079     authorized to dispense the self-administered hormonal contraceptive;
7080          (2) requires the physician to review at least annually the dispensing practices of those
7081     authorized by the physician to dispense the self-administered hormonal contraceptive;
7082          (3) requires those authorized by the physician to dispense the self-administered
7083     hormonal contraceptive to make and retain a record of each person to whom the
7084     self-administered hormonal contraceptive is dispensed, including:
7085          (a) the name of the person;
7086          (b) the drug dispensed; and
7087          (c) other relevant information; and
7088          (4) is approved by the department by administrative rule made in accordance with Title
7089     63G, Chapter 3, Utah Administrative Rulemaking Act.
7090          Section 140. Section 26B-4-506, which is renumbered from Section 26-64-106 is
7091     renumbered and amended to read:
7092          [26-64-106].      26B-4-506. Guidelines for dispensing a self-administered
7093     hormonal contraceptive.
7094          (1) A pharmacist or pharmacist intern who dispenses a self-administered hormonal
7095     contraceptive under [this chapter] Section 26B-4-504:

7096          (a) shall obtain a completed self-screening risk assessment questionnaire, that has been
7097     approved by the division in collaboration with the Board of Pharmacy and the Physicians
7098     Licensing Board, from the patient before dispensing the self-administered hormonal
7099     contraceptive;
7100          (b) if the results of the evaluation in Subsection (1)(a) indicate that it is unsafe to
7101     dispense a self-administered hormonal contraceptive to a patient:
7102          (i) may not dispense a self-administered hormonal contraceptive to the patient; and
7103          (ii) shall refer the patient to a primary care or women's health care practitioner;
7104          (c) may not continue to dispense a self-administered hormonal contraceptive to a
7105     patient for more than 24 months after the date of the initial prescription without evidence that
7106     the patient has consulted with a primary care or women's health care practitioner during the
7107     preceding 24 months; and
7108          (d) shall provide the patient with:
7109          (i) written information regarding:
7110          (A) the importance of seeing the patient's primary care practitioner or women's health
7111     care practitioner to obtain recommended tests and screening; and
7112          (B) the effectiveness and availability of long-acting reversible contraceptives as an
7113     alternative to self-administered hormonal contraceptives; and
7114          (ii) a copy of the record of the encounter with the patient that includes:
7115          (A) the patient's completed self-assessment tool; and
7116          (B) a description of the contraceptives dispensed, or the basis for not dispensing a
7117     contraceptive.
7118          (2) If a pharmacist dispenses a self-administered hormonal contraceptive to a patient,
7119     the pharmacist shall, at a minimum, provide patient counseling to the patient regarding:
7120          (a) the appropriate administration and storage of the self-administered hormonal
7121     contraceptive;
7122          (b) potential side effects and risks of the self-administered hormonal contraceptive;
7123          (c) the need for backup contraception;
7124          (d) when to seek emergency medical attention; and
7125          (e) the risk of contracting a sexually transmitted infection or disease, and ways to
7126     reduce the risk of contraction.

7127          (3) The division, in collaboration with the Board of Pharmacy and the Physicians
7128     Licensing Board, shall make rules in accordance with Title 63G, Chapter 3, Utah
7129     Administrative Rulemaking Act, establishing the self-screening risk assessment questionnaire
7130     described in Subsection (1)(a).
7131          Section 141. Section 26B-4-507, which is renumbered from Section 26-64-107 is
7132     renumbered and amended to read:
7133          [26-64-107].      26B-4-507. Limited civil liability.
7134          A physician who issues a standing prescription drug order in accordance with Section
7135     [26-64-105] 26B-4-505 is not liable for any civil damages for acts or omissions resulting from
7136     the dispensing of a self-administered hormonal contraceptive under [this chapter] Sections
7137     26B-4-504 through 26B-4-506.
7138          Section 142. Section 26B-4-508, which is renumbered from Section 26-55-103 is
7139     renumbered and amended to read:
7140          [26-55-103].      26B-4-508. Voluntary participation.
7141          [This chapter does] Sections 26B-4-509 through 26B-4-514 do not create a duty or
7142     standard of care for a person to prescribe or administer an opiate antagonist.
7143          Section 143. Section 26B-4-509, which is renumbered from Section 26-55-104 is
7144     renumbered and amended to read:
7145          [26-55-104].      26B-4-509. Prescribing, dispensing, and administering an
7146     opiate antagonist -- Immunity from liability.
7147          (1) (a) (i) For purposes of Subsection (1)(a)(ii), "a person other than a health care
7148     facility or health care provider" includes the following, regardless of whether the person has
7149     received funds from the department through the Opiate Overdose Outreach Pilot Program
7150     created in Section [26-55-107] 26B-4-512:
7151          (A) a person described in Subsections [26-55-107] 26B-4-512(1)(a)(i)(A) through
7152     (1)(a)(i)(F); or
7153          (B) an organization, defined by department rule made under Subsection [26-55-107]
7154     26B-4-512(7)(e), that is in a position to assist an individual who is at increased risk of
7155     experiencing an opiate-related drug overdose event.
7156          (ii) Except as provided in Subsection (1)(b), the following persons are not liable for
7157     any civil damages for acts or omissions made as a result of administering an opiate antagonist

7158     when the person acts in good faith to administer the opiate antagonist to an individual whom
7159     the person believes to be experiencing an opiate-related drug overdose event:
7160          (A) an overdose outreach provider; or
7161          (B) a person other than a health care facility or health care provider.
7162          (b) A health care provider:
7163          (i) is not immune from liability under Subsection (1)(a) when the health care provider is
7164     acting within the scope of the health care provider's responsibilities or duty of care; and
7165          (ii) is immune from liability under Subsection (1)(a) if the health care provider is under
7166     no legal duty to respond and otherwise complies with Subsection (1)(a).
7167          (2) Notwithstanding Sections 58-1-501, 58-17b-501, and 58-17b-502, a health care
7168     provider who is licensed to prescribe an opiate antagonist may prescribe, including by a
7169     standing prescription drug order issued in accordance with Subsection [26-55-105] 26B-4-
7170     510
(2), or dispense an opiate antagonist:
7171          (a) (i) to an individual who is at increased risk of experiencing an opiate-related drug
7172     overdose event;
7173          (ii) for an individual described in Subsection (2)(a)(i), to a family member, friend, or
7174     other person, including a person described in Subsections [26-55-107] 26B-4-512(1)(a)(i)(A)
7175     through (1)(a)(i)(F), that is in a position to assist the individual; or
7176          (iii) to an overdose outreach provider for:
7177          (A) furnishing the opiate antagonist to an individual described in Subsection (2)(a)(i)
7178     or (ii), as provided in Section [26-55-106] 26B-4-511; or
7179          (B) administering to an individual experiencing an opiate-related drug overdose event;
7180          (b) without a prescriber-patient relationship; and
7181          (c) without liability for any civil damages for acts or omissions made as a result of
7182     prescribing or dispensing the opiate antagonist in good faith.
7183          (3) A health care provider who dispenses an opiate antagonist to an individual or an
7184     overdose outreach provider under Subsection (2)(a) shall provide education to the individual or
7185     overdose provider that includes written instruction on how to:
7186          (a) recognize an opiate-related drug overdose event; and
7187          (b) respond appropriately to an opiate-related drug overdose event, including how to:
7188          (i) administer an opiate antagonist; and

7189          (ii) ensure that an individual to whom an opiate antagonist has been administered
7190     receives, as soon as possible, additional medical care and a medical evaluation.
7191          Section 144. Section 26B-4-510, which is renumbered from Section 26-55-105 is
7192     renumbered and amended to read:
7193          [26-55-105].      26B-4-510. Standing prescription drug orders for an opiate
7194     antagonist.
7195          (1) Notwithstanding Title 58, Chapter 17b, Pharmacy Practice Act, a person licensed
7196     under Title 58, Chapter 17b, Pharmacy Practice Act, to dispense an opiate antagonist may
7197     dispense the opiate antagonist:
7198          (a) pursuant to a standing prescription drug order made in accordance with Subsection
7199     (2); and
7200          (b) without any other prescription drug order from a person licensed to prescribe an
7201     opiate antagonist.
7202          (2) A physician who is licensed to prescribe an opiate antagonist, including a physician
7203     acting in the physician's capacity as an employee of the department, or a medical director of a
7204     local health department, as defined in Section [26A-1-102] 26B-4-512, may issue a standing
7205     prescription drug order authorizing the dispensing of the opiate antagonist under Subsection (1)
7206     in accordance with a protocol that:
7207          (a) limits dispensing of the opiate antagonist to:
7208          (i) an individual who is at increased risk of experiencing an opiate-related drug
7209     overdose event;
7210          (ii) a family member of, friend of, or other person, including a person described in
7211     Subsections 26-55-107(1)(a)(i)(A) through (1)(a)(i)(F), that is in a position to assist an
7212     individual who is at increased risk of experiencing an opiate-related drug overdose event; or
7213          (iii) an overdose outreach provider for:
7214          (A) furnishing to an individual who is at increased risk of experiencing an
7215     opiate-related drug overdose event, or to a family member of, friend of, or other individual who
7216     is in a position to assist an individual who is at increased risk of experiencing an opiate-related
7217     drug overdose event, as provided in Section [26-55-106] 26B-4-511; or
7218          (B) administering to an individual experiencing an opiate-related drug overdose event;
7219          (b) requires the physician to specify the persons, by professional license number,

7220     authorized to dispense the opiate antagonist;
7221          (c) requires the physician to review at least annually the dispensing practices of those
7222     authorized by the physician to dispense the opiate antagonist;
7223          (d) requires those authorized by the physician to dispense the opiate antagonist to make
7224     and retain a record of each person to whom the opiate antagonist is dispensed, which shall
7225     include:
7226          (i) the name of the person;
7227          (ii) the drug dispensed; and
7228          (iii) other relevant information; and
7229          (e) is approved by the Division of Professional Licensing within the Department of
7230     Commerce by administrative rule made in accordance with Title 63G, Chapter 3, Utah
7231     Administrative Rulemaking Act.
7232          Section 145. Section 26B-4-511, which is renumbered from Section 26-55-106 is
7233     renumbered and amended to read:
7234          [26-55-106].      26B-4-511. Overdose outreach providers.
7235          Notwithstanding Sections 58-1-501, 58-17b-501, and 58-17b-502:
7236          (1) an overdose outreach provider may:
7237          (a) obtain an opiate antagonist dispensed on prescription by:
7238          (i) a health care provider, in accordance with Subsections [26-55-104] 26B-4-509(2)
7239     and (3); or
7240          (ii) a pharmacist or pharmacy intern, as otherwise authorized by Title 58, Chapter 17b,
7241     Pharmacy Practice Act;
7242          (b) store the opiate antagonist; and
7243          (c) furnish the opiate antagonist:
7244          (i) (A) to an individual who is at increased risk of experiencing an opiate-related drug
7245     overdose event; or
7246          (B) to a family member, friend, overdose outreach provider, or other individual who is
7247     in a position to assist an individual who is at increased risk of experiencing an opiate-related
7248     drug overdose event; and
7249          (ii) without liability for any civil damages for acts or omissions made as a result of
7250     furnishing the opiate antagonist in good faith; and

7251          (2) when furnishing an opiate antagonist under Subsection (1), an overdose outreach
7252     provider:
7253          (a) shall also furnish to the recipient of the opiate antagonist:
7254          (i) the written instruction under Subsection [26-55-104] 26B-4-504(3) received by the
7255     overdose outreach provider from the health care provider at the time the opiate antagonist was
7256     dispensed to the overdose outreach provider; or
7257          (ii) if the opiate antagonist was dispensed to the overdose outreach provider by a
7258     pharmacist or pharmacy intern, any written patient counseling under Section 58-17b-613
7259     received by the overdose outreach provider at the time of dispensing; and
7260          (b) may provide additional instruction on how to recognize and respond appropriately
7261     to an opiate-related drug overdose event.
7262          Section 146. Section 26B-4-512, which is renumbered from Section 26-55-107 is
7263     renumbered and amended to read:
7264          [26-55-107].      26B-4-512. Opiate Overdose Outreach Pilot Program --
7265     Grants -- Annual reporting by grantees -- Rulemaking -- Annual reporting by
7266     department.
7267          (1) As used in this section:
7268          (a) "Persons that are in a position to assist an individual who is at increased risk of
7269     experiencing an opiate-related drug overdose event":
7270          (i) means the following organizations:
7271          (A) a law enforcement agency;
7272          (B) the department or a local health department, as defined in Section 26A-1-102;
7273          (C) an organization that provides drug or alcohol treatment services;
7274          (D) an organization that provides services to the homeless;
7275          (E) an organization that provides training on the proper administration of an opiate
7276     antagonist in response to an opiate-related drug overdose event;
7277          (F) a school; or
7278          (G) except as provided in Subsection (1)(a)(ii), any other organization, as defined by
7279     department rule made under Subsection (7)(e), that is in a position to assist an individual who
7280     is at increased risk of experiencing an opiate-related drug overdose event; and
7281          (ii) does not mean:

7282          (A) a person licensed under Title 58, Chapter 17b, Pharmacy Practice Act;
7283          (B) a health care facility; or
7284          (C) an individual.
7285          (b) "School" means:
7286          (i) a public school:
7287          (A) for elementary or secondary education, including a charter school; or
7288          (B) for other purposes;
7289          (ii) a private school:
7290          (A) for elementary or secondary education; or
7291          (B) accredited for other purposes, including higher education or specialty training; or
7292          (iii) an institution within the state system of higher education, as described in Section
7293     53B-1-102.
7294          (2) There is created within the department the "Opiate Overdose Outreach Pilot
7295     Program."
7296          (3) The department may use funds appropriated for the program to:
7297          (a) provide grants under Subsection (4);
7298          (b) promote public awareness of the signs, symptoms, and risks of opioid misuse and
7299     overdose;
7300          (c) increase the availability of educational materials and other resources designed to
7301     assist individuals at increased risk of opioid overdose, their families, and others in a position to
7302     help prevent or respond to an overdose event;
7303          (d) increase public awareness of, access to, and use of opiate antagonist;
7304          (e) update the department's Utah Clinical Guidelines on Prescribing Opioids and
7305     promote its use by prescribers and dispensers of opioids;
7306          (f) develop a directory of substance misuse treatment programs and promote its
7307     dissemination to and use by opioid prescribers, dispensers, and others in a position to assist
7308     individuals at increased risk of opioid overdose;
7309          (g) coordinate a multi-agency coalition to address opioid misuse and overdose; and
7310          (h) maintain department data collection efforts designed to guide the development of
7311     opioid overdose interventions and track their effectiveness.
7312          (4) No later than September 1, 2016, and with available funding, the department shall

7313     grant funds through the program to persons that are in a position to assist an individual who is
7314     at increased risk of experiencing an opiate-related drug overdose event.
7315          (5) Funds granted by the program:
7316          (a) may be used by a grantee to:
7317          (i) pay for the purchase by the grantee of an opiate antagonist; or
7318          (ii) pay for the grantee's cost of providing training on the proper administration of an
7319     opiate antagonist in response to an opiate-related drug overdose event; and
7320          (b) may not be used:
7321          (i) to pay for costs associated with the storage or dispensing of an opiate antagonist; or
7322          (ii) for any other purposes.
7323          (6) Grantees shall report annually to the department on the use of granted funds in
7324     accordance with department rules made under Subsection (7)(d).
7325          (7) No later than July 1, 2016, the department shall, in accordance with Title 63G,
7326     Chapter 3, Utah Administrative Rulemaking Act, make rules specifying:
7327          (a) how to apply for a grant from the program;
7328          (b) the criteria used by the department to determine whether a grant request is
7329     approved, including criteria providing that:
7330          (i) grants are awarded to areas of the state, including rural areas, that would benefit
7331     most from the grant; and
7332          (ii) no more than 15% of the total amount granted by the program is used to pay for
7333     grantees' costs of providing training on the proper administration of an opiate antagonist in
7334     response to an opiate-related drug overdose event;
7335          (c) the criteria used by the department to determine the amount of a grant;
7336          (d) the information a grantee shall report annually to the department under Subsection
7337     (6), including:
7338          (i) the amount of opiate antagonist purchased and dispensed by the grantee during the
7339     reporting period;
7340          (ii) the number of individuals to whom the opiate antagonist was dispensed by the
7341     grantee;
7342          (iii) the number of lives known to have been saved during the reporting period as a
7343     result of opiate antagonist dispensed by the grantee; and

7344          (iv) the manner in which the grantee shall record, preserve, and make available for
7345     audit by the department the information described in Subsections (7)(d)(i) through (7)(d)(iii);
7346     and
7347          (e) as required by Subsection (1)(a)(i)(G), any other organization that is in a position to
7348     assist an individual who is at increased risk of experiencing an opiate-related drug overdose
7349     event.
7350          Section 147. Section 26B-4-513, which is renumbered from Section 26-55-108 is
7351     renumbered and amended to read:
7352          [26-55-108].      26B-4-513. Coprescription guidelines.
7353          (1) As used in this section:
7354          (a) "Controlled substance prescriber" means the same as that term is defined in Section
7355     58-37-6.5.
7356          (b) "Coprescribe" means to issue a prescription for an opiate antagonist with a
7357     prescription for an opiate.
7358          (2) The department shall, in consultation with the Physicians Licensing Board created
7359     in Section 58-67-201, the Osteopathic Physician and Surgeon's Licensing Board created in
7360     Section 58-68-201, and the Division of Professional Licensing created in Section 58-1-103,
7361     establish by rule, made in accordance with Title 63G, Chapter 3, Utah Administrative
7362     Rulemaking Act, scientifically based guidelines for controlled substance prescribers to
7363     coprescribe an opiate antagonist to a patient.
7364          Section 148. Section 26B-4-514, which is renumbered from Section 26-55-109 is
7365     renumbered and amended to read:
7366          [26-55-109].      26B-4-514. Opiate abuse prevention pamphlet.
7367          (1) As funding is available, the department shall produce and distribute, in conjunction
7368     with the Division of Substance Abuse and Mental Health, a pamphlet about opiates that
7369     includes information regarding:
7370          (a) the risk of dependency and addiction;
7371          (b) methods for proper storage and disposal;
7372          (c) alternative options for pain management;
7373          (d) the benefits of and ways to obtain naloxone; and
7374          (e) resources if the patient believes that the patient has a substance abuse disorder.

7375          (2) The pamphlet described in Subsection (1) shall be:
7376          (a) evaluated periodically for effectiveness at conveying necessary information and
7377     revised accordingly;
7378          (b) written in simple and understandable language; and
7379          (c) available in English and other languages that the department determines to be
7380     appropriate and necessary.
7381          Section 149. Section 26B-4-601, which is renumbered from Section 26-67-102 is
7382     renumbered and amended to read:
7383     
Part 6. Adult Autism Treatment Program

7384          [26-67-102].      26B-4-601. Definitions.
7385          As used in this [chapter] part:
7386          (1) "Adult Autism Treatment Account" means the Adult Autism Treatment Account
7387     created in Section [26-67-205] 26B-1-322.
7388          (2) "Advisory committee" means the Adult Autism Treatment Program Advisory
7389     Committee created in Section [26B-1-204] 26B-1-424.
7390          (3) "Applied behavior analysis" means the same as that term is defined in Section
7391     31A-22-642.
7392          (4) "Autism spectrum disorder" means the same as that term is defined in Section
7393     31A-22-642.
7394          (5) "Program" means the Adult Autism Treatment Program created in Section
7395     [26-67-201] 26B-4-602.
7396          (6) "Qualified individual" means an individual who:
7397          (a) is at least 22 years old;
7398          (b) is a resident of the state;
7399          (c) has been diagnosed by a qualified professional as having:
7400          (i) an autism spectrum disorder; or
7401          (ii) another neurodevelopmental disorder requiring significant supports through
7402     treatment using applied behavior analysis; and
7403          (d) needs significant supports for a condition described in Subsection (6)(c), as
7404     demonstrated by formal assessments of the individual's:
7405          (i) cognitive ability;

7406          (ii) adaptive ability;
7407          (iii) behavior; and
7408          (iv) communication ability.
7409          (7) "Qualified provider" means a provider that is qualified under Section [26-67-202]
7410     26B-4-603 to provide services for the program.
7411          Section 150. Section 26B-4-602, which is renumbered from Section 26-67-201 is
7412     renumbered and amended to read:
7413          [26-67-201].      26B-4-602. Adult Autism Treatment Program -- Creation --
7414     Requirements -- Reporting.
7415          (1) There is created within the department the Adult Autism Treatment Program.
7416          (2) (a) The program shall be administered by the department in collaboration with the
7417     advisory committee.
7418          (b) The program shall be funded only with money from the Adult Autism Treatment
7419     Account.
7420          (3) (a) An individual may apply for a grant from the program by submitting to a
7421     qualified provider the information specified by the department under Subsection [26-67-204]
7422     26B-4-604(5).
7423          (b) As funding permits, the department shall award a grant from the program on behalf
7424     of an applicant in accordance with criteria established by the department, in collaboration with
7425     the advisory committee, by rule made in accordance with Title 63G, Chapter 3, Utah
7426     Administrative Rulemaking Act.
7427          (c) A grant shall:
7428          (i) be for a specific amount;
7429          (ii) cover a specific period, not to exceed five years; and
7430          (iii) be disbursed incrementally, if appropriate.
7431          (d) The department shall transmit a grant awarded on behalf of an applicant to a
7432     qualified provider designated by the applicant.
7433          (4) A qualified provider that receives a grant for the treatment of a qualified individual
7434     shall:
7435          (a) use the grant only for treatment of the qualified individual;
7436          (b) submit any reports that are required by the department; and

7437          (c) notify the department within seven days if:
7438          (i) the qualified individual:
7439          (A) has not received treatment from the qualified provider for 10 consecutive days;
7440          (B) is no longer receiving treatment from the qualified provider; or
7441          (C) is no longer a qualified individual; or
7442          (ii) the qualified provider is no longer a qualified provider.
7443          (5) A qualified provider that receives a grant for the treatment of a qualified individual
7444     shall refund any amount to the department on a prorated basis for each day that:
7445          (a) the qualified provider is no longer a qualified provider;
7446          (b) the individual is no longer a qualified individual; or
7447          (c) the qualified provider does not provide services to a qualified individual.
7448          Section 151. Section 26B-4-603, which is renumbered from Section 26-67-203 is
7449     renumbered and amended to read:
7450          [26-67-203].      26B-4-603. Provider qualifications.
7451          The department shall designate a provider as a qualified provider if the provider:
7452          (1) is able to treat a qualified individual's condition through:
7453          (a) one or more evidence-based treatments, including applied behavior analysis;
7454          (b) individualized, client-centered treatment;
7455          (c) any method that engages the qualified individual's family members in the treatment
7456     process; and
7457          (d) measured development of the qualified individual's pre-vocational, vocational, and
7458     daily-living skills; and
7459          (2) provides treatment to a qualified individual through:
7460          (a) a behavior analyst licensed under Title 58, Chapter 61, Part 7, Behavior Analyst
7461     Licensing Act; or
7462          (b) a psychologist who is licensed under Title 58, Chapter 61, Psychologist Licensing
7463     Act.
7464          Section 152. Section 26B-4-604, which is renumbered from Section 26-67-204 is
7465     renumbered and amended to read:
7466          [26-67-204].      26B-4-604. Department rulemaking.
7467          The department, in collaboration with the advisory committee, shall make rules in

7468     accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, to:
7469          (1) specify assessment tools and outcomes that a qualified provider may use to
7470     determine the types of supports that a qualified individual needs;
7471          (2) define evidence-based treatments that a qualified individual may pay for with grant
7472     funding;
7473          (3) establish criteria for awarding a grant under this [chapter] part;
7474          (4) specify the information that an individual shall submit to demonstrate that the
7475     individual is a qualified individual;
7476          (5) specify the information a provider shall submit to demonstrate that the provider is a
7477     qualified provider; and
7478          (6) specify the content and timing of reports required from a qualified provider,
7479     including a report on actual and projected treatment outcomes for a qualified individual.
7480          Section 153. Section 26B-4-701, which is renumbered from Section 26-46a-102 is
7481     renumbered and amended to read:
7482     
Part 7. Health Care Workforce

7483          [26-46a-102].      26B-4-701. Definitions.
7484          As used in this [chapter] part:
7485          (1) "Accredited clinical education program" means a clinical education program for a
7486     health care profession that is accredited by the Accreditation Council on Graduate Medical
7487     Education.
7488          (2) "Accredited clinical training program" means a clinical training program that is
7489     accredited by an entity recognized within medical education circles as an accrediting body for
7490     medical education, advanced practice nursing education, physician assistance education, doctor
7491     of pharmacy education, dental education, or registered nursing education.
7492          (3) "Centers for Medicare and Medicaid Services" means the Centers for Medicare and
7493     Medicaid Services within the United States Department of Health and Human Services.
7494          (4) "Health care professionals in training" means medical students and residents,
7495     advance practice nursing students, physician assistant students, doctor of pharmacy students,
7496     dental students, and registered nursing students.
7497          (5) "Health sector" means any place of employment where the primary function is the
7498     delivery of health care services.

7499          (6) (a) "Health workforce" means the individuals, collectively and by profession, who
7500     deliver health care services or assist in the delivery of health care services.
7501          (b) "Health workforce" includes any health care professional who does not work in the
7502     health sector and any non-health care professional who works in the health sector.
7503          [(1)] (7) "Hospital" means a general acute hospital, as defined in [Title 26, Chapter 21,
7504     Health Care Facility Licensing and Inspection Act.] Section 26B-2-201.
7505          [(2)] (8) "Physician" means a person:
7506          (a) licensed as a physician under Title 58, Chapter 67, Utah Medical Practice Act; or
7507          (b) licensed as a physician under Title 58, Chapter 68, Utah Osteopathic Medical
7508     Practice Act.
7509          [(3)] (9) "Rural county" means a county with a population of less than 50,000, as
7510     determined by:
7511          (a) the most recent official census or census estimate of the United States Bureau of the
7512     Census; or
7513          (b) the most recent population estimate for the county from the Utah Population
7514     Committee, if a population figure for the county is not available under Subsection (3)(a).
7515          [(4)] (10) "Rural hospital" means a hospital located within a rural county.
7516          (11) "UMEC" means the Utah Medical Education Council created in Section 26B-4-
7517     706
.
7518          Section 154. Section 26B-4-702, which is renumbered from Section 26-46-102 is
7519     renumbered and amended to read:
7520          [26-46-102].      26B-4-702. Creation of Utah Health Care Workforce
7521     Financial Assistance Program -- Duties of department.
7522          (1) As used in this section:
7523          (a) "Eligible professional" means a geriatric professional or a health care professional
7524     who is eligible to participate in the program.
7525          (b) "Geriatric professional" means a person who:
7526          (i) is a licensed:
7527          (A) health care professional;
7528          (B) social worker;
7529          (C) occupational therapist;

7530          (D) pharmacist;
7531          (E) physical therapist; or
7532          (F) psychologist; and
7533          (ii) is determined by the department to have adequate advanced training in geriatrics to
7534     prepare the person to provide specialized geriatric care within the scope of the person's
7535     profession.
7536          (b) "Health care professional" means:
7537          (i) a licensed:
7538          (A) physician;
7539          (B) physician assistant;
7540          (C) nurse;
7541          (D) dentist; or
7542          (E) mental health therapist; or
7543          (ii) another licensed health care professional designated by the department by rule.
7544          (d) "Program" means the Utah Health Care Workforce Financial Assistance Program
7545     created in this section.
7546          (e) "Underserved area" means an area designated by the department as underserved by
7547     health care professionals, based upon the results of a needs assessment developed by the
7548     department in consultation with the Utah Health Care Workforce Financial Assistance Program
7549     Advisory Committee created under Section 26B-1-419.
7550          [(1)] (2) There is created within the department the Utah Health Care Workforce
7551     Financial Assistance Program to provide, within funding appropriated by the Legislature for the
7552     following purposes:
7553          (a) professional education scholarships and loan repayment assistance to health care
7554     professionals who locate or continue to practice in underserved areas; and
7555          (b) loan repayment assistance to geriatric professionals who locate or continue to
7556     practice in underserved areas.
7557          [(2)] (3) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking
7558     Act, the department shall make rules governing the administration of the program, including
7559     rules that address:
7560          (a) application procedures;

7561          (b) eligibility criteria;
7562          (c) selection criteria;
7563          (d) service conditions, which at a minimum shall include professional service in an
7564     underserved area for a minimum period of time by any person receiving a scholarship or loan
7565     repayment assistance;
7566          (e) penalties for failure to comply with service conditions or other terms of a
7567     scholarship or loan repayment contract;
7568          (f) criteria for modifying or waiving service conditions or penalties in case of extreme
7569     hardship or other good cause; and
7570          (g) administration of contracts entered into before the effective date of this act,
7571     between the department and scholarship or loan repayment recipients, as authorized by law.
7572          [(3)] (4) The department may provide education loan repayment assistance to an
7573     eligible professional if the eligible professional:
7574          (a) agrees to practice in an underserved area for the duration of the eligible
7575     professional's participation in the program; and
7576          (b) submits a written commitment from the health care facility employing the eligible
7577     professional that the health care facility will provide education loan repayment assistance to the
7578     eligible professional in an amount equal to 20% of the total award amount provided to the
7579     eligible professional.
7580          [(4)] (5) The department shall seek and consider the recommendations of the Utah
7581     Health Care Workforce Financial Assistance Program Advisory Committee created under
7582     Section [26-46-103] 26B-1-419 as it develops and modifies rules to administer the program.
7583          [(5)] (6) Funding for the program:
7584          (a) shall be a line item within the appropriations act;
7585          (b) shall be nonlapsing unless designated otherwise by the Legislature; and
7586          (c) may be used to cover administrative costs of the program, including reimbursement
7587     expenses of the Utah Health Care Workforce Financial Assistance Program Advisory
7588     Committee created under Section [26-46-103] 26B-1-419.
7589          [(6)] (7) Refunds for loan repayment assistance, penalties for breach of contract, and
7590     other payments to the program are dedicated credits to the program.
7591          [(7)] (8) The department shall prepare an annual report on the revenues, expenditures,

7592     and outcomes of the program.
7593          Section 155. Section 26B-4-703, which is renumbered from Section 26-46a-103 is
7594     renumbered and amended to read:
7595          [26-46a-103].      26B-4-703. Rural Physician Loan Repayment Program --
7596     Purpose -- Repayment limit -- Funding -- Reporting -- Rulemaking -- Advisory
7597     committee.
7598          (1) There is created within the department the Rural Physician Loan Repayment
7599     Program to provide, within funding appropriated by the Legislature for this purpose, education
7600     loan repayment assistance to physicians in accordance with Subsection (2).
7601          (2) The department may enter into an education loan repayment assistance contract
7602     with a physician if:
7603          (a) the physician:
7604          (i) locates or continues to practice in a rural county; and
7605          (ii) has a written commitment from a rural hospital that the hospital will provide
7606     education loan repayment assistance to the physician;
7607          (b) the assistance provided by the program does not exceed the assistance provided by
7608     the rural hospital; and
7609          (c) the physician is otherwise eligible for assistance under administrative rules adopted
7610     under Subsection (6).
7611          (3) Funding for the program:
7612          (a) shall be a line item within an appropriations act;
7613          (b) may be used to pay for the per diem and travel expenses of the Rural Physician
7614     Loan Repayment Program Advisory Committee under Subsection [26-46a-104] 26B-1-423(5);
7615     and
7616          (c) may be used to pay for department expenses incurred in the administration of the
7617     program:
7618          (i) including administrative support provided to the Rural Physician Loan Repayment
7619     Program Advisory Committee created under Subsection [26-46a-104] 26B-1-423(7); and
7620          (ii) in an amount not exceeding 10% of funding for the program.
7621          (4) Refunds of loan repayment assistance, penalties for breach of contract, and other
7622     payments to the program are dedicated credits to the program.

7623          (5) The department shall prepare an annual report of the program's revenues,
7624     expenditures, and outcomes.
7625          (6) (a) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act,
7626     the department shall make rules governing the administration of the program, including rules
7627     that address:
7628          (i) application procedures;
7629          (ii) eligibility criteria;
7630          (iii) verification of the amount provided by a rural hospital to a physician for
7631     repayment of the physician's education loans;
7632          (iv) service conditions, which at a minimum shall include professional service by the
7633     physician in the rural hospital providing loan repayment assistance to the physician;
7634          (v) selection criteria and assistance amounts;
7635          (vi) penalties for failure to comply with service conditions or other terms of a loan
7636     repayment assistance contract; and
7637          (vii) criteria for modifying or waiving service conditions or penalties in the case of
7638     extreme hardship or for other good cause.
7639          (b) The department shall seek and consider the recommendations of the Rural
7640     Physician Loan Repayment Program Advisory Committee created [under Section 26-46a-104]
7641     in Section 26B-1-423 as it develops and modifies rules to administer the program.
7642          Section 156. Section 26B-4-704, which is renumbered from Section 26-60-103 is
7643     renumbered and amended to read:
7644          [26-60-103].      26B-4-704. Scope of telehealth practice -- Enforcement.
7645          (1) As used in this section:
7646          (a) "Asynchronous store and forward transfer" means the transmission of a patient's
7647     health care information from an originating site to a provider at a distant site.
7648          (b) "Distant site" means the physical location of a provider delivering telemedicine
7649     services.
7650          (c) "Originating site" means the physical location of a patient receiving telemedicine
7651     services.
7652          (d) "Patient" means an individual seeking telemedicine services.
7653          (e) (i) "Patient-generated medical history" means medical data about a patient that the

7654     patient creates, records, or gathers.
7655          (ii) "Patient-generated medical history" does not include a patient's medical record that
7656     a healthcare professional creates and the patient personally delivers to a different healthcare
7657     professional.
7658          (f) "Provider" means an individual who is:
7659          (i) licensed under Chapter 2, Part 2, Health Care Facility Licensing and Inspection;
7660          (ii) licensed under Title 58, Occupations and Professions, to provide health care; or
7661          (iii) licensed under Chapter 2, Part 1, Human Services Programs and Facilities.
7662          (g) "Synchronous interaction" means real-time communication through interactive
7663     technology that enables a provider at a distant site and a patient at an originating site to interact
7664     simultaneously through two-way audio and video transmission.
7665          (h) "Telehealth services" means the transmission of health-related services or
7666     information through the use of electronic communication or information technology.
7667          (i) "Telemedicine services" means telehealth services:
7668          (i) including:
7669          (A) clinical care;
7670          (B) health education;
7671          (C) health administration;
7672          (D) home health;
7673          (E) facilitation of self-managed care and caregiver support; or
7674          (F) remote patient monitoring occurring incidentally to general supervision; and
7675          (ii) provided by a provider to a patient through a method of communication that:
7676          (A) uses asynchronous store and forward transfer or synchronous interaction; and
7677          (B) meets industry security and privacy standards, including compliance with the
7678     federal Health Insurance Portability and Accountability Act of 1996, Pub. L. No. 104-191, 110
7679     Stat. 1936, as amended, and the federal Health Information Technology for Economic and
7680     Clinical Health Act, Pub. L. No. 111-5, 123 Stat. 226, 467, as amended.
7681          [(1)] (2) A provider offering telehealth services shall:
7682          (a) at all times:
7683          (i) act within the scope of the provider's license under Title 58, Occupations and
7684     Professions, in accordance with the provisions of this chapter and all other applicable laws and

7685     rules; and
7686          (ii) be held to the same standards of practice as those applicable in traditional health
7687     care settings;
7688          (b) if the provider does not already have a provider-patient relationship with the
7689     patient, establish a provider-patient relationship during the patient encounter in a manner
7690     consistent with the standards of practice, determined by the Division of Professional Licensing
7691     in rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act,
7692     including providing the provider's licensure and credentials to the patient;
7693          (c) before providing treatment or prescribing a prescription drug, establish a diagnosis
7694     and identify underlying conditions and contraindications to a recommended treatment after:
7695          (i) obtaining from the patient or another provider the patient's relevant clinical history;
7696     and
7697          (ii) documenting the patient's relevant clinical history and current symptoms;
7698          (d) be available to a patient who receives telehealth services from the provider for
7699     subsequent care related to the initial telemedicine services, in accordance with community
7700     standards of practice;
7701          (e) be familiar with available medical resources, including emergency resources near
7702     the originating site, in order to make appropriate patient referrals when medically indicated;
7703          (f) in accordance with any applicable state and federal laws, rules, and regulations,
7704     generate, maintain, and make available to each patient receiving telehealth services the patient's
7705     medical records; and
7706          (g) if the patient has a designated health care provider who is not the telemedicine
7707     provider:
7708          (i) consult with the patient regarding whether to provide the patient's designated health
7709     care provider a medical record or other report containing an explanation of the treatment
7710     provided to the patient and the telemedicine provider's evaluation, analysis, or diagnosis of the
7711     patient's condition;
7712          (ii) collect from the patient the contact information of the patient's designated health
7713     care provider; and
7714          (iii) within two weeks after the day on which the telemedicine provider provides
7715     services to the patient, and to the extent allowed under HIPAA as that term is defined in

7716     Section [26-18-17] 26B-3-126, provide the medical record or report to the patient's designated
7717     health care provider, unless the patient indicates that the patient does not want the telemedicine
7718     provider to send the medical record or report to the patient's designated health care provider.
7719          [(2)] (3) Subsection [(1)] (2)(g) does not apply to prescriptions for eyeglasses or
7720     contacts.
7721          [(3)] (4) Except as specifically provided in Title 58, Chapter 83, Online Prescribing,
7722     Dispensing, and Facilitation Licensing Act, and unless a provider has established a
7723     provider-patient relationship with a patient, a provider offering telemedicine services may not
7724     diagnose a patient, provide treatment, or prescribe a prescription drug based solely on one of
7725     the following:
7726          (a) an online questionnaire;
7727          (b) an email message; or
7728          (c) a patient-generated medical history.
7729          [(4)] (5) A provider may not offer telehealth services if:
7730          (a) the provider is not in compliance with applicable laws, rules, and regulations
7731     regarding the provider's licensed practice; or
7732          (b) the provider's license under Title 58, Occupations and Professions, is not active and
7733     in good standing.
7734          (6) (a) The Division of Professional Licensing created in Section 58-1-103 is
7735     authorized to enforce the provisions of this section as it relates to providers licensed under Title
7736     58, Occupations and Professions.
7737          (b) The department is authorized to enforce the provisions of:
7738          (i) this section as it relates to providers licensed under this title; and
7739          (ii) this section as it relates to providers licensed under Chapter 2, Part 1, Human
7740     Services Programs and Facilities.
7741          Section 157. Section 26B-4-705, which is renumbered from Section 26-69-301 is
7742     renumbered and amended to read:
7743          [26-69-301].      26B-4-705. Utah Health Workforce Information Center.
7744          (1) As used in this section:
7745          (a) "Council" means the Utah Health Workforce Advisory Council created in Section
7746     26B-1-425.

7747          (b) "Health sector" means any place of employment where the primary function is the
7748     delivery of health care services.
7749          (c) (i) "Health workforce" means the individuals, collectively and by profession, who
7750     deliver health care services or assist in the delivery of health care services.
7751          (ii) "Health workforce" includes any health care professional who does not work in the
7752     health sector and any non-health care professional who works in the health sector.
7753          [(1)] (2) There is created within the department the Utah Health Workforce
7754     Information Center.
7755          [(2)] (3) The information center shall:
7756          (a) under the guidance of the council, work with the Department of Commerce to
7757     collect data described in Section 58-1-112;
7758          (b) analyze data from any available source regarding Utah's health workforce including
7759     data collected by the Department of Commerce under Section 58-1-112;
7760          (c) send a report to the council regarding any analysis of health workforce data;
7761          (d) conduct research on Utah's health workforce as directed by the council;
7762          (e) notwithstanding the provisions of Subsection 35A-4-312(3), receive information
7763     obtained by the Department of Workforce Services under the provisions of Section 35A-4-312
7764     for purposes consistent with the information center's duties, including identifying changes in
7765     Utah's health workforce numbers, types, and geographic distribution;
7766          (f) project the demand for individuals to enter health care professions, including the
7767     nursing profession in accordance with Section 53B-26-202;
7768          (g) subject to Section [26-3-7] 26B-8-406, share data with any appropriate person as
7769     determined by the information center; and
7770          (h) conduct research and provide analysis for any state agency as approved by the
7771     executive director or the executive director's designee.
7772          [(3)] (4) Notwithstanding any other provision of state law, the information center is
7773     authorized to obtain data from any state agency if:
7774          (a) the council and the information center deem receiving the data necessary to perform
7775     a duty listed under Subsection [(2)] (3) or [26-69-202(1)] 26B-1-425(7); and
7776          (b) the information center's access to the data will not:
7777          (i) violate any federal statute or federal regulation; or

7778          (ii) violate a condition a state agency must follow:
7779          (A) to participate in a federal program; or
7780          (B) to receive federal funds.
7781          Section 158. Section 26B-4-706, which is renumbered from Section 26-69-402 is
7782     renumbered and amended to read:
7783          [26-69-402].      26B-4-706. Utah Medical Education Council.
7784          (1) (a) There is created the Utah Medical Education Council, which is a subcommittee
7785     of the Utah Health Workforce Advisory Council.
7786          (b) The membership of UMEC shall consist of the following appointed by the
7787     governor:
7788          (i) the dean of the school of medicine at the University of Utah;
7789          (ii) an individual who represents graduate medical education at the University of Utah;
7790          (iii) an individual from each institution, other than the University of Utah, that
7791     sponsors an accredited clinical education program;
7792          (iv) an individual from the health care insurance industry; and
7793          (v) (A) three members of the general public who are not employed by or affiliated with
7794     any institution that offers, sponsors, or finances health care or medical education; and
7795          (B) if the number of individuals appointed under Subsection (1)(b)(iii) is more than
7796     two, the governor may appoint an additional member of the public under this Subsection
7797     (1)(b)(v) for each individual the governor appoints under Subsection (1)(b)(iii) beyond two.
7798          (2) Except as provided in Subsections (1)(b)(i) and (ii), no two council members may
7799     be employed by or affiliated with the same:
7800          (a) institution of higher education;
7801          (b) state agency outside of higher education; or
7802          (c) private entity.
7803          (3) The dean of the school of medicine at the University of Utah:
7804          (a) shall chair UMEC;
7805          (b) may not be counted in determining the existence of a quorum; and
7806          (c) may only cast a vote on a matter before the council if the vote of the other council
7807     members results in a tied vote.
7808          (4) UMEC shall annually elect a vice chair from UMEC's members.

7809          (5) (a) Consistent with Subsection (6)(b), a majority of the members constitute a
7810     quorum.
7811          (b) The action of a majority of a quorum is the action of UMEC.
7812          (6) (a) Except as provided in Subsection (6)(b), members are appointed to four-year
7813     terms of office.
7814          (b) Notwithstanding Subsection (6)(a), the governor shall, at the time of the initial
7815     appointment, adjust the length of terms to ensure that the terms of council members are
7816     staggered so that approximately half of the members are appointed every two years.
7817          (c) If a vacancy occurs in the membership for any reason, the replacement shall be
7818     appointed by the governor for the unexpired term in the same manner as the original
7819     appointment was made.
7820          (7) A member may not receive compensation or benefits for the member's service, but
7821     may receive per diem and travel expenses in accordance with:
7822          (a) Section 63A-3-106;
7823          (b) Section 63A-3-107; and
7824          (c) rules made by the Division of Finance pursuant to Sections 63A-3-106 and
7825     63A-3-107.
7826          (8) The council shall provide staff for UMEC.
7827          Section 159. Section 26B-4-707, which is renumbered from Section 26-69-403 is
7828     renumbered and amended to read:
7829          [26-69-403].      26B-4-707. Medical Education Program.
7830          (1) There is created a Medical Education Program to be administered by UMEC in
7831     cooperation with the Division of Finance.
7832          (2) The program shall be funded from money received for graduate medical education
7833     from:
7834          (a) the federal Centers for Medicare and Medicaid Services or other federal agency;
7835          (b) state appropriations; and
7836          (c) donation or private contributions.
7837          (3) All funding for this program shall be nonlapsing.
7838          (4) Program money may only be expended if:
7839          (a) approved by UMEC; and

7840          (b) used for graduate medical education in accordance with Subsection [26-69-404]
7841     26B-4-708(4).
7842          Section 160. Section 26B-4-708, which is renumbered from Section 26-69-404 is
7843     renumbered and amended to read:
7844          [26-69-404].      26B-4-708. Duties of UMEC.
7845          UMEC shall:
7846          (1) seek private and public contributions for the program;
7847          (2) determine the method for reimbursing institutions that sponsor health care
7848     professionals in training;
7849          (3) determine the number and type of positions for health care professionals in training
7850     for which program money may be used;
7851          (4) distribute program money for graduate medical education in a manner that:
7852          (a) prepares postgraduate medical residents, as defined by the accreditation council on
7853     graduate medical education, for inpatient, outpatient, hospital, community, and geographically
7854     diverse settings;
7855          (b) encourages the coordination of interdisciplinary clinical training among health care
7856     professionals in training;
7857          (c) promotes stable funding for the clinical training of health care professionals in
7858     training; and
7859          (d) only funds accredited clinical training programs; and
7860          (5) advise on the implementation of the program.
7861          Section 161. Section 26B-4-709, which is renumbered from Section 26-69-405 is
7862     renumbered and amended to read:
7863          [26-69-405].      26B-4-709. Powers of UMEC.
7864          The UMEC may:
7865          (1) appoint advisory committees of broad representation on interdisciplinary clinical
7866     education, workforce mix planning and projections, funding mechanisms, and other topics as is
7867     necessary;
7868          (2) use federal money for necessary administrative expenses to carry out UMEC's
7869     duties and powers as permitted by federal law;
7870          (3) distribute program money in accordance with Subsection [26-69-404] 26B-4-
7871708(4); and
7872          (4) as is necessary to carry out UMEC's duties under Section [26-69-404] 26B-4-708,
7873     adopt rules in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
7874          Section 162. Section 26B-4-710, which is renumbered from Section 26-69-406 is
7875     renumbered and amended to read:
7876          [26-69-406].      26B-4-710. Rural residency training program.
7877          (1) As used in this section:
7878          (a) "Physician" means:
7879          (i) an individual licensed to practice medicine under Title 58, Chapter 67, Utah Medical
7880     Practice Act or Title 58, Chapter 68, Utah Osteopathic Medical Practice Act; and
7881          (ii) an individual licensed to practice dentistry under Title 58, Chapter 69, Dentist and
7882     Dental Hygienist Practice Act.
7883          (b) "Rural residency training program" means an accredited clinical training program
7884     that places a physician into a rural county for a part or all of the physician's clinical training.
7885          (2) Subject to appropriations from the Legislature, UMEC shall establish a pilot
7886     program to place physicians into rural residency training programs.
7887          Section 163. Section 26B-4-711, which is renumbered from Section 26-69-407 is
7888     renumbered and amended to read:
7889          [26-69-407].      26B-4-711. Residency grant program.
7890          (1) As used in this section:
7891          (a) "D.O. program" means an osteopathic medical program that prepares a graduate to
7892     obtain licensure as a doctor of osteopathic medicine upon completing a state's licensing
7893     requirements.
7894          (b) "M.D. program" means a medical education program that prepares a graduate to
7895     obtain licensure as a doctor of medicine upon completing a state's licensing requirements.
7896          (c) "Residency program" means a program that provides training for graduates of a
7897     D.O. program or an M.D. program.
7898          (2) UMEC shall develop a grant program where a sponsoring institution in Utah may
7899     apply for a grant to establish a new residency program or expand a current residency program.
7900          (3) An applicant for a grant shall:
7901          (a) provide the proposed specialty area for each grant funded residency position;

7902          (b) identify where the grant funded residency position will provide care;
7903          (c) (i) provide proof that the residency program is accredited by the Accreditation
7904     Council for Graduate Medical Education; or
7905          (ii) identify what actions need to occur for the proposed residency program to become
7906     accredited by the Accreditation Council for Graduate Medical Education;
7907          (d) identify how a grant funded residency position will be funded once the residency
7908     program exhausts the grant money;
7909          (e) agree to implement selection processes for a residency position that treat applicants
7910     from D.O. programs and applicants from M.D. programs equally;
7911          (f) agree to provide information identified by UMEC that relates to post-residency
7912     employment outcomes for individuals who work in grant funded residency positions; and
7913          (g) provide any other information related to the grant application UMEC deems
7914     necessary.
7915          (4) UMEC shall prioritize awarding grants to new or existing residency programs that
7916     will:
7917          (a) address a workforce shortage, occurring in Utah, for a specialty; or
7918          (b) serve an underserved population, including a rural population.
7919          (5) Before November 1, 2023, and each November 1 thereafter, UMEC shall provide a
7920     written report to the Higher Education Appropriations Subcommittee describing:
7921          (a) which sponsoring institutions received a grant;
7922          (b) the number of residency positions created; and
7923          (c) for each residency position created:
7924          (i) the type of specialty;
7925          (ii) where the residency position provides care; and
7926          (iii) an estimated date of when a grant funded residency position will no longer need
7927     grant funding.
7928          Section 164. Section 26B-4-712, which is renumbered from Section 26-69-408 is
7929     renumbered and amended to read:
7930          [26-69-408].      26B-4-712. Forensic psychiatrist fellowship grant.
7931          (1) As used in this section, "forensic psychiatry" means the provision of services by an
7932     individual who:

7933          (a) is a licensed physician;
7934          (b) is board certified for a psychiatry specialization recognized by the American Board
7935     of Medical Specialists or the American Osteopathic Association's Bureau of Osteopathic
7936     Specialists; and
7937          (c) uses scientific and clinical expertise in legal contexts involving the mental health of
7938     individuals.
7939          (2) UMEC shall establish a grant program that will facilitate the creation of a single
7940     forensic psychiatrist fellowship program.
7941          (3) An applicant for the grant shall:
7942          (a) demonstrate how the applicant is best suited for developing a forensic psychiatry
7943     fellowship program, including:
7944          (i) a description of resources that would be available to the program; and
7945          (ii) any resources or staff that need to be acquired for the program;
7946          (b) identify what needs to occur for the proposed residency program to become
7947     accredited by the Accreditation Council for Graduate Medical Education;
7948          (c) provide an estimate of how many individuals would be trained in the program at
7949     any one time;
7950          (d) provide any information related to the grant application UMEC deems necessary for
7951     awarding the grant; and
7952          (e) if awarded the grant, agree to:
7953          (i) enter into a contract with the Department of Corrections that the applicant will
7954     provide for the provision of forensic psychiatry services to an individual:
7955          (A) who needs psychiatric services; and
7956          (B) is under the Department of Corrections' jurisdiction;
7957          (ii) ensure that any individual hired to provide forensic psychiatry services will comply
7958     with all relevant:
7959          (A) national licensing requirements; and
7960          (B) state licensing requirements under Title 58, Occupations and Professions.
7961          Section 165. Section 26B-4-801, which is renumbered from Section 26-49-102 is
7962     renumbered and amended to read:
7963     
Part 8. Uniform Emergency Volunteer Health Practitioners Act


7964          [26-49-102].      26B-4-801. Definitions.
7965          As used in this [chapter] part:
7966          (1) "Disaster relief organization" means an entity that:
7967          (a) provides emergency or disaster relief services that include health or veterinary
7968     services provided by volunteer health practitioners;
7969          (b) is designated or recognized as a provider of the services described in Subsection
7970     (1)(a) under a disaster response and recovery plan adopted by:
7971          (i) an agency of the federal government;
7972          (ii) the department; or
7973          (iii) a local health department; and
7974          (c) regularly plans and conducts its activities in coordination with:
7975          (i) an agency of the federal government;
7976          (ii) the department; or
7977          (iii) a local health department.
7978          (2) "Emergency" means:
7979          (a) a state of emergency declared by:
7980          (i) the president of the United States;
7981          (ii) the governor in accordance with Title 53, Chapter 2a, Part 2, Disaster Response and
7982     Recovery Act; and
7983          (iii) the chief executive officer of a political subdivision in accordance with Title 53,
7984     Chapter 2a, Part 2, Disaster Response and Recovery Act, for a local emergency; or
7985          (b) a public health emergency declared by:
7986          (i) the executive director through a public health order in accordance with Title 26,
7987     Utah Health Code; or
7988          (ii) a local health department for a location under the local health department's
7989     jurisdiction.
7990          (3) "Emergency Management Assistance Compact" means the interstate compact
7991     approved by Congress by Public [Law] L. No. 104-321, 110 Stat. 3877 and adopted by Utah in
7992     Title 53, Chapter 2a, Part 4, Emergency Management Assistance Compact.
7993          (4) "Entity" means a person other than an individual.
7994          (5) "Health facility" means an entity licensed under the laws of this or another state to

7995     provide health or veterinary services.
7996          (6) "Health practitioner" means an individual licensed under Utah law or another state
7997     to provide health or veterinary services.
7998          (7) "Health services" means the provision of treatment, care, advice, guidance, other
7999     services, or supplies related to the health or death of individuals or human populations, to the
8000     extent necessary to respond to an emergency, including:
8001          (a) the following, concerning the physical or mental condition or functional status of an
8002     individual or affecting the structure or function of the body:
8003          (i) preventive, diagnostic, therapeutic, rehabilitative, maintenance, or palliative care; or
8004          (ii) counseling, assessment, procedures, or other services;
8005          (b) selling or dispensing a drug, a device, equipment, or another item to an individual
8006     in accordance with a prescription; and
8007          (c) funeral, cremation, cemetery, or other mortuary services.
8008          (8) "Host entity":
8009          (a) means an entity operating in Utah that:
8010          (i) uses volunteer health practitioners to respond to an emergency; and
8011          (ii) is responsible during an emergency, for actually delivering health services to
8012     individuals or human populations, or veterinary services to animals or animal populations; and
8013          (b) may include disaster relief organizations, hospitals, clinics, emergency shelters,
8014     health care provider offices, or any other place where volunteer health practitioners may
8015     provide health or veterinary services.
8016          (9) (a) "License" means authorization by a state to engage in health or veterinary
8017     services that are unlawful without authorization.
8018          (b) "License" includes authorization under this title to an individual to provide health
8019     or veterinary services based upon a national or state certification issued by a public or private
8020     entity.
8021          (10) "Local emergency" means the same as that term is defined in Section 53-2a-203.
8022          (11) "Local health department" means the same as that term is defined in Section
8023     26A-1-102.
8024          (12) "Public health emergency" means the same as that term is defined in Section
8025     [26-23b-102] 26B-7-301.

8026          (13) "Scope of practice" means the extent of the authorization to provide health or
8027     veterinary services granted to a health practitioner by a license issued to the practitioner in the
8028     state in which the principal part of the practitioner's services are rendered, including any
8029     conditions imposed by the licensing authority.
8030          (14) "State" means:
8031          (a) a state of the United States;
8032          (b) the District of Columbia;
8033          (c) Puerto Rico;
8034          (d) the United States Virgin Islands; or
8035          (e) any territory or insular possession subject to the jurisdiction of the United States.
8036          (15) "Veterinary services" shall have the meaning provided for in Subsection
8037     58-28-102(11).
8038          (16) (a) "Volunteer health practitioner" means a health practitioner who provides health
8039     or veterinary services, whether or not the practitioner receives compensation for those services.
8040          (b) "Volunteer health practitioner" does not include a practitioner who receives
8041     compensation under a preexisting employment relationship with a host entity or affiliate that
8042     requires the practitioner to provide health services in Utah, unless the practitioner is:
8043          (i) not a Utah resident; and
8044          (ii) employed by a disaster relief organization providing services in Utah during an
8045     emergency.
8046          Section 166. Section 26B-4-802, which is renumbered from Section 26-49-103 is
8047     renumbered and amended to read:
8048          [26-49-103].      26B-4-802. Applicability to volunteer health practitioners.
8049          This [chapter] part applies to volunteer health practitioners who:
8050          (1) are registered with a registration system that complies with Section [26-49-202]
8051     26B-4-804; and
8052          (2) provide health or veterinary services in Utah for a host entity during an emergency.
8053          Section 167. Section 26B-4-803, which is renumbered from Section 26-49-201 is
8054     renumbered and amended to read:
8055          [26-49-201].      26B-4-803. Regulation of services during emergency.
8056          (1) During an emergency, the [Department of Health] department or a local health

8057     department may limit, restrict, or otherwise regulate:
8058          (a) the duration of practice by volunteer health practitioners;
8059          (b) the geographical areas in which volunteer health practitioners may practice;
8060          (c) the types of volunteer health practitioners who may practice; and
8061          (d) any other matters necessary to coordinate effectively the provision of health or
8062     veterinary services during the emergency.
8063          (2) An order issued under Subsection (1) takes effect immediately, without prior notice
8064     or comment, and is not a rule within the meaning of Title 63G, Chapter 3, Utah Administrative
8065     Rulemaking Act, or an adjudication within the meaning of Title 63G, Chapter 4,
8066     Administrative Procedures Act.
8067          (3) A host entity that uses volunteer health practitioners to provide health or veterinary
8068     services in Utah shall:
8069          (a) to the extent practicable and in order to provide for the efficient and effective use of
8070     volunteer health practitioners, consult and coordinate its activities with:
8071          (i) the [Department of Health] department;
8072          (ii) local health departments; or
8073          (iii) the Department of Agriculture and Food; [or] and
8074          [(iv) the Department of Human Services; and]
8075          (b) comply with all state and federal laws relating to the management of emergency
8076     health or veterinary services.
8077          Section 168. Section 26B-4-804, which is renumbered from Section 26-49-202 is
8078     renumbered and amended to read:
8079          [26-49-202].      26B-4-804. Volunteer health practitioner registration
8080     systems.
8081          (1) To qualify as a volunteer health practitioner registration system, the registration
8082     system shall:
8083          (a) accept applications for the registration of volunteer health practitioners before or
8084     during an emergency;
8085          (b) include information about the licensure and good standing of health practitioners
8086     that is accessible by authorized persons;
8087          (c) be capable of confirming the accuracy of information concerning whether a health

8088     practitioner is licensed and in good standing before health services or veterinary services are
8089     provided under this chapter; and
8090          (d) meet one of the following conditions:
8091          (i) be an emergency system for advance registration of volunteer health practitioners
8092     established by a state and funded through the United States Department of Health and Human
8093     Services under Section 319I of the Public Health Services Act, 42 U.S.C. Sec. 247d-7b, as
8094     amended;
8095          (ii) be a local unit consisting of trained and equipped emergency response, public
8096     health, and medical personnel formed under Section 2801 of the Public Health Services Act, 42
8097     U.S.C. Sec. 300hh as amended;
8098          (iii) be operated by a:
8099          (A) disaster relief organization;
8100          (B) licensing board;
8101          (C) national or regional association of licensing boards or health practitioners;
8102          (D) health facility that provides comprehensive inpatient and outpatient healthcare
8103     services, including tertiary care; or
8104          (E) governmental entity; or
8105          (iv) be designated by the [Department of Health] department as a registration system
8106     for purposes of this chapter.
8107          (2) (a) Subject to Subsection (2)(b), during an emergency, the [Department of Health]
8108     department, a person authorized to act on behalf of the [Department of Health] department, or a
8109     host entity shall confirm whether a volunteer health practitioner in Utah is registered with a
8110     registration system that complies with Subsection (1).
8111          (b) The confirmation authorized under this Subsection (2) is limited to obtaining the
8112     identity of the practitioner from the system and determining whether the system indicates that
8113     the practitioner is licensed and in good standing.
8114          (3) Upon request of a person authorized under Subsection (2), or a similarly authorized
8115     person in another state, a registration system located in Utah shall notify the person of the
8116     identity of a volunteer health practitioner and whether or not the volunteer health practitioner is
8117     licensed and in good standing.
8118          (4) A host entity is not required to use the services of a volunteer health practitioner

8119     even if the volunteer health practitioner is registered with a registration system that indicates
8120     that the practitioner is licensed and in good standing.
8121          Section 169. Section 26B-4-805, which is renumbered from Section 26-49-203 is
8122     renumbered and amended to read:
8123          [26-49-203].      26B-4-805. Recognition of volunteer health practitioners
8124     licensed in other states.
8125          (1) During an emergency, a volunteer health practitioner registered with a registration
8126     system that complies with Section [26-49-202] 26B-4-804 and licensed and in good standing in
8127     the state upon which the practitioner's registration is based:
8128          (a) may practice in Utah to the extent authorized by this chapter as if the practitioner
8129     were licensed in Utah; and
8130          (b) is exempt from:
8131          (i) licensure in Utah; or
8132          (ii) operating under modified scope of practice provisions in accordance with
8133     Subsections 58-1-307(4) and (5).
8134          (2) A volunteer health practitioner qualified under Subsection (1) is not entitled to the
8135     protections of this chapter if the practitioner is licensed in more than one state and any license
8136     of the practitioner:
8137          (a) is suspended, revoked, or subject to an agency order limiting or restricting practice
8138     privileges; or
8139          (b) has been voluntarily terminated under threat of sanction.
8140          Section 170. Section 26B-4-806, which is renumbered from Section 26-49-204 is
8141     renumbered and amended to read:
8142          [26-49-204].      26B-4-806. No effect on credentialing and privileging.
8143          (1) For purposes of this section:
8144          (a) "Credentialing" means obtaining, verifying, and assessing the qualifications of a
8145     health practitioner to provide treatment, care, or services.
8146          (b) "Privileging" means the authorizing by an appropriate authority of a health
8147     practitioner to provide specific treatment, care, or services at a health facility subject to limits
8148     based on factors that include license, education, training, experience, competence, health status,
8149     and specialized skill.

8150          (2) This [chapter] part does not affect credentialing or privileging standards of a health
8151     facility, and does not preclude a health facility from waiving or modifying those standards
8152     during an emergency.
8153          Section 171. Section 26B-4-807, which is renumbered from Section 26-49-205 is
8154     renumbered and amended to read:
8155          [26-49-205].      26B-4-807. Provision of volunteer health or veterinary
8156     services -- Administrative sanctions -- Authority of Division of Professional Licensing.
8157          (1) Subject to Subsections (2) and (3), a volunteer health practitioner shall comply with
8158     the scope of practice for a similarly licensed practitioner established by the licensing
8159     provisions, practice acts, or other Utah laws.
8160          (2) Except as otherwise provided in Subsection (3), this [chapter] part does not
8161     authorize a volunteer health practitioner to provide services that are outside the volunteer
8162     health practitioner's scope of practice, even if a similarly licensed practitioner in Utah would be
8163     permitted to provide the services.
8164          (3) (a) In accordance with this section and Section 58-1-405, the Division of
8165     Professional Licensing may issue an order modifying or restricting the health or veterinary
8166     services that volunteer health practitioners may provide pursuant to this [chapter] part.
8167          (b) An order under this subsection takes effect immediately, without prior notice or
8168     comment, and is not a rule within the meaning of Title 63G, Chapter 3, Utah Administrative
8169     Rulemaking Act, or a directive within the meaning of Title 63G, Chapter 4, Administrative
8170     Procedures Act.
8171          (4) A host entity may restrict the health or veterinary services that a volunteer health
8172     practitioner may provide under this [chapter] part.
8173          (5) (a) A volunteer health practitioner does not engage in unauthorized practice unless
8174     the volunteer health practitioner has reason to know of any limitation, modification, or
8175     restriction under this chapter, Title 58, Chapter 1, Division of Occupational and Professional
8176     Licensing Act, or that a similarly licensed practitioner in Utah would not be permitted to
8177     provide the services.
8178          (b) A volunteer health practitioner has reason to know of a limitation, modification, or
8179     restriction, or that a similarly licensed practitioner in Utah would not be permitted to provide a
8180     service, if:

8181          (i) the volunteer health practitioner knows the limitation, modification, or restriction
8182     exists or that a similarly licensed practitioner in Utah would not be permitted to provide the
8183     service; or
8184          (ii) from all the facts and circumstances known to the volunteer health practitioner at
8185     the relevant time, a reasonable person would conclude that:
8186          (A) the limitation, modification, or restriction exists; or
8187          (B) a similarly licensed practitioner in Utah would not be permitted to provide the
8188     service.
8189          (6) In addition to the authority granted by law of Utah other than this chapter to
8190     regulate the conduct of volunteer health practitioners, the Division of Professional Licensing
8191     Act or other disciplinary authority in Utah:
8192          (a) may impose administrative sanctions upon a volunteer health practitioner licensed
8193     in Utah for conduct outside of Utah in response to an out-of-state emergency;
8194          (b) may impose administrative sanctions upon a volunteer health practitioner not
8195     licensed in Utah for conduct in Utah in response to an in-state emergency; and
8196          (c) shall report any administrative sanctions imposed upon a volunteer health
8197     practitioner licensed in another state to the appropriate licensing board or other disciplinary
8198     authority in any other state in which the volunteer health practitioner is known to be licensed.
8199          (7) In determining whether or not to impose administrative sanctions under Subsection
8200     (6), the Division of Professional Licensing Act or other disciplinary authority shall consider the
8201     circumstances in which the conduct took place, including:
8202          (a) any exigent circumstances; and
8203          (b) the volunteer health practitioner's scope of practice, education, training, experience,
8204     and specialized skill.
8205          Section 172. Section 26B-4-808, which is renumbered from Section 26-49-301 is
8206     renumbered and amended to read:
8207          [26-49-301].      26B-4-808. Relation to other laws.
8208          (1) (a) This [chapter] part does not limit rights, privileges, or immunities provided to
8209     volunteer health practitioners by laws other than this [chapter] part.
8210          (b) Except as otherwise provided in Subsection (2), this [chapter] part does not affect
8211     requirements for the use of health practitioners pursuant to Title 53, Chapter 2a, Part 4,

8212     Emergency Management Assistance Compact.
8213          (2) An authorized representative of a party state may incorporate volunteer health
8214     practitioners into the emergency forces of Utah even if those volunteer health practitioners are
8215     not officers or employees of Utah, a political subdivision of Utah, or a municipality or other
8216     local government within Utah.
8217          Section 173. Section 26B-4-809, which is renumbered from Section 26-49-401 is
8218     renumbered and amended to read:
8219          [26-49-401].      26B-4-809. Regulatory authority.
8220          (1) The [Department of Health] department shall make rules by following the
8221     procedures and requirements of Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
8222          (2) Before adopting rules under Subsection (1), the [Department of Health] department
8223     shall consult and consider:
8224          (a) the recommendations of the entity established to coordinate the implementation of
8225     the Emergency Management Assistance Compact; and
8226          (b) rules adopted by similarly empowered agencies in other states in order to promote
8227     uniformity of application of this [chapter] part and make the emergency response systems in
8228     the various states reasonably compatible.
8229          Section 174. Section 26B-4-810, which is renumbered from Section 26-49-501 is
8230     renumbered and amended to read:
8231          [26-49-501].      26B-4-810. Limitations on civil liability for volunteer health
8232     practitioners.
8233          Volunteer health practitioners who provide health or veterinary services pursuant to this
8234     chapter are immune from liability and civil damages as set forth in Section 58-13-2.
8235          Section 175. Section 26B-4-811, which is renumbered from Section 26-49-601 is
8236     renumbered and amended to read:
8237          [26-49-601].      26B-4-811. Workers' compensation coverage.
8238          (1) For purposes of this section, "injury" means a physical or mental injury or disease
8239     for which an employee of Utah who is injured or contracts the disease in the course of the
8240     employee's employment would be entitled to benefits under Title 34A, Chapter 2, Workers'
8241     Compensation Act.
8242          (2) A volunteer health practitioner is considered a state employee for purposes of

8243     receiving workers' compensation medical benefits under Title 34A, Chapter 2, Workers'
8244     Compensation Act, and Chapter 3, Utah Occupational Disease Act.
8245          (3) The state shall provide workers' compensation benefits for a volunteer health
8246     practitioner under:
8247          (a) Title 34A, Chapter 2, Workers' Compensation Act; and
8248          (b) Title 34A, Chapter 3, Utah Occupational Disease Act.
8249          (4) (a) In accordance with Section 34A-2-105, the workers' compensation benefits
8250     described in Subsection (3) are the exclusive remedy against the state or an officer, agent, or
8251     employee of the state, for all injuries and occupational diseases resulting from the volunteer
8252     health practitioner's services for the state.
8253          (b) For purposes of Subsection (4)(a), the state is considered the employer of the
8254     volunteer health practitioner.
8255          (5) To compute the workers' compensation benefits for a volunteer health practitioner
8256     described in Subsection (3), the average weekly wage of the volunteer health practitioner shall
8257     be the state's average weekly wage at the time of the emergency that is the basis for the
8258     volunteer health practitioner's workers' compensation claim.
8259          (6) (a) The Labor Commission shall:
8260          (i) adopt rules, enter into agreements with other states, or take other measures to
8261     facilitate the receipt of benefits for injury or death by volunteer health practitioners who reside
8262     in other states; and
8263          (ii) consult with and consider the practices for filing, processing, and paying claims by
8264     agencies with similar authority in other states to promote uniformity of application of this
8265     chapter with other states that enact similar legislation.
8266          (b) The Labor Commission may waive or modify requirements for filing, processing,
8267     and paying claims that unreasonably burden the volunteer health practitioners.
8268          Section 176. Section 26B-4-812, which is renumbered from Section 26-49-701 is
8269     renumbered and amended to read:
8270          [26-49-701].      26B-4-812. Uniformity of application and construction.
8271          In applying and construing this [chapter] part, consideration shall be given to the need
8272     to promote uniformity of the law with respect to its subject matter among states that enact it.
8273          Section 177. Repealer.

8274          This bill repeals:
8275          Section 26-1-2, Definitions.
8276          Section 26-1-7.5, Health advisory council.
8277          Section 26-2-1, Short title.
8278          Section 26-2-2, Definitions.
8279          Section 26-4-1, Short title.
8280          Section 26-5-2, Establishment of prevention programs by department.
8281          Section 26-5-3, System for detecting and monitoring diseases established by
8282     department.
8283          Section 26-5-4, Programs of community and professional education established by
8284     department.
8285          Section 26-6-1, Short title.
8286          Section 26-6-12, Rabies or other animal disease -- Investigation following order of
8287     quarantine.
8288          Section 26-6-13, Rabies or other animal disease -- Authority of peace officer to kill
8289     or capture animals.
8290          Section 26-6-14, Rabies or other animal disease -- Quarantine defined.
8291          Section 26-6b-2, Definitions.
8292          Section 26-8a-101, Title.
8293          Section 26-8a-102, Definitions.
8294          Section 26-8a-104, Committee advisory duties.
8295          Section 26-8a-204, Disaster coordination plan.
8296          Section 26-8a-205, Pediatric quality improvement program.
8297          Section 26-8a-206, Personnel stress management program.
8298          Section 26-8a-211, Report.
8299          Section 26-8b-101, Title.
8300          Section 26-8b-102, Definitions.
8301          Section 26-8b-601, Title.
8302          Section 26-8c-101, Title.
8303          Section 26-8d-101, Title.
8304          Section 26-9f-101, Title.

8305          Section 26-9f-102, Definitions.
8306          Section 26-9f-104, Duties and responsibilities.
8307          Section 26-10-1, Definitions.
8308          Section 26-15-1, Definitions.
8309          Section 26-15-5.1, Exemptions to food handler requirements.
8310          Section 26-15-12, Rules to implement statutes on smoking.
8311          Section 26-15a-101, Title.
8312          Section 26-15a-103, Duties.
8313          Section 26-15a-107, Duties.
8314          Section 26-15b-101, Title.
8315          Section 26-15b-102, Definitions.
8316          Section 26-15b-103, Permitting -- Fees.
8317          Section 26-15b-104, Permits.
8318          Section 26-15c-101, Title.
8319          Section 26-15c-102, Definitions.
8320          Section 26-15c-103, Permitting -- Fees.
8321          Section 26-15c-104, Safety and health inspections and permits.
8322          Section 26-18-1, Short title.
8323          Section 26-18-2, Definitions.
8324          Section 26-18-402.5, Nonlapsing Medicaid funds.
8325          Section 26-18-501, Definitions.
8326          Section 26-18-601, Title.
8327          Section 26-18-602, Definitions.
8328          Section 26-18-701, Definitions.
8329          Section 26-18-702, Division and Department of Workforce Services compliance
8330     with adoption assistance interstate compact.
8331          Section 26-18a-1, Definitions.
8332          Section 26-18a-3, Purpose of committee.
8333          Section 26-19-101, Title.
8334          Section 26-20-1, Title.
8335          Section 26-21-1, Title.

8336          Section 26-21-4, Per diem and travel expenses of committee members.
8337          Section 26-21-5, Duties of committee.
8338          Section 26-21-100, Reserved.
8339          Section 26-21-203, Department authorized to grant, deny, or revoke clearance --
8340     Department may limit direct patient access.
8341          Section 26-21-205, Department of Public Safety -- Retention of information --
8342     Notification of Department of Health.
8343          Section 26-21-206, Covered providers and covered contractors required to apply
8344     for clearance of certain individuals.
8345          Section 26-21-207, Covered providers required to apply for clearance for certain
8346     individuals other than residents residing in residential settings -- Certain individuals
8347     other than residents prohibited from residing in residential settings without clearance.
8348          Section 26-21-208, Application for clearance by individuals.
8349          Section 26-21-210, No civil liability.
8350          Section 26-21-301, Title.
8351          Section 26-21-302, Definitions.
8352          Section 26-21-304, Monitoring device -- Facility admission, patient discharge, and
8353     posted notice.
8354          Section 26-21a-201, Short title.
8355          Section 26-21b-101, Title.
8356          Section 26-21b-102, Definitions.
8357          Section 26-21b-301, Investigation and enforcement.
8358          Section 26-21c-101, Title.
8359          Section 26-21c-102, Definitions.
8360          Section 26-21c-104, Presenting protocols upon inspection.
8361          Section 26-23a-1, Definitions.
8362          Section 26-23a-3, Penalties.
8363          Section 26-23b-101, Title.
8364          Section 26-25-2, Restrictions on use of data.
8365          Section 26-25-3, Information considered privileged communications.
8366          Section 26-25-4, Information held in confidence -- Protection of identities.

8367          Section 26-25-5, Violation of chapter a misdemeanor -- Civil liability.
8368          Section 26-26-1,"Institution" defined.
8369          Section 26-26-2, Authorization for institutions to obtain impounded animals.
8370          Section 26-26-4, Institution to pay transportation expense -- Restrictions on use of
8371     animals -- Fee.
8372          Section 26-26-5, Records of animals required.
8373          Section 26-26-6, Revocation of authorization.
8374          Section 26-26-7, Adoption of rules by department -- Inspection and investigation of
8375     institutions.
8376          Section 26-28-101, Title.
8377          Section 26-31-101, Title.
8378          Section 26-31-102, Definitions.
8379          Section 26-31-202, Blood donation by a minor.
8380          Section 26-33a-101, Short title.
8381          Section 26-33a-103, Committee membership -- Terms -- Chair -- Compensation.
8382          Section 26-34-1, Short title.
8383          Section 26-34-2, Definition of death -- Determination of death.
8384          Section 26-35a-101, Title.
8385          Section 26-36b-101, Title.
8386          Section 26-36c-101, Title.
8387          Section 26-36d-101, Title.
8388          Section 26-37a-101, Title.
8389          Section 26-38-1, Title.
8390          Section 26-38-2, Definitions.
8391          Section 26-38-3.5, Smoking ban exemption for Native American ceremony.
8392          Section 26-38-6, Local ordinances.
8393          Section 26-38-7, Enforcement action by proprietors.
8394          Section 26-38-8, Penalties.
8395          Section 26-38-9, Enforcement of chapter.
8396          Section 26-39-101, Title.
8397          Section 26-39-203, Duties of the Child Care Center Licensing Committee.

8398          Section 26-40-101, Title.
8399          Section 26-41-101, Title.
8400          Section 26-41-102, Definitions.
8401          Section 26-43-101, Title.
8402          Section 26-43-103, Disclosure of information.
8403          Section 26-46-101, Definitions.
8404          Section 26-46a-101, Title.
8405          Section 26-47-101, Title.
8406          Section 26-47-102, Prescription Drug Assistance Program.
8407          Section 26-47-103, Department to award grants for assistance to persons with
8408     bleeding disorders.
8409          Section 26-49-101, Title.
8410          Section 26-50-101, Title.
8411          Section 26-50-102, Definitions.
8412          Section 26-51-101, Title.
8413          Section 26-51-202, Public education concerning methamphetamine contamination.
8414          Section 26-53-101, Title.
8415          Section 26-54-101, Title.
8416          Section 26-55-101, Title.
8417          Section 26-55-102, Definitions.
8418          Section 26-57-101, Title.
8419          Section 26-57-102, Definitions.
8420          Section 26-57-104, Labeling of nicotine products containing nicotine.
8421          Section 26-58-101, Title.
8422          Section 26-60-101, Title.
8423          Section 26-60-102, Definitions.
8424          Section 26-60-104, Enforcement.
8425          Section 26-60-105, Study by Public Utilities, Energy, and Technology Interim
8426     Committee and Health Reform Task Force.
8427          Section 26-61-101, Title.
8428          Section 26-61-102, Definitions.

8429          Section 26-61-202, Duties.
8430          Section 26-61a-101, Title.
8431          Section 26-62-101, Title.
8432          Section 26-64-101, Title.
8433          Section 26-66-101, Title.
8434          Section 26-66-102, Definitions.
8435          Section 26-66-201, Early Childhood Utah Advisory Council.
8436          Section 26-66-203, Compensation.
8437          Section 26-67-101, Title.
8438          Section 26-68-101, Title.
8439          Section 26-69-101, Definitions.
8440          Section 26-69-202, Council and executive director duties.
8441          Section 26-69-203, Members serve without pay -- Reimbursement for expenses.
8442          Section 26-69-401, Definitions.
8443          Section 26-70-101, Definitions.
8444          Section 26A-1-101, Short title.
8445          Section 26B-1-201.1, Transition to single state agency -- Transition plan.
8446          Section 26B-1a-101, Definitions.
8447          Section 26B-1a-102, Office of American Indian-Alaska Native Health and Family
8448     Services -- Creation -- Purpose.
8449          Section 26B-1a-103, Director of the office -- Appointment -- Qualifications -- Staff.
8450          Section 26B-1a-107, Liaison reporting.
8451          Section 62A-1-104, Definitions.
8452          Section 62A-1-123, Intergenerational poverty mitigation reporting.
8453          Section 62A-1-201, Title.
8454          Section 62A-2-101, Definitions.
8455          Section 62A-3-101, Definitions.
8456          Section 62A-4a-101.5, Juvenile services.
8457          Section 62A-4a-210, Definitions.
8458          Section 62A-5-206.8, Management of the Utah State Developmental Center
8459     Sustainability Fund.

8460          Section 62A-5-401, Purpose.
8461          Section 62A-5-403, Services for persons under 11 years of age.
8462          Section 62A-5a-101, Policy statement.
8463          Section 62A-5a-102, Definitions.
8464          Section 62A-5a-104, Powers of council.
8465          Section 62A-5a-105, Coordination of services for school-age children.
8466          Section 62A-5b-101, Title.
8467          Section 62A-6-101, Definitions.
8468          Section 62A-11-103, Definitions.
8469          Section 62A-11-301, Title.
8470          Section 62A-11-601, Title.
8471          Section 62A-11-701, Title.
8472          Section 62A-11-702, Definitions.
8473          Section 62A-14-101, Title.
8474          Section 62A-15-101, Title.
8475          Section 62A-15-102, Definitions.
8476          Section 62A-15-201, Title.
8477          Section 62A-15-645, Retrospective effect of provisions.
8478          Section 62A-15-1001, Definitions.
8479          Section 62A-15-1100, Definitions.
8480          Section 62A-15-1301, Definitions.
8481          Section 62A-15-1303, Statewide mental health crisis line and statewide warm line
8482     operational standards.
8483          Section 62A-15-1401, Definitions.
8484          Section 62A-15-1501, Definitions.
8485          Section 62A-15-1601, Definitions.
8486          Section 62A-15-1701, Definitions.
8487          Section 62A-15-1801, Definitions.
8488          Section 62A-16-101, Title.
8489          Section 62A-17-101, Title.
8490          Section 62A-18-101, Title.

8491          Section 62A-18-102, Definitions.
8492          Section 62A-18-103, Office of Quality and Design -- Creation.
8493          Section 62A-18-104, Director of the office -- Appointment -- Qualifications.
8494          Section 178. Revisor instructions.
8495          The Legislature intends that the Office of Legislative Research and General Counsel, in
8496     preparing the Utah Code database for publication:
8497          (1) not enroll this bill if any of the following bills do not pass:
8498          (a) S.B. 38, Health and Human Services Recodification Administration, Licensing, and
8499     Recovery Services;
8500          (b) S.B. 39, Health and Human Services Recodification Prevention, Supports,
8501     Substance Use and Mental Health; or
8502          (c) S.B. 41, Health and Human Services Recodification - Health Care Delivery and
8503     Repeals; and
8504          (2) in any new language added to the Utah Code by legislation passed during the 2023
8505     General Session, replace any references to Titles 26 or 62A with the renumbered reference as it
8506     is renumbered in this bill.