Representative Steve Eliason proposes the following substitute bill:


1     
PSYCHOTROPIC MEDICATION OVERSIGHT PILOT

2     
PROGRAM AMENDMENTS

3     
2024 GENERAL SESSION

4     
STATE OF UTAH

5     
Chief Sponsor: Steve Eliason

6     
Senate Sponsor: Michael S. Kennedy

7     

8     LONG TITLE
9     General Description:
10          This bill amends provisions related to the psychotropic medication oversight pilot
11     program.
12     Highlighted Provisions:
13          This bill:
14          ▸     removes a repeal date for the psychotropic medication oversight pilot program
15     (program);
16          ▸     amends provisions to make the program permanent;
17          ▸     adds minors committed to the Division of Juvenile Justice and Youth Services to
18     the program;
19          ▸     moves operation of the program from the Division of Child and Family Services to
20     the Division of Integrated Healthcare (division);
21          ▸     addresses the membership of the program's oversight team;
22          ▸     amends provisions regarding the duties of the oversight team, caseworkers, and case
23     managers;
24          ▸     adds certain reporting requirements for the division and the oversight team;
25          ▸     requires the Department of Health and Human Services to pay standard Medicaid
26     rates for outpatient behavioral health services for children in foster care and minors committed
27     to the Division of Juvenile Justice and Youth Services; and
28          ▸     makes technical and conforming changes.
29     Money Appropriated in this Bill:
30          None
31     Other Special Clauses:
32          None
33     Utah Code Sections Affected:
34     AMENDS:
35          63I-1-280, as enacted by Laws of Utah 2022, Chapter 335
36          80-2-503.5, as last amended by Laws of Utah 2023, Chapter 309
37     

38     Be it enacted by the Legislature of the state of Utah:
39          Section 1. Section 63I-1-280 is amended to read:
40          63I-1-280. Repeal dates: Title 80.
41          [Section 80-2-503.5 is repealed July 1, 2024.]
42          Section 2. Section 80-2-503.5 is amended to read:
43          80-2-503.5. Psychotropic medication oversight program -- Behavioral health
44     service rates for children in foster care.
45          (1) As used in this section[,]:
46          (a) "Advanced practice registered nurse" means an individual licensed to practice as an
47     advanced practice registered nurse in this state under Title 58, Chapter 31b, Nurse Practice Act.
48          (b) "Division" means the Division of Integrated Healthcare created in Section
49     26B-1-204.
50          (c) "HIPAA" means 45 C.F.R. Parts 160, 162, and 164, Health Insurance Portability
51     and Accountability Act of 1996, as amended.
52          (d) "Physician assistant" means an individual licensed to practice as a physician
53     assistant in this state under Title 58, Chapter 70a, Utah Physician Assistant Act.
54          (e) ["psychotropic] "Psychotropic medication" means medication prescribed to affect
55     or alter thought processes, mood, or behavior, including antipsychotic, antidepressant,
56     anxiolytic, or behavior medication.
57          (f) "Qualifying minor" means a minor committed to the Division of Juvenile Justice
58     and Youth Services under Section 80-6-703.
59          (2) The division shall, through contract with the [Department of Health and Human
60     Services] University of Utah or another qualified third party, [establish and] operate a
61     psychotropic medication oversight [pilot] program for children in foster care and qualifying
62     minors to ensure that [foster children are being] each foster child and qualifying minor is
63     prescribed psychotropic medication consistent with the foster [children's] child's or qualifying
64     minor's needs and consistent with clinical best practices.
65          (3) The division shall [establish] operate an oversight team to manage the psychotropic
66     medication oversight program, composed of at least the following individuals:
67          (a) a physician assistant with pediatric mental health experience, or an advanced
68     practice registered nurse[, as defined in Section 58-31b-102,] with pediatric mental health
69     experience, contracted with the [Department of Health and Human Services] division; [and]
70          (b) a child psychiatrist[.] contracted with the division;
71          (c) a data analyst contracted with the division; and
72          (d) an individual with care coordination experience.
73          (4) The oversight team shall monitor foster children and qualifying minors:
74          (a) six years old or younger who are being prescribed one or more psychotropic
75     medications; [and]
76          (b) seven years old or older who are being prescribed two or more psychotropic
77     medications[.]; and
78          (c) who are prescribed one or more antipsychotic medications.
79          (5) The division shall establish a business associate agreement with the oversight team
80     by which the oversight team shall, upon request, be given information or records related to the
81     foster child's or qualifying minor's health care history, including psychotropic medication
82     history and mental and behavioral health history, from:
83          (a) the division's Medicaid pharmacy program;
84          (b) the department's written and electronic records and databases;
85          (c) the foster child's current or past caseworker, or the qualifying minor's current or
86     past case manager;
87          [(b)] (d) the foster child or qualifying minor; or
88          [(c)] (e) the foster child's or qualifying minor's:
89          (i) current or past health care provider;
90          (ii) natural parents; or
91          (iii) foster parents.
92          (6) The oversight team may review and monitor the following information about a
93     foster child or qualifying minor:
94          (a) the foster child's or qualifying minor's history;
95          (b) the foster child's or qualifying minor's health care, including psychotropic
96     medication history and mental or behavioral health history;
97          (c) whether there are less invasive treatment options available to meet the foster child's
98     or qualifying minor's needs;
99          (d) the dosage or dosage range and appropriateness of the foster child's or qualifying
100     minor's psychotropic medication;
101          (e) the short-term or long-term risks associated with the use of the foster child's or
102     qualifying minor's psychotropic medication; or
103          (f) the reported benefits of the foster child's or qualifying minor's psychotropic
104     medication.
105          (7) (a) [The] On at least a quarterly basis, the oversight team [may] shall:
106          (i) review the medical and mental or behavioral health history for each foster child and
107     qualifying minor overseen by the program;
108          (ii) based on the review under Subsection (7)(a)(i), document the oversight team's
109     findings and recommendations; and
110          (iii) make written recommendations [to the foster child's health care providers]
111     concerning the foster child's or qualifying minor's psychotropic medication [or] and the foster
112     child's or qualifying minor's mental or behavioral health, including any recommendation for
113     psychotherapy treatment.
114          (b) The oversight [team shall provide the] team's recommendations [made] described
115     in Subsection (7)(a) [to the foster child's parent or guardian after discussing the
116     recommendations with the foster child's current health care providers] shall be provided to the
117     foster child's current caseworker or the qualifying minor's current case manager, the foster
118     child's or qualifying minor's parent or guardian, and the foster child's or qualifying minor's
119     current health care providers, in accordance with rules adopted pursuant to Subsection (8) and
120     in compliance with HIPAA and other relevant state and federal privacy laws.
121          (c) The member of the oversight team described in Subsection (3)(d) shall:
122          (i) provide the recommendations described in Subsection (7)(a) in writing and verbally,
123     or as otherwise provided in rules adopted pursuant to Subsection (8), to the foster child's or
124     qualifying minor's current health care providers; and
125          (ii) on at least a semiannual basis, follow up with the foster child's or qualifying
126     minor's current health care providers to document whether recommendations made by the
127     oversight team have been implemented.
128          (d) A foster child's caseworker or qualifying minor's case manager shall maintain a
129     confidential record of recommendations provided under Subsection (7)(b).
130          (8) The division may adopt administrative rules in accordance with Title 63G, Chapter
131     3, Utah Administrative Rulemaking Act, necessary to administer this section, including the
132     rules described in Subsection (7)(b).
133          (9) The division shall report regarding the psychotropic medication oversight program:
134          (a) to the Child Welfare Legislative Oversight Panel [regarding the psychotropic
135     medication oversight pilot program] by October 1 of each even numbered year[.]; and
136          (b) orally to the Health and Human Services Interim Committee, at least once every
137     two years at or before the October interim meeting.
138          (10) The oversight team shall report:
139          (a) quarterly to the division regarding the number of foster children and qualifying
140     minors reviewed and the number of recommendations made; and
141          (b) annually to the division regarding outcomes for foster children and qualifying
142     minors overseen by the program.
143          (11) Beginning on July 1, 2024, the department shall pay for outpatient behavioral
144     health services for children in foster care and qualifying minors at a rate no lower than the
145     standard Medicaid fee schedule.
146          Section 3. Effective date.
147          This bill takes effect on May 1, 2024.