Rep. Norm Thurston — Voting Record

Bill

Number

H.B. 236 (2022GS)

Sponsor

Rep. Eliason, S.

Final action

Governor Signed 3/22/2022

Outcome

Became law — signed by Gov. Spencer J. Cox

Summary

What it does

• This bill:
• creates and modifies definitions;
• requires the base budget to include certain appropriations to the Department of Health for behavioral health services;
• requires the Office of the Legislative Fiscal Analyst to include an estimate of the cost of behavioral health services in certain Medicaid funding forecasts;
• creates the collaborative care grant program;
• requires the Division of Substance Abuse and Mental Health to administer the collaborative care grant program;
• allows the state suicide prevention program to include a public education campaign;
• clarifies that the Governor's Suicide Prevention Fund may be used for components of the state suicide prevention program;
• provides a sunset date;
• includes reporting requirements; and
• makes technical and conforming changes.

Every vote on this bill

Bill text

BEHAVIORAL HEALTH AMENDMENTS
GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Steve Eliason
Senate Sponsor: 
Todd D. Weiler
LONG TITLE
General Description:
This bill addresses behavioral health services.
Highlighted Provisions:
This bill:
▸ creates and modifies definitions;
▸ requires the base budget to include certain appropriations to the Department of
Health for behavioral health services;
▸ requires the Office of the Legislative Fiscal Analyst to include an estimate of the
cost of behavioral health services in certain Medicaid funding forecasts;
▸ creates the collaborative care grant program;
▸ requires the Division of Substance Abuse and Mental Health to administer the
collaborative care grant program;
▸ allows the state suicide prevention program to include a public education campaign;
▸ clarifies that the Governor's Suicide Prevention Fund may be used for components
of the state suicide prevention program;
▸ provides a sunset date;
▸ includes reporting requirements; and
▸ makes technical and conforming changes.
Money Appropriated in this Bill:
This bill appropriates in fiscal year 2023:
▸ to Department of Health and Human Services -- Health Care Administration --
Integrated Health Care Administration, as a one-time appropriation:
• from General Fund, One-time, $1,000,000;
▸ to Department of Health and Human Services -- Integrated Health Care Services --
Non-Medicaid Behavioral Health Treatment and Crisis Response, as an ongoing
appropriation:
• from General Fund, $350,000; and
▸ to Department of Health and Human Services -- Integrated Health Care Services --
Non-Medicaid Behavioral Health Treatment and Crisis Response, as a one-time
appropriation:
• from General Fund, One-time, $2,430,000.
Other Special Clauses:
This bill provides a special effective date.
Utah Code Sections Affected:
AMENDS:
26-18-405.5
 (Effective 07/01/22)
, as last amended by Laws of Utah 2021, Chapter 404
62A-15-1101
, as last amended by Laws of Utah 2019, Chapters 136, 440 and last
amended by Coordination Clause, Laws of Utah 2019, Chapter 440
62A-15-1103
, as enacted by Laws of Utah 2018, Chapter 414
63I-1-262
, as last amended by Laws of Utah 2021, Chapters 29 and 91
ENACTS:
62A-15-124
, Utah Code Annotated 1953
Be it enacted by the Legislature of the state of Utah:
Section 1. Section 
26-18-405.5 (Effective 07/01/22)
 is amended to read:
26-18-405.5 (Effective 07/01/22).
Base budget appropriations for Medicaid
accountable care organizations and behavioral health plans -- Forecast of behavioral
health services cost.
(1) As used in this section:
(a) "ACO" means an accountable care organization that contracts with the state's
Medicaid program for:
(i) physical health services; or
(ii) integrated physical and behavioral health services.
(b) "Base budget" means the same as that term is defined in legislative rule.
(c) "Behavioral health plan" means a managed care or fee for service delivery system
that contracts with or is operated by the department to provide behavioral health services to
Medicaid eligible individuals.
(d) "Behavioral health services" means mental health or substance use treatment or
services.
[
(c)
] 
(e)
 "General Fund growth factor" means the amount determined by dividing the
next fiscal year ongoing General Fund revenue estimate by current fiscal year ongoing
appropriations from the General Fund.
[
(d) "Mental health plan" means a prepaid mental health plan or a health plan that uses
a fee-for-service payment model that contracts with the state's Medicaid program for behavioral
health services.
]
[
(e)
] 
(f)
 "Next fiscal year ongoing General Fund revenue estimate" means the next
fiscal year ongoing General Fund revenue estimate identified by the Executive Appropriations
[
Subcommittee
] 
Committee
, in accordance with legislative rule, for use by the Office of the
Legislative Fiscal Analyst in preparing budget recommendations.
[
(f)
] 
(g)
 "PMPM" means per-member-per-month funding.
(2) If the General Fund growth factor is less than 100%, the next fiscal year base
budget shall
, subject to Subsection (5),
 include an appropriation[
: (a)
] to the department [
for
ACOs under the department
] in an amount necessary to ensure that the next fiscal year PMPM
for [
the
] ACOs 
and behavioral health plans
 equals the current fiscal year PMPM for the ACOs
and behavioral health plans
 multiplied by 100%[
; and
]
.
[
(b) subject to Subsection (5), to the Department of Human Services for mental health
plans under the Department of Human Services in an amount necessary to ensure that the
funding for the mental health plans in the next fiscal year equals the funding for the mental
health plans in the current fiscal year multiplied by 100%.
]
(3) If the General Fund growth factor is greater than or equal to 100%, but less than
102%, the next fiscal year base budget shall
, subject to Subsection (5),
 include an
appropriation[
: (a)
] to the department [
for ACOs under the department
] in an amount necessary
to ensure that the next fiscal year PMPM for [
the
] ACOs 
and behavioral health plans
 equals the
current fiscal year PMPM for the ACOs 
and behavioral health plans
 multiplied by the General
Fund growth factor[
; and
]
.
[
(b) subject to Subsection (5), to the Department of Human Services for mental health
plans under the Department of Human Services in an amount necessary to ensure that the
funding for the mental health plans in the next fiscal year equals the funding for the mental
health plans in the current fiscal year multiplied by the General Fund growth factor.
]
(4) If the General Fund growth factor is greater than or equal to 102%, the next fiscal
year base budget shall
, subject to Subsection (5),
 include an appropriation[
: (a)
] to the
department [
for ACOs under the department
] in an amount necessary to ensure that the next
fiscal year PMPM for [
the
] ACOs 
and behavioral health plans
 is greater than or equal to the
current fiscal year PMPM for the ACOs 
and behavioral health plans
 multiplied by 102% and
less than or equal to the current fiscal year PMPM for the ACOs 
and behavioral health plans
multiplied by the General Fund growth factor[
; and
]
.
[
(b) subject to Subsection (5), to the Department of Human Services for mental health
plans under the Department of Human Services in an amount necessary to ensure that the
funding for the mental health plans in the next fiscal year is greater than or equal to the funding
for the mental health plans in the current fiscal year multiplied by 102% and less than or equal
to the funding for the mental health plans in the current fiscal year multiplied by the General
Fund growth factor.
]
(5) The appropriations provided to the [
Department of Human Services
] 
department for
behavioral health plans
 under this section shall be reduced by the amount contributed by
counties in the current fiscal year for [
mental
] 
behavioral
 health plans [
under the Department of
Human Services
] in accordance with Subsections 
17-43-201
(5)(k) and 
17-43-301
(6)(a)(x).
(6) In order for the department [
and the Department of Human Services
] to estimate the
impact of Subsections (2) through (4) before identification of the next fiscal year ongoing
General Fund revenue estimate, the Governor's Office of Planning and Budget shall, in
cooperation with the Office of the Legislative Fiscal Analyst, develop an estimate of ongoing
General Fund revenue for the next fiscal year and provide the estimate to the department [
and
the Department of Human Services
] no later than November 1 of each year.
(7) The Office of the Legislative Fiscal Analyst shall include an estimate of the cost of
behavioral health services in any state Medicaid funding or savings forecast that is completed
in coordination with the department and the Governor's Office of Planning and Budget.
Section 2. Section 
62A-15-124
 is enacted to read:
 62A-15-124.
Collaborative care grant program.
(1) As used in this section:
(a) "Applicant" means a small primary health care practice that applies for a grant
under this section.
(b) "Care manager" means an individual who plans, directs, and coordinates health care
services for a patient.
(c) "Collaborative care model" means a formal collaborative arrangement between a
primary care physician, a mental health professional, and a care manager, to provide integrated
physical and behavioral health services.
(d) "Mental health professional" means an individual licensed under Title 58, Chapter
60, Mental Health Professional Practice Act, or Title 58, Chapter 61, Psychologist Licensing
Act, or a psychiatrist.
(e) "Physician" means an individual licensed to practice as a physician or osteopath
under Title 58, Chapter 67, Utah Medical Practice Act, or Title 58, Chapter 68, Utah
Osteopathic Medical Practice Act.
(f) "Primary care physician" means a physician that provides health services related to
family medicine, internal medicine, pediatrics, obstetrics, gynecology, or geriatrics.
(g) "Program" means a program described in Subsection (2)(a).
(h) "Psychiatrist" means a physician who is board eligible for a psychiatry
specialization recognized by the American Board of Medical Specialists or the American
Osteopathic Association's Bureau of Osteopathic Specialists.
(i) "Small primary health care practice" means a medical practice of primary health
care physicians that:
(i) includes 10 or fewer primary care physicians; or
(ii) is primarily based in a county of the third through sixth class, as classified in
Section 
17-50-501
.
(2) (a) Before July 1, 2022, the division shall solicit applications from small primary
health care practices for a grant to support or implement a program to provide integrated
physical and behavioral health services under a collaborative care model.
(b) A grant under this section may be used to:
(i) hire and train staff to administer a program;
(ii) identify and formalize contractual relationships with mental health professionals
and case managers to implement a program; or
(iii) purchase or upgrade software and other resources necessary to support or
implement a program.
(c) The division shall approve at least one but not more than six applications each year.
(d) The division shall determine which applicants receive a grant under this section
before December 31, 2022.
(3) An application for a grant under this section shall:
(a) identify the population to whom the applicant will provide services under a
program;
(b) identify the small primary health care practice's current resources that are used to
provide integrated physical and behavioral health services;
(c) explain how the population described in Subsection (3)(a) will benefit from the
program;
(d) provide details regarding:
(i) how the applicant will provide timely and effective services under the program;
(ii) any existing or planned contracts or partnerships between the applicant and other
persons that are related to a collaborative care model;
(iii) the methods the applicant will use to:
(A) protect the privacy of each individual to whom the applicant provides services
under the program; and
(B) collect non-identifying data; and
(e) provide other information requested by the division for the division to evaluate the
application.
(4) In evaluating an application for a grant under this section, the division shall
consider:
(a) the extent to which providing the grant to the applicant will fulfill the purpose of
providing increased integrated physical and behavioral health services; and
(b) the extent to which the population described in Subsection (3)(a) is likely to benefit
from the applicant receiving the grant.
(5) Before July 1, 2023, the division shall submit a written report to the Health and
Human Services Interim Committee regarding each applicant the division provided a grant to
in the preceding year under this section.
(6) Before July 1, 2024, the division shall submit a written report to the Health and
Human Services Interim Committee regarding:
(a) data gathered and knowledge gained in relation to providing grants to an applicant;
and
(b) recommendations for how the state can better implement integrated physical and
behavioral health services.
Section 3. Section 
62A-15-1101
 is amended to read:
62A-15-1101.
Suicide prevention -- Reporting requirements.
(1) The division shall appoint a state suicide prevention coordinator to administer a
state suicide prevention program composed of suicide prevention, intervention, and postvention
programs, services, and efforts.
(2) The coordinator shall:
(a) establish a Statewide Suicide Prevention Coalition with membership from public
and private organizations and Utah citizens; and
(b) appoint a chair and co-chair from among the membership of the coalition to lead
the coalition.
(3) The state suicide prevention program may include the following components:
(a) delivery of resources, tools, and training to community-based coalitions;
(b) evidence-based suicide risk assessment tools and training;
(c) town hall meetings for building community-based suicide prevention strategies;
(d) suicide prevention gatekeeper training;
(e) training to identify warning signs and to manage an at-risk individual's crisis;
(f) evidence-based intervention training;
(g) intervention skills training; [
and
]
(h) postvention training[
.
]
; or
(i) a public education campaign to improve public awareness about warning signs of
suicide and suicide prevention resources.
(4) The coordinator shall coordinate with the following to gather statistics, among
other duties:
(a) local mental health and substance abuse authorities;
(b) the State Board of Education, including the public education suicide prevention
coordinator described in Section 
53G-9-702
;
(c) the Department of Health;
(d) health care providers, including emergency rooms;
(e) federal agencies, including the Federal Bureau of Investigation;
(f) other unbiased sources; and
(g) other public health suicide prevention efforts.
(5) The coordinator shall provide a written report to the Health and Human Services
Interim Committee, at or before the October meeting every year, on:
(a) implementation of the state suicide prevention program, as described in Subsections
(1) and (3);
(b) data measuring the effectiveness of each component of the state suicide prevention
program;
(c) funds appropriated for each component of the state suicide prevention program; and
(d) five-year trends of suicides in Utah, including subgroups of youths and adults and
other subgroups identified by the state suicide prevention coordinator.
(6) The coordinator shall, in consultation with the bureau, implement and manage the
operation of the firearm safety program described in Subsection 
62A-15-103
(3).
(7) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, the
division shall make rules:
(a) governing the implementation of the state suicide prevention program, consistent
with this section; and
(b) in conjunction with the bureau, defining the criteria for employers to apply for
grants under the Suicide Prevention Education Program described in Section 
62A-15-103.1
,
which shall include:
(i) attendance at the suicide prevention education course described in Subsection
62A-15-103
(3); and
(ii) distribution of the firearm safety brochures or packets created in Subsection
62A-15-103
(3), but does not require the distribution of a cable-style gun lock with a firearm if
the firearm already has a trigger lock or comparable safety mechanism.
(8) As funding by the Legislature allows, the coordinator shall award grants, not to
exceed a total of $100,000 per fiscal year, to suicide prevention programs that focus on the
needs of children who have been served by the Division of Juvenile Justice Services.
(9) The coordinator and the coalition shall submit to the advisory council, no later than
October 1 each year, a written report detailing the previous fiscal year's activities to fund,
implement, and evaluate suicide prevention activities described in this section.
Section 4. Section 
62A-15-1103
 is amended to read:
62A-15-1103.
Governor's Suicide Prevention Fund.
(1) There is created an expendable special revenue fund known as the Governor's
Suicide Prevention Fund.
(2) The fund shall consist of gifts, grants, and bequests of real property or personal
property made to the fund.
(3) A donor to the fund may designate a specific purpose for the use of the donor's
donation, if the designated purpose is described in Subsection (4) [
or 
62A-15-1101
(3)
].
(4) 
(a)
 Subject to Subsection (3), money in the fund shall be used for the following
activities:
[
(a)
] 
(i)
 efforts to directly improve mental health crisis response;
[
(b)
] 
(ii)
 efforts that directly reduce risk factors associated with suicide; and
[
(c)
] 
(iii)
 efforts that directly enhance known protective factors associated with suicide
reduction.
(b) Efforts described in Subsections (4)(a)(ii) and (iii) include the components of the
state suicide prevention program described in Subsection 
62A-15-1101
(3).
(5) The division shall establish a grant application and review process for the
expenditure of money from the fund.
(6) The grant application and review process shall describe:
(a) requirements to complete a grant application;
(b) requirements to receive funding;
(c) criteria for the approval of a grant application;
(d) standards for evaluating the effectiveness of a project proposed in a grant
application; and
(e) support offered by the division to complete a grant application.
(7) The division shall:
(a) review a grant application for completeness;
(b) make a recommendation to the governor or the governor's designee regarding a
grant application;
(c) send a grant application to the governor or the governor's designee for evaluation
and approval or rejection;
(d) inform a grant applicant of the governor or the governor's designee's determination
regarding the grant application; and
(e) direct the fund administrator to release funding for grant applications approved by
the governor or the governor's designee.
(8) The state treasurer shall invest the money in the fund under Title 51, Chapter 7,
State Money Management Act, except that all interest or other earnings derived from money in
the fund shall be deposited into the fund.
(9) Money in the fund may not be used for the Office of the Governor's administrative
expenses that are normally provided for by legislative appropriation.
(10) The governor or the governor's designee may authorize the expenditure of fund
money in accordance with this section.
(11) The governor shall make an annual report to the Legislature regarding the status of
the fund, including a report on the contributions received, expenditures made, and programs
and services funded.
Section 5. Section 
63I-1-262
 is amended to read:
63I-1-262.
Repeal dates, Title 62A.
(1) Section 
62A-3-209
 is repealed July 1, 2023.
(2) Section 
62A-4a-213
 is repealed July 1, 2024.
(3) Sections 
62A-5a-101
, 
62A-5a-102
, 
62A-5a-103
, and 
62A-5a-104
, which create the
Coordinating Council for Persons with Disabilities, are repealed July 1, 2022.
[
(4) Section 
62A-15-114
 is repealed December 31, 2021.
]
[
(5)
] 
(4)
 Subsections 
62A-15-116
(1) and (5), the language that states "In consultation
with the Behavioral Health Crisis Response Commission, established in Section 
63C-18-202
,"
is repealed January 1, 2023.
[
(6)
] 
(5)
 Section 
62A-15-118
 is repealed December 31, 2023.
(6) Section 
62A-15-124
 is repealed December 31, 2024.
(7) Subsections 
62A-15-605
(3)(h) and (4) relating to the study of long-term needs for
adult beds in the state hospital are repealed July 1, 2022.
(8) Section 
62A-15-605
, which creates the Forensic Mental Health Coordinating
Council, is repealed July 1, 2023.
(9) Subsections 
62A-15-1100
(1) and 
62A-15-1101
(9), in relation to the Utah
Substance Use and Mental Health Advisory Council, are repealed January 1, 2023.
(10) In relation to the Behavioral Health Crisis Response Commission, on July 1, 2023:
(a) Subsections 
62A-15-1301
(2) and 
62A-15-1401
(1) are repealed;
(b) Subsection 
62A-15-1302
(1)(b), the language that states "and in consultation with
the commission" is repealed;
(c) Subsection 
62A-15-1303
(1), the language that states "In consultation with the
commission," is repealed;
(d) Subsection 
62A-15-1402
(2)(a), the language that states "With recommendations
from the commission," is repealed; and
(e) Subsection 
62A-15-1702
(6) is repealed.
Section 6. 
Appropriation.
The following sums of money are appropriated for the fiscal year beginning July 1,
2022, and ending June 30, 2023. These are additions to amounts previously appropriated for
fiscal year 2023. Under the terms and conditions of Title 63J, Chapter 1, Budgetary Procedures
Act, the Legislature appropriates the following sums of money from the funds or accounts
indicated for the use and support of the government of the state of Utah.
ITEM 1
To Department of Health and Human Services -- Health Care Administration
From General Fund, One-time
$1,000,000
Schedule of Programs:
Integrated Health Care Administration $1,000,000
The Legislature intends that:
(1) the appropriations under this item be used for the collaborative care grant program
under Section 
62A-15-124
; and
(2) under Section 
63J-1-603
, the appropriations under this item not lapse at the close of
fiscal year 2023 and the use of any nonlapsing funds is limited to the purpose described in
Subsection (1) of this item.
ITEM 2
To Department of Health and Human Services -- Integrated Health Care Services
From General Fund
$350,000
From General Fund, One-time
$2,430,000
Schedule of Programs:
Non-Medicaid Behavioral Health Treatment
 and Crisis Response $2,780,000
The Legislature intends that:
(1) the appropriations under this item be used for the state suicide prevention program
described in Section 
62A-15-1101
; and
(2) under Section 
63J-1-603
, the appropriations under this item not lapse at the close of
fiscal year 2023 and the use of any nonlapsing funds is limited to the purpose described in
Subsection (1) of this item.
Section 7. 
Effective date.
This bill takes effect on May 4, 2022, except that Section 
26-18-405.5
 (Effective
07/01/22) takes effect on July 1, 2022.