02-12 13:01 H.B. 491
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Behavioral Health Modifications
2025 GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Steve Eliason
Senate Sponsor:
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LONG TITLE
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General Description:
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This bill amends provisions relating to behavioral health.
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Highlighted Provisions:
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This bill:
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▸ defines terms;
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▸ requires a behavioral health receiving center to comply with licensing requirements from
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the Department of Health and Human Services;
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▸ addresses Medicaid directed payments for the Utah State Hospital and the Huntsman
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Mental Health Institute;
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▸ requires the Department of Public Safety to:
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● survey all law enforcement agencies in the state and publish a publicly searchable
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registry that will allow the public to see whether each law enforcement agency is or is
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not available to receive a voluntarily committed firearm in accordance with safe
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harbor provisions; and
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● subject to available funding, create and implement a marketing plan to educate law
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enforcement agencies and the public about safe harbor options for firearms; and
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▸ makes technical and conforming changes.
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Money Appropriated in this Bill:
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This bill appropriates $125,428,400 in operating and capital budgets for fiscal year 2026,
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including:
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▸ $107,471,800 from General Fund; and
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▸ $17,956,600 from various sources as detailed in this bill.
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Other Special Clauses:
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None
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Utah Code Sections Affected:
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AMENDS:
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26B-2-101, as last amended by Laws of Utah 2024, Chapters 240, 267, 307, and 438
H.B. 491 H.B. 491 02-12 13:01
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53-5c-201, as last amended by Laws of Utah 2023, Chapters 138, 448
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ENACTS:
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26B-5-383, Utah Code Annotated 1953
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Be it enacted by the Legislature of the state of Utah:
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Section 1. Section 26B-2-101 is amended to read:
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26B-2-101 . Definitions.
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As used in this part:
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(1) "Adoption services" means the same as that term is defined in Section 80-2-801.
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(2) "Adult day care" means nonresidential care and supervision:
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(a) for three or more adults for at least four but less than 24 hours a day; and
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(b) that meets the needs of functionally impaired adults through a comprehensive
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program that provides a variety of health, social, recreational, and related support
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services in a protective setting.
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(3) "Applicant" means a person that applies for an initial license or a license renewal under
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this part.
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(4)(a) "Associated with the licensee" means that an individual is:
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(i) affiliated with a licensee as an owner, director, member of the governing body,
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employee, agent, provider of care, department contractor, or volunteer; or
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(ii) applying to become affiliated with a licensee in a capacity described in
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Subsection (4)(a)(i).
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(b) "Associated with the licensee" does not include:
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(i) service on the following bodies, unless that service includes direct access to a
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child or a vulnerable adult:
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(A) a local mental health authority described in Section 17-43-301;
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(B) a local substance abuse authority described in Section 17-43-201; or
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(C) a board of an organization operating under a contract to provide mental health
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or substance use programs, or services for the local mental health authority or
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substance abuse authority; or
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(ii) a guest or visitor whose access to a child or a vulnerable adult is directly
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supervised at all times.
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(5) "Behavioral health receiving center" means a 23-hour non-secure program or facility
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that is responsible for, and provides mental health crisis services to, an individual
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experiencing a mental health crisis.
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[(5)] (6)(a) "Boarding school" means a private school that:
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(i) uses a regionally accredited education program;
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(ii) provides a residence to the school's students:
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(A) for the purpose of enabling the school's students to attend classes at the
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school; and
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(B) as an ancillary service to educating the students at the school;
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(iii) has the primary purpose of providing the school's students with an education, as
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defined in Subsection [(5)(b)(i)] (6)(b)(i); and
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(iv)(A) does not provide the treatment or services described in Subsection [(40)(a)]
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(41)(a); or
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(B) provides the treatment or services described in Subsection [(40)(a)] (41)(a) on
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a limited basis, as described in Subsection [(5)(b)(ii)] (6)(b)(ii).
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(b)(i) For purposes of Subsection [(5)(a)(iii)] (6)(a)(iii), "education" means a course
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of study for one or more grades from kindergarten through grade 12.
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(ii) For purposes of Subsection [(5)(a)(iv)(B)] (6)(a)(iv)(B), a private school provides
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the treatment or services described in Subsection [(40)(a)] (41)(a) on a limited
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basis if:
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(A) the treatment or services described in Subsection [(40)(a)] (41)(a) are provided
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only as an incidental service to a student; and
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(B) the school does not:
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(I) specifically solicit a student for the purpose of providing the treatment or
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services described in Subsection [(40)(a)] (41)(a); or
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(II) have a primary purpose of providing the treatment or services described in
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Subsection [(40)(a)] (41)(a).
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(c) "Boarding school" does not include a therapeutic school.
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[(6)] (7) "Certification" means a less restrictive level of licensure issued by the department.
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[(7)] (8) "Child" means an individual under 18 years old.
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[(8)] (9) "Child placing" means receiving, accepting, or providing custody or care for any
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child, temporarily or permanently, for the purpose of:
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(a) finding a person to adopt the child;
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(b) placing the child in a home for adoption; or
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(c) foster home placement.
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[(9)] (10) "Child-placing agency" means a person that engages in child placing.
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[(10)] (11) "Client" means an individual who receives or has received services from a
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licensee.
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[(11)] (12)(a) "Congregate care program" means any of the following that provide
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services to a child:
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(i) an outdoor youth program;
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(ii) a residential support program;
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(iii) a residential treatment program; or
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(iv) a therapeutic school.
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(b) "Congregate care program" does not include a human services program that:
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(i) is licensed to serve adults; and
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(ii) is approved by the office to service a child for a limited time.
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[(12)] (13) "Day treatment" means specialized treatment that is provided to:
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(a) a client less than 24 hours a day; and
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(b) four or more persons who:
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(i) are unrelated to the owner or provider; and
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(ii) have emotional, psychological, developmental, physical, or behavioral
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dysfunctions, impairments, or chemical dependencies.
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[(13)] (14) "Department contractor" means an individual who:
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(a) provides services under a contract with the department; and
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(b) due to the contract with the department, has or will likely have direct access to a
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child or vulnerable adult.
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[(14)] (15) "Direct access" means that an individual has, or likely will have:
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(a) contact with or access to a child or vulnerable adult that provides the individual with
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an opportunity for personal communication or touch; or
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(b) an opportunity to view medical, financial, or other confidential personal identifying
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information of the child, the child's parents or legal guardians, or the vulnerable adult.
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[(15)] (16) "Directly supervised" means that an individual is being supervised under the
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uninterrupted visual and auditory surveillance of another individual who has a current
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background check approval issued by the office.
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[(16)] (17) "Director" means the director of the office.
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[(17)] (18) "Domestic violence" means the same as that term is defined in Section 77-36-1.
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[(18)] (19) "Domestic violence treatment program" means a nonresidential program
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designed to provide psychological treatment and educational services to perpetrators and
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victims of domestic violence.
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[(19)] (20) "Elder adult" means a person 65 years old or older.
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[(20)] (21) "Emergency safety intervention" means a tactic used to protect staff or a client
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from being physically injured, utilized by an appropriately trained direct care staff and
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only performed in accordance with a nationally or regionally recognized curriculum in
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the least restrictive manner to restore staff or client safety.
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[(21)] (22) "Foster home" means a residence that is licensed or certified by the office for the
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full-time substitute care of a child.
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[(22)] (23) "Health benefit plan" means the same as that term is defined in Section
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31A-22-634.
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[(23)] (24) "Health care provider" means the same as that term is defined in Section
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78B-3-403.
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[(24)] (25) "Health insurer" means the same as that term is defined in Section 31A-22-615.5.
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[(25)] (26)(a) "Human services program" means:
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(i) a foster home;
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(ii) a therapeutic school;
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(iii) a youth program;
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(iv) an outdoor youth program;
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(v) a residential treatment program;
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(vi) a residential support program;
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(vii) a resource family home;
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(viii) a recovery residence;[ or]
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(ix) a behavioral health receiving center; or
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[(ix)] (x) a facility or program that provides:
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(A) adult day care;
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(B) day treatment;
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(C) outpatient treatment;
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(D) domestic violence treatment;
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(E) child-placing services;
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(F) social detoxification; or
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(G) any other human services that are required by contract with the department to
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be licensed with the department.
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(b) "Human services program" does not include:
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(i) a boarding school;
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(ii) a residential, vocational and life skills program, as defined in Section 13-53-102;
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or
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(iii) a short-term relief care provider.
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[(26)] (27) "Indian child" means the same as that term is defined in 25 U.S.C. Sec. 1903.
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[(27)] (28) "Indian country" means the same as that term is defined in 18 U.S.C. Sec. 1151.
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[(28)] (29) "Indian tribe" means the same as that term is defined in 25 U.S.C. Sec. 1903.
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[(29)] (30) "Intermediate secure treatment" means 24-hour specialized residential treatment
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or care for an individual who:
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(a) cannot live independently or in a less restrictive environment; and
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(b) requires, without the individual's consent or control, the use of locked doors to care
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for the individual.
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[(30)] (31) "Licensee" means an individual or a human services program licensed by the
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office.
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[(31)] (32) "Local government" means a city, town, or county.
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[(32)] (33) "Minor" means child.
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[(33)] (34) "Office" means the Office of Licensing within the department.
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[(34)] (35) "Outdoor youth program" means a program that provides:
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(a) services to a child that has:
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(i) a chemical dependency; or
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(ii) a dysfunction or impairment that is emotional, psychological, developmental,
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physical, or behavioral;
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(b) a 24-hour outdoor group living environment; and
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(c)(i) regular therapy, including group, individual, or supportive family therapy; or
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(ii) informal therapy or similar services, including wilderness therapy, adventure
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therapy, or outdoor behavioral healthcare.
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[(35)] (36) "Outpatient treatment" means individual, family, or group therapy or counseling
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designed to improve and enhance social or psychological functioning for those whose
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physical and emotional status allows them to continue functioning in their usual living
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environment.
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[(36)] (37) "Practice group" or "group practice" means two or more health care providers
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legally organized as a partnership, professional corporation, or similar association, for
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which:
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(a) substantially all of the services of the health care providers who are members of the
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group are provided through the group and are billed in the name of the group and
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amounts received are treated as receipts of the group; and
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(b) the overhead expenses of and the income from the practice are distributed in
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accordance with methods previously determined by members of the group.
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[(37)] (38) "Private-placement child" means a child whose parent or guardian enters into a
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contract with a congregate care program for the child to receive services.
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[(38)] (39)(a) "Recovery residence" means a home, residence, or facility that meets at
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least two of the following requirements:
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(i) provides a supervised living environment for individuals recovering from a
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substance use disorder;
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(ii) provides a living environment in which more than half of the individuals in the
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residence are recovering from a substance use disorder;
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(iii) provides or arranges for residents to receive services related to the resident's
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recovery from a substance use disorder, either on or off site;
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(iv) is held out as a living environment in which individuals recovering from
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substance abuse disorders live together to encourage continued sobriety; or
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(v)(A) receives public funding; or
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(B) is run as a business venture, either for-profit or not-for-profit.
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(b) "Recovery residence" does not mean:
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(i) a residential treatment program;
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(ii) residential support program; or
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(iii) a home, residence, or facility, in which:
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(A) residents, by a majority vote of the residents, establish, implement, and
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enforce policies governing the living environment, including the manner in
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which applications for residence are approved and the manner in which
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residents are expelled;
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(B) residents equitably share rent and housing-related expenses; and
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(C) a landlord, owner, or operator does not receive compensation, other than fair
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market rental income, for establishing, implementing, or enforcing policies
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governing the living environment.
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[(39)] (40) "Regular business hours" means:
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(a) the hours during which services of any kind are provided to a client; or
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(b) the hours during which a client is present at the facility of a licensee.
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[(40)] (41)(a) "Residential support program" means a program that arranges for or
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provides the necessities of life as a protective service to individuals or families who
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have a disability or who are experiencing a dislocation or emergency that prevents
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them from providing these services for themselves or their families.
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(b) "Residential support program" includes a program that provides a supervised living
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environment for individuals with dysfunctions or impairments that are:
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(i) emotional;
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(ii) psychological;
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(iii) developmental; or
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(iv) behavioral.
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(c) Treatment is not a necessary component of a residential support program.
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(d) "Residential support program" does not include:
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(i) a recovery residence; or
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(ii) a program that provides residential services that are performed:
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(A) exclusively under contract with the department and provided to individuals
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through the Division of Services for People with Disabilities; or
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(B) in a facility that serves fewer than four individuals.
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[(41)] (42)(a) "Residential treatment" means a 24-hour group living environment for four
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or more individuals unrelated to the owner or provider that offers room or board and
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specialized treatment, behavior modification, rehabilitation, discipline, emotional
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growth, or habilitation services for persons with emotional, psychological,
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developmental, or behavioral dysfunctions, impairments, or chemical dependencies.
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(b) "Residential treatment" does not include a:
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(i) boarding school;
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(ii) foster home; or
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(iii) recovery residence.
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[(42)] (43) "Residential treatment program" means a program or facility that provides:
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(a) residential treatment; or
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(b) intermediate secure treatment.
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[(43)] (44) "Seclusion" means the involuntary confinement of an individual in a room or an
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area:
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(a) away from the individual's peers; and
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(b) in a manner that physically prevents the individual from leaving the room or area.
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[(44)] (45) "Short-term relief care provider" means an individual who:
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(a) provides short-term and temporary relief care to a foster parent:
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(i) for less than six consecutive nights; and
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(ii) in the short-term relief care provider's home;
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(b) is an immediate family member or relative, as those terms are defined in Section
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80-3-102, of the foster parent;
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(c) is direct access qualified, as that term is defined in Section 26B-2-120;
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(d) has been approved to provide short-term relief care by the department;
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(e) is not reimbursed by the department for the temporary relief care provided; and
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(f) is not an immediate family member or relative, as those terms are defined in Section
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80-3-102, of the foster child.
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[(45)] (46) "Social detoxification" means short-term residential services for persons who are
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experiencing or have recently experienced drug or alcohol intoxication, that are provided
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outside of a health care facility licensed under Part 2, Health Care Facility Licensing and
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Inspection, and that include:
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(a) room and board for persons who are unrelated to the owner or manager of the facility;
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(b) specialized rehabilitation to acquire sobriety; and
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(c) aftercare services.
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[(46)] (47) "Substance abuse disorder" or "substance use disorder" mean the same as
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"substance use disorder" is defined in Section 26B-5-501.
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[(47)] (48) "Substance abuse treatment program" or "substance use disorder treatment
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program" means a program:
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(a) designed to provide:
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(i) specialized drug or alcohol treatment;
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(ii) rehabilitation; or
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(iii) habilitation services; and
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(b) that provides the treatment or services described in Subsection [(47)(a)] (48)(a) to
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persons with:
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(i) a diagnosed substance use disorder; or
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(ii) chemical dependency disorder.
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[(48)] (49) "Therapeutic school" means a residential group living facility:
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(a) for four or more individuals that are not related to:
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(i) the owner of the facility; or
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(ii) the primary service provider of the facility;
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(b) that serves students who have a history of failing to function:
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(i) at home;
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(ii) in a public school; or
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(iii) in a nonresidential private school; and
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(c) that offers:
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(i) room and board; and
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(ii) an academic education integrated with:
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(A) specialized structure and supervision; or
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(B) services or treatment related to:
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(I) a disability;
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(II) emotional development;
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(III) behavioral development;
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(IV) familial development; or
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(V) social development.
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[(49)] (50) "Unrelated persons" means persons other than parents, legal guardians,
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grandparents, brothers, sisters, uncles, or aunts.
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[(50)] (51) "Vulnerable adult" means an elder adult or an adult who has a temporary or
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permanent mental or physical impairment that substantially affects the person's ability to:
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(a) provide personal protection;
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(b) provide necessities such as food, shelter, clothing, or mental or other health care;
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(c) obtain services necessary for health, safety, or welfare;
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(d) carry out the activities of daily living;
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(e) manage the adult's own resources; or
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(f) comprehend the nature and consequences of remaining in a situation of abuse,
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neglect, or exploitation.
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[(51)] (52)(a) "Youth program" means a program designed to provide behavioral,
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substance use, or mental health services to minors that:
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(i) serves adjudicated or nonadjudicated youth;
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(ii) charges a fee for the program's services;
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(iii) may provide host homes or other arrangements for overnight accommodation of
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the youth;
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(iv) may provide all or part of the program's services in the outdoors;
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(v) may limit or censor access to parents or guardians; and
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(vi) prohibits or restricts a minor's ability to leave the program at any time of the
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minor's own free will.
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(b) "Youth program" does not include recreational programs such as Boy Scouts, Girl
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Scouts, 4-H, and other such organizations.
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[(52)] (53)(a) "Youth transportation company" means any person that transports a child
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for payment to or from a congregate care program in Utah.
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(b) "Youth transportation company" does not include:
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(i) a relative of the child;
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(ii) a state agency; or
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(iii) a congregate care program's employee who transports the child from the
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congregate care program that employs the employee and returns the child to the
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same congregate care program.
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Section 2. Section 26B-5-383 is enacted to read:
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26B-5-383 . Directed payments.
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(1) To preserve and improve access to behavioral health hospital services, the department
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shall incorporate into the local mental health authorities' Medicaid prepaid mental health
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plan contract rate structure calculation, consistent with the certified actuarial rate range,
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an amount equal to the difference between payments made by local mental health
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authorities for the Medicaid eligibility categories for Medicaid-eligible services covered
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in Utah based on submitted encounter data and the maximum amount that could be paid
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for those services to be used for directed payments to the Utah State Hospital and the
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Huntsman Mental Health Institute within the University of Utah for inpatient and
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outpatient behavioral health services.
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(2) By June 30, 2025, the department shall submit to the Centers for Medicare and
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Medicaid Services the necessary request and supporting documentation to seek approval
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to make the Medicaid directed payments described in Subsection (1) with an effective
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date of July 1, 2025.
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(3) The department may implement directed payments for the Utah State Hospital when
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operationally feasible.
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Section 3. Section 53-5c-201 is amended to read:
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53-5c-201 . Voluntary commitment of a firearm by cohabitant -- Law
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enforcement to hold firearm.
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(1)(a) A cohabitant or owner cohabitant may voluntarily commit a firearm to a law
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enforcement agency or request that a law enforcement officer receive a firearm for
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safekeeping if the owner cohabitant or cohabitant believes that the owner cohabitant
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or another cohabitant with access to the firearm is an immediate threat to:
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(i) a cohabitant;
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(ii) the owner cohabitant; or
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(iii) another individual.
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(b) Except as provided in Subsection (2), if the owner of a firearm requests return of the
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firearm in person at the law enforcement agency's office, the law enforcement agency:
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(i) may not hold the firearm under this section; and
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(ii) shall return the firearm to the owner.
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(2) A law enforcement agency may not return a firearm to an owner under Subsection (1)(b)
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if the owner of the firearm:
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(a) is a restricted person under Section 76-10-503; or
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(b)(i) has been arrested and booked into a county jail on a class A misdemeanor or
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felony domestic violence offense;
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(ii) has had a court:
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(A) review the probable cause statement detailing the incident leading to the
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owner's arrest; and
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(B) determine that probable cause existed for the arrest; and
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(iii) is subject to a jail release agreement or a jail release court order arising out of the
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domestic violence offense.
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(3) Unless a firearm is an illegal firearm subject to Section 53-5c-202, a law enforcement
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agency that receives a firearm in accordance with this chapter shall:
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(a) record:
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(i) the owner cohabitant's name, address, and phone number;
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(ii) the firearm serial number and the make and model of each firearm committed; and
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(iii) the date that the firearm was voluntarily committed;
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(b) require the cohabitant to sign a document attesting that the cohabitant resides in the
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home;
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(c) hold the firearm in safe custody:
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(i) for 60 days after the day on which the firearm is voluntarily committed; or
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(ii)(A) for an owner described in Subsection (2)(b), during the time the jail release
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agreement or jail release court order is in effect; and
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(B) for 60 days after the day on which the jail release agreement or jail release
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court order expires; and
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(d) upon proof of identification, return the firearm to:
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(i)(A) the owner cohabitant after the expiration of the 60-day period; or
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(B) if the owner cohabitant requests return of the firearm before the expiration of
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the 60-day period, at the time of the request; or
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(ii) an owner other than the owner cohabitant in accordance with Section 53-5c-202.
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(4) The law enforcement agency shall hold the firearm for an additional 60 days:
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(a) if the initial 60-day period expires; and
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(b) the cohabitant or owner cohabitant requests that the law enforcement agency hold the
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firearm for an additional 60 days.
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(5) A law enforcement agency may not request or require that the owner cohabitant provide
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the name or other information of the cohabitant who poses an immediate threat or any
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other cohabitant.
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(6) Notwithstanding an ordinance or policy to the contrary adopted in accordance with
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Section 63G-2-701, a law enforcement agency shall destroy a record created under
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Subsection (3), Subsection 53-5c-202(3)(b)(iii), or any other record created in the
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application of this chapter immediately, if practicable, but no later than five days after
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immediately upon the:
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(a) return of a firearm in accordance with Subsection (3)(d); or
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(b) disposal of the firearm in accordance with Section 53-5c-202.
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(7) Unless otherwise provided, the provisions of Title 77, Chapter 11d, Lost or Mislaid
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Property, do not apply to a firearm received by a law enforcement agency in accordance
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with this chapter.
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(8) A law enforcement agency shall adopt a policy for the safekeeping of a firearm held in
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accordance with this chapter.
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(9) The department shall:
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(a) create a pamphlet to be distributed by a law enforcement officer under Section
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77-36-2.1 that includes information about a cohabitant's or owner cohabitant's ability
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to have the owner cohabitant's firearm committed to a law enforcement agency for
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safekeeping in accordance with this section[.] ;
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(b) survey all law enforcement agencies in the state and publish a publicly searchable
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registry that will allow the public to see whether each law enforcement agency is or is
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not available to receive a voluntarily committed firearm in accordance with this
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section; and
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(c) subject to available funding, create and implement a marketing plan to educate law
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enforcement agencies and the public regarding the options available under this
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chapter.
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Section 4. FY 2026 Appropriations.
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The following sums of money are appropriated for the fiscal year beginning July 1,
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2025, and ending June 30, 2026. These are additions to amounts previously appropriated for
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fiscal year 2026.
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Subsection 4(a). Operating and Capital Budgets
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Under the terms and conditions of Title 63J, Chapter 1, Budgetary Procedures Act, the
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Legislature appropriates the following sums of money from the funds or accounts indicated for
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the use and support of the government of the state of Utah.
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ITEM 1 To Department of Health and Human Services - Integrated Health Care Services
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From General Fund 8,204,300
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From General Fund, One-time 5,495,800
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Schedule of Programs:
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Non-Medicaid Behavioral Health Treatment and
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Crisis Response 8,900,100
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State Hospital 4,800,000
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The Legislature intends that the Department of
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Health and Human Services use:
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(1) $3,060,000 one-time appropriation, and
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$2,244,000 ongoing appropriation for one new rural
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behavioral health receiving center.
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(2) $1,035,800 one-time appropriation, and
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$1,010,300 ongoing appropriation for one new Mobile
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Crisis Outreach Team.
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(3) $1,000,000 ongoing appropriation for Utah's
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statewide Live On suicide prevention campaign.
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(4) $400,000 one-time appropriation for up to
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five pilot projects in rural areas to fund innovative and
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more humane ways to transport people experiencing a
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behavioral health crisis between medical settings.
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(5) $150,000 ongoing appropriation for
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community and clinical suicide prevention trainings,
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community and continuum of care resources, and
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educational materials.
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(6) $1,000,000 one-time appropriation, and
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$3,800,000 ongoing appropriation for operational cost
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increases at the Utah State Hospital.
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ITEM 2 To Department of Health and Human Services - Clinical Services
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From General Fund 299,700
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Schedule of Programs:
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Medical Examiner 299,700
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The Legislature intends that the Department of
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Health and Human Services use the appropriation in Item
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2 to fund family outreach specialists at the Office of the
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Medical Examiner.
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ITEM 3 To Department of Health and Human Services - Integrated Health Care Services
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From General Fund 4,674,200
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From General Fund, One-time 88,797,800
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From Federal Funds 17,956,600
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Schedule of Programs:
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Medicaid Behavioral Health Services 21,399,100
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State Hospital 90,029,500
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The Legislature intends that the Department of
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Health and Human Services use:
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(1) $24,000 ongoing appropriation to increase
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Medicaid rates for peer support specialist services.
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(2) $3,412,000 ongoing appropriation to
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continue a 5% increased rate for behavioral health
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services.
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(3) $6,500 ongoing appropriation to increase
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Medicaid rates for mobile crisis outreach teams.
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(4) $88,797,800 one-time appropriation, and
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$1,231,700 ongoing appropriation to expand the
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availability of long-term care beds at the Utah State
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Hospital and other residential facilities as needed.
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Section 5. Effective Date.
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This bill takes effect on May 7, 2025.
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