02-20 09:52 2nd Sub. (Salmon) S.B. 65
Jen Plumb proposes the following substitute bill:
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Medication Assisted Treatment Amendments
2025 GENERAL SESSION
STATE OF UTAH
Chief Sponsor: Jen Plumb
House Sponsor:
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LONG TITLE
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General Description:
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This bill addresses the use of medical assisted treatment in certain human services programs.
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Highlighted Provisions:
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This bill:
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▸ defines terms;
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▸ requires the Office of Licensing within the Department of Health and Human Services to
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establish and enforce rules concerning the use of medication assisted treatment in certain
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residential treatment programs and recovery residences; and
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▸ makes technical and conforming changes.
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Money Appropriated in this Bill:
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None
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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
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26B-2-117, as renumbered and amended by Laws of Utah 2023, Chapter 305
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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)(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); and
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(iv)(A) does not provide the treatment or services described in Subsection [(40)(a)]
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(42)(a); or
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(B) provides the treatment or services described in Subsection [(40)(a)] (42)(a) on
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a limited basis, as described in Subsection (5)(b)(ii).
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(b)(i) For purposes of Subsection (5)(a)(iii), "education" means a course of study for
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one or more grades from kindergarten through grade 12.
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(ii) For purposes of Subsection (5)(a)(iv)(B), a private school provides the treatment
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or services described in Subsection [(40)(a)] (42)(a) on a limited basis if:
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(A) the treatment or services described in Subsection [(40)(a)] (42)(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)] (42)(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)] (42)(a).
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(c) "Boarding school" does not include a therapeutic school.
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(6) "Certification" means a less restrictive level of licensure issued by the department.
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(7) "Child" means an individual under 18 years old.
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(8) "Child placing" means receiving, accepting, or providing custody or care for any child,
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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) "Child-placing agency" means a person that engages in child placing.
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(10) "Client" means an individual who receives or has received services from a licensee.
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(11)(a) "Congregate care program" means any of the following that provide services to a
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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) "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) "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) "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) "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) "Director" means the director of the office.
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(17) "Domestic violence" means the same as that term is defined in Section 77-36-1.
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(18) "Domestic violence treatment program" means a nonresidential program designed to
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provide psychological treatment and educational services to perpetrators and victims of
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domestic violence.
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(19) "Elder adult" means a person 65 years old or older.
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(20) "Emergency safety intervention" means a tactic used to protect staff or a client from
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being physically injured, utilized by an appropriately trained direct care staff and only
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performed in accordance with a nationally or regionally recognized curriculum in the
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least restrictive manner to restore staff or client safety.
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(21) "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) "Health benefit plan" means the same as that term is defined in Section [31A-22-634]
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31A-1-301.
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(23) "Health care provider" means the same as that term is defined in Section 78B-3-403.
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(24) "Health insurer" means[ the same as that term is defined in Section 31A-22-615.5.] :
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(a) an insurer who offers health care insurance as that term is defined in Section
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31A-1-301;
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(b) health benefits offered to state employees under Section 49-20-202; and
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(c) a workers' compensation insurer:
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(i) authorized to provide workers' compensation insurance in the state; or
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(ii) that is a self-insured employer as defined in Section 34A-2-201.5.
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(25)(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 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) "Indian child" means the same as that term is defined in 25 U.S.C. Sec. 1903.
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(27) "Indian country" means the same as that term is defined in 18 U.S.C. Sec. 1151.
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(28) "Indian tribe" means the same as that term is defined in 25 U.S.C. Sec. 1903.
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(29) "Intermediate secure treatment" means 24-hour specialized residential treatment or
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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) "Licensee" means an individual or a human services program licensed by the office.
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(31) "Local government" means a city, town, or county.
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(32) "Medication assisted treatment" means the use of a prescribed medication approved by
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the United States Food and Drug Administration, such as buprenorphine, methadone, or
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naltrexone, to treat substance use withdrawal symptoms or a substance use disorder.
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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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(39) "Qualifying residential treatment program" means a residential treatment program that
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is licensed under this part and:
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(a) is operated as a nonprofit corporation or foreign nonprofit corporation, as those terms
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are defined in Section 16-6a-102; or
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(b) receives any local, state, or federal government funding, government grant money, or
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any other form of government assistance to operate or provide services or training in
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the ordinary course of business.
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(40) "Qualifying recovery residence" means a recovery residence that is licensed under this
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part and:
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(a) is operated as a nonprofit corporation or foreign nonprofit corporation, as those terms
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are defined in Section 16-6a-102; or
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(b) receives any local, state, or federal government funding, government grant money, or
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any other form of government assistance to operate or provide services or training in
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the ordinary course of business.
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[(38)] (41)(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)] (42) "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)] (43)(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)] (44)(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)] (45) "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)] (46) "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)] (47) "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)] (48) "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)] (49) "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)] (50) "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)] (49)(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)] (51) "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)] (52) "Unrelated persons" means persons other than parents, legal guardians,
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grandparents, brothers, sisters, uncles, or aunts.
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[(50)] (53) "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)] (54)(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)] (55)(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-2-117 is amended to read:
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26B-2-117 . Licensing residential treatment programs and recovery residences --
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Notification of local government.
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(1)(a) In accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act,
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the office shall make rules that establish categories of residential treatment and
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recovery residence licenses based on differences in the types of residential treatment
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programs and recovery residences.
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(b) The categories referred to in Subsection (1)(a) may be based on differences in:
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(i) services offered;
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(ii) types of clients served;
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(iii) risks posed to the community; or
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(iv) other factors that make regulatory differences advisable.
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(2) Subject to the requirements of federal and state law, and pursuant to the authority
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granted by Section 26B-2-104, the office shall establish and enforce rules that:
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(a)(i) relate generally to all categories of residential treatment program and recovery
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residence licenses; and
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[(b)] (ii) relate to specific categories of residential treatment program and recovery
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residence licenses on the basis of the regulatory needs, as determined by the
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office, of residential treatment programs and recovery residences within those
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specific categories[.] ;
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(b) preclude each qualified residential treatment program and each qualified recovery
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residence from refusing to accept a client based solely on the client's use of
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medication assisted treatment consistent with the recommendation of a licensed
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prescriber or provider;
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(c) require each qualified residential treatment program and each qualified recovery
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residence to allow a client to receive medication assisted treatment as recommended
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by a licensed prescriber or provider; and
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(d) require that each Medicaid provider contract with a qualified residential treatment
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program or a qualified recovery residence includes a provision obligating the
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provider to comply with rules enacted pursuant to Subsections (2)(b) and (c), subject
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to the sanctions provided pursuant to Subsection 26B-3-108(6).
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(3)(a) Beginning July 1, 2014, the office shall charge an annual licensing fee, set by the
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office in accordance with the procedures described in Section 63J-1-504, to a
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recovery residence in an amount that will pay for the cost of the licensing and
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inspection requirements described in this section and in Section 26B-2-104.
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(b) The office shall deposit the licensing fees described in this section in the General
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Fund as a dedicated credit to be used solely to pay for the cost of the licensing and
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inspection requirements described in this section and in Section 26B-2-104.
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(4) Before submitting an application for a license to operate a residential treatment
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program, the applicant shall serve notice of its intent to operate a residential treatment
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program on the governing body of:
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(a) the city in which the residential treatment program will be located; or
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(b) if the residential treatment program will be located in the unincorporated area of a
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county, the county in which the residential treatment program will be located.
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(5) The notice described in Subsection (4) shall include the following information relating
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to the residential treatment program:
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(a) an accurate description of the residential treatment program;
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(b) the location where the residential treatment program will be operated;
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(c) the services that will be provided by the residential treatment program;
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(d) the type of clients that the residential treatment program will serve;
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(e) the category of license for which the residential treatment program is applying to the
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office;
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(f) the name, telephone number, and address of a person that may be contacted to make
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inquiries about the residential treatment program; and
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(g) any other information that the office may require by rule.
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(6) When submitting an application for a license to operate a residential treatment program,
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the applicant shall include with the application:
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(a) a copy of the notice described in Subsection (4); and
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(b) proof that the applicant served the notice described in Subsection (4) on the
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governing body described in Subsection (4).
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Section 3. Effective Date.
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This bill takes effect on May 7, 2025.
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