Bill Summary – FastDemocracy

Enrolled Copy                                                                         S.B. 154
                                   ADOPTION AMENDMENTS
                                       2023 GENERAL SESSION
                                            STATE OF UTAH
                                 Chief Sponsor: Chris H. Wilson
                               House Sponsor: Jefferson S. Burton
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 LONG TITLE
 General Description:
        This bill addresses adoptions.
 Highlighted Provisions:
        This bill:
        < defines terms;
        < addresses Medicaid coverage and payments related to a birth mother who considers
 or proceeds with an adoptive placement for a child;
        < prohibits a child-placing agency from charging for services that are not actually
 rendered or for medical or hospital expenses that were paid for with public funds;
        < requires certain child-placing agencies to join a child-placing consortium by which
 the consortium can serve all birth mothers and all prospective adoptive parents;
        < provides protections for consortium-member child-placing agencies that cannot
 participate in child placing that is contrary to the agency's religious teachings,
 practices, or beliefs, or certain wishes of the birth mother;
        < requires the Judicial Council to create a uniform fee and expense form for adoption
 proceedings;
        < with certain conditions and exceptions:
            C   requires a prospective adoptive parent to file a fee and expense form with the
 court prior to the finalization of an adoption;
            C   requires the court to review a fee and expense form for completeness;
            C   requires a child placing agency to file a fee and expense form with the Office of
 Licensing within the Department of Health and Human Services; and
       S.B. 154                                                                     Enrolled Copy
            C   requires the Department of Health and Human Services to provide an annual
 report to the Health and Human Services Interim Committee and Judicial
 Council regarding adoption costs in the state; and
        < makes technical and conforming changes.
 Money Appropriated in this Bill:
        None
 Other Special Clauses:
        None
 Utah Code Sections Affected:
 AMENDS:
        26-18-3, as last amended by Laws of Utah 2021, Chapter 422
        62A-2-108.6, as last amended by Laws of Utah 2022, Chapters 287, 326 and
 renumbered and amended by Laws of Utah 2022, Chapter 334 and last amended by
 Coordination Clause, Laws of Utah 2022, Chapter 334
        63G-20-102, as enacted by Laws of Utah 2015, Chapter 46
        63G-20-202, as enacted by Laws of Utah 2015, Chapter 46
        78B-6-140, as last amended by Laws of Utah 2021, Chapter 65
 ENACTS:
        63G-20-203.5, Utah Code Annotated 1953
49
 Be it enacted by the Legislature of the state of Utah:
        Section 1. Section 26-18-3 is amended to read:
        26-18-3. Administration of Medicaid program by department -- Reporting to the
 Legislature -- Disciplinary measures and sanctions -- Funds collected -- Eligibility
 standards -- Internal audits -- Health opportunity accounts.
        (1) The department shall be the single state agency responsible for the administration
 of the Medicaid program in connection with the United States Department of Health and
 Human Services pursuant to Title XIX of the Social Security Act.
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       Enrolled Copy                                                                             S.B. 154
           (2) (a) The department shall implement the Medicaid program through administrative
 rules in conformity with this chapter, Title 63G, Chapter 3, Utah Administrative Rulemaking
 Act, the requirements of Title XIX, and applicable federal regulations.
           (b) The rules adopted under Subsection (2)(a) shall include, in addition to other rules
 necessary to implement the program:
           (i) the standards used by the department for determining eligibility for Medicaid
 services;
           (ii) the services and benefits to be covered by the Medicaid program;
           (iii) reimbursement methodologies for providers under the Medicaid program; and
           (iv) a requirement that:
           (A) a person receiving Medicaid services shall participate in the electronic exchange of
 clinical health records established in accordance with Section 26-1-37 unless the individual
 opts out of participation;
           (B) prior to enrollment in the electronic exchange of clinical health records the enrollee
 shall receive notice of enrollment in the electronic exchange of clinical health records and the
 right to opt out of participation at any time; and
           (C) beginning July 1, 2012, when the program sends enrollment or renewal information
 to the enrollee and when the enrollee logs onto the program's website, the enrollee shall receive
 notice of the right to opt out of the electronic exchange of clinical health records.
           (3) (a) The department shall, in accordance with Subsection (3)(b), report to the Social
 Services Appropriations Subcommittee when the department:
           (i) implements a change in the Medicaid State Plan;
           (ii) initiates a new Medicaid waiver;
           (iii) initiates an amendment to an existing Medicaid waiver;
           (iv) applies for an extension of an application for a waiver or an existing Medicaid
 waiver;
           (v) applies for or receives approval for a change in any capitation rate within the
 Medicaid program; or
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        S.B. 154                                                                        Enrolled Copy
        (vi) initiates a rate change that requires public notice under state or federal law.
        (b) The report required by Subsection (3)(a) shall:
        (i) be submitted to the Social Services Appropriations Subcommittee prior to the
 department implementing the proposed change; and
        (ii) include:
        (A) a description of the department's current practice or policy that the department is
 proposing to change;
        (B) an explanation of why the department is proposing the change;
        (C) the proposed change in services or reimbursement, including a description of the
 effect of the change;
        (D) the effect of an increase or decrease in services or benefits on individuals and
 families;
        (E) the degree to which any proposed cut may result in cost-shifting to more expensive
 services in health or human service programs; and
        (F) the fiscal impact of the proposed change, including:
        (I) the effect of the proposed change on current or future appropriations from the
 Legislature to the department;
        (II) the effect the proposed change may have on federal matching dollars received by
 the state Medicaid program;
        (III) any cost shifting or cost savings within the department's budget that may result
 from the proposed change; and
        (IV) identification of the funds that will be used for the proposed change, including any
 transfer of funds within the department's budget.
        (4) Any rules adopted by the department under Subsection (2) are subject to review and
 reauthorization by the Legislature in accordance with Section 63G-3-502.
        (5) The department may, in its discretion, contract with the Department of Human
 Services or other qualified agencies for services in connection with the administration of the
 Medicaid program, including:
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        Enrolled Copy                                                                          S.B. 154
        (a) the determination of the eligibility of individuals for the program;
        (b) recovery of overpayments; and
        (c) consistent with Section 26-20-13, and to the extent permitted by law and quality
 control services, enforcement of fraud and abuse laws.
        (6) The department shall provide, by rule, disciplinary measures and sanctions for
 Medicaid providers who fail to comply with the rules and procedures of the program, provided
 that sanctions imposed administratively may not extend beyond:
        (a) termination from the program;
        (b) recovery of claim reimbursements incorrectly paid; and
        (c) those specified in Section 1919 of Title XIX of the federal Social Security Act.
        (7) (a) Funds collected as a result of a sanction imposed under Section 1919 of Title
 XIX of the federal Social Security Act shall be deposited in the General Fund as dedicated
 credits to be used by the division in accordance with the requirements of Section 1919 of Title
 XIX of the federal Social Security Act.
        (b) In accordance with Section 63J-1-602.2, sanctions collected under this Subsection
 (7) are nonlapsing.
        (8) (a) In determining whether an applicant or recipient is eligible for a service or
 benefit under this part or Chapter 40, Utah Children's Health Insurance Act, the department
 shall, if Subsection (8)(b) is satisfied, exclude from consideration one passenger vehicle
 designated by the applicant or recipient.
        (b) Before Subsection (8)(a) may be applied:
        (i) the federal government shall:
        (A) determine that Subsection (8)(a) may be implemented within the state's existing
 public assistance-related waivers as of January 1, 1999;
        (B) extend a waiver to the state permitting the implementation of Subsection (8)(a); or
        (C) determine that the state's waivers that permit dual eligibility determinations for
 cash assistance and Medicaid are no longer valid; and
        (ii) the department shall determine that Subsection (8)(a) can be implemented within
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        S.B. 154                                                                        Enrolled Copy
 existing funding.
         (9) (a) For purposes of this Subsection (9):
         (i) "aged, blind, or has a disability" means an aged, blind, or disabled individual, as
 defined in 42 U.S.C. Sec. 1382c(a)(1); and
         (ii) "spend down" means an amount of income in excess of the allowable income
 standard that shall be paid in cash to the department or incurred through the medical services
 not paid by Medicaid.
         (b) In determining whether an applicant or recipient who is aged, blind, or has a
 disability is eligible for a service or benefit under this chapter, the department shall use 100%
 of the federal poverty level as:
         (i) the allowable income standard for eligibility for services or benefits; and
         (ii) the allowable income standard for eligibility as a result of spend down.
         (10) The department shall conduct internal audits of the Medicaid program.
         (11) (a) The department may apply for and, if approved, implement a demonstration
 program for health opportunity accounts, as provided for in 42 U.S.C. Sec. 1396u-8.
         (b) A health opportunity account established under Subsection (11)(a) shall be an
 alternative to the existing benefits received by an individual eligible to receive Medicaid under
 this chapter.
         (c) Subsection (11)(a) is not intended to expand the coverage of the Medicaid program.
         (12) (a) (i) The department shall apply for, and if approved, implement an amendment
 to the state plan under this Subsection (12) for benefits for:
         (A) medically needy pregnant women;
         (B) medically needy children; and
         (C) medically needy parents and caretaker relatives.
         (ii) The department may implement the eligibility standards of Subsection (12)(b) for
 eligibility determinations made on or after the date of the approval of the amendment to the
 state plan.
         (b) In determining whether an applicant is eligible for benefits described in Subsection
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        Enrolled Copy                                                                         S.B. 154
 (12)(a)(i), the department shall:
        (i) disregard resources held in an account in the savings plan created under Title 53B,
 Chapter 8a, Utah Educational Savings Plan, if the beneficiary of the account is:
        (A) under the age of 26; and
        (B) living with the account owner, as that term is defined in Section 53B-8a-102, or
 temporarily absent from the residence of the account owner; and
        (ii) include the withdrawals from an account in the Utah Educational Savings Plan as
 resources for a benefit determination, if the withdrawal was not used for qualified higher
 education costs as that term is defined in Section 53B-8a-102.5.
        (13) (a) The department may not deny or terminate eligibility for Medicaid solely
 because an individual is:
        (i) incarcerated; and
        (ii) not an inmate as defined in Section 64-13-1.
        (b) Subsection (13)(a) does not require the Medicaid program to provide coverage for
 any services for an individual while the individual is incarcerated.
        (14) The department is a party to, and may intervene at any time in, any judicial or
 administrative action:
        (a) to which the Department of Workforce Services is a party; and
        (b) that involves medical assistance under:
        (i) Title 26, Chapter 18, Medical Assistance Act; or
        (ii) Title 26, Chapter 40, Utah Children's Health Insurance Act.
        (15) (a) The department may not deny or terminate eligibility for Medicaid solely
 because a birth mother, as that term is defined in Section 78B-6-103, considers an adoptive
 placement for the child or proceeds with an adoptive placement of the child.
        (b) A health care provider, as that term is defined in Section 26-18-17, may not decline
 payment by Medicaid for covered health and medical services provided to a birth mother, as
 that term is defined in Section 78B-6-103, who is enrolled in Utah's Medicaid program and
 who considers an adoptive placement for the child or proceeds with an adoptive placement of
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        S.B. 154                                                                              Enrolled Copy
 the child.
         Section 2. Section 62A-2-108.6 is amended to read:
         62A-2-108.6. Child placing licensure requirements -- Prohibited acts --
 Consortium.
         (1) As used in this section:
         (a) (i) "Advertisement" means any written, oral, or graphic statement or representation
 made in connection with a solicitation of business.
         (ii) "Advertisement" includes a statement or representation described in Subsection
 (1)(a)(i) by a noncable television system, radio, printed brochure, newspaper, leaflet, flyer,
 circular, billboard, banner, Internet website, social media, or sign.
         (b) "Birth parent" means the same as that term is defined in Section 78B-6-103.
         (c) "Clearly and conspicuously disclose" means the same as that term is defined in
 Section 13-11a-2.
         (d) (i) "Matching advertisement" means any written, oral, or graphic statement or
 representation made in connection with a solicitation of business to provide the assistance
 described in Subsection (3)(a)(i), regardless of whether there is or will be an exchange
 described in Subsection (3)(a)(ii).
         (ii) "Matching advertisement" includes a statement or representation described in
 Subsection (1)(d)(i) by a noncable television system, radio, printed brochure, newspaper,
 leaflet, flyer, circular, billboard, banner, Internet website, social media, or sign.
         (2) (a) Subject to Section 78B-24-205, a person may not engage in child placing, or
 solicit money or other assistance for child placing, without a valid license issued by the office
 in accordance with this chapter.
         (b) If a child-placing agency's license is suspended or revoked in accordance with this
 chapter, the care, control, or custody of any child who is in the care, control, or custody of the
 child-placing agency shall be transferred to the Division of Child and Family Services.
         (3) (a) (i) An attorney, physician, or other person may assist:
         (A) a birth parent to identify or locate a prospective adoptive parent who is interested
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        Enrolled Copy                                                                            S.B. 154
 in adopting the birth parent's child; or
        (B) a prospective adoptive parent to identify or locate a child to be adopted.
        (ii) A payment, charge, fee, reimbursement of expense, or exchange of value of any
 kind, or promise or agreement to make the same, may not be made for the assistance described
 in Subsection (3)(a)(i).
        (b) An attorney, physician, or other person may not:
        (i) issue or cause to be issued to any person a card, sign, or device indicating that the
 attorney, physician, or other person is available to provide the assistance described in
 Subsection (3)(a)(i);
        (ii) cause, permit, or allow any sign or marking indicating that the attorney, physician,
 or other person is available to provide the assistance describ