With the Utah Legislature scheduled to begin its 2023 general session next Tuesday, multiple bills related to behavioral healthcare—both its workforce and its provision—have been filed ahead of the assembly.
The Health and Human Services Interim Committee approved several measures that address crisis response and the mental health support for first responders. House Bill 23 would modify the duties, membership, and responsibilities of the Utah Substance Use and Mental Health Advisory Council (SUMHAC) to include forensic mental health as part of its legislative assessment.
Under the bill, SUMHAC would incorporate the responsibilities of the Forensic Mental Health Coordinating Council and work with the Department of Corrections to address the staffing and provision of state mental health services to incarcerated individuals and justice-involved juveniles.
Another measure sponsored by Rep. Steve Eliason (R- Sandy) and developed by the Utah Behavioral Health Crisis Response Commission, HB 66, would establish funding for local law enforcement agencies to establish or expand mobile crisis outreach teams through grant programs, building out the state’s crisis support network. A similar bill, HB 29, approved by the Law Enforcement and Criminal Justice Interim Committee would also expand mobile crisis response through local grants.
Law enforcement in select areas including Salt Lake and Utah Counties is already working with mobile response teams virtually connected to a licensed clinical social worker to manage an individual’s episode and refer them to a nearby crisis receiving center, if necessary.
HB 78 would require health plans to cover mental health treatment for its enrollees regardless of whether the provider is in-network or not. HB 81 would require state-employee health plans to comply with the federal Mental Health Parity and Addiction Equity Act, including limitations that can be placed on residential treatment.
Utah youth and families need behavioral health support, according to Vice Chair of Education for the Department of Psychiatry at Huntsman Mental Health Institute, Aaron Fischer, PhD.
Fischer leads work on the Utah School Mental Health Collaborative (SMHC), a pilot program that builds mental health collaboration with public schools through student assessments, staff training, and implementation of mental health supports and services for students.
The collaborative partners with the Utah State Board of Education and the Office of Substance Use and Mental Health to support the voluntary program, working with 10 or more schools in a limited number of counties, including Logan County, where community mental health needs systemic support to provide direct therapy services.
Fischer said the collaborative has been conducting wellness screening on students across the state and using the information to help schools make better decisions.
“There’s a shortage of professionals to do this work across the state, but particularly in these rural communities, and underserved communities,” Fischer said. “We really want to try to figure out ways we can bridge that gap. And so, a lot of what we’re doing through this project is really trying to utilize a telehealth framework to the extent possible, and really create opportunities for professional learning and community connection.”
Fischer said the collaborative has been in communication with Rep. Eliason on issues surrounding youth mental health and looking into ways to potentially broaden the collaborative’s efforts statewide.
There are also upcoming bills that address professional healthcare licensing requirements. HB 159 would allow professionals who hold a healthcare license from a different state to provide telehealth services to Utahns under certain circumstances. HB 166 would ease licensing requirements and remove remote therapy restrictions for clinical social workers, marriage and family therapists, and clinical mental health counselors.
Tiana McCall, LCWS, a school-based social worker and mental health specialist with the Utah State Board of Education and participant in the SMHC, is having conversations with policy leaders about building comprehensive systems of mental healthcare through collaborative efforts.
“This means considering the spectrum of services from prevention to intervention to postvention and working within multidisciplinary teams to ensure the needs of students are being met,” McCall said. “Collaboration between school teams, community providers, and students and families is key to supporting student mental health.
The most commonly reported workforce issues that I hear about are struggles with finding qualified mental health professionals to fill open positions and lack of funding to provide adequate salaries for qualified mental health professionals.”
The state has multiple funding options to address Medicaid and behavioral health. The state’s Medicaid expansion fund, which was established through a 2018 ballot initiative, has some $200 million for legislators to work with.
The $1.7 trillion federal omnibus spending bill passed in late December appropriates billions of dollars in funding for states to address mental health and addiction, including provisions for school-based and other youth mental health and substance use services.
Rep. Rosemary Lesser (D – Ogden) said the legislature is looking at ways to utilize those federal funds and expand the presence of mental health professionals in schools.
“[Federal omnibus] funding would allow for expanding the number and allowing more mental health providers to be in schools,” Lesser said. “Providing therapy for students is needed. So I see that as a really important place to offer intervention. I know that at the hospital where I used to practice before I became a citizen legislator, we had an employee assistance program, in which the mental health providers were very well trained in the specific stressors that healthcare workers are experiencing.
I think [having an] employee assistance program for educators and paraprofessionals would be similarly helpful, because this has really become a big stressor for our educational system [and its] employees. So putting in an Employee Assistance Project, I think would be a really good use of the omnibus package.”