H.B. 70 Correctional Health Services Amendments: transcript

Go ahead. Great. Uh, thank you Mr. Chair. Uh, this is a follow up from a bill. It was actually a committee bill, I believe. Um, it was a follow up also from last session where, just as a little background, several sessions ago the legislature passed, uh, legislation requiring, uh, DHHS to seek a Medicaid waiver, uh, for to implement a justice involved waiver that was approved. Utah was one of five states that received that. Uh, the goal of that is to reduce recidivism and improve, uh, inmate healthcare just subsequent to their release and kind of provide a bridge for them into the community. Um, the bill last year required DHHS to go out and, uh, or to form a working group to look into whether or not they needed an EMR that's electronic medical record. And if so, then to, uh, do an RFP for that, that's underway and almost completed. The only problem is, is that there is not funding for, uh, the EMR, um, without an EMR. The current, uh, electronic health record within, uh, correctional Health Services, uh, does not have the functionality to be able to bill Medicaid with an EMR or EHR that can bill Medicaid. Then prior to 90 days prior to release, the state can bill for inmate healthcare services, which will be a tremendous savings to the state. So this bill takes, uh, funds out of a, uh, restricted account related to Medicaid on a one-time basis to fund, uh, the new electronic health record. Um, and then also requires that, uh, inmates during their first 90 days, uh, are, uh, treated for opioid use disorders, uh, and then 90 days prior to release that they're treated for those, uh, particular conditions. Um, so if we had a dynamic fiscal note, this bill should show a very large return to the state over, uh, the coming years. But that's not how we do it. I do have, uh, Dr. Wisner here with me from Correctional, the Director of Correctional Health Services CHS. Since we like acronyms around here, as part of my presentation, I'd just like to give Dr. Wisner a a little bit of time to kind of just talk about the, the genesis for the bill and the justice involved waiver and how an e EMR can help facilitate that process. Thank you. Uh, Mr.

Chair, if I may, uh, one of the major, oh, excuse me. Dr. Mark Whiner, uh, director of Correctional Health Services. Um, one of the major hurdles, uh, for billing, uh, the 1115 Justice involved waiver is the electronic medical record. Uh, a system that is built to bill, typically in corrections, Medicaid. And its, uh, money was unavailable to those who were incarcerated until the bill, until the law was made that, um, or until the 1115 Justice involved waiver was passed. Having said that the systems are in Correctional Healthcare across the nation, don't, don't have the ability to, to bill, to code Medicaid and to keep track like a system like the hospitals or even in private, uh, practices and private clinics. So this would be a huge step forward in, uh, allowing correctional health services to tap into 1115, uh, money, uh, with Medicaid. So without it, we are somewhat hamstrung and the money and the ability to, the money and the ability is, is there, uh, to pay us, but we just can't get to the point of where we can get paid. So Thank, thank You. That, uh, that concludes my presentation, Mr. Chair.

13. Thank you, Mr. Chair. Um, make a motion that we, did we already adopt it? Sub three? We did correct. Thank you. Just checking. Um, um, make a motion that we favorably recommend to the Senate, um, third substitute HB 70. Okay. That's an order discussion to the motion committee members. Um, That's a gigantic, uh, lift and thank you representative. Um, your work speaks for itself, but we need, this is part of how we address, uh, history with corrections and really proactively making sure we're giving the resources. So, you know, recidivism decreases all the things that you said that are huge. ROI. So this is a good investment. Thank you. It's a good bill.

Uh, thank you, Madam Chair. Uh, uh, Madam Chair and Committee. This was an interim bill that, uh, we considered. I am gonna be speaking to the first substitute that's online. It, it is always interesting, uh, when you have an interim bill that this one did pass unanimously, how after it passes, a a lot more comments come, which is a great reason why it's good to bring a bill to interim because it gives, uh, stakeholders a lot longer to kind of, uh, digest what's in the bill and analyze it. And then, of course, the reality of the fiscal note always hits home, which is part of the considerations for the, the changes. Um, so let me just go over what the, the substitute bill does, which is very similar to the original bill, but just with, uh, a few adjustments. Um, so the first part of this bill that is just super critical. Um, several years ago, the legislature passed, uh, a bill for DHHS Medicaid office to seek a waiver for the Juab we call the justice Involved waiver. That bill or that waiver was passed. We would've only, I believe, five states granted that that demonstration, waiver, that waiver allows the state, um, they have to follow certain requirements, but they can bill Medicaid for inmates healthcare 90 days prior to release. Um, of course, one of the Medicaid golden rules is, is you cannot bill Medicaid while somebody is in a carceral setting. This is an exception to that rule. Um, all the department's been kind of doing, uh, an analysis of how much this will save the state. Um, we'll have a, a very quick payback, um, on this. And you might say, well, where's the, where's the payback? Well, that's where the first part comes in. In order to be able to bill Medicaid, they have to have an, an electronic medical record, an EMR for short, that can actually bill Medicaid. The system they've been using, I believe it's called Fusion, was built for carceral settings where they don't bill Medicaid. So that doesn't have the built-in functionality. So if they want to be able to finally implement this waiver that has now been approved by the legislature and approved by CMS, the last big component is a system that can actually bill, um, for those services during the last 90 days of incarceration. I did ask, um, somebody from Correctional Health Services. I said, well, what if this doesn't get approved? I mean, it's kind of the linchpin to implementing the waiver. And I was told, we've talked about doing, doing the billing on spreadsheets. I'm, I'm just gonna tell you, I mean, that was, that's a, a great state employee trying to figure out what they have to do when they're not given the tools to do. It's kinda like if you don't have a backhoe to dig a dig a foundation, well, I guess I could use my hands. That's probably the equivalent. Like, that's just not a good option. Um, so the first part of this bill says that, uh, funding can be taken out of the Medicaid, uh, growth production and budget stabilization account one time for an electronic health record. And this is, again, to fund a completely a, a total Medicaid related issue. And again, the amount that, uh, will be saved, uh, on an annual basis should be millions of dollars. I, if we, we can get those exact numbers, but it's, uh, once it's paid back, then there'll be ongoing savings to Correctional Healthcare because we can bill for those Medicaid services. One great thing about that waiver also is it has a number of components to it to try to reduce, uh, recidivism and keep people have a seamless transition from the prison into the community in terms of being connected with both insurance, Medicaid and, uh, appropriate providers medications and diagnoses. That's the first component of the bill. Um, the second component just, just allows, uh, money appropriate to the department to pay for unanticipated, uh, high cost correctional health expenses to be non lapsing. That kind of ebbs and flows. I mean, you can have a oncology case that costs seven figures and it can really spike their budget. So this is just allows them to lapse, uh, funds in that category to smooth out those kind of unexpected but expected costs. Um, and then the next component that's had the biggest changes to it requires the department in consultation with the Department of Corrections to prepare and implement a plan providing opioid use disorder treatment to certain inmates who suffer from opioid use disorder. Um, what we're doing here, the, the interim bill was basically, let's try to address this issue across the entire, uh, prison population, um, for both logistical and cost reasons. That's gonna probably be too ambitious to try to do, um, all at once. I mean, there is some of this already going on. I don't want you to think that they've just neglected this. But, um, so what the substitute bill says is this, um, Will The, for the first 90 days when someone is, uh, reports to prison kind of sequestered in a separate unit, um, they would focus on treating those, uh, those inmates that have, um, a substance use disorder to, uh, including medication assisted treatment to, uh, give them the, the treatment they need to hopefully be able to, um, not have ongoing or at least a serious ongoing issues once they're in general population. And then would require once the waiver is been implemented, that for the last 90 days, that all inmates that have, uh, this type of, uh, need are also treated. Um, one other thing the bill does is appropriates 500,000, um, uh, in operating capital budgets. One time for, from the general fund to, uh, purchase a program that they've been piloting, uh, related to AI that monitors, uh, communications between inmates and individuals on the outside. I won't go into some of the details, but that can reveal a number of, uh, we'll just say it, it, it has detected mental health issues and prevented suicide. Um, other health and safety related issues that is very proven to, um, make the prison a, a safer, healthier environment. Um, those are the main components of the bill. As part of my presentation, I would like to ask Dr. Wisner, uh, mark Wisner, uh, who's the Director of Correctional Health Services, um, to just give general comments about the bill, if you're willing, now that you're here. Thank You. Representative.

Yes. Uh, Dr. Mark Whiner, director of Correctional Health Services. Um, this bill is, uh, going to allow us to really, um, leverage the legislation that's already been passed. Uh, as far as the 1115 waiver. Uh, currently we are hamstrung with our, um, uh, EHR. It does not have a billing module and, uh, coding system. So I know many of you work in the industry and understand just how imperative that is to, to actually, uh, working with Medicaid or any outside, um, uh, insurance company. So that is, that is our biggest obstacle with billing, the 1115 waiver currently. Um, also with, as far as the MAT and the, um, Sorry, the mat is medication assisted treatment. Yeah, sorry for the acronyms. Uh, Medicaid assisted treatment, right now we have about 6,500 inmates. Um, about 35, 3500 of those come in with a diagnosis of a substance use disorder. Um, this allows us to, um, this legislation allows us to open up the doors and treat substance use disorder in a specifically, um, where we find, uh, big problems in the, uh, opioid use disorder in that subset of substance uses. So, um, happy to answer any questions that, That will include my, uh, presentation. Thank you.

Thank you. Can you just talk me through again, the fiscal note that's on the bill? It, I mean, I see a very large o ongoing amount and a onetime amount. Is the onetime amount the amount for purchasing the EMR or is it the on ongoing amount?

Yeah. Yeah. Thank you. Um, so the fiscal note is for the non substitute, the original bill, and that is, so the substitute that was just made public today does not have a new fiscal note. Um, I ventured to say that the new fiscal note would only reflect the $500,000 cost, which if that needs to be shed, that will be shed. And the one-time cost for the EMR, there's some inherent challenges with trying to peg the number for the, the EMR. Dr. Wisner used the term EHR, that's electronic health record. Same thing we're talking about here. That's currently under RFP. And, um, so suffice it to say the fund that that would come out of has plenty sufficient funds to allow this. And from a pure fiscal analysis, um, though accessing those funds one time, uh, will save exponentially more times that money to allow us to do this waiver. Any incremental ongoing costs for the maintenance of the EHR. 'cause they already have a budget for an E-H-R-E-M-R if they exp are gonna have any incremental costs above that. Um, that will be funded out of the savings that they're achieving from being able to bill Medicaid for the healthcare services. Thank you. And I got a question for Dr. Wisner, if I might also, please go ahead.

So medication assisted treatment is, and, and we talk about substance abuse treatment. Um, so the one portion of that is giving opioids to people who have a problem with opioids. So they won't be in withdrawal, which sounds a little weird 'cause we're just giving them opioids. Um, in an outpatient setting, you see people do very, very well. Their lives are outta control. You get them on Suboxone and they keep their job, they take care of their children. They, you know, things go really well for them. They're still stuck on the opioids, but the rest of their life is going really well. I, it has been a little bit harder for me to parse out exactly what our intentions are when we say that we're gonna, when someone comes in, if the person's using heroin, let, let's just say they come in and they're out of control on heroin, is the intention to put them on Suboxone and keep them on for an entire five year sentence for the long term, is the intention to wean them off. I mean, often in the outpatient setting, many people wind on, wind up on it for their whole life. You try to titrate them off two or three times and they can't, they just cannot make it off. And so you keep them on a long time. Uh, and as long as the whole rest of life's going good. That seems like a really good trade. But I've just been left a little puzzled. What is even intended when we say treatment, is it a short taper off? Is it to keep them on the entire time they're in the carceral setting? Is it to not have them on any until 30 days before they go out, when they're gonna relapse and then we start them again? What are we planning to do? Madam Chair, if I may? Yes, please.

Uh, excellent question. Uh, Dr. Ward, I appreciate the opportunity to answer it. Um, I know you and I have had similar conversations about this, uh, from, uh, our own personal practice experience. Um, a couple of things, that situation, which you mentioned with the, the individual addicted to heroin, um, they don't come to us directly off the street. Typically they're coming through county jails, which are implementing the, our larger county jails are already implementing a MAT program, uh, MOUD program. And so when we get them, they're already either on that and, and working towards, um, treatment. And, um, what we're looking forward to doing is continuing that. Um, now timeframes, I have not seen the research that suggests there is a timeframe as far as weaning them off successfully. Each individual has their own, their own battle and their own, their own, um, treatment needs. We have seen, however, that we have a high rate of recidivism associated, or those who come back often have substance use disorders. And so what we would like to do is focus on those 90 day prior to release where we can get them set up with the MAT program, with the counseling that goes along with it, transition them with the reentry division with, uh, department of Corrections, and then have them transferred over to A PMP and then be able to really track the numbers on how successful the MAT program is actually working and what impacts it's having in people's lives in real time. So that's, that's the goal as far as how do we wean people off? I, I would probably turn that question back to you and ask you how have you been able to wean people off? I, I, I have not seen it successfully. So oftentimes as far as a, a matrix goes, right, if you're on it for six months, then you are likely to be off of it. I, I've just seen it where it's a very individualized treatment plan. I guess it makes easy, good sense what you said. If, if the priority is to start them just before they leave and to make sure they're stable and there's a handoff to a clinic where they can be seen, that part's easy or for me to understand. The part I still wasn't sure on is if someone coming in who's gonna be there five years is we're gonna say, well, we we're gonna just, our plan will be to give you the opiate for the whole five years or not. That's the part I'm a little fuzzier on.

yes, if they come in currently, if they come in based off of the um, uh, statute that we operate under currently, if they come in with an active prescription, we will continue that active prescription.

Okay. Okay.

If, if I may, Madam chair, yes. Just to clarify the difference between the substitute and the original bill, we were looking in the original bill at just treating the entire general population. We're bifurcating it here to say those fixing those getting ready to be released. And those that are just coming in, they're more, also more controlled environments. And there's some kind of interesting division of duties between UDOC and CHS on treatment of, uh, SUD disorder. I, we won't get into that, but there's, it's complicated. Good.

Thank you, Madam Chair. Um, I have a couple of questions. I'm wondering who the vendor is for this program. You be mentioned an AI program that you were using and that there's money set aside for the vendor. Who is that?

Um, I would need, I don't know. I would need to let somebody from the Department of Corrections address that, but what I can tell you is with anything the state would purchase, it has to go through state purchasing, uh, code purchasing laws where they look at multiple vendors. They've just found that type of tool extremely helpful to improve the safety and welfare of, of inmates because there are hundreds of thousands of calls that happen and they can't pay somebody to sit there and listen to 'em, which they have every right to do. But they've had ground found great success with that. So I, I'm sure they can tell us Offline, but we would have, so there are multiple programs then that do this? Is that what you're saying? Um, and you Know which one it is, to the best of my knowledge, I don't even know which one they're using. They would have to go out and do an RFP to follow a state purchasing law if that portion of the bill is funded, if it stays in the bill at all.

Okay. And then I know of instances where AI has actually encouraged people to commit suicide. So how are we sure that this particular program won't do that?

That's an easy question to answer. There is no direct interface with the inmate and ai. The AI tool is simply monitoring the conversations and then flagging if certain key words or phrases or Conversations between inmates, Um, inmates and people on the outside. Okay. And then that can be reviewed by a live person to see if that's something that needs to be okay. For instance, this may be hypothetical, this may not somebody, uh, says goodbye to somebody that they have a specific plan to take their life, uh, within the walls of the prison. And then that can be flagged and be followed up on to mitigate, uh, an attempted suicide. But I know exactly what you're talking about in terms of chat bots. There's no chat bots involved here. Okay.

Thank you. Yeah, thank you.

I'll just add, I've, I've seen that program actually in action. It's quite amazing. And, um, I can hook you up if you want.

Thank you. I just wondered, I was looking at the, so you're going, you're proposing the, the first sub? Yes. Is that right? Yes. Yes. Um, because I liked something in the original one, and I wondered if it carried over or not. The, the last, um, highlighted provision on board of Pardons and Parole where it said that they may be parole, or, or that they may, it allows the board to require assisted outpatient treatment as a condition of parole. Um, is that being scrapped in the sub?

Yes, but, sorry, there's somebody here actually, can I call somebody, can I do a lifeline here? Sure. Brit, Brittany, are you in the room? Oh, sorry. There goes my lifeline. That's okay. Um, um, actually, what we discovered is we reached a compromise on that last year in the bill. Oh. And that had already passed. And I think the, I, I'd had to tone that down. I think what it, we ended up putting the accelerated language back in, which I really like, but it dramatically complicates it between the board of Pardons, AP and P corrections and will come at a very high cost. And so it's a policy that while I really like, I'd had to take outta the bill for just logistical purposes at this point in time.

Okay. But I'm glad you liked it. Maybe In a future bill or something. Yes. Okay. Yes. Thank you.

Yeah, that's a really good question. Um, I'll let Dr. Wimy wisner correct me if I say this wrong, but, um, in my discussions with CHS, the savings that they'll achieve from being able to bill Medicaid would cover any incremental costs of coding or incremental maintenance costs over what they already have appropriated for their EMR maintenance costs. Because like, like any software, typically you have an upfront purchase price that's installation, training, customization, and then you have an annual maintenance cost. They already have funding for annual maintenance, but to the extent that under their RFPs they're looking at it's higher, they will have the savings inherent in that to pay for those incremental costs. So, yes, but they'll have the money for it.

Yeah. Um, happy to answer that. And I just wanna make sure I understand. Um, you're asking about the, the treatment or the MR, the E-M-R-M-R? Yeah. So yes, we have explored that extensively. Um, there are certain, there's a very popular EMR uh, being utilized throughout the state currently. Um, we do not know if they've bid on the RFP or not because of the way that state purchasing rules are. We have, uh, explored, they have an option where you can be a, um, an associate user. However, with that, you become, um, low, low person on the to, on the, on the work order, right? So it, you, your options and your ability to work within the system are dictated by the owner and the, the super user. So for example, let's say we say University of Utah, can we be an associate user with your EMR? And they could say, yeah, sounds good. However, we dictate the terms of service and, and the menus and the workflows are all University of Utah. Well, corrections in correctional medicine is a little different. And so we would need certain menus and workflows, but we could not get that changed without the University of Utah. And this is all hypothetical, but we've seen it play out in Texas since that's the model we explored extensively. And so we're kind of held hostage a bit by the super user and the owner of the system. And it just, we're, we're different enough that it makes it difficult to, to operate within someone else's EHR. Okay.

Thank, thank you, Madam Chair. And I, I just wanna say too that I know Representative Eliason worked really hard on this, so I, I'm gonna support, I'm gonna support the bill to move outta com, uh, committee today. I do, I just do wanna flag something for you. And, and, uh, I, I like, I like the line on line, uh, 76 on the sub, the in consultation with the Department of Corrections. So, uh, what, what has worried me in the past, and, and obviously we've had these conversations, but this is a correctional facility and the patients that you're treating aren't there for singing too loud in the church choir. And that, I think, brings a unique consideration that is different than other clinical settings. And I really, really want to see collaboration between the Department of Corrections and CMS. I know there's been some consternation there in the past where, um, maybe both, both CMS and UDC feel like it's a struggle, you know, working together on, on patient treatment and different things like that. And I think MAT in particular, or OUD does, uh, bring some unique challenges in a correctional facility with diversion and different things like that. And so, could you speak at all, either Representative Peterson or Dr. Wisner to what that collaboration is like? And I, I think you hear, hear where I'm coming from that, you know, I totally support the, the mission here, but I want to make sure that if the, if UDC is starting to see challenges that CMS doesn't just say, well, this is how we treat our patients, because I, I do think that there's an important public safety component that we can't overlook even, even as you're doing the best that you can, um, with the data that you have and your, and your treatment plans and your professionalism. I just wanna make sure that we're taking a, taking a really, we're being really judicious about making sure that we're not overruling public safety concerns that UDC might have. So any thoughts that you have on that would be well appreciated. But like I said, I'll definitely sup support, support you Representative Ellison on this. 'cause I know that you've, you've worked very, very, uh, hard to get this to a good place. Yeah.

Uh, yeah. Thank you. Uh, Madam Chair. Um, so I, I don't know for sure if there's anybody here from Department of Corrections, but I did meet with Director Garcia and Deputy Director Brown. I made all of the requested changes that they had in the sub. And my understanding as of, at least earlier this morning, was, they're good with how we've structured it. And it was actually trying to strike that compromise between safety and some of the issues they're dealing with, with, I mean, they also have the full recognition that we need to have some degree of treatment, especially if we can get 'em as they're coming in, that helps their, their long-term stabilization. And if we can get 'em going out, hopefully that keeps them from coming back. So that was the balance that we struck. But if, if there is anybody from corrections, um, either online or in person, I, I would love for them to answer that question also. But go ahead, doc. Do you have anything to add? Yeah,

Absolutely. Madam Chair, if I may. Yes. Um, I think that's a very good point. I think what you're seeing in this bill, in that line in particular, is a result of us coming, uh, working together saying, okay, listen, this, this isn't uni. This isn't one side versus the other. It has to, it has to work together. And if, if we're gonna be successful, um, we realize that, um, while we have the, the statutory language to, to move forward with this, it's not going to be successful if we, if we march to our own, to our own beat. Especially as far as the public safety happens. Um, they're, they're responsible for the operations. We're there to assist with their eighth amendment mandate to provide adequate healthcare, and, um, doing so, we do it within the walls of the prison that they own and operate. So, um, consultation is a must. I, I, I would say that, uh, we meet regularly, uh, on these things. And, and Matt was relatively new last year, and we, we had some starts and stops and some hiccups as we tried to find our way. I would say we are light years ahead of where we were, uh, last year as far as understanding each other, what we're trying to accomplish. But I do appreciate that comment, and I'm happy to report from my perspective as the director of CHS, that we have a clear understanding of where, uh, UDC wants to go and where they wanna, how they wanted this to operate. Awesome. Thanks. Thanks for your consideration on that.

Sorry, just a quick question. Does the AI listen everywhere to the inmates? Like does it listen in cells or anything? Or is it just conversations with people on the outside,

OOO? Only to my knowledge only, uh, on phone conversations from the inside to the outside.

Thank you. Thank you.

I would motion to move first sub, um, house bill 70.

Um, no. Okay. End with the, It's what I've been speaking to. Thank you. Perfect.

Yeah, I am. Happy to. So I, I think that there's been a lot of good conversations. So I would make a motion to, um, recommend favorably from our, our committee, HB 70, the first sub.

I'll, I'll just be really brief and say that this is, I think, a good example of just because some, I wasn't the original sponsor of the bill that required the 1115 waiver, but it's just a good example of just because you pass a bill, it doesn't mean everything's on autopilot. It's kind of like the analogy would be the first bill launched the plane. It's flow, it's flowing, its destination. We've got the approval, we're on final approach. And if we don't put the Blanding gear down, which is the kind of the E-H-R-E-M-R, it's going to, it's not gonna end pretty, it's not gonna even happen, really. So this is just kind of the final component. I mean, the other parts are important too, but that is kind of the, the big impetus of this bill to make sure that we close that loop, that few passed legislatures started, uh, launched. So that's my conclusion. Thank you.

Yeah. Um, if you're gonna fly a plane, you should land it good. So if you have to fly it again. Exactly. You can do It. Right, exactly. So, so that's a good point. No, I, I appreciate the work. I think there's been a lot of comments, um, and, and there might be some things to continue working on with this. So I, I can appreciate that and, um, support the sponsor and support the bill.

First substitute House bill 70 Correctional Health Services amendments by representative Stevie Liston. This spoke was heard in Health and Human Services with the vote of 12 0 2. Representative Stevie Liston.

Uh, thank you Mr. Speaker. Motion to circle

Uh, yes. Uh, I am waiting on a sub to help reduce the fiscal note.

Uh, thank you Mr. Speaker ProAm. Motion to adopt, uh, to move second substitute to HB 70 in my name. The motion is to adopt second substitute house bill 70. We'd like to speak to it. Yes. Uh, this, uh, pulls out, uh, some of the, uh, one of the items that was, uh, uh, driving the, the fiscal note and will lower the potential cost of, we will lower the cost of the, the fiscal note of the bill.

Uh, thank you Mr. Speaker Pro Tem. Uh, Mr. Speaker Pro Tem, uh, several years ago, uh, you passed an important legislation that, uh, related to the justice involved waiver, uh, related to correctional healthcare. Utah was one of five states that had that waiver approved that allows the state to bill Medicaid 90 days, uh, prior to release for inmates for their healthcare costs. More importantly, it's looking at, uh, addressing some of the underlying issues relating to behavioral health, substance use disorder, uh, that, uh, caused our, some of our high rates of recidivism. Uh, that legislation passed. Uh, the state sought the waiver, it was approved, but there's one significant barrier implementing that waiver. And that is, uh, having corrections, uh, have a, the, the need for corrections to have an electronic medical record that can actually bill Medicaid. The EMR electronic medical record they've been using called Fusion is not designed to bill Medicaid. So last year, uh, we passed legislation required corrections, correctional health services to create a working group to study their need. They decided they needed this. Uh, they then have gone out for RFP, which is currently underway. There's currently no funding to acquire that necessary software to be able to bill Medicaid. The return on investment for taxpayers if this bill passes is significant because we'll be able to bill Medicaid for the, the 90 days, uh, prior to release for the healthcare costs for the approximately 6,500 inmates within the Department of Corrections. And about 98% of those individuals are going to be released from custody. So almost every inmate, uh, in the correctional system, uh, would uh, kind of benefit from this bill in terms of not only having that, those costs paid for, uh, prior to release, but it helps provide a seamless transition back into the community with necessary support. So certain individual needs, uh, substance use disorder treatment or a, say a long acting injectable for a serious mental illness, which approximately a third of our inmates have, they'll have seamless care as they reenter our community, which is critical to reducing our approximately 66% recidivism rate. Uh, this bill also, the way that this is funded is out of the, excuse me, the Medicaid growth reduction in budget stabilization account, which is a restricted account for Medicaid related expenditures, of which this is because it's tied to the justice involved Medicaid waiver. Um, the bill also, uh, requires the department to Department of Corrections and Correctional Healthcare Service to focus on inmates for the first 90 days. They come in and the 90 days prior to release that have substance use disorders and mental health issues to make sure that those are addressed in the most clinically appropriate way possible. So those are the basics of what the, the bill does. Mr. Speaker, this was actually a unanimous interim bill. Been working with the Department of Corrections, department of Health and Human Services Correctional Healthcare Services on this bill. And I think it's to, uh, a really good spot to, uh, continue his journey forward. Thank you Mr. Speaker, for sponsoring the original legislation and for the time on this bill.

Thank you, Mr. Speaker ProAm. I just wanna give an example of why this is important. So if I'm on a blood pressure medication as a sim simple example, and I am arrested and I am put into jail or especially into to our correctional facility, I have to wait to get a new appointment with a new doctor for me to remember what my prescription was, to tell 'em this is the medicines that I was on. Because the secure the security in prison also includes all the medical records. There's no records coming in, there's no records going out. It doesn't collaborate. And so what's really important about this, it saves us as taxpayers a lot of money having to redo and re um, diagnose, um, individuals with prescriptions that may, they may need. And so this seamless process when they come in, when they go out, instead of starting all over every single time. So I am great support of this bill.

Uh, thank you Mr. Speaker. I'm in informally naming this Oscar's bill after a, uh, late constituent of mine who was discharged from corrections last year and died by suicide shortly after his release. Uh, he struggled with serious mental illness and, uh, well, I can't say this bill would've prevented his death. We know that if inmates are diagnosed appropriately, put on treatment and have coverage for a period subsequent to release their chances for success of reentering the community are greatly enhanced that will inherently reduce cost to taxpayers and reduce recidivism. Thank you, Mr. Speaker Pro. Tim.

Yes. Uh, this, uh, pulls out, uh, some of the, uh, one of the items that was, uh, uh, driving the, the fiscal note and will lower the potential cost of, we will lower the cost of the, the fiscal note of the bill.

Uh, thank you Mr. Speaker Pro Tem. Uh, Mr. Speaker Pro Tem, uh, several years ago, uh, you passed an important legislation that, uh, related to the justice involved waiver, uh, related to correctional healthcare. Utah was one of five states that had that waiver approved that allows the state to bill Medicaid 90 days, uh, prior to release for inmates for their healthcare costs. More importantly, it's looking at, uh, addressing some of the underlying issues relating to behavioral health, substance use disorder, uh, that, uh, caused our, some of our high rates of recidivism. Uh, that legislation passed. Uh, the state sought the waiver, it was approved, but there's one significant barrier implementing that waiver. And that is, uh, having corrections, uh, have a, the, the need for corrections to have an electronic medical record that can actually bill Medicaid. The EMR electronic medical record they've been using called Fusion is not designed to bill Medicaid. So last year, uh, we passed legislation required corrections, correctional health services to create a working group to study their need. They decided they needed this. Uh, they then have gone out for RFP, which is currently underway. There's currently no funding to acquire that necessary software to be able to bill Medicaid. The return on investment for taxpayers if this bill passes is significant because we'll be able to bill Medicaid for the, the 90 days, uh, prior to release for the healthcare costs for the approximately 6,500 inmates within the Department of Corrections. And about 98% of those individuals are going to be released from custody. So almost every inmate, uh, in the correctional system, uh, would uh, kind of benefit from this bill in terms of not only having that, those costs paid for, uh, prior to release, but it helps provide a seamless transition back into the community with necessary support. So certain individual needs, uh, substance use disorder treatment or a, say a long acting injectable for a serious mental illness, which approximately a third of our inmates have, they'll have seamless care as they reenter our community, which is critical to reducing our approximately 66% recidivism rate. Uh, this bill also, the way that this is funded is out of the, excuse me, the Medicaid growth reduction in budget stabilization account, which is a restricted account for Medicaid related expenditures, of which this is because it's tied to the justice involved Medicaid waiver. Um, the bill also, uh, requires the department to Department of Corrections and Correctional Healthcare Service to focus on inmates for the first 90 days. They come in and the 90 days prior to release that have substance use disorders and mental health issues to make sure that those are addressed in the most clinically appropriate way possible. So those are the basics of what the, the bill does. Mr. Speaker, this was actually a unanimous interim bill. Been working with the Department of Corrections, department of Health and Human Services Correctional Healthcare Services on this bill. And I think it's to, uh, a really good spot to, uh, continue his journey forward. Thank you Mr. Speaker, for sponsoring the original legislation and for the time on this bill.

Thank you, Mr. Speaker ProAm. I just wanna give an example of why this is important. So if I'm on a blood pressure medication as a sim simple example, and I am arrested and I am put into jail or especially into to our correctional facility, I have to wait to get a new appointment with a new doctor for me to remember what my prescription was, to tell 'em this is the medicines that I was on. Because the secure the security in prison also includes all the medical records. There's no records coming in, there's no records going out. It doesn't collaborate. And so what's really important about this, it saves us as taxpayers a lot of money having to redo and re um, diagnose, um, individuals with prescriptions that may, they may need. And so this seamless process when they come in, when they go out, instead of starting all over every single time. So I am great support of this bill.

Uh, thank you Mr. Speaker. I'm in informally naming this Oscar's bill after a, uh, late constituent of mine who was discharged from corrections last year and died by suicide shortly after his release. Uh, he struggled with serious mental illness and, uh, well, I can't say this bill would've prevented his death. We know that if inmates are diagnosed appropriately, put on treatment and have coverage for a period subsequent to release their chances for success of reentering the community are greatly enhanced that will inherently reduce cost to taxpayers and reduce recidivism. Thank you, Mr. Speaker Pro. Tim.