R523. Health and Human Services, Substance Use and Mental Health.

R523-2. Local Mental Health Authorities and Local Substance Abuse Authorities.

R523-2-1. Authority and Purpose.

(1) Sections 26B-5-104 and 26B-5-107 authorize this rule.

(2) This rule establishes:

(a) a procedure to seek local mental health authority (LMHA) and local substance abuse authority (LSAA) input;

(b) priority of services for a LMHA and LSAA; and

(c) formulas for allocating funds that are authorized by the Utah Legislature for the treatment of substance use and mental health disorders to an LMHA and LSAA.

R523-2-2. LMHA and LSAA Input on Policies, Procedures, and Rules.

(1) The Division of Integrated Healthcare (division) shall regularly seek and receive input from the Utah Behavioral Health Committee on:

(a) priorities for services;

(b) changes to existing policy or implementation of new policy; and

(2) The division shall send notice of any change to a service priority, policy, procedure, or rule to the current chair of the Utah Behavioral Health Committee.

R523-2-3. LMHA and LSAA Minimum Program Standards.

(1) Each LMHA and LSAA program shall have any legally mandated licenses, including the appropriate current license issued by the Office of Licensing under the Department of Health and Human Services.

(2) Each LMHA and LSAA shall have a comprehensive plan of service that shall be reviewed and updated at least annually to reflect changing needs of those served. This plan shall:

(a) be consistent with division directives;

(b) define the LMHA's or LSAA's priorities for service and the population to be served; and

(3) Each LMHA shall provide or arrange for the provision of services within the following continuum of care:

(a) 24-hour crisis care and services;

(b) case management services;

(i) family support services;

(ii) in-home services;

(iii) housing; and

(iv) respite services;

(d) consultation, education, and preventative services, including;

(i) case consultation;

(ii) collaboration with other county service agencies; and

(iii) providing public education and public information;

(e) day treatment and psycho-social rehabilitation;

(f) inpatient care and services;

(g) outpatient care and services;

(h) psychotropic medication management;

(i) residential care and services; and

(j) services to persons incarcerated in a county jail or other county correctional facility.

(4) Each LSAA shall provide or arrange for the provision of services within the following continuum of care:

(a) indicated prevention, including an educational series approved by the division in Rule R523-11, for individuals convicted of driving under the influence;

(b) recovery support services;

(d) treatment services prescribed by division contract or directive; and

(e) universal prevention.

(5) Each LMHA and LSAA shall participate in a yearly on-site evaluation conducted by the division.

(6) Each LMHA and LSAA shall be responsible for monitoring and evaluating each subcontract to ensure:

(a) progress is made toward accomplishing contract goals and objectives; and

(b) services delivered to consumers are commensurate with funds provided.

(7)(a) Each LMHA and LSAA shall conduct a minimum of one site visit per year with each subcontractor and produce a written report to document the reviewed activities and findings.

(b) A copy of the written site visit report shall be made available to the division upon request.

R523-2-4. Formula for the Annual Allocation of Funding to LMHAs and LSAAs.

(1) Funds authorized by the Legislature for mental health services shall be allocated to LMHAs and LSAAs as described in Section 26B-5-107 and as follows:

(a)(i) 5% of the total mental health funds shall be divided between the 24 smallest county LMHAs ranked by population as a rural differential; and

(ii) the rural differential shall be allocated using the following methodology:

(A) 35% shall be divided in equal amounts to the first through sixth smallest counties;

(B) 30% shall be divided in equal amounts to the seventh through twelfth smallest counties;

(D) 15% shall be divided in equal amounts to the nineteenth through the twenty-fourth smallest counties.

(b) The division shall allocate the remaining mental health funds to the LMHAs on a per capita basis, using the most current population data available on the Utah Department of Health and Human Services Indicator-Based Information System for Public Health (IBIS-PH) website.

(c) The funding formula may utilize a determination of need other than population if the division establishes by valid and acceptable data that other defined factors are relevant and reliable indicators of need.

(2) Funds appropriated by the Legislature to the division for substance use disorder services shall be allocated using the following formula:

(a)(i) 5% of the total substance use disorder services funds shall be divided between the 24 smallest county LMHAs ranked by population as a rural differential; and

(ii) the rural differential shall be allocated using the following methodology:

(A) 35% shall be divided in equal amounts to the first through sixth smallest counties;

(B) 30% shall be divided in equal amounts to the seventh through twelfth smallest counties;

(D) 15% shall be divided in equal amounts to the nineteenth through the twenty-fourth smallest counties.

(b) 57% of the total substance use disorder services funds shall be allocated to each county based on the incidence and prevalence of substance use disorders using the following data:

(i) the percent of adults estimated to be binge drinkers as reported by the Behavioral Risk Factor Surveillance System (BRFSS);

(ii) the percent of adults estimated to be chronic drinkers as reported by BRFSS;

(iii) the percent of youth reporting alcohol use within the past 30 days by the most current Student Health and Risk Protection (SHARP) survey;

(iv) the percent of youth estimated to be binge drinkers by the most current SHARP survey; and

(v) the percent of youth needing drug treatment as reported by the most current SHARP survey.

(c) 38% of the total substance use disorder services funds shall be allocated to LSAAs on a per capita basis, according to the most current population data available from the IBIS-PH.

R523-2-5. Formula for Allocation of Medicaid Match Funds.

(1) For this section, "Medicaid member month" means the number of eligible Medicaid recipients in each county for each month of the previous state fiscal year.

(2) The division shall obtain the following data from the division's Medicaid program:

(a) each Medicaid member month; and

(b) the actuarially established rates for a capitated Medicaid service system as determined by the Department of Health and Human Services and approved by the federal government for each county.

(3) The division shall calculate county need for Medicaid match funds by multiplying each county's total Medicaid member months by that county's corresponding actuarial rates for the most current 12-month period.

(4) The division shall sum county need to determine the state Medicaid match need.

(5) The percent of total Medicaid match funds for each local authority shall be determined by dividing the sum of county need by the state Medicaid match need.

(6) LMHAs and LSAAs that do not participate in the Medicaid prospective payment-capitation plan shall receive the amount of funds the LMHA or LSAA would have received if the funds had been distributed using state population as a determinate.

KEY: funding formula, bed allocations, Local Mental Health Authority, Local Substance Abuse Authority

Date of Last Change: June 29, 2026

Notice of Continuation: December 1, 2025

Authorizing, and Implemented or Interpreted Law: 26B-5-104; 26B-5-107