Bill
Number: S.B. 1336
Carter
Floor Amendment
Reference
to: printed bill
Amendment
drafted by: Leg Council
FLOOR
AMENDMENT EXPLANATION
1. Allows monies from the
Seriously Mentally Ill Housing Trust Fund (Fund) to be used for persons with
serious mental illness (SMI) in:
a)
a
community living home where the person with SMI holds a lease and that has
embedded in-home support that meets the needs of the person and up to 24 hours
of support and supervision as indicated by their treatment plan; or
b)
a
licensed behavioral health residential facility (BHRF) that provides in-house
wraparound services and secure 24-hour on-site support, treatment and
supervision for persons with SMI who require assistance to live in the
community and who are subject to a plan of care that is court-ordered or part
of a diversion agreement.
2. Directs the Arizona
Health Care Cost Containment System to issue a request for proposals for a
third-party to conduct a program study that measures the outcomes of SMI
residents in the housing settings in a one-year period and that includes an
analysis of the costs and efficacy of the provided services.
3. Permits the Director of
the Department of Health Services (DHS) to classify secure BHRFs.
4. Directs DHS, by January
1, 2020, to adopt rules that allow a BHRF to be a secure facility if it is the
least restrictive environment that satisfies the resident's treatment needs,
the resident is an incapacitated person and the resident is ordered by a court
or diversion agreement to a secure BHRF.
5. Exempts DHS from
prescribed rulemaking requirements for one year and requires DHS to provide an
opportunity for public comment on the proposed rules.
6. Adds an emergency
clause.
Page 1,
between lines 1 and 2, insert:
"Section 1. Section 36-405, Arizona Revised Statutes,
is amended to read:
START_STATUTE36-405. Powers
and duties of the director
A. The
director shall adopt rules to establish minimum standards and requirements for
the construction, modification and licensure of health care institutions
necessary to ensure the public health, safety and welfare. The standards and
requirements shall relate to the construction, equipment, sanitation, staffing
for medical, nursing and personal care services, and recordkeeping pertaining
to the administration of medical, nursing, behavioral health and personal care
services, in accordance with generally accepted practices of health care. The
director shall use the current standards adopted by the joint commission on
accreditation of hospitals and the commission on accreditation of the American
osteopathic association or those adopted by any recognized accreditation
organization approved by the department as guidelines in prescribing minimum
standards and requirements under this section.
B. The
director, by rule, may:
1. Classify
and subclassify health care institutions according to character, size, range of
services provided, medical or dental specialty offered, duration of care and
standard of patient care required for the purposes of
licensure. Classes of health care institutions may include
hospitals, infirmaries, outpatient treatment centers, health screening services
centers and residential care facilities, including secure
behavioral health residential facilities. Whenever the
director reasonably deems distinctions in rules and standards to be appropriate
among different classes or subclasses of health care institutions, the director
may make such distinctions.
2. Prescribe
standards for determining a health care institution's substantial compliance
with licensure requirements.
3. Prescribe
the criteria for the licensure inspection process.
4. Prescribe
standards for the selection of health care-related demonstration projects.
5. Establish
nonrefundable application and licensing fees for health care institutions,
including a grace period and a fee for the late payment of licensing fees, and
fees for architectural plans and specifications reviews.
6. Establish
a process for the department to notify a licensee of the licensee's licensing
fee due date.
7. Establish
a process for a licensee to request a different licensing fee due date,
including any limits on the number of requests by the licensee.
C. The
director, by rule, shall adopt licensing provisions that facilitate the
colocation and integration of outpatient treatment centers that provide
medical, nursing and health‑related services with behavioral health
services consistent with article 3.1 of this chapter.
D. Ninety
percent of the fees collected pursuant to this section shall be deposited,
pursuant to sections 35‑146 and 35‑147, in the health services
licensing fund established by section 36‑414 and ten percent of the fees
collected pursuant to this section shall be deposited, pursuant to sections 35‑146
and 35‑147, in the state general fund.
E. Subsection
B, paragraph 5 of this section does not apply to a health care institution
operated by a state agency pursuant to state or federal law or to adult foster
care residential settings.END_STATUTE"
Renumber to
conform
Page 1, line
14, after "C." insert "Except
as provided in subsection D of this section,"
Page
1, between lines 16 and 17, insert:
"D. Fund monies may be spent for seriously mentally ill
persons in the following settings:
1. A community living home that is for
persons who hold their own leases and that has embedded in-home support to meet
the individualized needs of the person and up to twenty-four hours of support
and supervision as indicated by the person's individual treatment plan.
2. A behavioral health residential
facility that:
(a) Is licensed by the
department of health services.
(b) Provides in‑house
wraparound services and secure twenty‑four‑hour on-site support,
treatment and supervision by staff with behavioral health training for persons
who have serious mental illness of sufficient severity as to require assistance
to live in the community and who are subject to a plan of care that is ordered
by a mental health court, a mental health division of the probate court, a
criminal court as part of a plea agreement or judgment and conviction or a
court as part of guardianship proceedings or that is part of a diversion
agreement entered into with a law enforcement agency."
Reletter to
conform
After line
45, insert:
"Sec. 3. Seriously mentally ill residential setting; program study
The Arizona
health care cost containment system administration shall issue a request for
proposals for a third-party entity to conduct a program study that measures the
outcomes of seriously mentally ill residents in each setting described by
section 41-3955.01, subsection D, Arizona Revised Statutes, as amended by this
act, for a twelve-month period. The program study shall include an analysis of
costs and effectiveness of the services provided in each setting that takes
into consideration the encounters of the seriously mentally ill residents
related to inpatient care, emergency department visits, hospitalization, civil
commitment proceedings, incarceration, homelessness, employment, community
engagement, encounters with police and fire personnel, including petitioning
and contact with crisis centers, citation in lieu of detention, jail bookings
and other contact with first responders.
Sec. 4. Department of health services; rules; exemption from rulemaking
A. On
or before January 1, 2020, the director of the department of health services
shall adopt rules to allow a behavioral health residential facility to be a
secure facility if the behavioral health residential facility is the least
restrictive environment that meets the resident's treatment needs and the
resident is an incapacitated person as defined in section 14-5101, Arizona
Revised Statutes, and is either ordered by the court or part of a
post-conviction or pretrial diversion agreement to a secure behavioral health
residential facility. The director may use the assisted living facility rules
as guidelines in determining standards for a secure residential facility.
B. The
department of health services is exempt from the rulemaking requirements of
title 41, chapter 6, Arizona Revised Statutes, for one year after the effective
date of this act. The department shall provide the public an opportunity to
comment on the proposed rules.
Sec. 5. Emergency
This act is
an emergency measure that is necessary to preserve the public peace, health or
safety and is operative immediately as provided by law."
Amend title to conform