SB1336 - 541R

Be it enacted by the Legislature of the State of Arizona:

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

Sec. 2. Section 41-3955.01, Arizona Revised Statutes, is amended to read:

START_STATUTE41-3955.01. Seriously mentally ill housing trust fund; purpose; report

A. The seriously mentally ill housing trust fund is established. The director of the Arizona health care cost containment system administration shall administer the fund. The fund consists of monies received pursuant to section 44‑313 and investment earnings.

B. On notice from the director of the Arizona health care cost containment system administration, the state treasurer shall invest and divest monies in the fund as provided by section 35‑313, and monies earned from investment shall be credited to the fund.

C. Except as provided in subsection D of this section, fund monies shall be spent on approval of the Arizona health care cost containment system administration solely for housing projects and rental assistance for seriously mentally ill persons.

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.

D. E. The director of the Arizona health care cost containment system administration shall report annually to the legislature on the status of the seriously mentally ill housing trust fund. The report shall include a summary of facilities for which funding was provided during the preceding fiscal year and shall show the cost and geographic location of each facility and the number of individuals benefiting from the operation, construction or renovation of the facility. The report shall also include the number of individuals who benefited from rental assistance. The report shall be submitted to the president of the senate and the speaker of the house of representatives no not later than September 1 of each year.

E. F. Monies in the seriously mentally ill housing trust fund are exempt from the provisions of section 35‑190 relating to lapsing of appropriations.

F. G. An amount not to exceed ten percent of the seriously mentally ill housing trust fund monies may be appropriated annually by the legislature to the Arizona health care cost containment system for administrative costs in providing services relating to the seriously mentally ill housing trust fund.

G. H. For any construction project financed by the Arizona health care cost containment system administration pursuant to this section, the administration shall notify a city, town, county or tribal government that a project is planned for its jurisdiction and, before proceeding, shall seek comment from the governing body of the city, town, county or tribal government or an official authorized by the governing body of the city, town, county or tribal government. The Arizona health care cost containment system administration shall not interfere with or attempt to override the local jurisdiction's planning, zoning or land use regulations. END_STATUTE

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.