Chapter 0224 - 541R - S Ver of SB1535

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

Section 1. Title 36, chapter 29, article 1, Arizona Revised Statutes, is amended by adding sections 36-2907.14 and 36‑2907.15, to read:

START_STATUTE36-2907.14. AHCCCS; contractors; opioid treatment programs; reimbursement; report; definitions

A. Pursuant to section 36‑2907, the administration and its contractors may reimburse an opioid treatment program provider for enrolled members only if the provider demonstrates enforcement of each plan contained in the annual report pursuant to subsection B of this section and the administration approves the report pursuant to subsection C of this section.

B. An opioid treatment program provider that receives reimbursement from the administration or its contractors shall submit an annual report on a schedule that is prescribed by the administration and that contains all of the following:

1. A detailed security plan that incorporates standards from the substance abuse and mental health services administration and the United States drug enforcement administration. The plan shall include patient management strategies that are designed to reduce potential harm to patients and lower the risk of exposure to illicit transactions and other consequences of overcrowding and poor patient management.

2. A neighborhood engagement plan that outlines engagement with key stakeholders in the neighborhood in which the opioid treatment program is located, including homeowners' associations, school administrators, neighboring businesses, community organizations, the city or town council and local law enforcement. The plan shall include information about ensuring consideration of and response to reasonable safety, security and trash removal concerns, concerns regarding adequate parking for patients and staff and other matters of concern to the entities prescribed in this paragraph.

3. A comprehensive plan related to the care of all patients to demonstrate how the opioid treatment program ensures that appropriate standards of care are met for medication‑assisted treatment, including dosing, the provision of or referral to appropriate counseling and behavioral therapy services and peer support services, as required by the substance abuse and mental health services administration. This plan shall include whether the opioid treatment program provides the therapy services directly or refers patients for services through a separate provider. If the program refers patients for services through a separate provider, the report shall include strategies employed to ensure patients are able to access referred services in a timely manner.

4. A community relations and education plan that includes policies and procedures to measure and minimize the negative impact the opioid treatment program may have on the community, to promote peaceful coexistence and to plan for change in the program and program growth, including:

(a) Considering community needs and impacts when selecting a site for the program or program growth.

(b) Considering community input on the potential impact the program may have on the community.

(d) Communicating with community leaders to foster good community relations.

(e) Developing and implementing a community relations plan that is specified to the needs of the program within its community and that includes the following actions:

(i) Establishing a liaison with community representatives to share information about the program, the community and mutual concerns and issues.

(ii) Identifying program personnel who will function as community relations coordinators and define the goals and procedures of the community relations plan.

(iii) Serving as a community resource on substance use and related health and social issues as well as promoting the benefit of medication‑assisted treatment in preserving the public health.

(iv) Soliciting community input about medication‑assisted treatment and the program's presence in the community.

(v) Developing program policies and procedures to effectively address or resolve community problems, including patient loitering and medication diversion, and ensuring that program operations do not affect community life adversely.

(vi) Documenting community contacts and community relations efforts and evaluating the effectiveness of activities over time in addressing outstanding problems or deficiencies.

(vii) Disclosing the process for community contacts to notify the Administration's clinical resolution unit of any unresolved problems or deficiencies that includes, if appropriate, coordination with the state opioid treatment authority.

(viii) Developing communication mechanisms that provide interested parties and potential patients with general information about the program outside of regular operating hours.

5. A current diversion control plan that contains specific measures to reduce the possibility of diversion of controlled substances from legitimate treatment use.

C. The administration shall post the reports received pursuant to subsection B of this section on its public website. the administration shall notify each city or town in which an opioid treatment program is located of the posted report and allow the city or town thirty days to provide comments on the report. The administration shall consider the city's or town's comments on the report and approve or reject the annual report within thirty days after the close of the comment period. If the administration identifies areas of concern regarding compliance with state rules, federal regulations or administration policies, the administration must provide the opioid treatment program thirty days to revise the report. the administration shall also take any appropriate regulatory action based on the deficiencies identified. If the opioid treatment program does not submit the report within the required timelines or does not demonstrate enforcement of each plan contained in the report, or if the administration does not approve the report initially or after the requested revision, the administration, with appropriate notification to the provider, shall suspend reimbursement by the administration or its contractors to the opioid treatment program until the report is approved.

D. On or before January 15 of each year, the administration shall submit a report to the governor, the president of the senate and the speaker of the house of representatives that summarizes the reports submitted pursuant to subsection B of this section. A copy of the report shall be provided to the secretary of state.

E. For the purposes of this section:

1. "Medication‑assisted treatment" has the same meaning prescribed in section 32‑3201.01.

2. "Opioid treatment program" means a licensed and accredited program that is authorized to dispense medications for the treatment of opioid use disorders through highly structured protocols defined in federal regulations and state rules. END_STATUTE

START_STATUTE36-2907.15. Opioid use disorder treatment; standards; centers of excellence; annual report

A. On or before December 31, 2019, the administration and the department of health services shall establish standards for designating centers of excellence for treating opioid use disorder statewide. The director of the Arizona health care cost containment system shall publish the draft standards on the administration's public website and hold at least two public hearings to receive input before implementing the standards. The administration shall publish the final standards for designating centers of excellence for treating opioid use disorder on its public website.

B. At a minimum, the standards established pursuant to subsection A of this section shall include:

1. Information regarding opioid treatment program providers and facilities.

2. Information regarding office‑based opioid agonist treatment providers.

3. Parameters to ensure coordination of care that includes behavioral health, physical health and medication‑assisted treatment for opioid use disorder.

4. Tracking and reporting requirements that identify:

(a) Treatment capacity.

(b) Quantitative metrics related to quality of care and patient outcomes.

5. An annual evaluation by a third‑party auditor of the accuracy and completeness of data provided by the centers of excellence.

C. The administration shall establish a statewide learning collaborative to share best practices and establish peer-to-peer support between centers of excellence.

D. The administration shall maintain an accurate list of designated centers of excellence, including contact information, on its website.

E. Designated centers of excellence shall:

1. Increase capacity for treating opioid use disorder in opioid treatment programs and office‑based opioid agonist treatment statewide.

2. Demonstrate effective delivery of medication‑assisted treatment for opioid use disorder using evidence‑based practices as defined by the substance abuse and mental health services administration, a federally designated accreditation agency for rehabilitation facilities and the administration.

3. Comply with all tracking, reporting and evaluation requirements.

4. Participate in the statewide learning collaborative.

F. On or before January 15 of each year, the administration shall submit a report to the governor, the president of the senate and the speaker of the house of representatives, and shall provide a copy to the secretary of state, outlining:

1. The standards for designating centers of excellence.

2. The statewide list of designated centers of excellence.

3. A summary of the performance of the centers of excellence. END_STATUTE

Sec. 2. Arizona opioid use disorder review council; members; duties; annual report; delayed repeal

A. The Arizona opioid use disorder review council is established consisting of the following members:

1. The chairpersons of the health and human services committees of the senate and the house of representatives, who shall serve as cochairpersons.

2. The director of the Arizona health care cost containment system or the director's designee.

3. The director of the department of health services or the director's designee.

4. The following members who are appointed by the governor:

(a) Two family members of individuals who currently receive medication‑assisted treatment for opioid use disorder.

(b) A representative from a managed care organization contracted with the Arizona health care cost containment system.

(d) A representative of an office‑based opioid agonist treatment program.

(e) An administrator of a publicly funded opioid treatment program.

(f) A representative of a commercial health care insurer.

(g) A representative from a municipality with a population of more than one million four hundred thousand persons.

(h) A representative from a county with a population of more than one million persons.

(i) A representative from a county with a population of more than two hundred thousand and less than two hundred ten thousand persons.

B. Appointed members shall serve at the pleasure of the governor.

C. Council members are not eligible to receive compensation, but members appointed by the governor are eligible for reimbursement of expenses under title 38, chapter 4, article 2, Arizona Revised Statutes.

D. The Arizona health care cost containment system administration shall provide reports periodically on a schedule determined by the council that include the following information based on utilization data received by the administration and in compliance with all federal and state privacy laws and regulations:

1. The number of patients provided medication‑assisted treatment services for each provider submitting claims and encounters received by the administration for services during the period covered by the report.

2. The treatment type, if available, including medications and other related services provided by each provider and the number of patients receiving those treatment types and services.

3. The length of stay based on utilization data for each treatment type.

E. The council shall:

1. Review and make recommendations to the Arizona health care cost containment system regarding:

(a) The standards for designating centers of excellence for medication‑assisted treatment for opioid use disorder.

(b) The reporting requirements for care delivery activities in designated centers of excellence.

(c) Availability of and barriers to access to all United States food and drug administration‑approved medications for treating opioid use disorder and whether utilization controls are appropriate.

(d) Other state licensure and treatment models that provide outpatient opioid treatment.

(e) Patient outcomes that are reported to the Arizona health care cost containment system administration by contracted providers who receive reimbursement for medication‑assisted treatment for opioid use disorder.

2. Recommend to the legislature changes to the laws regarding medication‑assisted treatment for opioid use disorder.

3. On or before December 15 of each year, submit a report regarding the council's activities and recommendations to the governor, the president of the senate and the speaker of the house of representatives and provide a copy of this report to the secretary of state.

F. The Arizona health care cost containment system and the department of health services shall provide technical assistance to the Arizona opioid use disorder review council.

G. This section is repealed from and after December 31, 2023.