PROPOSED
HOUSE OF REPRESENTATIVES AMENDMENTS TO H.B. 2319
(Reference to printed bill)
Strike everything after the enacting clause and insert:
"Section 1. Title 36, chapter 2, article 1, Arizona Revised Statutes, is amended by adding section 36-205.01, to read:
36-205.01. State hospital governing body; membership; appointments
A. The governing body of the state hospital consists of at least nine voting members who are appointed by the governor and confirmed by the senate. Members of the governing body serve at the pleasure of the governor. the governing body's membership includes the following:
1. The director or the director's designee, who serves as the chairperson of the governing body. the director shall attend meetings of the governing body whenever possible and shall review and sign all minutes of the meetings.
2. The superintendent.
3. At least one member who is a licensed body‑certified forensic psychiatrist with experience in operating psychiatric hospitals.
4. At least one member who is a licensed forensic psychologist with experience in operating psychiatric hospitals.
5. The chairperson of the independent oversight committee at the ARizona state hospital established by section 41‑3803, who serves as a nonvoting member of the body.
B. Except for the director and the superintendent, a voting member of the governing body may not be employed by this state or any entity or program that directly contracts with this state.
C. The governing body is responsible for conducting the state hospital as an institution and shall provide oversight to ensure that the delivery of services is consistent with the state hospital's mission, vision and purpose and with state and federal law.
D. Members of the governing body are not eligible to receive compensation but are eligible for reimbursement of expenses pursuant to title 38, chapter 4, article 2.
Sec. 2. Section 36-217, Arizona Revised Statutes, is amended to read:
36-217. State hospital; reports
A. On or before January 1 of each year, the director shall submit to the governor, the speaker of the house of representatives and the president of the senate a financial and programmatic report on the state hospital for the preceding fiscal year. This report shall include all revenues and expenditures of the state hospital, including specific identification of administrative costs for and the number of persons served at the state hospital.
B. On or before September 30 of each year, the director shall submit to the governor, the president of the senate and the speaker of the house of representatives a report that covers the preceding twelve months and that addresses all of the following:
1. Implementing evidence-based individualized treatment and discharge plans and performance against fidelity measures.
2. Budget requests for staffing that include the number of filled, appropriated and non-appropriated full-time equivalent positions in each facility, and the status of implementing the staffing plan.
3. Implementing and operating the audio video surveillance system.
4. Assault reduction.
5. For civil commitments, the time between the request for admission and the admission date and steps to reduce any delay.
6. Admission, census and clinical information documenting the types of patients served and the patients' progress toward release to a more integrated level of care or to the community.
7. Clinical areas in which there is a lack of resources to provide adequate evidence-based treatment to patients.
C. The report submitted pursuant to subsection B of this section shall include, regarding forensic patients at the state hospital, documentation of the state hospital's compliance with and an explanation of any noncompliance with requests from the psychiatric security review board for mental health reports or risk assessments on patients appearing before the board, the provision of patients' medical records requested by the psychiatric security review board and the appearance of hospital employees as witnesses at hearings if requested by the psychiatric security review board.
D. On or before September 30 of each year, the governing body shall submit to the governor, the president of the senate and the speaker of the house of representatives a separate annual report that, at a minimum, provides a summary of topics reviewed by the governing body, the governing body's discussions and decisions on each topic and any recommendations from the governing body to the governor and the legislature regarding clinical quality performance metrics and patient safety.
Sec. 3. Title 36, chapter 2, article 1, Arizona Revised Statutes, is amended by adding sections 36-220, 36-221, 36-222, 36-223 and 36-224, to read:
36-220. Staffing plan
The director, in consultation with the state hospital governing body, shall develop, implement and document a staffing plan to reduce vacancy rates at the civil facility, the forensic facility and the Arizona community protection and treatment center to a level that the director deems appropriate to carry out an active program of treatment for individuals receiving services at the state hospital.
36-221. Individualized treatment and discharge plans
A. Within thirty days after a patient's admission, a psychiatrist shall develop, implement and document an individualized treatment and discharge plan for each patient. The individualized treatment and discharge plans shall be administered by or under the supervision of a psychiatrist. Each individual treatment and discharge plan shall be based on evidence-based national standards and fidelity measures, which shall include diagnosis‑specific, measurable programming and clinical outcomes that are reviewed and modified at least every ninety days.
B. For forensic patients, each individualized treatment and discharge plan shall both:
1. Include specific programming to treat the patient's mental disease or defect that resulted in commitment to the state hospital pursuant to section 13‑3994.
2. Focus on the patient achieving stable remission and eliminating dangerousness, if any, so the patient can meet the statutory criteria for release by the psychiatric security review board or transfer to the state department of corrections.
36-222. Assault reduction and response plan; training
The director shall contract with an independent third party contractor to develop, implement and document an assault reduction and response plan that includes ongoing evaluation criteria using national standards and fidelity measures, including a root cause analysis. The plan shall require staff training at the time of hire as well as ongoing training to ensure that all state hospital staff maintain competency in assault prevention and response. The training shall be provided at least semiannually and evaluated at least annually by an external body.
36-223. Psychiatric security review board requests; state hospital response
A. The superintendent shall respond in good faith and on a timely basis to requests from the psychiatric security review board for each of the following:
1. A patient's records.
2. A report on a patient's clinical progress or the patient's individualized treatment and discharge plan.
3. A patient risk assessment.
4. An explanation of a rule violation by a patient.
5. A witness from the treatment team to appear before the psychiatric security review board when a patient appears before the board.
B. If the superintendent in good faith believes as a matter of law that the state hospital cannot comply with a request from the psychiatric security review board regarding a patient, the state hospital shall immediately notify the parties involved in the patient's matter and arrange to meet and confer jointly with the chairperson of the board and the patient's attorney or the patient if the patient is not represented. If a resolution cannot be reached, the state hospital shall immediately pursue available legal remedies to obtain a judicial resolution.
36-224. Surveillance system; storage requirements
The state hospital shall maintain A surveillance system that includes both audio and visual capability and secure storage of the audio and visual files for at least twelve months after the date of any incident.
Sec. 4. Appropriation; department of health services; surveillance system; Arizona state hospital
The sum of $___ is appropriated from the state general fund in fiscal year 2020‑2021 to the department of health services to install and maintain a surveillance system with audio and visual capability at the Arizona state hospital."
Amend title to conform