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ARIZONA HOUSE OF REPRESENTATIVESFifty-fourth Legislature Second Regular Session |
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HB 2319: technical correction; midwives
S/E: Arizona state hospital
Sponsor: Representative Barto, LD 15
Committee on Health & Human Services
Overview
Includes provisions for a governing body, reports, staffing plan, individualized treatment and discharge plans, assault reduction and response plan, Psychiatric Security Review Board (PSRB) requests, surveillance system and an appropriation.
History
The Arizona Department of Health Services (DHS) contains six divisions: the Director's Office; Licensing; Planning and Operations; Preparedness; and Prevention; and the Arizona State Hospital (ASH). It is the mission of ASH to provide evidence-based, recovery-oriented and trauma informed care to the individuals receiving services at ASH in order to facilitate their successful transition to the least restrictive alternative possible.
In September of 2019, the Arizona Auditor General issued a Performance Audit on the Arizona Department of Health Services - Arizona State Hospital. As noted in the audit, ASH provides long-term inpatient psychiatric treatment to persons with mental illness. When individuals with a mental disorder are court-ordered to undergo treatment, statute requires they received treatment in the least restrictive treatment alternative available. ASH is considered to be highest and most restrictive level of care in the State and is the only state-operated psychiatric hospital in Arizona.
Provisions
State hospital governing body; membership; appointments
1.
Provides that the governing body of the
state hospital consists of at least nine voting members appointed by and who
serve at the pleasure of the governor. (Sec. 1)
2. Outlines the membership as follows:
a) The Director of DHS or the Director's designee, who serves as the chairperson of the governing body. The Director must attend meetings of the governing body whenever possible and must review and sign all minutes of the meetings;
b) The Superintendent of ASH;
c) At least one member who is a licensed body-certified forensic psychiatrist with experience in operating psychiatric hospitals;
d) At least one member who is a licensed forensic psychologist with experience in operating psychiatric hospitals; and
e) The chairperson of the Independent Oversight Committee at ASH, who serves as a nonvoting member of the body. (Sec. 1)
3. States that a voting member may not be employed by this state or any entity that contracts with the state, except for the Director and Superintendent. (Sec. 1)
4. Provides that the governing body is responsible for conducting ASH as an institution and must provide oversight to ensure that the delivery of services is consistent with ASH's mission, vision and purpose. (Sec. 1)
5. Prohibits governing body members from receiving compensation but allowing for reimbursement of expenses. (Sec. 1)
State hospital; reports
6. Requires, by October 1 of each year, the Director to submit to the Governor, the President of the Senate and the Speaker of the House of Representatives a report that covers the preceding 12 months and that addresses all of the following:
a) Implementing evidence-based individualized treatment and discharge plans and performance against fidelity measures;
b) 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;
c) Implementing and operating the audio-visual surveillance system;
d) Assault reduction;
e) For civil commitments, the time between the request for admission and the admission date and steps to reduce any delay;
f) 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; and
g) Clinical areas in which there is a lack of resources to provide adequate evidence-based treatment to patients. (Sec. 2)
7. Requires the report to include, regarding forensic patients, documentation of ASH's compliance with and an explanation of any noncompliance with requests from the PSRB for mental health reports or risk assessments on patients appearing before the PSRB, the provision of patients' medical records requested by the PSRB and the appearance of hospital employees as witnesses at hearings if requested by the PSRB. (Sec. 2)
Staffing plan
8. Specifies that the Director, in consultation with the ASH Governing Body, must 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 ASH. (Sec. 3)
Individualized treatment and discharge plans
9. Requires a psychiatrist, within 30 days of admission, to develop, implement and document an individualized treatment and discharge plan for each patient. (Sec. 3)
10. States the individual treatment and discharge plans must be administered by or under the supervision of psychiatrist. (Sec. 3)
11. Specifies that each individual treatment and discharge plan be based on evidence-based national standards and fidelity measures, which must include diagnosis-specific, measurable programming and clinical outcomes that are reviewed and modified at least every 90 days. (Sec. 3)
12. Provides that for forensic patients, each individualized treatment and discharge plan must both:
a) Include specific programming to treat the patient's mental disease or defect that resulted in commitment to ASH; and
b) Focus on the patient achieving stable remission and eliminating dangerousness, if any, so the patient can meet the statutory criteria for release by the PSRB or transfer to the state Department of Corrections. (Sec. 3)
Assault reduction and response plan; training
13. States the Director must 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 must require staff training at the time of hire as well as ongoing training to ensure that staff maintain competency in assault prevention and response. (Sec. 3)
14. Requires the training to be provided at least twice a year and evaluated once a year by an external body. (Sec. 3)
15. Requires the Superintendent to respond in good faith and on a timely basis to requests from the PSRB for each of the following:
a) A patient's records;
b) A report on a patient's clinical progress or the patient's individualized treatment and discharge plan;
c) A patient risk assessment;
d) An explanation of a rule violation by a patient; and
e) A witness from the treatment team to appear before the PSRB when a patient appears before the Board. (Sec. 3)
Psychiatric security review board requests; state hospital response
16. States that if the Superintendent in good faith believes as a matter of law that ASH cannot comply with a request from the PSRB regarding a patient, ASH must 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. (Sec. 3)
17. Provides that if a resolution cannot be reached, ASH must immediately pursue available legal remedies to obtain a judicial resolution. (Sec. 3)
Surveillance system; storage requirements
18. Requires ASH to maintain a surveillance system that includes both audio and visual capability and secure storage of the audio and visual files for at least 12 months after the date of any incident. (Sec. 3)
Appropriation; department of health services; surveillance system; Arizona state hospital
19. Contains a blank appropriation from the state General Fund in fiscal year 2021 to DHS to install and maintain a surveillance system and audio and visual capability at ASH. (Sec. 3)
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23. HB 2319
24. Initials IG Page 0 Health & Human Services
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