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ARIZONA STATE SENATE
Fifty-Fifth Legislature, First Regular Session
AMENDED
Arizona state hospital
(NOW: Arizona state hospital; admission; governance)
Purpose
Specifies information that must be included in the Department of Health Services' annual report on the Arizona State Hospital (ASH). Establishes the Joint Legislative Psychiatric Hospital Review Council (Council) and prescribes Council membership and duties.
Background
ASH, operated by DHS and located in Phoenix, Arizona, is a 260-bed facility that provides long-term inpatient psychiatric care to individuals with mental illnesses, personality disorders or emotional conditions who are under a court order to receive treatment. The Civil Adult Rehabilitation Program at ASH includes treatment units that specialize in providing services to adults who are civilly committed as a danger to self, danger to others, gravely disabled or persistently and acutely disabled, and who have completed a required 25 days of treatment in a community inpatient setting prior to admission to ASH. Forensic patients at ASH are court-ordered for either pre-trial or post-trial treatment as a result of involvement with the criminal justice system due to a mental health issue. The Forensic Adult Program includes individuals who have been committed through a court-order as part of a criminal process for patients who either: 1) are being housed in one unit providing pre-trial evaluation, treatment and restoration to competency to stand trial; or 2) have been adjudicated guilty except insane (GEI) and are serving a sentence under the jurisdiction of the Psychiatric Security Review Board (PSRB) (A.R.S. Title 36, Chapter 2). Statute authorizes the PSRB to release any GEI person under its jurisdiction from ASH to the community if the person meets statutory release criteria (A.R.S. § 13-502).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Requires the annual ASH report to include the following information, in addition to any other information DHS deems relevant:
a) a breakdown of the number of patients served at each ASH facility, including:
i. gender;
ii. race;
iii. age;
iv. legal status;
v. country of origin;
vi. program type;
vii. census by unit;
viii. primary diagnosis of each by category; and
ix. length of stay.
b) admissions by civil commitment, including:
i. the number of admissions and discharges;
ii. the time between the request for admission and the date of admission or denial; and
iii. aggregate data, by category, regarding the reason a commitment request was denied;
c) data collected from ASH's safety plan, including:
i. the number and type of assaults by category, with sexual assaults reported separately;
ii. the number of assaults reported to law enforcement and other specified agencies; and
iii. the number of times law enforcement was called ASH in response to an assault.
d) the status of establishing a psychiatric center of excellence.
2. Asserts that the aforementioned requirements do not necessitate the release of individually identifiable health information.
3. Establishes the Council and prescribes Council membership and duties.
4. Requires the Council Co-chairpersons to invite specified subject matter experts to advise the Council.
5. Requires the Council, before December 31, 2021 and 2022, to submit a report of its findings and recommendations to the Governor and the presiding officer in each chamber of the Legislature.
6. Directs the Council to provide a copy of the report to the Secretary of State.
7. Repeals the Council on September 1, 2023.
8. Directs DHS, by October 1, 2021 and in coordination with the Arizona Department of Administration, to issue a request for information (RFI) for a surveillance system for ASH that meets audio, visual and storage capability requirements.
9. Specifies that the RFI can separately include requirements for ASH's civil and forensic units.
10. Makes technical changes.
11. Becomes effective on the general effective date.
Amendments Adopted by Committee
1. Directs ASH to give priority to the most ill patients.
2. Modifies proposed Governing Body membership.
3. Eliminates proposed language directing the IOC Chairperson to advise the Governing Body.
4. Decreases, from $200 to $100, the amount of compensation for Governing Body members.
5. Modifies and expands information required to be included in the annual financial and programmatic report.
6. Eliminates proposed language requiring ASH to develop staffing and assault reduction plans.
Amendments Adopted by Committee of the Whole
1. Prohibits ASH from placing admission limitations based solely on a patient’s county of residence.
2. Requires the prescribed annual Governing Body report to include information regarding ASH’s strategic plans related to clinical services.
3. Specifies that prescribed Governing Body reporting requirements do not require the release of individually identifiable health information.
4. Specifies that the ASH IOC Chairperson must be invited to each meeting of the Governing Body and requires the ASH IOC Chairperson to provide a quarterly report to the Governing Body.
5. Requires an ASH patient’s treating psychiatrist, or a designee, to appear as a witness before the PSRB at each hearing regarding the patient’s conditional release.
Amendments Adopted by the House of Representatives
1. Removes proposed language establishing an ASH Governing Body.
2. Eliminates proposed language regarding master, treatment and discharge plans.
3. Removes proposed language regarding PSRB information requests.
4. Establishes the Council and prescribes Council membership and duties.
5. Eliminates the proposed $500,000 appropriation to DHS for a surveillance system and instead directs DHS to issue an RFI for a surveillance system at ASH.
6. Removes proposed language prohibiting ASH placing a limitation on admission based on a patient's county of residence.
Senate Action House Action
HHS 2/18/21 DPA 5-3-0 HHS 3/22/21 DP 7-1-0-1
3rd Read 3/09/21 13-15-2 APPROP 3/30/21 DPA 8-5-0-0
3rd Read* 3/10/21 16-14-0 3rd Read 5/25/21 60-0-0
*on reconsideration
Prepared by Senate Research
June 11, 2021
CRS/kja