ARIZONA STATE SENATE

CHERIE STONE

LEGISLATIVE RESEARCH ANALYST

HEALTH & HUMAN SERVICES COMMITTEE

Telephone: (602) 926-3171

RESEARCH STAFF

TO:                  MEMBERS OF THE SENATE

HEALTH & HUMAN SERVICES COMMITTEE

DATE:            March 22, 2021

SUBJECT:      Strike everything amendment to H.B. 2386, relating to crisis standards of care

Purpose

            Establishes requirements for a Crisis Standards of Care (CSC) Plan adopted by the Department of Health Services (DHS).

Background

According to the U.S. Centers for Disease Control and Prevention, CSC are those that reflect a substantial change in usual health care operations and the level of care that health care providers are capable of delivering during a crisis (CDC). When a state government formally declares the need for CSC, this formal declaration enables specific legal and regulatory powers and protections for health care providers as they perform the necessary tasks of allocating and using scarce medical resources and adopting alternate health care operations during a crisis.

            DHS, in collaboration with public health, emergency management, first responders, health care, legal and other partners, created the Arizona CSC Plan (Arizona CSC Plan). The CSC Plan includes provisions regarding stewardship of resources, duty to care, reciprocity, proportionality and transparency for health care facilities and providers.

            There is no anticipated fiscal impact to the state General Fund associated with this legislation.

Provisions

1. Applies the following requirements to a CSC Plan, crisis guidance or crisis standards adopted or established by DHS to address resource allocation when the demand for certain health care services exceeds the supply of resources:

a) the allocation of health care resource decisions must be made on the basis of valuing all life;

b) a patient or their health care decision maker has the right to make their own choices;

c) decisions regarding the allocation of health care resources cannot discriminate based on disability, age, race, sex, religion, veteran status or income;

d) health care providers can only consider short-term survival when making resource allocation decisions;

e) treatment resources cannot be allocated based on quality of life judgments, long-term life expectancy and mortality or resource intensity and duration of need due to disability or age;

f) each patient has a right to an individualized assessment on the basis of the best available objective medical evidence;

g) patients with a disability and the aged have the right to reasonable modifications to ensure equal access to medical care, including reasonable modification in patient assessment, communication and support needs; and

h) patients and their health care decision makers have the right to appeal any triage decision.

2. Prohibits a health care provider or health care institution staff member from requiring that a patient or their health care decision maker sign a do-not-resuscitate order or make any particular health care decision.

3. Establishes representatives of the state protection and advocacy agency and advocates for the aged as members of the State Disaster Medical Advisory Committee (Advisory Committee).

4. Asserts that the Advisory Committee is responsible for developing CSC and other
incident-specific priorities and guidance for the delivery of health care and use of scarce medical resources during a public health emergency.

5. Defines short-term survival.

6. Requires DHS to modify any adopted CSC Plan, crisis guidelines or crisis standards within 60 days after the effective date of this legislation.

7. Becomes effective on the general effective date.