HB2603 - 551R

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

Section 1. Title 11, chapter 2, Arizona Revised Statutes, is amended by adding article 11.1, to read:

ARTICLE 11.1. PRETRIAL DIVERSION PROGRAMS

START_STATUTE11-366. Pretrial diversion program; establishment; length; discharge; contract administrator

A. A county may establish a pretrial diversion program as an alternative method of holding low level offenders accountable for violations of the law. A pretrial diversion program includes participation in evidence-based education or treatment programs that target factors related to recidivism. The program is an alternative to prosecution either before filing criminal charges or after filing criminal charges. A participant who successfully completes the program will have all charges dismissed or no charges filed against the participant. If a participant fails to successfully complete the program, charges will be filed or a motion to reinstate the charges will be filed.

B. Participants shall remain in A pretrial diversion program for at least three months and not longer than six months depending on participant needs. On approval of the county attorney, and if good cause exists, a participant may remain in the program longer than six months. In consultation with the county attorney, program completion occurs when the participant has met all established treatment and social service goals and has been actively engaged in the program.

C. The county attorney may discharge A participant from the program for failing to remain engaged in the program, continually failing to make progress toward established treatment and social service goals, repeatedly refusing to comply with urinalysis or testing positive for prohibited substances. Before discharging a participant for marijuana use, the county attorney must complete a review of the participant's case to determine if the marijuana use complies with title 36, chapter 28.1.

D. If a county establishes a pretrial diversion program, The county business manager is the contract administrator. Nonperformance by A Contractor, managed care coordinator or care manager may result in suspension or termination of the contract. END_STATUTE

START_STATUTE11-366.01. Pretrial diversion program contractors; requirements; financial assessment; partnering treatment providers; reports

A. A county that establishes a pretrial program must use a contractor that does all of the following:

1. Uses a comprehensive and validated risk-need-responsivity assessment tool to evaluate a participant. The assessment shall assess the participant's risk to reoffend, and risk level score and shall identify targeted criminogenic factors as well as underlying problems and additional needs that negatively affect the participant's lifestyle.

2. Develops an individualized case management plan to address services to support the participant's recovery including referrals to community agencies for assistance with employment, housing, food, clothing, medical care, childcare and accessing state or federal entitlements, including medicaid, temporary assistance for needy families, the federal women, infants and children food program, food stamps and veteran benefits.

3. Facilitates the participant's choice of a partnering treatment provider based on location, payor source, ability to access and behavioral health treatment provider history, if applicable.

4. Refers and ensures a warm hand-off to the participant's choice of partnering treatment provider, including relevant results of the risk‑need-responsivity assessment tool assessment.

5. Collects, stores and refers to the partnering treatment provider's individualized treatment plans and goals relative to the targeted criminogenic risk factors and needs.

6. Ensures services provided are beneficial and appropriate for the participant's learning style, motivation, abilities and strengths.

7. Ensures that the continuum of substance abuse related services provided are matched for the dose and duration with the participant's risk-need-responsivity assessment, risk level, targeted criminogenic factors and needs. Services should include evidence-based drug education, education with individualized counseling and support groups and peer support, standard group therapy and intensive outpatient treatment. Optional services may include residential treatment, detoxification services or the ability to refer the participant to higher-end services, if necessary.

8. Ensures the implementation of a robust substance abuse testing protocol for participants that, requires frequent random urinalyses for the detection of controlled substances and alcohol that is consistent with the risk‑need-responsivity assessment. The county attorney shall review and approve this protocol.

9. Ensures that all services provided for participants are available in a community-based setting at multiple locations throughout the county.

10. Ensures that services are provided in individual and group settings and include open and closed formats. The length and frequency of service, hours of operation, including weeknights and weekend availability consideration, and the staff-to-participant ratio must safely and effectively meet the needs of the participants.

11. Ensures that services provided are culturally relevant and linguistically appropriate to the population that is served and are consistently delivered in a structured and supportive learning environment that promotes attainment of treatment and case management goals.

12. To deliver services, Refers to partnering treatment providers who preferably hold a master's degree in a human services-related field and who are licensed by the Arizona board of behavioral health examiners or are exempt from licensure pursuant to title 32, chapter 33. Behavioral health technicians who are under the supervision of a master's level clinician may also deliver Services.

13. Has one point of contact at the staff level to communicate with participants.

14. Before implementation, Submits all forms, including informational flyers, brochures and working documents used and given to participants, to the county attorney in advance for approval. The contractor may not create forms or represent the county attorney or the program without the county attorney's prior knowledge and consent.

15. Is a member of and participates in an organization in the county that focuses on improving cross-system collaboration to reduce the involvement of persons with mental and substance use disorders in the justice system.

16. Provides the county attorney with the following, all of which may be subject to the county attorney's approval:

(a) a copy of the participant's financial assessment application.

(b) A copy of the established contractor sliding scale.

17. Establishes and works with partnering treatment providers to implement a standardized financial assessment process and sliding scale that is based on federal poverty guidelines for all contractor, care manager, treatment and nontreatment fees. The contractor must annually revise the contractor's sliding scale to reflect federal adjustments in the federal poverty guidelines and must adopt these revisions not later than thirty days after the adjusted federal poverty guidelines are published. The contractor's sliding scale may be subject to approval by the county attorney.

B. A contractor must use a standardized financial assessment for each participant in a pretrial diversion program. The contractor shall conduct the standardized financial assessment process before commencing services, as follows:

1. The contractor shall provide a financial assessment application and application instructions to the participant. The contractor shall assist the participant with the financial assessment application to further the participant's understanding and completion of the application, while emphasizing it is the participant's responsibility to complete the application and to provide supporting documentation by a reasonable date that is determined by the contractor. FOr the purposes of this paragraph, "Supporting documentation" includes any of the following:

(a) Tax returns and pay stubs.

(b) Statements showing income from:

(i) Social security, medicaid, supplemental nutritional assistance program, pension, annuity, veterans and military benefits.

(ii) Alimony and child support.

(iii) Businesses.

(iv) Rent.

(v) Interest.

(vi) Dividends.

(vii) Any other income.

2. If the participant fails to provide a completed financial assessment application and supporting documentation by the date specified, full fees will be assessed. The participant must inform the contractor of any changes in the participant's financial circumstances.

3. The contractor shall offer a fee payment plan to the participant and shall be based on the participant's estimated length of participation so that fee payment completion parallels program completion. If there are extenuating circumstances, the contractor may extend the fee payment plan beyond the date of program completion. The extension of the fee payment plan must be based on the participant's assessed ability to pay by an agreed-on due date. During this extension period, the contractor may require random urinalysis, except that the contractor shall consider the participant's ability to pay for continued urinalysis when setting a testing schedule. If the participant fails to pay fees by the agreed-on extended due date, the participant is deemed to have unsuccessfully completed and will be terminated from the program.

4. The contractor shall establish a policy that outlines the financial assessment process. The contractor shall provide a copy of this policy to the county attorney. The policy may be subject to approval by the county attorney.

5. The contractor must maintain the participant's financial assessment application and supporting documentation in the participant's case file.

6. The contractor shall verify the participant's title XIX enrollment status or eligibility. When applicable, the contractor shall assist the participant with the application process to ascertain eligibility and coverage for treatment under the Arizona health care cost containment system.

C. A contractor in a pretrial diversion program may partner with various treatment providers to meet the needs of program participants regarding location, insurance needs and services. All partnering treatment providers must hold and maintain a license issued by the department of health services, which license is in good standing for each facility from which services are provided. With the approval of the county attorney, exceptions may be made for participants who seek services out of state. The following requirements apply to a partnering treatment provider:

1. The contractor must enter into a business associates agreement with a partnering treatment provider that outlines the expectations of the program requirements. Copies of business associates agreements and the provider's copies of a department of health services license for each facility must be submitted to the county attorney.

2. If the contractor operates an Arizona department of health services licensed treatment facility and also acts as a partnering treatment provider, any discussion of a participant's choice of all available treatment providers must be documented in the participant's case file.

D. A pretrial diversion program contractor must comply with the following information, notice and reporting requirements:

1. On enrollment in the program, the contractor shall complete the statement of facts form that is approved and provided to the contractor by the county Attorney. A copy of the statement of facts form must be provided to a participant and provided to the county attorney for review. The original statement of facts form must be retained in the participant's case file.

2. The contractor shall provide immediate notification to the county attorney when a participant is enrolled in the program and when the participant completes the program successfully or is unsuccessful and terminated from the Program. For the purposes of this paragraph, "immediate notification" means the next business day but not longer than three business days after enrollment or completion or termination, or both.

3. On completion and termination from the program, the contractor shall complete and provide to the county attorney all of the following:

(a) A discharge report that describes all of the following:

(i) The case management goals and partnering treatment goals.

(ii) The participant's participation and financial obligation compliance, including collected fees, copays and, if applicable, restitution.

(iii) The reasons for the participant's successful or unsuccessful program completion.

(iv) Documented attempts by the contractor to engage the participant in the Program and any referrals to community resources that were designed to assist the participant in recovery and to help the participant maintain stability and resilience in the community.

(b) A copy of the statement of facts that is signed by the participant at enrollment.

4. The contractor must have the capability to transmit updates electronically regarding program enrollment and discharge.

5. By the end of the tenth business day of each month, the contractor shall provide to the county attorney the following statistical information for the previous month:

(a) The number of new pre-file participants who have not been in the program before and who are enrolled in the Program.

(b) The number of new post-file participants enrolled who have not been in the program before and who are enrolled in the program.

(c) The number of pre-file participants who enrolled in the program and who had previously been enrolled in the program one or more times.

(d) The number of post-file participants who enrolled in the program and who had previously been enrolled in the program one or more times.

(e) The total number of participants enrolled in the program.

(f) The number of pre-file participants who were unsuccessful and terminated from the Program.

(g) The number of pre-file participants who successfully completed the program.

(h) The number of post-file participants who were unsuccessful and who were terminated from the program.

(i) The number of post-file participants who successfully completed the program.

(j) The number of participants in each tier of federal poverty guidelines on the contractor's sliding scale.

(k) The number of participants who enrolled with each partnering treatment provider.

6. The contractor shall provide quarterly and annual reports to the county attorney with the aggregate statistical information. Additional relevant data may also be submitted with these reports.

7. The contractor shall provide additional data and information to the County Attorney as requested.

8. The contractor shall maintain, and grant the county attorney access to, a database that includes the following participant-specific information. The database must be current within three business days after the occurrence of any of the events giving rise to the following information:

(a) The full name and date of birth of every participant, including past and present participants in the program, along with the participant's contact information, including the participant's address, phone number and email address.

(b) The current status of every participant together with the dates the participant enrolled in the program, was discharged unsuccessfully or graduated from the program. The contractor shall identify a participant's current status as one of the following:

(i) Currently in the Program.

(ii) Discharged from the program for failure to satisfactorily complete the program.

(iii) Graduated from the program following successful program completion.

(c) A summary of the participant's urinalysis results, the date of each test and the test result, including whether the test result was marked controlled substance detected, controlled substance not detected, sample diluted or test not completed. The contractor shall provide copies of each urinalysis result.

(d) A copy of the participant's discharge report, if any.

(e) A copy of the participant's statement of facts.

(f) Copies of any program documentation, including program rules and requirements, confidentiality waivers and ANY DOCUMENTATION SIGNED BY THE PARTICIPANT, that was provided to each participant.

(g) Each restitution payment amount received from the participant together with the date the payment was received and the date the payment was transmitted to the county attorney.

(h) The total county diversion program fee, participation fee and contractor, treatment and nontreatment service fees assessed against each participant, together with the dates and amounts of each payment towards each fee made by the participant.

(i) A copy of each participant's financial assessment application, copies of all supporting documentation provided by the participant and copies of all supporting documentation of the participant's indigency and ability to pay.

(j) The participant's Title XIX enrollment status and eligibility.

(k) Whether the participant received a waiver or fee reduction pursuant to the contractor's sliding scale, and if so, the nature of the reduction.

9. by The contractor and care manager must create and maintain all information using reasonable security standards pertaining to the secure storage of data. The data within the database should be encrypted and should limit access to users who are currently approved by the county attorney or the contractor.

10. Data in the database must be saved and accessible in a format or formats that is requested by the county attorney. The county attorney may make reasonable requests for additional data that shall be contained within the database and may make reasonable modifications to the technical requirements for how that data is securely saved or accessed.

E. At a minimum, each pretrial diversion program Contractor shall meet the following performance requirements:

1. The contractor sets Service milestones that are based on the needs of the participant, except that the desired outcomes must include the participant's:

(a) Exhibiting progress on treatment goals as outlined in the treatment plan.

(b) Improving daily functioning, particularly related to the program goals.

(c) Identifying community supports that are part of the discharge plan in place to help maintain stability and resilience in the community.

2. The contractor makes all reasonable efforts to deliver services to the participant in a timely manner to meet the needs of the participant.

3. The contractor conducts all contacts between the managed care coordinator, care manager, participants and the county attorney with professionalism, fairness, respect and dignity to the participant. The contractor may not discriminate against a participant based on race, national origin, religion, gender, sexual orientation, age, disability, marital status, diagnosis or source of payment.

4. The contractor's successful performance is determined by the managed care coordinator and care manager compliance with the terms of the contract. END_STATUTE

START_STATUTE11-366.02. Program fees; collection and accounting requirements

A. A pretrial diversion program must have reasonable participation fees. A program must Accept multiple forms of payment including money orders, debit cards and credit cards as payment for services or have the ability to bill private insurers or the Arizona health care cost containment system to cover case management costs. A partnering treatment provider may establish reasonable treatment and nontreatment fees and accept multiple forms of payment including money orders, debit cards and credit cards as payment for services or the ability to bill private insurers or the Arizona health care cost containment system to cover treatment or education costs.

B. A pretrial diversion program must include the following fee collection and accounting requirements:

1. The contractor must have the ability to collect from the participant the county diversion program fee, determined by the county attorney, on behalf of the county attorney using the contractor's sliding scale. Using the contractor's sliding scale and the standardized financial assessment process, the contractor shall determine if the participant qualifies for a waiver or reduction in the county diversion program fee.

2. The Contractor may collect the county diversion program fee only after all other contractor and treatment provider fees and restitution, if applicable, are paid.

3. By the tenth day of each month, the contractor shall transmit the county diversion program fees collected during the previous month to the county attorney either in a physical draft or check or electronic funds transfer and shall electronically submit or import detailed records regarding those collections including participant names, case numbers and the amount of monies collected for the month. This draft, check or electronic funds transfer and submission must be separate from any collection of restitution payment submissions.

4. If applicable, the contractor shall collect restitution from the participant on behalf of the county attorney. By the tenth day of each month, the contractor shall transmit the restitution collected during the previous month to the county attorney either in a physical draft or check or electronic funds transfer and shall electronically submit or import detailed records regarding those collections including, participant names, case numbers and the amount of monies collected for the month. This draft, check or electronic funds transfer and submission must be separate from any submission of county diversion program fees.

5. The contractor must retain adequate accounting and case reconciliation records for review by the County Attorney. END_STATUTE

START_STATUTE11-366.03. Managed care coordinator; requirements

A pretrial diversion program must include a managed care coordinator and care manager direct service standards based on the following requirements:

1. The managed care coordinator shall inform participants of program rules, including confidentiality, participant rights and expected behavior, and shall obtain the participant's written consent for release of information. The managed care coordinator shall document the explanation of program rules in the participant's case file.

2. The managed care coordinator shall inform participants of program requirements and the criteria necessary for successful completion of the program and document that information in the participant's case file.

3. The managed care coordinator shall inform participants of the financial obligations associated with program participation, including participation fees and the county diversion program fees or copays, methods of acceptable payment, including the Arizona health care cost containment system, private insurance or self-pay, and payment schedules and due dates for remitting payment. The participant's financial obligations must be documented in the participant's case file.

4. The managed care coordinator shall use the risk‑need‑responsivity assessment with identified targeted criminogenic factors and needs throughout the course of case management and treatment and shall record this usage in the participant's case file. The risk-need-responsivity assessment and its supporting and collateral documentation, including the interview notes, interview guide, self-report form and scoring guide, must be retained in the participant's case file.

5. The county attorney shall refer program participants to the managed care coordinator by email and provide the participant's name and contact information and the date on which the participant was instructed to contact the managed care coordinator.

6. On contact, the managed care coordinator shall schedule a meeting with the participant within twenty‑four hours, unless otherwise impracticable.

7. The managed care coordinator must have a face-to-face meeting with the participant and complete the risk-need-responsivity assessment tool to identify the participant's treatment and social service needs and to detail service recommendations and urinalysis frequency. The managed care coordinator shall assist the participant install a mobile health application on the participant's mobile telephone or on a mobile telephone provided with contractor's assistance.

8. Within three days after the participant meets with the managed care coordinator, the participant must be scheduled for a face‑to‑face meeting with a care manager, unless otherwise impracticable, and must be provided with the care manager's contact information.

9. The care manager must develop a detailed treatment and social service plan in conjunction with the participant that outlines participant goals and includes identified community resources to address treatment and social service needs.

10. Both the case management plan and the partnering treatment plan must be updated with information that demonstrates structured sessions occurred for a specific and authorized period and that works toward the attainment of treatment goals. The participant's progress and participation must be documented in the participant's case file.

11. If the risk-need-responsivity assessment or partnering treatment assessment determines that the participant would benefit from mental health services or peer support services, or both, a referral to a mental health provider or peer support service agency, or both, must be made. This referral may include the participant's current mental health provider. The referral information must be documented in participant's case file.

12. The care manager must support the participant's recovery by providing referrals to community agencies for assistance with employment, housing, food, clothing, medical care, childcare and accessing state or federal entitlements, including medicaid, temporary assistance for needy families, the federal women, infants and children food program, food stamps and veteran benefits. Any referrals made to the participant must be documented in participant's case file.

13. The care manager must facilitate regular engagement with participants using digital, teleconference and in-person platforms and may use global positioning system monitoring to monitor participants. The care manager must document participant engagements in each participant's case file. The care manager must maintain regular contact with participants to facilitate participant engagement and to monitor progress towards goal completion.

14. The contractor or a partnering treatment provider may directly provide Urinalysis either through testing on site or deoxyribonucleic acid testing by mail. Standards for alcohol and drug testing collection, laboratory testing and chain of custody for specimen collection must be met as described in Arizona supreme court administrative order 2011‑137 and section 6‑110 of the Arizona code of judicial administration. END_STATUTE

Sec. 2. Appropriation; pretrial diversion program

A. The sum of $____________ is appropriated from the state general fund in fiscal year 2021-2022 to each county that establishes a pretrial diversion program pursuant to title 11, chapter 2, article 11.1 Arizona Revised Statutes, as added by this act.