SB1391 - 552R

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

Section 1. Section 36-103.01, Arizona Revised Statutes, is amended to read:

START_STATUTE36-103.01. Governmental units succeeded; statutory references to succeeded governmental units

A. The department succeeds to the authority, powers, duties and responsibilities of the following:

1. State department of health.

2. Arizona health planning authority.

3. Crippled children's services.

4. Arizona state hospital.

5. 4. Anatomy board.

B. In the Arizona Revised Statutes, references to the agencies and departments listed in subsection A of this section shall be deemed to be references to the department of health services or its appropriate organizational units.

C. In the Arizona Revised Statutes, references to the state board of health, when used in the context of and in connection with the adoption of rules, the appellate or original review of administrative decisions, or the approval of decisions by department officers, shall be references to the director of the department of health services. In all other places, references to the state board of health shall be references to the department of health services.

D. In this title, and in the Arizona Revised Statutes, references to the commissioner of health shall be references to the director of the department of health services. END_STATUTE

Sec. 2. Section 36-137, Arizona Revised Statutes, is amended to read:

START_STATUTE36-137. Annual report of director

The director shall submit annually to the governor, the president of the senate and the speaker of the house of representatives a copy of the annual report setting forth:

1. The condition of public health in the state.

2. The activities of the department during the preceding fiscal year.

3. The work done in each county.

4. The character and extent of all diseases reported.

5. The expenditures of the department and of each county or district health department.

6. Recommendations the director deems advisable for protection of the public health.

7. The financial statement of the affairs of the Arizona state hospital.

8. 7. The operations and administration of the program of service for children with a physical disability or who are suffering from conditions that lead to a physical disability. END_STATUTE

Sec. 3. Section 36-201, Arizona Revised Statutes, is amended to read:

START_STATUTE36-201. Definitions

In this article, unless the context otherwise requires:

1. "Chief medical officer" means the chief medical officer of the state hospital.

2. "Department" means the department of health services Arizona HEALTH care cost containment system.

3. "Director" means the director of the department of health services Arizona health care cost containment system administration.

4. "Employee" means an officer or employee of the state hospital.

5. "State hospital" means Arizona state hospital.

6. "Superintendent" means the superintendent of the state hospital.END_STATUTE

Sec. 4. Section 36-202, Arizona Revised Statutes, is amended to read:

START_STATUTE36-202. State hospital for the mentally disordered; official name; purpose; facilities and equipment

A. A state hospital shall be maintained for the care and treatment of persons with mental disorders and persons with other personality disorders or emotional conditions who will benefit from care and treatment. Admissions to the state hospital shall be in accordance with law. The hospital shall be called the Arizona state hospital.

B. Subject to legislative appropriation, the state hospital may provide services to persons suffering from alcoholism and to persons suffering from drug abuse.

C. The state hospital shall have adequate facilities and equipment for enlightened and scientific treatment of nervous and mental diseases in accordance with approved methods of mental therapeutics. The facilities shall include, among other things:

1. Facilities for medical and psychiatric treatment with special attention to occupational therapy and other special therapies.

2. Facilities for proper segregation and care of child patients.

3. Facilities for recreation and physical training.

4. An institutional library for the use of patients.

5. A properly equipped dental department.

6. A properly equipped laboratory and x-ray department.

7. A patient tracking system approved by the director that monitors individual progress on an inpatient basis and ensures suitable aftercare placement.

D. The state hospital shall be under the charge and control of the director of the department of health services, pursuant to this article.END_STATUTE

Sec. 5. Section 36-210, Arizona Revised Statutes, is amended to read:

START_STATUTE36-210. Expenditures

A. This article does not give the director or any employee authority to create a debt or obligation in excess of the amount appropriated by the legislature to carry out its the provisions of this article. If monies are not appropriated to carry out the purpose of this article, the director shall submit recommendations to the legislature, with a statement of the cost when an improvement is requested.

B. Except as provided by subsection D of this section, the director of the department of administration shall not issue a warrant for expenditures by the state hospital in excess of the estimate contained in the monthly financial statement unless the superintendent submits a written request that is approved in writing by the director of the department of health services Arizona health care cost containment system administration and that states the reasons for the request. The director of the department of administration shall not issue warrants in excess of the amount available for the current quarter.

C. If a patient in the state hospital requires a health care service that the state hospital or a facility or provider contracted by the state hospital cannot provide, the department of health services arizona health care cost containment system shall pay approved claims from a facility or provider that provides these required services as follows:

1. For inpatient and outpatient hospital services, the state shall reimburse at a level that does not exceed the reimbursement methodology established in section 36-2903.01, subsection G.

2. For health and medical services, the state shall reimburse providers at a level that does not exceed the capped fee-for-service schedule that is adopted by the Arizona health care cost containment system administration pursuant to chapter 29, article 1 of this title and that is in effect at the time the service is delivered.

D. Monies appropriated for capital investment may be expended spent at any time during the fiscal period for which the monies are appropriated as directed by the director. END_STATUTE

Sec. 6. Section 36-503.03, Arizona Revised Statutes, is amended to read:

START_STATUTE36-503.03. Civil commitment treatment population; cap

The Arizona state hospital shall collect census data for adult civil commitment treatment programs to establish maximum capacity and the allocation formula required by section 36-206, subsection D. The Arizona state hospital or the department of health services Arizona health care cost containment system is not required to provide civil commitment treatment that exceeds the funded capacity. If the Arizona state hospital reaches its funded capacity in civil commitment treatment programs, the superintendent of the state hospital shall establish a waiting list for admission based on the date of the court order issued pursuant to this section. END_STATUTE

Sec. 7. Section 36-545.01, Arizona Revised Statutes, is amended to read:

START_STATUTE36-545.01. Payment of costs and expenses; ability to pay; power and duty of court; acceptance of other benefits; per capita cost limitation; guardians; parental liability; lien; duty of county attorney

A. When a patient is admitted to the state hospital for court-ordered treatment pursuant to article 5 of this chapter or pursuant to section 13-3992, the business manager of the state hospital shall inquire into the ability of the patient to pay the costs of examination, maintenance and treatment. The business manager shall file with the clerk of the court a written report of the manager's findings and the basis of those findings.

B. If the patient is able to pay all or any portion of the charges, the court shall order the payment of the amount the patient can afford of the per capita cost for examination, treatment and maintenance as estimated by the superintendent. The court, on petition of an interested person and at a hearing of which all concerned parties have received notice, may increase or decrease the maintenance charge payable by the patient or the patient's estate.

C. Notwithstanding subsection B of this section, any federal, state, public or private medical benefits that are payable to the state hospital where the patient is receiving care and treatment or that are payable to the patient may be accepted by the state hospital without a court order, except that the state hospital shall not accept any benefits that alone or in addition to any amounts payable pursuant to subsection B of this section exceed the per capita cost for the patient.

D. The court, if necessary, may appoint a conservator of the patient to carry out this section. If a conservator is appointed, the clerk of the court shall file a certificate so stating. All proceedings relating to that conservatorship shall be had as provided by law for conservators of estates. The conservator shall pay the amount ordered by the court pursuant to subsection B of this section.

E. If the patient is a minor, the business manager of the state hospital shall inquire into the ability of the minor's parents to bear charges pursuant to this section. All obligations, charges and liens that may be imposed on a patient pursuant to this section shall be imposed on the minor's parents if it is determined that the parents have the ability to pay.

F. The charges fixed by the court as provided by this section and ordered paid by the patient or the patient's estate, on filing with the county recorder, become a lien on the property of the patient or the patient's estate.

G. The county attorney of each county, on an order of a judge of the superior court, shall enforce the lien and collect the charges from the person ordered to pay if the charges become delinquent.

H. Costs of examination, treatment and maintenance shall not be charged to any patient found by a court of competent jurisdiction to be unlawfully detained.

I. Notwithstanding section 36-545.02, the department Arizona health care cost containment system shall deposit, pursuant to sections 35-146 and 35-147, monies collected through contracts entered into pursuant to section 36-3410 in the Arizona state hospital fund established by section 36-545.08. The department Arizona health care cost containment system shall use these monies for the treatment of to treat patients at the state hospital or for the placement of to place clients in the community. END_STATUTE

Sec. 8. Section 36-545.08, Arizona Revised Statutes, is amended to read:

START_STATUTE36-545.08. Arizona state hospital fund; purpose

A. The Arizona state hospital fund is established for the purposes prescribed in section 36-545.01, subsection I. The department of health services ARizona health care cost containment system shall administer the fund. The fund consists of the following:

1. Monies reimbursed by the federal government under title XIX of the social security act for services provided at the state hospital.

2. Monies collected pursuant to section 36-3410 for services to clients at the state hospital.

3. Monies collected from counties for the cost of a defendant's inpatient competency restoration treatment.

B. The department ARizona health care cost containment system shall deposit monies collected pursuant to subsection A of this section into three separate accounts.

C. Monies in the fund deposited under subsection A, paragraphs 1 and 3 of this section are subject to legislative appropriation and are designated for state hospital operations. Monies in the fund deposited under subsection A, paragraph 2 of this section are a continuing appropriation and are exempt from the provisions of section 35-190 relating to lapsing of appropriations. Monies in the fund deposited under subsection A, paragraph 3 of this section remaining unexpended and unencumbered at the end of the fiscal year revert to the state general fund. Monies in the fund deposited under subsection A, paragraph 1 of this section are exempt from the provisions of section 35-190 relating to lapsing of appropriations.END_STATUTE

Sec. 9. Section 36-3410, Arizona Revised Statutes, is amended to read:

START_STATUTE36-3410. Regional behavioral health authorities; contracts; monthly summaries; inspection; copying fee; children's behavioral health and seriously mentally ill services

A. If the administration contracts with behavioral health contractors that would act as regional behavioral health authorities or directly with a service provider for behavioral health services, the administration and each behavioral health contractor or service provider shall prepare and make available monthly summary statements, in a format prescribed by the administration, that separately detail by title XIX and nontitle XIX and by service category and service type, as defined by contract with the administration, the number of clients served, the units of service provided and the state and federal monies distributed through the administration to each regional behavioral health authority or direct contract service provider and the amounts distributed by each regional behavioral health authority or direct contract service provider to its subcontractors. The director may require additional information in the monthly statement that the director determines to be critical for proper regulation and oversight of the regional behavioral health authority or the direct contract service provider.

B. For services provided directly by a regional behavioral health authority, the maximum reimbursement to that regional behavioral health authority shall be thirty percent above the Arizona health care cost containment system fee for service fee-for-service rate for the particular service rendered.

C. Except as provided in subsections D and E of this section, behavioral health contractors under contract with the administration to act as regional behavioral health authorities may perform only managed care functions. Regional behavioral health authorities and their subsidiaries shall not deliver behavioral health services directly to clients.

D. If a direct services behavioral health provider experiences contract performance failure, the regional behavioral health authority, after receiving approval from the administration, may provide direct care services for only as long as necessary to ensure delivery of uninterrupted care to clients and either:

1. Accomplish the orderly transition of those members to a new provider or other existing providers.

2. Until the provider in question reorganizes or otherwise corrects the contract performance failure.

E. Subsection C of this section does not apply to a regional behavioral health authority operated by a federally recognized Indian tribe.

F. In the contracts specified under subsection A of this section, the administration may include a provision to charge, payable to the department of health services, for services provided at the state hospital. The charges are only for clients on whose behalf the contractor has been paid by the administration.

G. The summaries and the contracts on which they are based are open to public inspection. The administration and each regional behavioral health authority or direct contract service provider shall make the summaries available for inspection and copying at the office of each regional behavioral health authority or direct contract service provider and at the administration.

H. The administration and a regional behavioral health authority or direct contract service provider shall charge a copying fee that is does not in excess of exceed the actual cost of reproduction or the amount charged by the secretary of state pursuant to section 41-126, whichever is less.

I. Copying fees received by the administration, pursuant to subsection H of this section, shall be placed in the Arizona health care cost containment system fund established by section 36-2913.

J. Monies appropriated each fiscal year for children's behavioral health services shall be spent on services only as prescribed by the appropriation and may not be used for any other purpose.

K. Monies appropriated each fiscal year for seriously mentally ill services shall be spent on services only as prescribed by the appropriation and shall not be used for any other purpose. END_STATUTE

Sec. 10. Transfer; effect; succession

A. All matters, including contracts, orders and judicial or quasi-judicial actions, whether completed or pending, of the department of health services relating to the Arizona state hospital are transferred, on the effective date of this act, and maintain the same status with the Arizona health care cost containment system.

B. Rules adopted by the department of health services relating to the Arizona state hospital are effective until superseded by rules adopted by the Arizona health care cost containment system.

C. All personnel, property and records, all data and investigative findings and all obligations of the department of health services relating to the Arizona state hospital are transferred to the Arizona health care cost containment system and may be used for the purposes of this act.

Sec. 11. Conforming legislation

The legislative council staff shall prepare proposed legislation conforming the Arizona Revised Statutes to the provisions of this act for consideration in the fifty-sixth legislature, first regular session.

Sec. 12. Effective date

This act is effective from and after June 30, 2023.