ARIZONA HOUSE OF REPRESENTATIVES

Fifty-fifth Legislature

Second Regular Session

House: HHS DP 6-2-1-0

HB 2450: outpatient treatment centers; licensure; exemption

Sponsor: Representative Osborne, LD 13

House Engrossed

Overview

Defines an exempt outpatient treatment center (OTC) and outlines requirements.

History

A collaborating OTC means a licensed OTC that has a written agreement with one or more OTC's, exempt health care providers or licensed counseling facilities that requires the collaborating OTC to be liable and responsible pursuant to written policies for all common areas that one or more colocators use. A colocator is an exempt provider or a governing authority operating as an outpatient treatment center or a licensed counseling facility that is authorized to share common areas and nontreatment personnel with another colocator (A.R.S. § 36-439).

One or more OTC licensees providing medical, nursing and health-related services may colocate or colocate with one or more licenses that provide those services or licensed counseling facilities. They may also share common areas at the collaborating OTC premises and share nontreatment personnel (A.R.S. § 36-439.01).

Colocators at collaborating OTCs are required to: 1) designate which OTC will be the collaborating OTC and be liable and responsible for the health, safety, cleanliness and maintenance of all common areas and the supervision and training of all shared nontreatment personnel pursuant to written policies of the collaborating outpatient treatment center; 2) designate which areas are considered common areas and which personnel are designated as shared nontreatment personnel; 3) designate the associated licensed providers; and 4) ensure that medical records that are located in common areas or shared by colocators are maintained pursuant to all federal and state confidentiality laws. A colocator may have access to a patient's medical records only if the patient has consented (A.R.S. § 36-439.02).

Provisions

Exempt OTC Requirements

1.   ☐ Prop 105 (45 votes) ☐ Prop 108 (40 votes) ☐ Emergency (40 votes) ☐ Fiscal NoteAllows a clinical nurse specialist to prescribe or dispense pharmacological agents for patients in an OTC that is exempt from licensure. (Sec. 1)

2.   Exempts an OTC that has the same governing authority as a licensed hospital and that is staffed by licensed health care providers from licensure, supervision, regulation or control of the Department of Health Services (DHS) unless:

a)   Patients are kept overnight in the OTC or are treated under general anesthesia, except when the treatment by general anesthesia is regulated under the dentistry statutes;

b)   The OTC is an abortion clinic; or

c)   The OTC is a pain management clinic. (Sec. 3)

3.   Specifies that except for an OTC that is exempt from licensure, a person wishing to begin operating an OTC before a licensing inspection is completed must submit specified materials to DHS. (Sec. 4)

4.   Subjects an OTC that is exempt from licensure and that has the same governing authority as a licensed hospital to reasonable inspection by DHS if DHS receives a complaint that patient harm is occurring at that OTC. (Sec.4)

5.   States that a substantiated complaint that harm is occurring at an exempt OTC is a violation against the hospital's license. (Sec. 4)

6.   Specifies that, notwithstanding any other provisions, one or more licensed OTC's or exempt OTC's that provide specified health-related services may colocate or colocate with one or more licensees, exempt OTC's or licensed counseling facilities and share common areas at the collaborating OTC premises and nontreatment personnel. (Sec. 6)

7.   Allows the governing authority of a collaborating exempt OTC, by agreement, to share nontreatment personnel with one or more exempt health care providers or licensed counseling facilities. (Sec. 7)

8.   Allows treatment areas that are licensed under an OTC to be used by an exempt OTC.       (Sec. 7)

9.   Allows a licensed or exempt OTC to contract with or employ an exempt health care provider to provide health care services to the patients of the licensed or exempt OTC. (Sec. 7)

10.  Includes exempt OTC's in the list of circumstances they may provide behavioral health services at a private office or clinic that is operated by an exempt health care provider.         (Sec. 8)

11.  Requires an exempt OTC to report to DHS of any unexpected death, self-injury or other injuries of a patient under their employees care. (Sec. 8)

12.  Allows unlicensed employees of an exempt OTC to provide services at the private office or clinic of the exempt health care professional only when a licensed health care professional employed by the licensed or exempt OTC is on-site. (Sec. 8)

Miscellaneous

13.  Specifies that patients of private offices and clinics of health care providers that are kept overnight as bed patients or treated under general anesthesia are subject to licensure, supervision, regulation or control of the Director of DHS. (Sec. 3)

14.  Removes the amount of designated satellite facilities that are located farther than one-half mile from the main hospital building that can be included on a single group license issued by DHS at the request of an applicant or licensee. (Sec. 4)

15.  Removes the amount of designated satellite facilities that are located farther than 35 miles from the main hospital building that can be included on a single group license issued by DHS, at the request of an applicant or licensee. (Sec. 4)

16.  Defines terms. (Sec. 2, 5)

17.  Modifies the definitions of associated licensed provider, collaborating OTC and colocator to include an exempt OTC. (Sec. 5)

18.  Makes technical and conforming changes. (Sec. 1, 3, 4, 5, 6, and 7)

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22.                    HB 2450

23.  Initials AG Page 0 House Engrossed

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