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ARIZONA STATE SENATE
Fifty-Fifth Legislature, Second Regular Session
AMENDED
group home monitoring; complex needs
Purpose
Establishes the Developmental Disabilities Group Home Monitoring Program (Program) within the Department of Economic Security (DES). Appropriates $1.2 million from the state General Fund (state GF) in FY 2023 to DES for administering the Program.
Background
The Independent Oversight Committee on Persons with Developmental Disabilities (Committee) was established within the Arizona Department of Administration (ADOA) to promote the rights of clients who are receiving developmental disabilities services from ADOA (A.R.S. § 41-3801). The Committee must provide independent oversight to: 1) ensure that the rights of clients are protected; 2) review incidents of possible abuse, neglect or denial of a client's rights; and 3) make recommendations to the director of any department and service provider subject to oversight and to the Legislature regarding laws, rules, policies, procedures and practices to ensure the protection of the rights of clients receiving behavioral health and developmental disability services. The Committee must submit written objections to specific problems or violations of client rights by ADOA or a service provider through the ADOA Director for review by the director of the department that is responsible for the client. The director of the responsible department must deliver to the Committee a detailed written response to each written objection within 21 calendar days after receiving the objection from ADOA (A.R.S. § 41-3804).
The Committee must
issue an annual report of its activities and recommendations, if any, to the:
1) ADOA Director; 2) DES Director; 3) Department of Child Safety (DCS)
Director;
4) Department of Health Services (DHS) Director; 5) Arizona Health Care Cost
Containment System (AHCCCS) Director; 6) President of the Senate; 7) Speaker of
the House of Representatives; and 8) Chairpersons of the Senate and House of
Representatives Health and Human Services (HHS) Committee, or their successor
committees (A.R.S.
§ 41-3804).
The Developmentally Disabled Assistance and Bill of Rights Act (Act) was established with the goal of providing individuals with developmental disabilities with the necessary information, skills, opportunities and support to: 1) make informed choices and decisions about their lives; 2) live in homes and communities in which such individuals can exercise their full rights and responsibilities as citizens; 3) pursue meaningful and productive lives; 4) contribute to their families, communities, the states and the United States; 5) have interdependent friendships and relationships with other people; 6) live free of abuse, financial and sexual exploitation, neglect and violations of their legal and human rights; and 7) achieve full integration and inclusion in society, in an individualized manner, consistent with the unique strengths, resources, priorities, concerns, abilities and capabilities of each individual (42 U.S.C. § 15001).
S.B. 1309 appropriates $1.2 million from the state GF in FY 2023 to DES for the Program.
Provisions
Program
1. Establishes the Program within DES.
2. Appropriates $1.2 million from the state GF in FY 2023 to DES for administering the Program and exempts the appropriation from lapsing.
3. Requires DES to oversee the Program and contract with the entity that has been designated by the state to conduct the Program and to operate the protection and advocacy system for persons with developmental disabilities in Arizona, in accordance with the Act.
4. Requires the Program designated entity to:
a) investigate quality of care complaints concerning any group home funded by DES; and
b) compile a comprehensive report of all observations and outcomes during the preceding year.
5. Requires the Program designated entity to monitor, in-person, the group homes that provide services to clients with complex needs to determine, at a minimum, whether:
a) the client with complex needs receives the services identified in the client's person-centered service plan, including medication monitoring and habilitation treatment, as applicable;
b) the provision of services identified in the person-centered service plan of the client with complex needs has been effective in addressing the client's complex needs;
c) the services have resulted in a reduction in behaviors that interfered with the ability of the client with complex needs to live safely in the community; and
d) all physical interventions have complied with the behavioral treatment plan of the client with complex needs and applicable state laws.
DES Report
6. Requires, by July 1, 2023, DES to provide an annual report to the:
a) Chairpersons of the Senate and House of Representatives HHS Committees, or their successor committees;
b) Directors of AHCCCS and DHS;
c) designated entity conducting the Program; and
d) Secretary of State (SOS).
7. Requires the DES annual report to include:
a) the number of incident reports;
b) the number of Medicaid fraud investigations of group home service providers;
c) the number of group home contracts by service provider;
d) the annual amount the division paid the service provider for each group home contract;
e) the cost per client by service provider;
f) the number of any type of contract sanction; and
g) the number of service providers from whom the division recouped payments for group home services in the preceding year.
8. Requires the DES group home report to include the number of incident reports:
a) that were received from group homes in the preceding two years;
b) that resulted in any type of contract sanction;
c) that involved medication errors;
d) that resulted in changes to a behavioral treatment plan;
e) that required additional staff training;
f) that involved law enforcement; and
g) aggregated by service provider and individual group home.
9. Requires the designated entity, by December 31, 2023, and each year thereafter, to provide a copy of the report to the SOS and to report the observations and outcomes of the Program to:
a) the Governor;
b) the President of the Senate; and
c) the Speaker of the House of Representatives.
10. Requires the report from the designated entity to include:
a) systemic issues that were identified;
b) the quality of services being provided to persons with developmental disabilities who have complex needs in Arizona; and
c) any recommendations for service improvements.
Miscellaneous
11. Requires DES, by January 1, 2023, to establish an expedited referral system to ensure that quality of care complaints are transferred to the designated entity for investigation.
12. Requires, if the designated entity substantiates an allegation in a quality-of-care complaint, the information to be provided to DES and the Committee.
13. Defines client with complex needs as a client with dual disorders, including psychiatric disorders and developmental disabilities, who engages in behaviors that:
a) are disruptive;
b) are socially inappropriate;
c) are harmful or dangerous to self or others;
d) interfere with functioning and quality of life; or
e) may cause destruction of property.
14. Becomes effective on the general effective date.
Amendments Adopted by Committee
1. Removes the requirement that the Program designated entity visit each group home with clients identified as being at higher risk for abuse or neglect at least once every four months.
2. Removes the specification that a client is considered as being at higher risk of abuse or neglect if:
a) the client has experienced a destabilizing event such as hospitalization, emergency medical treatment, arrest, abuse or neglect in the past year;
b) the client has been the subject of an adult protective services or DCS referral in the past year; or
c) the client's guardian is the public fiduciary.
Senate Action
HHS 2/2/22 DPA 8-0-0
Prepared by Senate Research
February 3, 2022
MM/MC/sr