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ARIZONA STATE SENATE
Fifty-Fifth Legislature, Second Regular Session
AMENDED
appropriation; DWR;
water efficiency projects
(NOW: group homes; monitoring; reporting; appropriation)
Purpose
Establishes the Developmental Disabilities Group Home Monitoring Pilot 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 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 successor
committees (A.R.S.
§ 41-3804).
The Developmental Disabilities 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 the individuals' lives; 2) live in homes and communities in which such individuals can exercise the individuals' full rights and responsibilities as citizens; 3) pursue meaningful and productive lives; 4) contribute to the individuals' families, communities, the individuals' 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 the individuals' 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).
H.B. 2560 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.
3. Requires DES to oversee the Program for three years 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, by January 1, 2023, the Program designated entity to:
a) investigate quality-of-care complaints received by the designated entity concerning any group home funded by DES; and
b) compile a comprehensive report of all observations and outcomes during the preceding year.
5. Requires, by January 1, 2023, 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.
6. Requires DES to provide education to service providers on the requirements of the Program and the role of the designated entity.
7. Requires the designated entity, by December 31, 2023, and each year thereafter, to report the observations and outcomes of the Program.
8. 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.
9. Requires the designated entity to provide the report to the:
a) Governor;
b) President of the Senate;
c) Speaker of the House; and
d) Secretary of State.
10. Exempts the appropriation from lapsing.
11. Repeals the Program on January 1, 2027.
DES Report
12. Requires, by January 1, 2024, DES to provide an annual report to the:
a) Chairpersons of the Senate and House of Representatives HHS Committees or successor committees;
b) Directors of AHCCCS and DHS;
c) designated entity conducting the Program; and
d) Secretary of State;
13. Requires the DES annual report to include the:
a) number of incident reports that were received from group homes in the preceding two years;
b) total number of times medication was distributed to clients;
c) number of Medicaid fraud investigations of group home service providers;
d) number of group home contracts by service provider;
e) annual amount the Division of Developmental Disabilities (DDD) paid the service provider for each group home contract for the group home services provided;
f) cost per client by service provider;
g) number of any type of contract sanction; and
h) number of service providers from whom the DDD recouped payments for group home services in the preceding year for Medicaid fraud.
14. Requires the DES group home report to include the number of incident reports:
a) categorized by severity level;
b) that resulted in any type of contract sanction, broken down by reason for the sanction;
c) that involved medication errors;
d) that resulted in changes to a behavioral treatment plan;
e) that required additional staff training mandated by the DDD after review of the incident report;
f) that involved law enforcement; and
g) aggregated by service provider and individual group home without identifying the specific location or name of the home.
Quality-Of-Care Complaints Referral System
15. Requires DES, by January 1, 2023, to establish an expedited referral system to ensure that copies of all quality-of-care complaints are forwarded to the designated entity for investigation.
16. Requires DES to identify quality-of-care complaints related to abuse, neglect and client safety as priorities for investigation.
17. Requires, if the designated entity substantiates an allegation in a quality-of-care complaint, the information to be provided to DES, the service provider and the Committee.
Miscellaneous
18. 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.
19. Becomes effective on the general effective date.
Amendments Adopted by Committee
1. Extends, from October 31, 2023, to January 1, 2024, the date by which DES must provide an annual report to outlined persons.
2. Clarifies that all quality-of-care complaints must be forwarded by DES to the designated entity for investigation.
3. Requires DES to identify quality-of-care complaints related to abuse, neglect and client safety as priorities for investigation.
4. Requires a DES-substantiated quality-of-care complaint allegation to be shared with the service provider.
House Action Senate Action
HHS 2/9/22 DPA/SE 8-0-0-0 HHS 3/9/22 DP 7-1-0
3rd Read 2/23/22 43-16-1 APPROP 3/22/22 DPA 9-0-1
Prepared by Senate Research
March 30, 2022
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