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ARIZONA STATE SENATE
Fifty-Sixth Legislature, First Regular Session
AMENDED
mental health coverage; collaborative care
(NOW: collaborative care; appropriation)
Purpose
Establishes the Collaborative Care Uptake Fund (Fund) and directs the Department of Health Services (DHS) to award grants to outlined primary care physicians and technical assistance centers to aid primary care physicians on providing services through the collaborative care model. Appropriates $1,000,000 from the state General Fund (state GF) in FY 2024 to the Fund and from the Fund to DHS.
Background
DHS is established to protect the physical and mental health of Arizona’s children and adults. DHS's responsibilities include: 1) the licensure and regulation of health care and child care facilities and certain health care professionals; 2) disease control; 3) immunization education and promotion; 4) emergency preparedness; 5) emergency medical services; 6) the state laboratory; 7) the state hospital; 8) public health statistics; 9) radiation regulatory programs; and 10) vital records which include birth and death certificates (A.R.S. Title 36).
The Psychiatric Collaborative Care Model is a specific model for behavioral health integration that is typically provided by a primary care team consisting of a primary care provider and a care manager who works in collaboration with a psychiatric consultant, such as a psychiatrist. The primary care team directs the patient's care, which includes structured care management with regular assessments of clinical status using validated tools and modifying treatment as necessary. The psychiatric consultant regularly consults the primary care team to review the clinical status and care of the patient and makes recommendations (81 FR 220).
S.B. 1018 appropriates $1,000,000 from the state GF in FY 2024 to the Fund and from the Fund to DHS.
Provisions
1. Establishes the Fund in DHS consisting of monies appropriated by the Legislature.
2. Subjects monies in the Fund to legislative appropriation.
3. Stipulates that the monies in the Fund do not revert to the state GF.
4. Appropriates $1,000,000 from the state GF in FY 2024 to the Fund and from the Fund to DHS.
5. Exempts the appropriation from lapsing.
6. Requires DHS to use the Fund monies:
a) to make grants to primary care physicians who are in a medical practice with not more than 50 employees to meet the initial costs of establishing and delivering behavioral health integration services through the collaborative care model; and
b) for technical assistance grants to collaborative care technical assistance centers.
7. Allows a primary care physician that receives a grant from the Fund to use the monies to:
a) hire staff;
b) identify and formalize contractual relationships with other health care practitioners, including health care practitioners who will function as psychiatric consultants and behavioral health care managers in providing behavioral health integration services through the collaborative care model;
c) purchase or upgrade software and other resources needed to appropriately provide behavioral health integration services through the collaborative care model, including resources needed to establish a patient registry and implement measurement-based care; and
d) for any other purposes DHS prescribes as necessary to support the collaborative care model.
8. Requires DHS to solicit proposals from and enter into grant agreements with eligible collaborative care technical assistance center applicants to provide technical assistance to primary care physicians on providing behavioral health integration services through the collaborative care model.
9. Requires, in the grant application, each collaborative care technical assistance center applicant to provide information on how the collaborative care technical assistance center will meet the prescribed assistance requirements in order to be eligible for a grant.
10. Requires a collaborative care technical assistance center that receives a grant to provide technical assistance to primary care physicians and assist the primary care physicians with the following:
a) developing financial models and budgets for program launch and sustainability based on practice size;
b) developing staffing models for essential staff roles, including care managers and consulting psychiatrists;
c) providing information technology expertise to assist with building the model requirements into electronic health records, including assistance with care manager tools, patient registry, ongoing patient monitoring and patient records;
d) providing training support for all key staff and operational consultation to develop practice workflows;
e) establishing methods to ensure the sharing of best practices and operational knowledge among primary care physicians who provide behavioral health integration services through the collaborative care model; and
f) for any other purposes DHS prescribes as necessary to support the collaborative care model.
11. Defines collaborative care model as the evidence-based, integrated behavioral health service delivery method that is described as the psychiatric collaborative care model in 81 Federal Register 80230, that includes a formal collaborative arrangement among a primary care team consisting of a primary care physician, a care manager and a psychiatric consultant and that includes the following elements:
a) care directed by the primary care team;
b) structured care management;
c) regular assessments of clinical status using developmentally appropriate, validated tools; and
d) modification of treatment as appropriate.
12. Defines collaborative care technical assistance center as:
a) a health care organization that can provide educational support and technical assistance related to the collaborative care model; and
b) includes an academic medical center.
13. Defines terms.
14. Becomes effective on the general effective date.
Amendments Adopted by Committee
· Adopted the strike-everything amendment.
Senate Action
COM 2/16/23 DPA/SE 5-1-1
Prepared by Senate Research
March 10, 2023
JT/FB/sr