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ARIZONA STATE SENATE
Fifty-Sixth Legislature, First Regular Session
DHS; licensure; group homes
Purpose
Requires, beginning July 1, 2024, behavioral-supported group homes to be licensed for the health and safety through the Department of Health Services (DHS).
Background
DHS licenses group homes for persons with developmental disabilities for health and safety. DHS establishes requirements for group homes through the Division of Developmental Disabilities (DDD) within the Department of Economic Security (DES). DHS must issue a license to an accredited facility for a three-year accreditation period. DHS may conduct an inspection of an accredited facility to ensure that the facility meets health and safety licensure standards (A.R.S. §§ 36-132 and 36-591)
A group home is a community residential setting for not more than six persons with developmental disabilities that is operated by a service provider under DES contract and that provides room and board, daily habilitation and other assessed medically necessary services and supports to meet the needs of each person. A group home does not include an adult developmental home, a child developmental home or an intermediate care facility for individuals with intellectual disabilities (A.R.S. § 36-551).
Each licensed premises of a health care institution must have its own accreditation report. The Director of DHS (DHS Director) may accept proof that a health care institution is an accredited hospital or is an accredited health care institution, in lieu of all required compliance inspections, if the DHS Director receives a copy of the institution's accreditation report for the licensure period and the institution is accredited by an accrediting organization approved by the Secretary of the U.S. Department of Health and Human Services. The DHS Director may not accept an accreditation report in lieu of a compliance inspection of an intermediate care facility for individuals with intellectual disabilities or a health care institution if the health care institution has been subject to an enforcement action within the year preceding the annual licensing fee anniversary date (A.R.S. § 36-424).
If there is a cost associated with the licensing of behavioral-supported group homes by DHS, there may be a fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Requires, beginning July 1, 2024, behavioral-supported group homes that are operated by a service provider in Arizona and that are contracted with DES to be licensed for health and safety by DHS.
2. Requires the Director of DES to adopt rules regarding behavioral-supported group homes that include:
a) ensuring that each client has a functional behavioral assessment completed by a qualified clinical professional, in consultation with a multidisciplinary team and an integrated treatment plan that is reviewed by the multidisciplinary team every 90 days to determine if the plan interventions are effective;
b) ensuring that each client's behavioral treatment plan is developed, integrated, coordinated and monitored by a clinical professional;
c) ensuring that each client has an integrated treatment plan; and
d) requiring that the direct care staff in a behavioral-supported group home, at a minimum, have:
i. at least one year of experience working directly with persons with dual disorders, including psychiatric disorders and developmental disabilities, who engage in behaviors that are disruptive, socially inappropriate, harmful or dangerous to self or others, interfere with functioning and quality of life or that may cause destruction of property; and
ii. specialized training in applied behavior analysis and positive behavioral supports.
3. Requires, in the adopted rules for behavioral-supported group homes, a clinical professional to:
a) have at least two years of experience working directly with persons with dual disorders, including psychiatric disorders and developmental disabilities, who engage in behaviors that are disruptive, socially inappropriate, harmful or dangerous to self or others, interfere with functioning and quality of life or that may cause destruction of property;
b) have specialized training in applying behavioral interventions, including applied behavior analysis and positive behavioral supports; and
c) hold at least a master's degree in occupational therapy, physical therapy, psychology, social work, speech and language pathology, behavior analysis or a similar human service degree such as sociology, special education or rehabilitation counseling.
4. Allows the multidisciplinary team to include, if appropriate, the:
a) psychiatric, medical, nursing and nutrition providers;
b) physical, occupational and speech therapists;
c) educational personnel;
e) client;
f) client's family or guardian;
g) behavioral health providers;
h) group home direct care staff;
i) home health personnel; and
j) representatives from DDD.
5. Requires the integrated treatment plan to be reviewed by the entire multidisciplinary team every 90 days to determine if the interventions in the plan are effective.
6. Requires DDD to notify DHS of service providers that it enters into contracts with for behavioral-supported group homes.
7. Requires DHS to immediately notify DDD:
a) when the license of a behavioral-supported group home has been denied, suspended or revoked; and
b) of any other licensing action taken on a behavioral-supported group home.
2. Requires DES to take any necessary action to carry out its licensure duties, including denying the application for licensure and suspending or revoking a behavioral-supported group home's license.
8. Prohibits the DHS Director from accepting an accreditation report in lieu of a compliance inspection of a nursing-supported group home.
9. Defines behavioral-supported group home as a community residential setting that:
a) is for up to six persons with developmental disabilities;
b) is operated by a service provider under DES contract; and
c) provides room and board, daily habilitation, assistance in self-administering medication and medication administration and behavioral health services for clients with dual disorders, including psychiatric disorders and developmental disabilities, who engage in behaviors that are disruptive, socially inappropriate, harmful or dangerous to self or others, interfere with functioning and quality of life or that may cause destruction of property.
10. Clarifies that, in the definition of a group home, a behavioral-supported group home is not a group home.
11. Defines behavioral treatment plan as a document that stipulates goals to treat, manage, control or extinguish predictable and continuing behaviors of the client and that is one component of the client's integrated treatment plan.
12. Defines integrated treatment plan as a document that coordinates all treatment interventions that address the client's physical health and behavioral health needs for the purpose of ensuring seamless, coordinated and comprehensive treatment.
13. Exempts DHS and DES from statutory rulemaking requirements for 18 months for purposes of licensing and regulating behavioral-supported group homes.
14. Makes technical and conforming changes.
15. Becomes effective on the general effective date.
House Action
HHS 2/13/23 DP 9-0-0-0
RA 2/15/23 DP 7-0-0-0
3rd Read 2/22/23 50-10-0
Prepared by Senate Research
March 10, 2023
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