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ARIZONA STATE SENATE
Fifty-Seventh Legislature, First Regular Session
AMENDED
appropriation; secure behavioral health facilities
Purpose
Appropriates $25,000,000 from the state General Fund (state GF) to the Arizona Health Care Cost Containment System (AHCCCS) to distribute for secure behavioral health residential facilities (SBHRF). Requires appropriated monies to be used either to construct new SBHRFs or to retrofit existing buildings for use as SBHRFs. Outlines reporting requirements, and metrics and outcomes that each SBHRF must measure and evaluate.
Background
Beginning January 1, 2024, if a factfinder finds that a defendant is dangerous and should be involuntarily committed to treatment, the court must dismiss the charges against the defendant without prejudice and commit the defendant to a secure state mental health facility (Laws 2022, Ch. 352; A.R.S. § 13-4521). A secure state mental health facility is an SBHRF that is licensed by the Department of Health Services to provide secure 24 hour on-site supportive treatment and supervision by staff with behavioral health training for persons who have been determined to be seriously mentally ill, chronically resistant to treatment for a mental disorder and who are placed in the SBHRF pursuant to court order (A.R.S. §§ 13-4501 and 36-425.06).
Laws 2022, Chapter 313 appropriated $25,000,000 to AHCCCS to support five SBHRFs to provide secure on-site supportive treatment to persons who are determined to be seriously mentally ill, chronically resistant to treatment and placed in an SBHRF pursuant to court order. Appropriations for construction or other permanent improvements do not lapse until the purpose for which the appropriation was made has been accomplished or abandoned, unless the appropriation is available during the entire fiscal year without an expenditure from or encumbrance on the appropriation (A.R.S. § 35-190). In FY 2024, the $25,000,000 appropriation made to AHCCCS in FY 2023 was reduced to remove funding for the construction of SBHRFs (Laws 2023, Ch. 133).
S.B.1442 appropriates $25,000,000 from the state GF in FY 2026 to AHCCCS.
Provisions
1. Appropriates $25,000,000 from the state GF in FY 2026 to AHCCCS to distribute for SBHRFs.
2. Requires AHCCCS, in consultation with the Arizona Department of Administration (ADOA), to issue a request for proposals for the SBHRFs by January 1, 2026.
3. Requires SBHRFs to provide secure on-site supportive treatment to persons who are placed under court order and determined to be either:
a) seriously mentally ill and chronically resistant to treatment; or
b) dangerous, incompetent to stand trial and not restorable.
4. Prohibits a recipient SBHRF from providing treatment, at the same facility, to both civilly committed persons and committed person who are found dangerous, incompetent to stand trial and not restorable in a criminal proceeding.
5. Requires an entity that receives a distribution of the appropriated monies to use the monies only to:
a) construct a new SBHRF; or
b) retrofit an existing building to become an SBHRF, subject to prior approval from AHCCCS.
6. Requires AHCCCS, when determining which entities will receive appropriated monies, to:
a) prioritize SBHRFs that can operate within 12 months of the general effective date;
b) prioritize facilities that meet the geographic needs of Arizona;
c) consider an entity's experience in operating behavioral health facilities; and
d) consider the benefits of selecting one entity or multiple entities to receive appropriated monies.
7. Requires each SBHRF that receives an allocation of funds from AHCCCS to use prescribed quantitative and qualitative methods to measure and evaluate:
a) clinical outcomes, including measurements of positive and negative symptoms, medication adherence, hospital admissions, psychiatric hospital admissions, emergency room visits and incidents of self-harm;
b) independent living functional and social outcomes, including the management of personal hygiene, meal preparation and participation in volunteerism, job training, employment or education programming;
c) program-specific metrics, including attendance and participation in therapy sessions, group activities and psychoeducation programs, readmission rates and successful transitioning to less intensive care; and
d) physical health, including weight, body mass index, blood pressure and heart rate.
8. Requires AHCCCS to report the outlined quantitative and qualitative measures and evaluations, by September 30 following each fiscal year in which monies allocated for the construction and support of SBHRFs are used, to the:
a) Governor;
b) President of the Senate;
c) Speaker of the House of Representatives; and
d) Secretary of State
9. Requires AHCCCS to redact personal identifying information from the outlined quantitative and qualitative measures and evaluations in each report.
10. Exempts the appropriation from lapsing.
11. Becomes effective on the general effective date.
Amendments Adopted by Committee of the Whole
1. Replaces the specification that the appropriated monies be used for the support and construction of five SBHRFs with the requirement that the appropriated monies be used to:
a) construct new SBHRFs; or
b) retrofit existing buildings to become SBHRFs, subject to prior approval from AHCCCS.
2. Requires AHCCCS, in consultation with ADOA, to issue a request for proposals for the SBHRFs by January 1, 2026.
3. Removes the allocation limit of $5,000,000 for each recipient SBHRF.
4. Removes the requirement that a total of five recipient SBHRFs be placed across the three geographic service areas as outlined.
5. Prohibits a recipient SBHRF from treating civilly committed patients at the same SBHRF as patients who are committed after being found dangerous, incompetent to stand trial and not restorable in a criminal proceeding.
6. Adds to the factors that AHCCCS must consider when determining to which entity or entities to distribute appropriated monies.
7. Requires AHCCCS to redact personal identifying information from the outlined reports.
8. Makes technical and conforming changes.
Senate Action
HHS 2/12/25 DP 7-0-0
APPROP 2/18/25 DP 8-1-1
Prepared by Senate Research
March 6, 2025
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