Accomplishments

Provides 1 million dollars for case management in the appropriation budget.

https://www.azleg.gov/legtext/56leg/2R/bills/HB2897H.pdf

Enhances oversight and support for individuals with SMI by:

• Mandating peer specialists to complete training with psychosis-specific content.
• Requiring inpatient facilities to provide a comprehensive list of medications to patients with SMI upon discharge.
• Directing AHCCCS to study the implementation of real-time surveys for SMI members to gather feedback and improve service quality.
• Establishing guidelines to protect personal health information of members with SMI.

AHCCCS must report annually on SMI services & outcomes.

People with SMI + substance use still eligible for mental health treatment.

SMI patients who are incompetent/dangerous placed in secure, 16-bed facilities.

Enhances rights of guardians and agents in involuntary treatment processes, ensuring they are notified of petitions, can participate in treatment planning, and clarifying procedures for court-ordered evaluations.

Creates secure commitment & release process for incompetent/dangerous defendants.

Makes it easier for courts & doctors to place patients in ASH when needed.

Seals records of court-ordered treatment.

Allows courts to appoint a guardian ad litem to evaluate if a criminal defendant deemed incompetent requires a guardian or conservator.

Superior Court now reviews GEI (Guilty Except Insane) discharges from ASH.

This bill addressed reforms to the Psychiatric Security Review Board (PSRB). ACMI was actively involved in shaping this legislation.

Enhances oversight and evaluation of mental health services by:

• Expanding AHCCCS's powers to monitor and evaluate contractors and agencies providing mental health services.
• Requiring the collection and reporting of detailed data and outcomes related to members with a serious mental illness designation.
• Establishing new requirements for the retention and documentation of applications for emergency admission and releases from emergency evaluation.
• Creating a workgroup to develop recommendations on improving the availability and transparency of information related to members with a serious mental illness designation.

Key Provisions

1. Protection of Personal Health Information (36-2903.14)

• AHCCCS must require its contracted housing program administrators to reduce duplicative paperwork and limit unnecessary sharing of personal health information for members with serious mental illness (SMI).

• Housing administrators are prohibited from selling or sharing personal health information, except when legally required under state or federal law (including HIPAA).

2. Peer Specialists (36-2903.15)

• AHCCCS must develop processes to ensure contractors oversee peer specialists effectively, verifying qualifications, supervision, and training.

• Beginning October 1, 2025, peer specialists must complete AHCCCS-developed training that includes psychosis-specific content, such as anosognosia.

• AHCCCS must submit an annual report (starting November 1, 2024) to the Governor and Legislature on the development, implementation, and monitoring of peer support processes.

3. Discharge Medication Lists (36-2903.16)

• Behavioral health facilities discharging patients with an SMI designation must provide a complete, accurate medication list (psychiatric, nonpsychiatric, prescription, and over-the-counter).

• This list must be given to the patient or representative and the receiving care provider to ensure continuity of care.

4. SMI Member Survey Study (Sec. 2)

• By January 31, 2025, AHCCCS must study the feasibility of implementing a real-time, automated survey for SMI members (or representatives) to gather feedback and identify care issues.

• The study must involve public input (including individuals with SMI and their families) and report to the Joint Legislative Budget Committee and health committee chairs on development and cost estimates.

5. Inpatient Psychiatric Discharge Requirements (Sec. 3)

• AHCCCS must create clear requirements and processes for discharging SMI members from inpatient psychiatric facilities.

• Rules must ensure continuity of care, including verification of medication types, doses, schedules, and administration routes, aligned with the patient’s treatment plan, by qualified treatment team members.

Chapter 0200 - 562R - H Ver of SB1609

HB 2152 (2019) – Reporting Requirement
The Arizona Health Care Cost Containment System (AHCCCS) must report to the chairs of the Senate Health and Human Services Committee and the House Health Committee (or their successors) on the availability and use of behavioral health residential facility (BHRF) beds and supportive housing beds for adults with a serious mental illness. The report must include:

1. Average length of stay in each type of residential bed.

2. For each type of bed, the number of residents arrested by law enforcement while living there.

3. The number of beds with 24/7 on-site staff providing support and supervision.

4. The number of residents who leave a facility or housing program against the advice of their treatment team.

https://apps.azleg.gov/BillStatus/BillOverview/71247?Sessionid=121

 

HB 2059 (2019) — Summary of IOC Provisions

• The bill updates A.R.S. §§ 41-3803 and 41-3804 governing Independent Oversight Committees (IOCs) to strengthen transparency, oversight, and public access.

• Each region served by a Regional Behavioral Health Authority (RBHA) must have at least one IOC.

• IOCs must include between 7 and 15 members, with expertise in fields like psychology, law, medicine, mental health, housing, criminal justice, or public safety. They must include at least one current or former behavioral health client.

• IOCs are empowered to hold community forums to solicit feedback from individuals with mental illness, caregivers, and families concerning their experience across the behavioral health system.

• The Department must ensure that RBHAs and service providers implement a human rights training plan so that all providers understand client rights and the role / duties of IOCs.

• IOCs and the Department are required to post the IOC’s annual report on their websites, increasing public access to oversight findings.

• The oversight of the Arizona State Hospital is explicitly expanded: the IOC for that hospital must cover oversight of both civil and forensic patients at the State Hospital.

• The bill mandates that IOCs adopt operational guidelines (terms, quorum, removal procedures) subject to Department approval, and that IOCs meet at least quarterly each year.

https://apps.azleg.gov/BillStatus/BillOverview/71106?SessionId=121

SB1396 required the Arizona Health Care Cost Containment System (AHCCCS) to submit a report, by December 1, 2018, to the chairs of the Senate Health and Human Services Committee and the House Health Committee.

The report had to detail the current number of behavioral health residential facility beds and supportive housing beds available statewide for adults determined to have a serious mental illness (SMI).

https://www.azleg.gov/legtext/53leg/2R/laws/0151.pdf

• The legislation renames “Human Rights Committees” (HRCs) as Independent Oversight Committees (IOCs).

• It reassigns these IOCs from being under multiple agencies (ADES, AHCCCS, DCS) to being under the Arizona Department of Administration (ADOA).

• It limits the number of current or former provider representatives (i.e., people working in service provision) who can serve on each IOC focused on the mentally ill to two.

• The bill took effect on August 3, 2018.

Amends procedures for mental health evaluations by:

• Providing additional rights for persons detained for evaluation or treatment, including visitation, telephone access, correspondence, and religious freedom.
• Expanding requirements for applications for court-ordered evaluations, including information on the proposed patient's history, willingness to undergo voluntary evaluation, and potential safety concerns.
• Clarifying consent requirements for voluntary inpatient and outpatient evaluations.
• Requiring evaluation agencies to solicit and consider information from individuals with a significant relationship to the proposed patient during the evaluation process.
• Adding provisions related to petitions for court-ordered treatment, including allowing for a determination of chronic treatment resistance.

Allows use of non-police transport for SMI patients (more humane).

Continued funding and tracking for reentry program.

Counties must evaluate & treat inmates showing mental illness.

Up to 500 released inmates with SMI get services (housing, case management).

Bans retaliation, requires clinical improvement plan at ASH.

Removes 55-patient cap for Maricopa County in ASH (Vetoed).

Summary of HB 2754 (2019)

Secure Behavioral Health Residential Facilities and Court-Ordered Treatment

1. Licensing of Secure Behavioral Health Residential Facilities

• The Department must license secure facilities that provide 24/7 on-site supportive treatment and supervision by trained behavioral health staff.

• These facilities are only for adults with serious mental illness (SMI) who are chronically resistant to treatment and are placed there by court order under § 36-550.09.

• Each facility is capped at 16 beds and may not serve other populations.

• “Secure” means restricting patient exit only as much as needed to comply with the court-ordered treatment plan.

2. Court Options for Treatment (36-540 amendments)

• Courts must consider the least restrictive treatment alternative when ordering care for someone with a mental disorder who poses a danger to self/others or has a disability.

• Options include outpatient, combined inpatient/outpatient, or inpatient treatment.

• Courts may now specifically order placement in a licensed secure behavioral health residential facility for eligible individuals.

• Orders are time-limited (up to 365 days for grave disability, 180 days for danger to others or persistent/acute disability, 90 days for danger to self).

• The statute also addresses outpatient noncompliance, emergency transfers, and the ability to amend orders for inpatient care.

3. Community Residential Treatment Services (36-550.05 amendments)

• Programs must be small, homelike, and include:

  • Short-term crisis residential treatment,

  • Longer-term residential treatment (up to 2 years),

  • Secure residential programs for SMI individuals resistant to treatment (newly added),

  • Semi-supervised group living, and

  • Day/socialization programs.

• Emphasis is on prevention services, independence, and integration into the community.

4. New Statute § 36-550.09

• Establishes the legal framework for court-ordered placement into secure behavioral health residential facilities.

• HB 2754 is a budget reconciliation bill relating to health and welfare for the 2019–2020 fiscal years.

• Among its many provisions, it created or codified A.R.S. § 36-2903.13, which requires AHCCCS to provide an annual report on inpatient psychiatric treatment capacity.

• The report must cover metrics such as:
    • the number of inpatient psychiatric treatment beds available in the state,
    • occupancy rates,
    • out-of-state utilization, and
    • trends in demand and placement.

• $3.5M for building secure residential facilities for SMI.

• The legislation’s passage on May 31, 2019 made these statutory changes effective as part of the 2019 law package.

Legislative support for community-based SMI treatment.

Clarifies who pays for voluntary mental health evaluations.

Makes it easier for patients to get prescribed mental health drugs.

Courts can order intensive treatment (case management, housing, transportation) for chronically resistant SMI patients.

No Death Penalty for SMI

Enhanced services

Court-ordered treatment; enhanced services; appropriation

Tax incentive for employers hiring SMI individuals

PSRB hearing reforms

Prisoners; Mental Health Transition Program

Housing Trust Fund; Unclaimed Property

Public Safety Guardianships