Accomplishments

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

View House Bill 2897

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.

Main points in the bill

• Permits virtual mental health hearings for court proceedings involving mental health evaluation or treatment.
• Allows witness testimony by audiovisual means in specified circumstances, so a person can testify remotely rather than being physically in the courtroom.
• Keeps the hearing in the court system / Title 36 mental health process, but modernizes the process so transport and in-person appearance are not always required.

Why it matters in practice

For Arizona’s civil commitment / Title 36 process, this could make it easier to:

• hold hearings when a patient is in a hospital or treatment setting,
• avoid transportation delays and security/logistics issues,
• get psychiatrists or other witnesses to appear without traveling to court,
• move cases more quickly when in-person appearances are difficult.

The key changes

1. Guardians must be notified before early release/discharge
   • If a patient under court-ordered treatment is going to be released before the court-ordered treatment period ends, the mental health treatment agency’s medical director must give notice to the patient’s guardian.
   • The bill makes the guardian a required recipient of notice; the guardian does not have to separately file a demand for notice in order to receive it.
2. 10-day notice to the guardian in certain release situations
   • If a patient under guardianship no longer needs the current inpatient level of care, the medical director must notify the guardian at least 10 days before the intended release date.
3. Guardian is added to the list of people who get notice before a patient is released early from court-ordered treatment
   • Before a patient is released or discharged before the treatment order expires, the medical director must notify:
     • the court,
     • certain relatives/victims/persons entitled to notice, and
     • the patient’s guardian.
4. The guardian can ask the court to review whether release is appropriate
   • During the notice period, a person entitled to notice — now including the guardian — may make a motion asking the court to determine whether the legal standard for early release has actually been met.
5. Special notice rules still apply in prosecutor-filed / danger-to-others cases
   • For cases involving a prosecutor-filed petition under A.R.S. § 13-4517 or a patient treated as a danger to others, the medical director must still give the required notice before release/discharge, and the court/prosecutor continues to receive notice under those provisions. SB 1243 does not remove those protections; it adds the guardian into the notice framework.

Key changes in the bill

1) Someone else can request a review on the patient's behalf

Before, the law focused on the patient requesting judicial review. HB 2923 expressly allows either:

• the patient receiving court-ordered treatment, or
• any person acting on the patient’s behalf

to ask the court to review whether the patient still needs continued court-ordered treatment.

2) It clarifies that judicial review is separate from habeas corpus

The bill states that these judicial review rights are in addition to the existing right to seek a writ of habeas corpus. So the patient keeps both avenues for challenging continued treatment.

3) It sets timing limits on when review can be requested

HB 2923 changes the timing rules for judicial review requests:

• No judicial review request earlier than 90 days after the original court-ordered treatment order is entered.
• After a court rules on a prior judicial review request, a later request generally cannot be made for at least 60 days, subject to exceptions.

4) It keeps the process flexible for submitting the request

A written request for judicial review may be given to any member of the treatment staff at the mental health treatment agency providing the patient’s care, rather than requiring a more formal route through a particular person.

5) It limits judicial review when another AHCCCS administrative remedy exists

The bill says judicial review is not available for issues that already have an administrative remedy under AHCCCS rules. In practice, that means if the dispute is one that shoulent’s behalfd be handled through an AHCCCS administrative process, the court-review route under this statute is not the right vehicle for that issue.

What the bill does

1) Lets Arizona State Hospital temporarily take certain dangerous, incompetent defendants on the forensic campus

Until December 31, 2031, if a person has already been:

• found dangerous and incompetent under the criminal competency statutes,
• ordered committed to a secure state mental health facility, and
• no secure facility bed is available in Arizona,

then the Arizona State Hospital (ASH) may accept that person on its forensic campus if all of the following are true:

• the person has already received at least 12 months of restoration services, and
• the person has a primary psychiatric condition.

2) Keeps the person in secure custody until one of two things happens

The court order must require the defendant to remain committed until either:

• the court finds the person is competent to stand trial, or
• the court finds the person is no longer dangerous.

3) Gives ASH authority to treat and manage safety/security

The bill allows the court order to authorize ASH to:

• provide necessary treatment, including medications as clinically indicated, and
• use a standing order for restraints when needed to maintain facility safety and security.

4) Requires transfer to a secure state mental health facility once one is licensed/available

If Arizona licenses a secure state mental health facility for these defendants, ASH must coordinate transfer of defendants placed under this temporary mechanism to that secure facility as soon as practicable.

5) Makes DHS pay the cost

The bill puts the cost of care for these defendants on the Arizona Department of Health Services (DHS), including non-psychiatric/non-mental-health services provided during the admission.

6) Limits how many small-county defendants ASH can take under this workaround

ASH may not accept more than one such defendant from a county with a population under 400,000 under this provision.

7) Requires a study committee on secure state mental health facilities

The bill also creates a legislative study committee on secure state mental health facilities to examine the issue and make recommendations, including capacity and placement questions for this population.

SB 1113 does not change the legal standard for court-ordered evaluation or treatment. Instead, it changes who may serve the paperwork and how service is documented. The practical goal is to make the involuntary evaluation/treatment process move more efficiently.

Main changes in the bill

1) An evaluation agency can serve the papers if the court authorizes it

Before, service of process in these cases was generally handled through more traditional service methods. SB 1113 allows the court, in a proceeding for court-ordered evaluation or court-ordered treatment, to authorize an evaluation agency to serve the required documents on the patient.

2) The bill applies to key mental health court documents

The documents that can be served under this process include the materials tied to a petition for court-ordered evaluation or treatment, such as the petition and notice of the hearing or related court paperwork required under the mental health statutes.

3) Proof of service must be filed with the court

The person who serves the documents must file proof of service with the court, showing the date, time, and manner of service. That creates a record that the patient received the required notice.

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.

View Bill History for HB2152

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.

Bill History for HB2059

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).

View Senate Bill 1396

• 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.

SB 1813, Arizona State Hospital admissions bill, would have:

• required Arizona State Hospital (ASH) to base admissions on clinical need,
• prohibited ASH from limiting admission based on a patient’s county of residence, and
• required a patient found to meet ASH admission criteria to be admitted within 60 days.

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

Public Safety Guardianships

Housing Trust Fund; Unclaimed Property