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ARIZONA STATE SENATE
Fifty-Fourth Legislature, First Regular Session
AMENDED
independent oversight committees; report; website
Purpose
Outlines requirements for Independent Oversight Committees (IOCs) relating to policymaking and record requests. Directs IOCs and the Arizona Department of Administration (ADOA) to post a copy of each IOC meeting agenda and a copy of the annual report of its activities and recommendations on its website.
Background
Statute establishes IOCs under the ADOA for: 1) persons with developmental disabilities; 2) children, youth and families; and 3) the mentally ill (A.R.S. §§ 41-3801; 41-3802; and 41-3803). Each IOC must adopt guidelines that govern its operation, subject to the approval of the Director of the ADOA (Director). Employees of the Department of Economic Security (DES), the Department of Child Safety (DCS) and the Arizona Health Care Cost Containment System (AHCCCS) are authorized to serve on an IOC, under the condition that they serve only as nonvoting IOC members whose presence is not counted for the purpose of determining a quorum. Each IOC is required to meet at least quarterly and provide independent oversight to: 1) ensure that the rights of clients are protected; 2) review incidents of possible abuse, neglect or denial of a client’s rights; and 3) make recommendations to the Director and the Legislature regarding laws, rules, policies, procedures and practices to ensure the protection of the rights of clients receiving behavioral health and developmental disability services.
IOCs submit, to the Director, written objections to specific problems or violations of clients’ rights by DCS, DES and AHCCCS employees or service providers. Additionally, IOCs are responsible for issuing an annual report to the Director and certain members of the Legislature that includes activities and recommendations for changes. In order to conduct their duties, IOC members have access to client information and specified department, service provider and Regional Behavioral Health Authority records, as appropriate. Records must be released to the IOC without personally-identifiable information, unless the information is necessary for official IOC purposes; however, each person who receives client information must maintain the information as confidential (A.R.S. § 41-3804).
An individual who has a serious mental illness (SMI) is an individual who, as a result of a mental disorder, exhibits emotional or behavioral functioning which is so impaired that it substantially interferes with their capacity to remain in the community without supportive treatment or services of a long-term or indefinite duration. Individuals with SMI experience severe and persistent mental disability that results in a long-term limitation of their functional capacities for daily living activities (A.R.S. § 36-550).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
1. Requires each IOC and the ADOA to post on the ADOA website a copy of each IOC meeting agenda and each IOC's annual report of activities and recommendations.
2. Requires IOCs to issue annual reports to the Directors of DES, DCS, the Department of Health Services (DHS) and AHCCCS.
3. Requires the IOC at the Arizona State Hospital (ASH) to have oversight of SMI patients who are hospitalized and receiving behavioral health services at the civil and forensic hospital.
4. Requires ASH to provide the IOC at ASH information regarding:
a) the seclusion of patients;
b) the use of restraints on patients;
c) incident accident reports;
d) allegations of illegal, dangerous or inhumane treatment of patients;
e) provisions of services to patients in need of special assistance;
f) allegations of neglect and abuse; and
g) allegations of denial of rights afforded to SMI patients, except where a right may be restricted for the safety of the patient, ASH or the public.
5. Requires the Director in conjunction with each IOC to adopt policies relating to the authority and responsibility of IOCs that define the processes and procedures that each IOC, department and service provider that is subject to oversight must follow in fulfilling the purposes of the IOC.
6. Requires the Director to do the following before adopting the policies:
a) post the proposed policies on the ADOA's public website for 30 days;
b) provide for public comment; and
c) consider the public comments when adopting the proposed policies.
7. Prohibits IOC guidelines from conflicting with open meeting law requirements and policies adopted by the Director.
8. Allows employees of DHS to serve on an IOC as nonvoting members.
9. Requires IOCs to provide independent oversight to make recommendations to the director of any department and service provider subject to oversight.
10. Specifies that an IOC's written objections to specific problems or violations of client rights must be reviewed by the director of the department that is responsible for the client and requires the director to deliver a detailed written response to objections within 21 days after receiving the objections from the ADOA.
11. Requires IOC members and consultants to have access to any incident reports or investigation reports to conduct IOC duties, subject to state law, attorney-client privilege and attorney work product doctrine.
12. Requires a department or service provider to redact protected information in documents if the department or service provider determines in good faith that the information is protected.
13. Requires a department or service provider to object a record request in writing within 21 calendar days in a manner that, without revealing the information that is believed to be protected, enables the requesting IOC to understand the basis on which the department or service provider determined the information or records are protected.
14. Requires DES, rather than a service provider, to provide information or records relating to persons with developmental disabilities and redact any necessary information.
15. Provides that each IOC within its jurisdiction must, for an SMI client who needs special assistance, or may, for any other SMI client, make regular site visits to a residential environment and meet with the client in a residential environment to determine the client's satisfaction with the residential environment, if the client or client's guardian is given the right to decline for any reason and without explanation.
16. Requires for an IOC's request for information or records that are denied by a department or service provider:
a) at least one representative of the department or service provider and at least one IOC member to meet and confer within five business days after the date of the request or on a later date that is agreed on by both parties and attempt to resolve the objection informally and cooperatively in good faith; and
b) the department director to timely conduct the review within 21 calendar days and deliver to the IOC a written decision explaining in detail the factual and legal basis and reasoning for the department's decision.
17. Requires each IOC, appropriate department and service provider to conduct activities in good faith at all times to promote and protect the rights of persons who receive the specified behavioral health services.
18. Makes technical and conforming changes.
19. Becomes effective on the general effective date.
Amendments Adopted by Committee
1. Requires IOCs and the ADOA to post on its website a copy of each IOC meeting agenda in addition to annual reports.
2. Specifies that the IOC at ASH has oversight of SMI patients who are hospitalized and receiving behavioral health services at the civil and forensic hospital and outlines information that ASH must provide to the IOC.
3. Requires the ADOA to post the proposed policies on its website for 30 days, provide for public comment and consider the public comments when adopting the proposed policies.
4. Allows DHS employees to serve on an IOC as nonvoting members.
5. Removes the requirement that each IOC provide independent oversight to conduct research in the field of mental health.
6. Requires each IOC to issue an annual report to the Directors of DES, DCS, DHS and AHCCCS.
7. Requires a department or service provider to redact protected information in documents if the department or service provider determines in good faith that the information is protected and modifies procedures for an objection to record requests.
8. Grants SMI clients the right to decline participation in an IOC site visit for any reason and without explanation.
9. Requires each IOC, appropriate department and service provider to conduct activities in good faith at all times to promote and protect the rights of persons who receive specified behavioral health services.
Amendments Adopted by Committee of the Whole
2. Expands the meet and confer requirement to allow the parties to meet and confer on an agreed upon later date.
3. Makes technical changes.
House Action Senate Action
HHS 2/21/19 DPA 8-0-0-1 HHS 3/28/19 DPA 7-0-1
3rd Read 3/11/19 60-0-0
Prepared by Senate Research
April 24, 2019
CRS/AB/kja