SB1211 - 541R

Be it enacted by the Legislature of the State of Arizona:

Section 1. Section 8-804, Arizona Revised Statutes, is amended to read:

START_STATUTE8-804. Central registry; notification; definition

A. The department shall maintain a central registry of reports of child abuse and neglect that are substantiated and the outcome of the investigation of these reports made under this article. A finding made by a court pursuant to section 8‑844, subsection C that a child is dependent based on an allegation of abuse or neglect shall be recorded as a substantiated finding of abuse or neglect. The department shall incorporate duplicate reports on the same incident in the original report and shall not classify duplicate reports as new reports.

B. The department shall conduct central registry background checks and shall use the information contained in the central registry only for the following purposes:

1. As a factor to determine qualifications for foster home licensing, adoptive parent certification, individuals who apply for child welfare agency licensing, child care home certification, registration of unregulated child care homes with the child care resource and referral system, and home and community based services certification for services to children or vulnerable adults.

2. As a factor to determine qualifications for persons who are employed or who are applying for employment with this state in positions that provide direct service to children or vulnerable adults.

3. As a factor to determine qualifications for individuals who are employed or who are applying for employment with a child welfare agency in positions that provide direct service to children or vulnerable adults.

4. As a factor to determine qualifications for positions that provide direct service to children or vulnerable adults for:

(a) Any person who applies for a contract with this state and that person's employees.

(b) All employees of a contractor.

(d) Prospective employees of the contractor or subcontractor at the request of the prospective employer.

5. Beginning August 1, 2013, To provide information to licensees that do not contract with this state regarding persons who are employed or seeking employment to provide direct services to children pursuant to title 36, chapter 7.1.

6. To identify and review reports concerning individual children and families, in order to facilitate the assessment of safety and risk.

7. To determine the nature and scope of child abuse and neglect in this state and to provide statewide statistical and demographic information concerning trends in child abuse and neglect.

8. To allow comparisons of this state's statistical data with national data.

9. To comply with section 8‑804.01, subsection B.

10. To provide information to licensees regarding persons who are employed or seeking employment in an intermediate care facility for individuals with intellectual disabilities.

C. Beginning August 1, 2013, Licensees that do not contract with the state and that employ persons who provide direct services to children pursuant to title 36, chapter 7.1 must submit to the department of child safety in a manner prescribed by the department of child safety information necessary to conduct central registry background checks. The department of health services shall verify whether licensees, pursuant to title 36, chapter 7.1, have complied with the requirements of this subsection and any rules adopted by the department of health services to implement this subsection.

D. Beginning on the effective date of this amendment to this section, Licensees that employ persons to provide direct care in an intermediate care facility for individuals with intellectual disabilities must submit to the department of child safety in a manner prescribed by the department of child safety information necessary to conduct central registry background checks. The department of health services shall verify whether the licensees, pursuant to title 36, chapter 4, comply with the requirement of this subsection.

D. E. If the department of economic security received a report before September 1, 1999 and determined that the report was substantiated, the department of child safety shall maintain the report in the central registry until eighteen years from the child victim's date of birth.

E. F. If the department of economic security or the department of child safety received a report on or after September 1, 1999 and determined that the report was substantiated, the department of child safety shall maintain the report in the central registry for a maximum of twenty‑five years after the date of the report. If the department of child safety maintains reports in the central registry for less than twenty‑five years, the department shall adopt rules to designate the length of time it must maintain those reports in the central registry.

F. G. The department shall annually purge reports and investigative outcomes received pursuant to the time frames prescribed in subsections D E and E F of this section.

G. H. Any person who was the subject of a department investigation may request confirmation that the department has purged information about the person pursuant to subsection F G of this section. On receipt of this request, the department shall provide the person with written confirmation that the department has no record containing identifying information about that person.

H. I. The department shall notify a person, contractor or licensee identified in subsection B, paragraph 4, subdivisions (a), (b) and (c) and subsection B, paragraph paragraphs 5 and 10 of this section who is disqualified because of a central registry check conducted pursuant to subsection B of this section that the person may apply to the board of fingerprinting for a central registry exception pursuant to section 41‑619.57.

I. J. Before being employed in a position that provides direct services to children or vulnerable adults pursuant to subsection B, paragraphs 4, and 5 and 10 or subsection subsections C and D of this section, employees shall certify, under penalty of perjury, on forms that are provided by the department whether an allegation of abuse or neglect was made against them and was substantiated. The forms are confidential. If this certification does not indicate a current investigation or a substantiated report of abuse or neglect, the employee may provide direct services pending the findings of the central registry check.

J. K. A person who is granted a central registry exception pursuant to section 41‑619.57 is not entitled to a contract, employment, licensure, certification or other benefit because the person has been granted a central registry exception.

K. L. An agency of this state that conducts central registry background checks as a factor to determine qualifications for positions that provide direct services to children or vulnerable adults shall publish a list of disqualifying acts of substantiated abuse or neglect.

L. M. An agency of this state that conducts central registry background checks may provide information contained in the central registry on all reports of child abuse and neglect that are substantiated and the outcomes of the investigations of the reports to carry out the provisions of this section. Identifying information regarding any person other than the perpetrator may not be released. Information received pursuant to this section may not be further disseminated unless authorized by law or court order.

N. The department may enter into agreements with other state agencies to conduct the central registry background checks required by this section.

O. For the purposes of this section, "intermediate care facility for individuals with intellectual disabilities" has the same meaning prescribed in section 36-551. END_STATUTE

Sec. 2. Section 36-401, Arizona Revised Statutes, is amended to read:

START_STATUTE36-401. Definitions; adult foster care

A. In this chapter, unless the context otherwise requires:

1. "Accredited health care institution" means a health care institution, other than a hospital, that is currently accredited by a nationally recognized accreditation organization.

2. "Accredited hospital" means a hospital that is currently accredited by a nationally recognized organization on hospital accreditation.

3. "Adult day health care facility" means a facility that provides adult day health services during a portion of a continuous twenty‑four‑hour period for compensation on a regular basis for five or more adults who are not related to the proprietor.

4. "Adult day health services" means a program that provides planned care supervision and activities, personal care, personal living skills training, meals and health monitoring in a group setting during a portion of a continuous twenty‑four‑hour period. Adult day health services may also include preventive, therapeutic and restorative health‑related services that do not include behavioral health services.

5. "Adult foster care home" means a residential setting that provides room and board and adult foster care services for at least one and no more than four adults who are participants in the Arizona long‑term care system pursuant to chapter 29, article 2 of this title or contracts for services with the United States department of veterans affairs and in which the sponsor or the manager resides with the residents and integrates the residents who are receiving adult foster care into that person's family.

6. "Adult foster care services" means supervision, assistance with eating, bathing, toileting, dressing, self‑medication and other routines of daily living or services authorized by rules adopted pursuant to section 36‑405 and section 36‑2939, subsection C.

7. "Assisted living center" means an assisted living facility that provides resident rooms or residential units to eleven or more residents.

8. "Assisted living facility" means a residential care institution, including an adult foster care home, that provides or contracts to provide supervisory care services, personal care services or directed care services on a continuous basis.

9. "Assisted living home" means an assisted living facility that provides resident rooms to ten or fewer residents.

10. "Behavioral health services" means services that pertain to mental health and substance use disorders and that are either:

(a) Performed by or under the supervision of a professional who is licensed pursuant to title 32 and whose scope of practice allows for the provision of these services.

(b) Performed on behalf of patients by behavioral health staff as prescribed by rule.

11. "Construction" means the building, erection, fabrication or installation of a health care institution.

12. "Continuous" means available at all times without cessation, break or interruption.

13. "Controlling person" means a person who:

(a) Through ownership, has the power to vote at least ten percent of the outstanding voting securities.

(b) If the applicant or licensee is a partnership, is the general partner or a limited partner who holds at least ten percent of the voting rights of the partnership.

(c) If the applicant or licensee is a corporation, an association or a limited liability company, is the president, the chief executive officer, the incorporator or any person who owns or controls at least ten percent of the voting securities. For the purposes of this subdivision, corporation does not include nonprofit corporations.

(d) Holds a beneficial interest in ten percent or more of the liabilities of the applicant or the licensee.

14. "Department" means the department of health services.

15. "Directed care services" means programs and services, including supervisory and personal care services, that are provided to persons who are incapable of recognizing danger, summoning assistance, expressing need or making basic care decisions.

16. "Direction" means authoritative policy or procedural guidance for the accomplishment of a function or activity.

17. "Director" means the director of the department of health services.

18. "Facilities" means buildings that are used by a health care institution for providing any of the types of services as defined in this chapter.

19. "Freestanding urgent care center":

(a) Means an outpatient treatment center that, regardless of its posted or advertised name, meets any of the following requirements:

(i) Is open twenty‑four hours a day, excluding at its option weekends or certain holidays, but is not licensed as a hospital.

(ii) Claims to provide unscheduled medical services not otherwise routinely available in primary care physician offices.

(iii) By its posted or advertised name, gives the impression to the public that it provides medical care for urgent, immediate or emergency conditions.

(iv) Routinely provides ongoing unscheduled medical services for more than eight consecutive hours for an individual patient.

(b) Does not include the following:

(i) A medical facility that is licensed under a hospital's license and that uses the hospital's medical provider number.

(ii) A qualifying community health center pursuant to section 36‑2907.06.

(iii) Any other health care institution licensed pursuant to this chapter.

(iv) A physician's office that offers extended hours or same‑day appointments to existing and new patients and that does not meet the requirements of subdivision (a), item (i), (iii) or (iv) of this paragraph.

20. "Governing authority" means the individual, agency, partners, group or corporation, appointed, elected or otherwise designated, in which the ultimate responsibility and authority for the conduct of the health care institution are vested.

21. "Health care institution" means every place, institution, building or agency, whether organized for profit or not, that provides facilities with medical services, nursing services, behavioral health services, health screening services, other health‑related services, supervisory care services, personal care services or directed care services and includes home health agencies as defined in section 36‑151, outdoor behavioral health care programs and hospice service agencies. Health care institution does not include a community residential setting as defined in section 36‑551.

22. "Health‑related services" means services, other than medical, that pertain to general supervision, protective, preventive and personal care services, supervisory care services or directed care services.

23. "Health screening services" means the acquisition, analysis and delivery of health‑related data of individuals to aid in the determination of the need for medical services.

24. "Hospice" means a hospice service agency or the provision of hospice services in an inpatient facility.

25. "Hospice service" means a program of palliative and supportive care for terminally ill persons and their families or caregivers.

26. "Hospice service agency" means an agency or organization, or a subdivision of that agency or organization, that is engaged in providing hospice services at the place of residence of its clients.

27. "Inpatient beds" or "resident beds" means accommodations with supporting services, such as food, laundry and housekeeping, for patients or residents who generally stay in excess of twenty‑four hours.

28. "Intermediate care facility for individuals with intellectual disabilities" has the same meaning prescribed in section 36‑551.

28. 29. "Licensed capacity" means the total number of persons for whom the health care institution is authorized by the department to provide services as required pursuant to this chapter if the person is expected to stay in the health care institution for more than twenty‑four hours. For a hospital, licensed capacity means only those beds specified on the hospital license.

29. 30. "Medical services" means the services that pertain to medical care and that are performed at the direction of a physician on behalf of patients by physicians, dentists, nurses and other professional and technical personnel.

30. 31. "Modification" means the substantial improvement, enlargement, reduction or alteration of or other change in a health care institution.

31. 32. "Nonproprietary institution" means any health care institution that is organized and operated exclusively for charitable purposes, no part of the net earnings of which inures to the benefit of any private shareholder or individual, or that is operated by the state or any political subdivision of the state.

32. 33. "Nursing care institution" means a health care institution that provides inpatient beds or resident beds and nursing services to persons who need continuous nursing services but who do not require hospital care or direct daily care from a physician.

33. 34. "Nursing services" means those services that pertain to the curative, restorative and preventive aspects of nursing care and that are performed at the direction of a physician by or under the supervision of a registered nurse licensed in this state.

34. 35. "Organized medical staff" means a formal organization of physicians, and dentists where appropriate, with the delegated authority and responsibility to maintain proper standards of medical care and to plan for continued betterment of that care.

35. 36. "Outdoor behavioral health care program" means an agency that provides behavioral health services in an outdoor environment as an alternative to behavioral health services that are provided in a health care institution with facilities. Outdoor behavioral health care programs do not include:

(a) Programs, facilities or activities that are operated by a government entity or that are licensed by the department as a child care program pursuant to chapter 7.1 of this title.

(b) Outdoor activities for youth that are designated to be primarily recreational and that are organized by church groups, scouting organizations or similar groups.

36. 37. "Personal care services" means assistance with activities of daily living that can be performed by persons without professional skills or professional training and includes the coordination or provision of intermittent nursing services and the administration of medications and treatments by a nurse who is licensed pursuant to title 32, chapter 15 or as otherwise provided by law.

37. 38. "Physician" means any person who is licensed pursuant to title 32, chapter 13 or 17.

38. 39. "Recidivism reduction services" means services that are delivered by an adult residential care institution to its residents to encourage lawful behavior and to discourage or prevent residents who are suspected of, charged with or convicted of one or more criminal offenses, or whose mental health and substance use can be reasonably expected to place them at risk for the future threat of prosecution, diversion or incarceration, from engaging in future unlawful behavior.

39. 40. "Recidivism reduction staff" means a person who provides recidivism reduction services.

40. 41. "Residential care institution" means a health care institution other than a hospital or a nursing care institution that provides resident beds or residential units, supervisory care services, personal care services, behavioral health services, directed care services or health‑related services for persons who do not need continuous nursing services.

41. 42. "Residential unit" means a private apartment, unless otherwise requested by a resident, that includes a living and sleeping space, kitchen area, private bathroom and storage area.

42. 43. "Respite care services" means services that are provided by a licensed health care institution to persons otherwise cared for in foster homes and in private homes to provide an interval of rest or relief of not more than thirty days to operators of foster homes or to family members.

43. 44. "Substantial compliance" means that the nature or number of violations revealed by any type of inspection or investigation of a health care institution does not pose a direct risk to the life, health or safety of patients or residents.

44. 45. "Supervision" means direct overseeing and inspection of the act of accomplishing a function or activity.

45. 46. "Supervisory care services" means general supervision, including daily awareness of resident functioning and continuing needs, the ability to intervene in a crisis and assistance in the self‑administration of prescribed medications.

46. 47. "Temporary license" means a license that is issued by the department to operate a class or subclass of a health care institution at a specific location and that is valid until an initial licensing inspection.

47. 48. "Unscheduled medical services" means medically necessary periodic health care services that are unanticipated or cannot reasonably be anticipated and that require medical evaluation or treatment before the next business day.

B. If there are fewer than four Arizona long‑term care system participants receiving adult foster care in an adult foster care home, nonparticipating adults may receive other types of services that are authorized by law to be provided in the adult foster care home as long as the number of adults served, including the Arizona long‑term care system participants, does not exceed four.

C. Nursing care services may be provided by the adult foster care licensee if the licensee is a nurse who is licensed pursuant to title 32, chapter 15 and the services are limited to those allowed pursuant to law. The licensee shall keep a record of nursing services rendered. END_STATUTE

Sec. 3. Section 36-424, Arizona Revised Statutes, is amended to read:

START_STATUTE36-424. Inspections; suspension or revocation of license; report to board of examiners of nursing care institution administrators

A. Subject to the limitation limit prescribed by subsection B of this section, the director shall inspect the premises of the health care institution and investigate the character and other qualifications of the applicant to ascertain whether the applicant and the health care institution are in substantial compliance with the requirements of this chapter and the rules established pursuant to this chapter. The director may prescribe rules regarding department background investigations into an applicant's character and qualifications.

B. The director shall accept proof that a health care institution is an accredited hospital or is an accredited health care institution in lieu of all compliance inspections required by this chapter if the director receives a copy of the institution's accreditation report for the licensure period. If the health care institution's accreditation report is not valid for the entire licensure period, the department may conduct a compliance inspection of the health care institution during the time period the department does not have a valid accreditation report for the health care institution. The director may not accept an accreditation report in lieu of a compliance inspection of an intermediate care facility for individuals with intellectual disabilities.

C. On a determination by the director that there is reasonable cause to believe a health care institution is not adhering to the licensing requirements of this chapter, the director and any duly designated employee or agent of the director, including county health representatives and county or municipal fire inspectors, consistent with standard medical practices, may enter on and into the premises of any health care institution that is licensed or required to be licensed pursuant to this chapter at any reasonable time for the purpose of determining the state of compliance with this chapter, the rules adopted pursuant to this chapter and local fire ordinances or rules. Any application for licensure under this chapter constitutes permission for and complete acquiescence in any entry or inspection of the premises during the pendency of the application and, if licensed, during the term of the license. If an inspection reveals that the health care institution is not adhering to the licensing requirements established pursuant to this chapter, the director may take action authorized by this chapter. Any health care institution, including an accredited hospital, whose license has been suspended or revoked in accordance with this section is subject to inspection on application for relicensure or reinstatement of license.

D. The director shall immediately report to the board of examiners of nursing care institution administrators information identifying that a nursing care institution administrator's conduct may be grounds for disciplinary action pursuant to section 36‑446.07. END_STATUTE

Sec. 4. Title 36, chapter 4, article 2, Arizona Revised Statutes, is amended by adding section 36-425.05, to read:

START_STATUTE36-425.05. Intermediate care facilities for individuals with intellectual disabilities; licensure

On or before January 1, 2020, an intermediate care facility for individuals with intellectual disabilities That is operated by the department of economic security or a private entity shall be licensed pursuant to this chapter and certified pursuant to 42 Code of Federal Regulations part 483, subpart I. END_STATUTE

Sec. 5. Section 36-551, Arizona Revised Statutes, as amended by Laws 2016, chapter 286, section 6, is amended to read:

START_STATUTE36-551. Definitions

In this chapter, unless the context otherwise requires:

1. "Adaptive behavior" means the effectiveness or degree to which the individual meets the standards of personal independence and social responsibility expected of the person's age and cultural group.

2. "Adult developmental home" means a residential setting in a family home in which the care, physical custody and supervision of the adult client are the responsibility, under a twenty‑four‑hour care model, of the licensee who, in that capacity, is not an employee of the division or of a service provider and the home provides the following services for a group of siblings or up to three adults with developmental disabilities:

(a) Room and board.

(b) Habilitation.

(d) Appropriate supervision.

3. "Adult household member" means a person who is at least eighteen years of age and who resides in an adult developmental home, child developmental home or other home and community based service setting for at least thirty days or who resides in the household throughout the year for more than a cumulative total of thirty days.

4. "Advisory council" means the developmental disabilities advisory council.

5. "Arizona training program facility" means a state‑operated institution for clients of the department with developmental disabilities.

6. "Attributable to cognitive disability, epilepsy, cerebral palsy or autism" means that there is a causal relationship between the presence of an impairing condition and the developmental disability.

7. "Autism" means a condition characterized by severe disorders in communication and behavior resulting in limited ability to communicate, understand, learn and participate in social relationships.

8. "Case management" means coordinating the assistance needed by persons with developmental disabilities and their families in order to ensure that persons with developmental disabilities attain their maximum potential for independence, productivity and integration into the community.

9. "Case manager" means a person who coordinates the implementation of the individual program plan of goals, objectives and appropriate services for persons with developmental disabilities.

10. "Cerebral palsy" means a permanently disabling condition resulting from damage to the developing brain that may occur before, after or during birth and that results in loss or impairment of control over voluntary muscles.

11. "Child developmental certified home" means a regular foster home as defined in section 8‑501 that is licensed pursuant to section 8‑509 and that is certified by the department pursuant to section 36‑593.01.

12. "Child developmental home" means a residential setting in a family home in which the care and supervision of the child are the responsibility, under a twenty‑four‑hour care model, of the licensee who serves as the developmental home provider of the child in the home setting and who, in that capacity, is not an employee of the division or of a service provider and the home provides the following services for a group of siblings or up to three children with developmental disabilities:

(a) Room and board.

(b) Habilitation.

(d) Appropriate supervision.

13. "Client" means a person receiving developmental disabilities services from the department.

14. "Cognitive disability" means a condition that involves subaverage general intellectual functioning, that exists concurrently with deficits in adaptive behavior manifested before the age of eighteen and that is sometimes referred to as intellectual disability.

15. "Community residential setting" means a residential setting in which persons with developmental disabilities live and are provided with appropriate supervision by the service provider responsible for the operation of the residential setting. Community residential setting includes a child developmental home or an adult developmental home operated or contracted by the department or the department's contracted vendor or a group home operated or contracted by the department.

16. "Consent" means voluntary informed consent. Consent is voluntary if not given as the result of coercion or undue influence. Consent is informed if the person giving the consent has been informed of and comprehends the nature, purpose, consequences, risks and benefits of the alternatives to the procedure, and has been informed and comprehends that withholding or withdrawal of consent will not prejudice the future provision of care and services to the client. In cases of unusual or hazardous treatment procedures performed pursuant to section 36‑561, subsection A, experimental research, organ transplantation and nontherapeutic surgery, consent is informed if, in addition to the foregoing, the person giving the consent has been informed of and comprehends the method to be used in the proposed procedure.

17. "Daily habilitation" means habilitation as defined in this section except that the method of payment is for one unit per residential day.

18. "Department" means the department of economic security.

19. "Developmental disability" means either a strongly demonstrated potential that a child under six years of age has a developmental disability or will develop a developmental disability, as determined by a test performed pursuant to section 36‑694 or by other appropriate tests, or a severe, chronic disability that:

(a) Is attributable to cognitive disability, cerebral palsy, epilepsy or autism.

(b) Is manifested before the age of eighteen.

(d) Results in substantial functional limitations in three or more of the following areas of major life activity:

(i) Self‑care.

(ii) Receptive and expressive language.

(iii) Learning.

(iv) Mobility.

(v) Self‑direction.

(vi) Capacity for independent living.

(vii) Economic self‑sufficiency.

(e) Reflects the need for a combination and sequence of individually planned or coordinated special, interdisciplinary or generic care, treatment or other services that are of lifelong or extended duration.

20. "Director" means the director of the department of economic security.

21. "Division" means the division of developmental disabilities in the department of economic security.

22. "Epilepsy" means a neurological condition characterized by abnormal electrical‑chemical discharge in the brain. This discharge is manifested in various forms of physical activities called seizures.

23. "Group home" means a community residential setting for not more than six persons with developmental disabilities that is operated by a service provider under contract with the department and that provides room and board and daily habilitation, and other assessed medically necessary services and supports to meet the needs of each person. Group home does not include an adult developmental home, a child developmental home or an intermediate care facility for persons individuals with an intellectual disability disabilities.

24. "Guardian" means the person who, under court order, is appointed to fulfill the powers and duties prescribed in section 14‑5312. Guardian does not include a guardian pursuant to section 14‑5312.01.

25. "Habilitation" means the process by which a person is assisted to acquire and maintain those life skills that enable the person to cope more effectively with personal and environmental demands and to raise the level of the person's physical, mental and social efficiency.

26. "Indigent" means a person with a developmental disability whose estate or parent is unable to bear the full cost of maintaining or providing services for that person in a developmental disabilities program.

27. "Individual program plan" means a written statement of services to be provided to a person with developmental disabilities, including habilitation goals and objectives, that is developed following initial placement evaluation and revised after periodic evaluations.

28. "Intermediate care facility for persons individuals with an intellectual disability disabilities" means a facility that primarily provides health and rehabilitative services to persons with developmental disabilities that are above the service level of room and board or supervisory care services or personal care services as defined in section 36‑401 but that are less intensive than skilled nursing services.

29. "Large group setting" means a setting that in addition to residential care provides support services such as therapy, recreation and transportation to seven or more persons with developmental disabilities who require intensive supervision.

30. "Least restrictive alternative" means an available program or facility that fosters independent living, that is the least confining for the client's condition and where service and treatment are provided in the least intrusive manner reasonably and humanely appropriate to the individual's needs.

31. "Likely to continue indefinitely" means that the developmental disability has a reasonable likelihood of continuing for a protracted period of time or for life.

32. "Manifested before the age of eighteen" means that the disability must be apparent and have a substantially limiting effect on a person's functioning before the age of eighteen.

33. "Physician" means a person who is licensed to practice pursuant to title 32, chapter 13 or 17.

34. "Placement evaluation" means an interview and evaluation of a person with a developmental disability and a review of the person's prior medical and program histories to determine the appropriate developmental disability programs and services for the person and recommendations for specific program placements for the person.

35. "Psychologist" means a person who is licensed pursuant to title 32, chapter 19.1.

36. "Respite services" means services that provide a short‑term or long‑term interval of rest or relief to the care provider of a person with a developmental disability.

37. "Responsible person" means the parent or guardian of a minor with a developmental disability, the guardian of an adult with a developmental disability or an adult with a developmental disability who is a client or an applicant for whom no guardian has been appointed.

38. "Service provider" means a person or agency that provides services to clients pursuant to a contract, service agreement or qualified vendor agreement with the division.

39. "State operated service center" means a state owned or leased facility that is operated by the department and that provides temporary residential care and space for child and adult services that include respite care, crisis intervention and diagnostic evaluation.

40. "Subaverage general intellectual functioning" means measured intelligence on standardized psychometric instruments of two or more standard deviations below the mean for the tests used.

41. "Substantial functional limitation" means a limitation so severe that extraordinary assistance from other people, programs, services or mechanical devices is required to assist the person in performing appropriate major life activities.

42. "Supervision" means the process by which the activities of an individual with developmental disabilities are directed, influenced or monitored. END_STATUTE

Sec. 6. Section 36-551, Arizona Revised Statutes, as amended by Laws 2018, chapter 251, section 1, is amended effective from and after June 30, 2019, to read:

START_STATUTE36-551. Definitions

In this chapter, unless the context otherwise requires:

(a) Room and board.

(b) Habilitation.

(d) Appropriate supervision.

3. "Adult household member":

(a) Means a person who is at least eighteen years of age and who resides in an adult developmental home, child developmental home or other home and community based service setting for at least thirty days or who resides in the household throughout the year for more than a cumulative total of thirty days.

(b) Does not include a person who is receiving developmental disabilities services from the department.

4. "Advisory council" means the developmental disabilities advisory council.

5. "Arizona training program facility" means a state‑operated institution for clients of the department with developmental disabilities.

7. "Autism" means a condition characterized by severe disorders in communication and behavior resulting in limited ability to communicate, understand, learn and participate in social relationships.

9. "Case manager" means a person who coordinates the implementation of the individual program plan of goals, objectives and appropriate services for persons with developmental disabilities.

(a) Room and board.

(b) Habilitation.

(d) Appropriate supervision.

13. "Client" means a person receiving developmental disabilities services from the department.

17. "Daily habilitation" means habilitation as defined in this section except that the method of payment is for one unit per residential day.

18. "Department" means the department of economic security.

(a) Is attributable to cognitive disability, cerebral palsy, epilepsy or autism.

(b) Is manifested before the age of eighteen.

(d) Results in substantial functional limitations in three or more of the following areas of major life activity:

(i) Self‑care.

(ii) Receptive and expressive language.

(iii) Learning.

(iv) Mobility.

(v) Self‑direction.

(vi) Capacity for independent living.

(vii) Economic self‑sufficiency.

20. "Director" means the director of the department of economic security.

21. "Division" means the division of developmental disabilities in the department of economic security.

23. "Group home" means a community residential setting for not more than six persons with developmental disabilities that is operated by a service provider under contract with the department and that provides room and board and daily habilitation and other assessed medically necessary services and supports to meet the needs of each person. Group home does not include an adult developmental home, a child developmental home or an intermediate care facility for persons individuals with an intellectual disability disabilities.