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ARIZONA STATE SENATE
Fifty-Fifth Legislature, First Regular Session
Arizona state hospital
Purpose
Establishes the Arizona State Hospital (ASH) Governing Body (Governing Body) and prescribes Governing Body membership and duties. Requires ASH to maintain a surveillance system and appropriates $500,000 in FY 2022 to the Department of Health Services (DHS) for the installation and maintenance of a surveillance system at ASH.
Background
ASH, operated by DHS and located in Phoenix, Arizona, is a 260-bed facility that provides long-term inpatient psychiatric care to individuals with mental illnesses, personality disorders or emotional conditions who are under a court order to receive treatment. The Civil Adult Rehabilitation Program at ASH includes treatment units that specialize in providing services to adults who are civilly committed as a danger to self, danger to others, gravely disabled or persistently and acutely disabled, and who have completed a required 25 days of treatment in a community inpatient setting prior to their admission to ASH. Forensic patients at ASH are court-ordered for either pre-or post-trial treatment as a result of involvement with the criminal justice system due to a mental health issue. The Forensic Adult Program includes individuals who have been committed through a court-order as part of a criminal process for patients who are either being housed on one unit providing pre-trial evaluation, treatment, and restoration to competency to stand trial or who have been adjudicated Guilty Except Insane (GEI) and who are serving a sentence under the jurisdiction of the Psychiatric Security Review Board (PSRB) (A.R.S. Title 36, Chapter 2). Statute authorizes the PSRB to release any GEI person under its jurisdiction from ASH to the community if the person meets statutory release criteria (A.R.S. § 13-502).
S.B. 1716 appropriates $500,000 in FY 2022 to DHS for the installation and maintenance of a surveillance system at ASH.
Provisions
ASH
1. Directs ASH to admit patients based on clinical need for treatment and prohibits ASH from placing a limitation on admission based on a patient's county of residence.
2. Requires, within 30 days after a patient's admission to ASH, a psychiatrist to develop, document and supervise the implementation of a master inpatient treatment plan and an individualized treatment and discharge plan for each patient.
3. Requires that each master inpatient treatment plan and individualized treatment and discharge plan be:
a) administered by or under the supervision of a psychiatrist;
b) based on evidence-based treatment and include measurable goals and criteria for goal attainment; and
c) reviewed and updated at least every 90 days, in consultation with the treatment team and the patient's family or designated representative.
4. Requires that each forensic patient's master inpatient treatment plan and individualized treatment and discharge plan additionally be:
a) focused on diagnoses that resulted in the patient's commitment to ASH; and
b) related to the criteria used by the PSRB to make decisions regarding a patient's conditional release, termination of jurisdiction to the Department of Corrections or another agency.
5. Directs the Director to contract with an independent third party to develop, implement and document an assault reduction and response plan that includes sexual assaults.
6. Specifies that the plan must have a goal of reduction in both the number of assaults and harm to patients and staff.
7. Requires the plan to include evaluation and reporting relating to:
a) the number, type, nature and circumstances of each assault;
b) the number of assaults reported to regulatory agencies and how the assaults were reported;
c) the number of times law enforcement was called to ASH related to an assault;
d) the number and type of any employment actions taken against ASH staff who are involved in an assault.
8. Requires ASH, subject to available appropriations, to maintain a surveillance system that includes audio and visual capability and secure storage of files for at least 24 months after the date of any assault resulting in injury.
9. Directs ASH to maintain surveillance videos in every assault involving a patient, including videos not containing audio, for at least 24 months.
10. Appropriates $500,000 to DHS in FY 2022 to DHS for the installation and maintenance of a surveillance system at ASH.
PSRB
11. Obligates ASH to make timely, good-faith responses to requests from the PSRB to provide patients and the PSRB members with adequate time and information to prepare for a PSRB meeting.
12. Requires ASH, upon the PSRB request and at every hearing for a patient, to provide PSRB and the patient with the following information at least 45 days prior to a hearing:
a) a report on the patient that has information as requested by the PSRB;
b) a patient risk assessment; and
c) an explanation of any rule violation by the patient and the rule's relevance.
13. Mandates that a patient's treating psychiatrist or their designee appear as a witness before the PSRB when the patient appears.
Governing Body
14. Establishes the Governing Body that consists of seven to nine voting members who are appointed by the Governor and confirmed by the Senate, and that includes:
a) the DHS Director, or their designee, who serves as Chairperson;
b) the Superintendent of ASH;
c) at least five public members who meet specified professional and familial criteria;
d) the Chairperson of the Independent Oversight Committee (IOC) at ASH, who serves as a nonvoting member.
15. Requires the ASH IOC Chairperson to participate in Governing Body discussions, advise the Governing Body on issues that affect patient rights and report on the work of the ASH IOC.
16. Requires the DHS Director to attend Governing Body meetings when possible and to review and sign Governing Body meeting minutes.
17. Prohibits Governing Body voting members from being employed by the state or an entity that contracts with the state, with exceptions for the DHS Director and ASH Superintendent.
18. Specifies that Governing Body members serve at the pleasure of the Governor.
19. Entitles Governing Body members, with exception of the DHS Director and ASH Superintendent, to compensation in an amount of $200 for each meeting attended annually, up to 12 meetings.
20. Requires the Governing Body to operate ASH consistent with related statutes and ASH's mission and vision.
21. Directs the Governing Body to adopt and maintain bylaws that include provisions that ensure ASH reports on its operations in a manner that provides institutional accountability to the public and state government.
22. Requires the Governing Body, rather than the DHS Director, to submit an annual financial and programmatic report for ASH, by October 1, and to submit the report to the Governor and the presiding officer in each chamber of the Legislature.
23. Requires the annual ASH report to include the following information:
a) a breakdown of the number of patients served by diagnosis, treatment length and clinical progress;
b) ASH's work and results in delineated service areas;
c) the number of patients transferred between the civil hospital, forensic hospital, and the Arizona Community and Prevention Treatment Center, the reason for the transfer and the length of time in the reassigned location;
d) admissions by civil commitment, including:
i. the number of admissions and discharges;
ii. the time between the request for admission and the date of admission;
iii. the reason a commitment request was denied; and
iv. the efforts made to reduce the time between a request for admission and the admission occurring;
e) ASH's plans and priorities for improved or expanded clinical services, including plans to utilize technology capabilities for patient services;
f) information regarding the GEI Program for forensic patients, including patient participation and completion of the Program, Program components and supporting measures;
g) ASH's participation in cases before the PSRB, including outlined information;
h) information about ASH's use of evidence-based practices in the GEI Program, including utilized practices and measurable goals;
i) ASH's priorities to improve patient outcomes and protect public safety and the resources needed to act on the priorities; and
j) the status of establishing a psychiatric center of excellence.
24. Requires the DHS Director, in consultation with the Governing Body, to maintain a staffing plan that, in addition to clinical treatment, includes provisions to achieve acuity-based staffing with minimal or no use of contracted staff and that supports the prescribed assault reduction and response plan.
Miscellaneous
25. Makes technical changes.
26. Becomes effective on the general effective date.
Prepared by Senate Research
February 16, 2021
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