Assigned to HHS                                                                                                                               AS VETOED

 


 

 

 


ARIZONA STATE SENATE

Fifty-Fifth Legislature, Second Regular Session

 

VETOED

 

AMENDED

FACT SHEET FOR s.b. 1308

 

DHS licensure; group homes

Purpose

Requires, beginning July 1, 2023, behavioral-supported group homes and other specified group homes to be licensed and regulated through the Department of Health Services (DHS).

Background

DHS regulates and licenses group homes for persons with developmental disabilities. DHS establishes requirements for group homes through the Division of Developmental Disabilities within the Department of Economic Security (DES). DHS must issue a license to an accredited facility for a three-year accreditation period. DHS may conduct an inspection of an accredited facility to ensure that the facility meets health and safety licensure standards (A.R.S. §§ 32-132 and 32-591)

A group home is a community residential setting for not more than six persons with developmental disabilities that is operated by a service provider under DES contract and that provides room and board, daily habilitation and other assessed medically necessary services and supports to meet the needs of each person.  A group home does not include an adult developmental home, a child developmental home or an intermediate care facility for individuals with intellectual disabilities (A.R.S. § 36-551).

A nursing-supported group home is a health care institution that: 1) is a community residential setting for not more than six persons with developmental disabilities; 2) is operated by a service provider under DES-contract; and 3) provides room and board, daily habilitation and continuous nursing support and intervention (A.R.S. § 36-401).

Each licensed premises of a health care institution must have its own accreditation report. The DHS Director may accept proof that a health care institution is an accredited hospital, or is an accredited health care institution in lieu of all required compliance inspections, if the Director receives a copy of the institution's accreditation report for the licensure period and the institution is accredited by an accrediting organization approved by the U.S. Department of Health and Human Services Secretary. The Director may not accept an accreditation report in lieu of a compliance inspection of an intermediate care facility for individuals with intellectual disabilities or a health care institution if the health care institution has been subject to an enforcement action within the year preceding the annual licensing fee anniversary date (A.R.S. § 36-424).

There is no anticipated fiscal impact to the state General Fund associated with this legislation.

Provisions

Behavioral-Supported Group Homes

1.   Requires, beginning July 1, 2023, behavioral-supported group homes and DES contracted group homes to be licensed through DHS.

2.   Requires the Director to adopt rules regarding behavioral-supported group homes that include:

a)   ensuring that each client has a functional behavioral assessment completed by a qualified clinical professional, in consultation with a multidisciplinary team and an integrated treatment plan that is reviewed by the multidisciplinary team every 90 days to determine if the plan interventions are effective;

b)   ensuring that each client's behavioral treatment plan is developed, integrated, coordinated and monitored by a clinical professional; and

c)   requiring that the direct care staff in a behavioral-supported group home, at a minimum, have:

i.   at least one year of experience working directly with persons with dual disorders, including psychiatric disorders and developmental disabilities, who engage in behaviors that are disruptive, socially inappropriate, harmful or dangerous to self or others, interfere with functioning and quality of life or that may cause destruction of property; and

ii.   specialized training in applied behavior analysis and positive behavioral supports.

3.   Requires, in the adopted rules for behavioral-supported group homes, a clinical professional to:

a)   have at least two years of experience working directly with persons with dual disorders, including psychiatric disorders and developmental disabilities, who engage in behaviors that are disruptive, socially inappropriate, harmful or dangerous to self or others, interfere with functioning and quality of life or that may cause destruction of property;

b)   have specialized training in applying behavioral interventions, including applied behavior analysis and positive behavioral supports; and

c)   hold at least a master's degree in occupational therapy, physical therapy, psychology, social work, speech and language pathology, behavior analysis or a similar human service degree such as sociology, special education or rehabilitation counseling.

4.   Allows the multidisciplinary team to include, if appropriate, the:

a)   psychiatric, medical, nursing and nutrition providers;

b)   physical, occupational and speech therapists;

c)   educational personnel;

d)   day program staff;

e)   client;

f) client's family or guardian;

g)   behavioral health providers;

h)   group home direct care staff;

i) home health personnel; and

j) representatives from the DES Division of Developmental Disabilities.

5.   Exempts group homes and behavioral-supported group homes from the requirement to comply with DHS-prescribed zoning standards for a health care institution.

6.   Prohibits the DHS Director from accepting an accreditation report in lieu of a compliance inspection of a behavioral-supported group home, group home or nursing-supported group home.

7.   Excludes, effective July 1, 2023, behavioral-supported group homes and nursing-supported group homes that are licensed by DHS from the license requirement for a community residential setting regarding contracts for the purchase of residential care services.

Group Home License Transfer

8.   Requires DHS, beginning July 1, 2023, to transfer all group home licenses to the appropriate subclass of health care institution license.

9.   Includes a group home for individuals with developmental disabilities in the definition of a nursing-supported group home for health care institution licensing purposes.

10.  Requires a group home's initial licensure date or previous license expiration date, that is before July 1, 2023, to be considered the group home's anniversary date for health care institution licensing purposes.

11.  Repeals the group home licensure transfer requirements on July 1, 2025.

Miscellaneous

12.  Clarifies that, in the definition of a group home, a behavioral-supported group home is not a group home.

13.  Includes, effective July 1, 2023, a behavioral-supported group home in the definition of community residential setting.

14.  Defines behavioral-supported group home as a health care institution that:

a)   is a community residential setting for up to six persons with developmental disabilities;

b)   is operated by a service provider under contract with DES; and

c)   provides room and board, daily habilitation, assistance in self-administering medication and medication administration and behavioral health services for clients with dual disorders, including psychiatric disorders and developmental disabilities, who engage in behaviors that are disruptive, socially inappropriate, harmful or dangerous to self or others, interfere with functioning and quality of life or that may cause destruction of property.

15.  Defines behavioral treatment plan as a document that stipulates goals to treat, manage, control or extinguish predictable and continuing behaviors of the client and that is one component of the client's integrated treatment plan.

16.  Defines integrated treatment plan as a document that coordinates all treatment interventions that address the client's physical health and behavioral health needs for the purpose of ensuring seamless, coordinated and comprehensive treatment.

17.  Defines client, developmental disability, group home and habilitation.

18.  Exempts DHS and DES from statutory rulemaking requirements for 18 months for purposes of licensing and regulating behavioral-supported group homes.

19.  Makes technical and conforming changes.

20.  Becomes effective on the general effective date, with a delayed effective date as noted.

Amendments Adopted by Committee of the Whole

1.   Includes, in the multidisciplinary team that assesses client functional behavior, the:

a)   day program staff;

b)   client; and

c)   client's family or guardian.

2.   Defines behavioral treatment plan and integrated treatment plan.

3.   Makes conforming changes.

Amendments Adopted by the House of Representatives

1.   Requires DHS, beginning July 1, 2023, to transfer all group home licenses to the appropriate subclass of health care institution license.

2.   Includes a group home for individuals with developmental disabilities in the definition of a nursing-supported group home for health care institution licensing purposes.

3.   Requires a group home's initial licensure date or previous license expiration date, that is before July 1, 2023, to be considered the group home's anniversary date for health care institution licensing purposes.

4.   Repeals the group home licensure transfer requirements on July 1, 2025.

5.   Exempts DES from statutory rulemaking requirements for 18 months for purposes of licensing and regulating behavioral-supported group homes.

6.   Modifies the definitions of behavioral-supported group home and integrated treatment plan.

Governor's Veto Message

         The Governor indicates in his veto message that S.B. 1308 does not achieve the goal for individuals with disabilities to be cared for in a manner that helps them thrive and reach their highest potential and that the policy provisions of the bill can only be achieved if the Legislature allocates the necessary resources. 

Senate Action                                                           House Action

HHS                2/2/22        DP       8-0-0                  HHS                3/14/22      DP      9-0-0-0

3rd Read           2/24/22                  28-0-2                3rd Read           5/5/22                   50-0-10

Vetoed by the Governor 7/6/22

Prepared by Senate Research

July 7, 2022

MM/MC/sr