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ARIZONA STATE SENATE
Fifty-Seventh Legislature, First Regular Session
VETOED
health care; 2025-2026
Purpose
Makes statutory and session law changes relating to health care necessary to implement the FY 2026 state budget.
Background
The Arizona Constitution prohibits substantive law from being included in the general appropriations, capital outlay appropriations and supplemental appropriations bills. However, it is often necessary to make statutory and session law changes to effectuate the budget. Thus, separate bills called budget reconciliation bills (BRBs) are introduced to enact these provisions. Because BRBs contain substantive law changes, the Arizona Constitution provides that they become effective on the general effective date, unless an emergency clause is enacted.
H.B. 2953 contains the budget reconciliation provisions for changes relating to health care.
Provisions
Arizona Board of Nursing (AZBN) – Provisional Licensure
1. Requires the AZBN to issue a provisional license or certificate to an advanced practice registered nurse (APRN), registered nurse (RN) or a licensed practical nurse (LPN) within five business days after the AZBN receives a complete application and the fees required by the AZBN for an out-of-state nurse who is seeking licensure or certification if all the following apply:
a) the person holds a current license or certificate to practice as an APRN, RN, or an LPN in at least one other U.S. state and the license or certificate is in good standing in all U.S. states in which the person holds the license or certificate;
b) the person provides proof of a valid and unencumbered license or certificate in another U.S. state through an AZBN review of a National Nurse License Verification System or in another manner determined by the AZBN as sufficient proof that the person is in good standing with all licensing entities that have issued the person a license or certificate;
c) the person has not had a license or certificate revoked or denied and has not voluntarily surrendered a license or certificate in any U.S. state;
d) the person does not have a complaint or investigation pending before a licensing entity in any U.S. state;
e) the person has submitted a full set of fingerprints to the AZBN for the purpose of obtaining a state and federal criminal records check statutorily required by state and public law; and
f) the person is a resident of Arizona or attests in the application that the person is physically working or has accepted an offer to physically work in Arizona.
2. Requires an APRN, RN or an LPN who applies for a provisional license to include a sworn declaration attesting to the completeness and veracity of the information submitted in the application for provisional licensure or certification.
3. States that, if an APRN, RN or an LPN who applies for a provisional license or certification has any complaint or investigation pending, the five-day time frame does not apply and the AZBN may determine whether the person can safely practice nursing in Arizona.
4. Allows the Department of Public Safety to exchange submitted fingerprint data with the Federal Bureau of Investigation.
5. States that, if an APRN, RN or an LPN who applies for a provisional license or certificate has had discipline imposed by any licensing entity in another U.S. state, the five-day time frame does not apply and the AZBN may determine whether the person can safely practice nursing in Arizona.
6. Requires the AZBN to acknowledge by written or oral communication to an applicant for a provisional license or certificate the date of the receipt of the application for the provisional licensure or certification.
7. Requires the AZBN, within five business days after the receipt of the application, to provide the applicant either:
a) a notice of provisional licensure or certification approval; or
b) a written explanation of the reason or reasons the applicant is not eligible for provisional licensure or certification.
8. Requires the AZBN to further investigate the application as necessary to determine whether the applicant may be licensed or certified in accordance with statute.
9. Subjects a person who applies for or receives a provisional license or certificate to the laws regulating the person's practice in Arizona and the AZBN's jurisdiction.
10. Deems the issued provisional license or certificate valid only in Arizona.
11. Allows the person to who the provisional license or certificate is issued to practice as an APRN, RN or LPN in Arizona.
12. Allows a provisional license or certificate issued to be converted to a regular, single-state license or certificate six months after the provisional license or certificate is issued and is valid until the regular license or certificate is required to be renewed.
13. Allows the AZBN to terminate a provisional license or certificate issued within six months after issuance if the AZBN determines that there is a reasonable basis to require restrictions on or the termination of the provisional license or certificate.
14. Waives any required fees for U.S. Armed Forces veterans and spouses of active-duty members.
AZBN – Grant Program
15. Establishes, for FY 2026, the Student Registered Nurse Anesthetist Clinical Rotation Program within AZBN to expand the capacity of preceptor training programs at health care institutions for nurse anesthetist students.
16. Requires the AZBN to develop a grant program to distribute appropriated Program monies, for FY 2026, to licensed health care institutions to pay for the direct and indirect costs of expanding or developing clinical training placements for nurse anesthetist students, with preference given to expanding or developing clinical rotations in obstetrics, pediatrics, cardiovascular, thoracic and neurological care.
17. Specifies that awarded Program grant monies are intended to supplement, not supplant, existing training program expenses covered by the health care institution grantee.
18. Allows grant monies to be used to fund a clinical training placement through:
a) an anesthesia provider group who is contracted with a health care institution;
b) an authorized preceptor; or
c) a health care institution directly.
19. Prohibits more than 20 percent of a grant award from being spent on the indirect costs of expanding or developing clinical training placements.
20. Requires grant monies be distributed to grantees before the expenses for expanding or developing clinical rotations are incurred.
21. Directs grantees to return all monies to the AZBN that are not spent on the direct and indirect costs related to expanding or developing clinical rotations.
22. Requires the AZBN to establish an application process for Program grants.
23. Requires the AZBN to consider the following factors when determining grant awards:
a) the geographic and population distribution;
b) the number of nurse anesthetist students expected to be trained and retained; and
c) the cost of the proposal for the number of nurse anesthetist students expected to participate and be retained, compared to other proposals.
Department of Health Services
24. Delays, retroactive to June 30, 2025, the repeal of the Collaborative Care Uptake Fund from July 1, 2025, to July 1, 2027.
25. Requires the Department of Health Services (DHS) to distribute monies appropriated in the FY 2026 General Appropriations Act for a nonprofit organization to implement a public education campaign that increases awareness of Alzheimer's disease and dementia in rural and underserved urban areas in Arizona.
26. Requires DHS to distribute the monies to a nonprofit organization that:
a) demonstrates expertise in memory loss, dementia and Alzheimer's disease;
b) hosts a 24-hour, 7 days a week toll-free hotline, with interpreter service if needed, staffed by master's level consultants to provide education on Alzheimer's signs and symptoms, decision-making support, dementia crisis assistance, treatment options and referrals to local community resources;
c) provides care and support for those affected by Alzheimer's and other dementias; and
d) demonstrates experience in marketing and public awareness campaigns.
27. Requires DHS to submit a report on the impact of the public awareness campaign to the Governor, President of the Senate, Speaker of the House of Representatives and Secretary of State by November 1, 2026.
Arizona Health Care Cost Containment System (AHCCCS)
28. Removes, from AHCCCS-covered health and medical services, the exclusion of coverage for speech therapy and cochlear implants for persons who are at least 21 years old.
29. Prohibits Hospital Assessment Fund monies from being used to provide speech therapy and cochlear implants to eligible persons who are at least 21 years old.
30. Allows the hospital assessment to fund a portion of the costs of behavioral health services for certain expansion populations on an ongoing basis.
31. Requires, beginning January 1, 2026, AHCCCS to enter into a data matching agreement with the Department of Revenue (ADOR) to identify members who have lottery or gambling winnings of $3,000 or more.
32. Requires AHCCCS to review the information on lottery or gambling winnings on at least a monthly basis.
33. Requires AHCCCS, if a member fails to disclose winnings of $3,000 or more and is identified through the database match, to consider the member’s failure to disclose the information a violation of the system's terms of eligibility.
34. Requires AHCCCS, on at least a monthly basis, to:
a) receive and review death record information from the Department of Health Services concerning members and adjust system eligibility accordingly; and
b) review information concerning members that indicates a change in circumstances that may affect eligibility, including potential changes in residency as identified by out-of-state electronic benefit transfer card transactions.
35. Requires AHCCCS, on at least a quarterly basis, to:
a) receive and review information from the Department of Economic Security concerning members that indicates a change in circumstances that may affect eligibility, including changes to unemployment benefits, employment status and wages; and
b) receive and review information from ADOR concerning members that indicates a change in circumstances that may affect eligibility for the system, including potential changes in income, wages or residency as identified by tax records.
36. Prohibits AHCCCS from:
a) accepting self-attestation of income, residency, age, household composition, caretaker or relative status or receipt of other health insurance coverage without independent verification before enrollment, unless required by federal law;
b) requesting authority to waive or decline to periodically check any available income-related data sources to verify eligibility; or
c) accepting eligibility determinations of the system from a federally-facilitated exchange established in accordance with federal law.
37. Allows AHCCCS to accept assessments from a federally-facilitated exchange established in accordance with federal law.
38. Requires AHCCCS to independently verify eligibility and make eligibility determinations from the assessments accepted from a federally-facilitated exchange.
39. Requires AHCCCS to review a member’s eligibility if it receives information concerning that member indicating a change in circumstances that may affect eligibility.
40. Allows AHCCCS to:
a) execute a memorandum of understanding with any other department of Arizona for information required to be shared in accordance with the eligibility verification requirements; and
b) contract with one or more independent vendors to provide additional data or information that may indicate a change in circumstances and affect an individual’s eligibility.
41. Requires AHCCCS, by April 1, 2026, to submit to the Centers for Medicare and Medicaid Services (CMS), any waiver requests necessary to implement eligibility verification requirements.
42. Requires AHCCCS to request approval from CMS for a section 1115 waiver to allow AHCCCS to eliminate mandatory hospital presumptive eligibility and restrict presumptive eligibility determinations to children and pregnant women eligibility groups.
43. Requires AHCCCS, if approval for the section 1115 waiver is denied, to resubmit a subsequent request for approval within 12 months after each denial.
44. Prohibits AHCCCS, unless required by federal law, from designating itself as a qualified health entity for the purpose of making presumptive eligibility determinations or for any purpose not expressly authorized by state law.
45. Requires a qualified hospital, when making presumptive eligibility determinations to do all of the following:
a) notify AHCCCS of each presumptive eligibility determination within five working days after the date the determination is made;
b) assist individuals who are determined presumptively eligible under the system with completing and submitting a full application for AHCCCS eligibility;
c) notify each applicant in writing and on all relevant forms with plain language and large print that if the applicant does not file a full application for system eligibility with AHCCCS before the last day of the following month, presumptive eligibility coverage will end of the last day of the following month; and
d) notify each applicant that if the applicant files a full application for system eligibility with AHCCCS before the last day of the following month, presumptive eligibility coverage will continue until an eligibility determination is made on the application that was filed.
46. Requires AHCCCS to apply the following standards to establish and ensure the accurate presumptive eligibility determinations are made by each qualified hospital:
a) whether the qualified hospital submitted to AHCCCS the presumptive eligibility card within five working days after the determination date;
b) whether a full application for system eligibility was received by AHCCCS before the expiration of the presumptive eligibility period; and
c) whether the individual was found to be eligible under the system if a full application was received by AHCCCS.
47. Requires AHCCCS to notify a qualified hospital in writing within five working days after AHCCCS determines that the hospital fails to meet the established standards for any presumptive eligibility determination made by the hospital.
48. Requires the determination notice to include:
a) for a first violation:
i. a description of the standard that was not met and an explanation of why it was not met; and
ii. confirmation that a second finding will require that all applicable hospital staff participate in mandatory training by AHCCCS on hospital presumptive eligibility rules;
b) for a second violation:
i. a description of the standard that was not met and an explanation of why it was not met; and
ii. confirmation that all appliable hospital staff will be required to participate in a mandatory training by AHCCCS on hospital presumptive eligibility rules, including the date, time and location of the training as determined by AHCCCS;
iii. a description of available appellate procedures by which a qualified hospital may dispute the findings and remove the finding from the qualified hospital’s record by providing clear and convincing evidence that the standard was met; and
iv. confirmation that if the qualified hospital subsequently fails to meet any of the standards for presumptive eligibility for any determination, the qualified hospital will no longer by qualified to make presumptive eligibility determinations under the system;
c) for a third violation:
i. a description of the standard that was not met and an explanation of why it was not met;
ii. a description of available appellate procedures by which a qualified hospital may dispute the finding and remove the finding from the hospital’s record by providing clear and convincing evidence that the standard was met; and
iii. confirmation that, effective immediately, the hospital is no longer qualified to make presumptive eligibility determinations under the system.
49. Continues to require AHCCCS to transfer to the counties any excess monies necessary to comply with the federal Patient Protection and Affordable Care Act, regarding the counties' proportional share of the state's contribution.
50. Continues to allow AHCCCS, for the contract year beginning October 1, 2025, and ending on September 30, 2026, to extend risk contingency rate settings for all managed care organizations (MCOs) and funding for all MCO administrative funding levels imposed for the contract year beginning October 1, 2010, and ending September 30, 2011.
51. Declares the Legislature's intent that AHCCCS implement a Medicaid program within the available appropriation for FY 2026.
Court Ordered Stabilization of Impaired Persons
52. Allows, until December 31, 2027, the medical director of an evaluation agency in a county with a population between 1,000,000 and 1,500,000 persons to file a petition for court-ordered stabilization of a person, if the medical director determines that the proposed patient is an impaired person after examining or evaluating the proposed patient.
53. Specifies that an impaired person who is involuntarily admitted for a stabilization period has all of the civil and legal rights as prescribed for mental health patients.
54. Allows a petition for court-ordered stabilization to be filed, until December 31, 2027, by the medical director of an evaluation agency based on a personal assessment and review of an individual's medical record.
55. Requires a petition for court ordered stabilization to be accompanied by an affidavit from the medical director that outlines details regarding the patient who is the subject of the petition for stabilization, including:
a) that the individual is an impaired person and the clinical facts that support this conclusion;
b) that the individual is unable or unwilling to consent to voluntary admission;
c) the reasons why discharging the individual would be unsafe;
d) the reasons why the proceedings prescribed for court-ordered evaluation and treatment of persons who are severely mentally ill and chronically resistant to treatment are inappropriate; and
e) the date the individual was initially involuntarily admitted to the evaluation agency.
56. Requires the petition for court-ordered stabilization to request that the court issue an order admitting the impaired person to the evaluation agency for a stabilization period of up to five calendar days after the date the individual was involuntarily admitted to the evaluation agency.
57. Prohibits a petition for court-ordered stabilization from being filed to detain an individual who is at risk of using substances, but who is not currently intoxicated, in withdrawal or having substance-induced symptoms.
58. Requires the court to:
a) deny a petition for court-ordered stabilization if the court determines that there is insufficient evidence presented in the petition to find that the individual is an impaired person; or
b) grant a petition for court-ordered stabilization if the court determines that there is reasonable cause to believe that the individual is an impaired person.
59. Stipulates that, if the court denies a petition for court-ordered stabilization, the evaluation agency must immediately release the person who was the subject of the petition.
60. Directs the court to appoint counsel for the impaired person at the time of issuing an order for stabilization.
61. Requires an attorney who is appointed to represent an impaired person to confer with the impaired person within 24 hours of being appointed and to inform the impaired person of the person's rights.
62. Requires a copy of any stabilization order issued by the court to be personally served, as prescribed by law, court rule or as ordered by the court, on the impaired person with a copy of the petition for court-ordered stabilization.
63. States that the evaluation agency is not financially responsible for serving the stabilization order and copy of the petition for court-ordered stabilization on the impaired person.
64. Specifies that, each day an impaired person is detained under an order for stabilization, the impaired person must be offered treatment which the person may consent to.
65. Prohibits an impaired person under a stabilization order from being treated for impairment without the impaired person's express consent, except that seclusion and mechanical or pharmacological restraints may be used as emergency measures for the safety of the impaired person or others.
66. Requires the evaluation agency to assess the impaired person each day to determine whether the person remains impaired.
67. Stipulates that, if a person under an order for stabilization no longer meets the definition of an impaired person, the evaluation agency must release the person from the court-ordered stabilization period and discharge the person from the facility or admit the person to the evaluation agency on a voluntary basis.
68. Requires the evaluation agency to comply with outlined quality of treatment requirements.
69. Requires each impaired person undergoing stabilization care to receive physical care and treatment in a manner that allows the person's family or guardian to participate in the care and treatment, when appropriate, for the full period during which the impaired person is detained.
70. Instructs an evaluation agency that provides care and treatment to impaired persons to keep a clinical record for each impaired person that details all medical evaluations, care and treatment received by the impaired person.
71. Directs an evaluation agency that administers observation or inpatient stabilization care and treatment of an impaired person, in conjunction with the community treatment agency if applicable, and before the release of the impaired person to:
a) prepare a plan for the impaired person's care after release; and
b) provide the plan to the impaired person's guardian, if applicable.
72. Prohibits the use of seclusion or mechanical or pharmacological restraints on an impaired person undergoing stabilization except in the case of an emergency for the safety of the impaired person or others, or as part of a prescribed written stabilization plan for the person.
73. Requires any use of seclusion or restraint to be properly recorded in the impaired person's medical record.
74. Specifies that the use of any restraint or seclusion measure must be governed by written procedures of the applicable evaluation agency and is subject to DHS rules.
75. Prohibits an impaired person under an order for stabilization from being detained for more than five calendar days after the date that the impaired person is involuntarily admitted to the evaluation agency.
76. Allows an impaired person who is admitted for a stabilization period to be released at any time if release is appropriate in the opinion of the medical director of the evaluation agency.
77. States that the medical director is not civilly liable for any act committed by an impaired person who was released if the medical director, in good faith, has followed the prescribed requirements related to court-ordered stabilization of impaired persons.
78. Specifies that a person who was court ordered to stabilization treatment may continue treatment on a voluntary basis at any time and that the person must be offered the opportunity for voluntary admission each day.
79. Stipulates that, if an impaired person who is admitted for a stabilization period is released, the petition for court-ordered stabilization must be retained with a written statement by the medical director that states why the release was appropriate.
80. Requires the county attorney for the county in which a petition for court-ordered stabilization is filed to represent the person who filed the petition or the evaluation agency in any judicial proceeding for court-ordered stabilization and to defend all challenges to the detention of an impaired person.
81. Requires the appointed attorney for an impaired person who is involuntarily detained for stabilization to inform the impaired person of the right to:
a) a hearing to determine whether the impaired person should be involuntarily detained for stabilization; and
b) be represented by an attorney at the hearing.
82. Stipulates that if an impaired person requests a hearing to determine whether the person should be involuntarily detained for stabilization the court must schedule the hearing at the court's earliest opportunity to determine if there is a reasonable basis for the detention.
83. Requires the costs of court proceedings and services provided relating to the court ordered stabilization process to be charged to AHCCCS or to another third-party payor, if available.
84. Prohibits an impaired person from being charged for services related to the court ordered stabilization treatment of the person.
85. Requires, by January 1, 2028, counties utilizing court-ordered stabilization to submit a report to the Governor and the chairpersons of the Health and Human Services Committees of the Senate and the House of Representatives, or their successor committees, detailing:
a) the number of impaired persons who received court-ordered stabilization;
b) the average length of stay of impaired persons;
c) a list of the substances involved in cases of court-ordered stabilization;
d) the number and percentages of impaired persons who agreed to voluntary treatment and additional time in the evaluation agency;
e) the locations to which impaired persons were discharged, by number and percentage;
f) the number and percentages of impaired persons who received court-ordered stabilization and had a co-occurring mental health diagnosis;
g) the name of the payor of the court-ordered stabilization services; and
h) whether the impaired persons who received court-ordered stabilization had repeat applications filed on the person's behalf and subsequently received court-ordered stabilization.
86. Requires the Health and Human Services Committees, or their successor committees, to review the report and determine whether court-ordered stabilization should be continued, modified or discontinued.
87. Instructs the counties to provide a copy of the outlined report to the Secretary of State.
88. Specifies that medical director of an evaluation agency has the same meaning as prescribed by statute relating to mental health services.
89. Repeals the court-ordered stabilization process on January 1, 2029.
Health Care Interoperability Grant Program
90. Requires the Arizona Department of Administration (ADOA), for FYs 2026, 2027 and 2028, to administer a competitive grant program that provides a single company that licenses an interoperability software technology solution to support acute care for rural hospitals, health care providers and trauma centers with resources to further treatment and care coordination with a focus on reducing public and private health care costs and unnecessary transportation costs.
91. Prohibits the grant recipient from using a third-party vendor to comply with any of the grant program requirements.
92. Requires ADOA to award the grant by December 1, 2025.
93. Requires the grant program to enable the implementation of a single licensed interoperability software technology solution that is shared by hospitals and health care providers to benefit patients, before and after discharge from the provider's care, and that is accessible to current and future providers via a mobile, native smartphone application.
94. Requires the software to be made available to rural hospitals, health care providers and trauma centers that wish to participate by enabling a hospital's electronic medical records system to interface with interoperability technology and other electronic medical records systems and providers to promote mobile connectivity between hospital systems and facilitate increased communication between hospital staff and providers that use different or distinctive online and mobile platforms and information systems when treating acute patients.
95. Directs ADOA to award one grant for an interoperability software technology solution that, at a minimum:
a) complies with the federal Health Insurance Portability and Accountability Act (HIPAA) privacy standards;
b) captures and forwards clinical data, including laboratory results and images, and provides synchronous patient clinical data to health care providers regardless of geographic location;
c) provides a synchronous data exchange, that is not batched or delayed, at the point the clinical data is captured and available in the hospital's electronic record system;
d) is capable of providing proactive alerts to health care providers on their smartphones or a smart device;
e) allows synchronous and asynchronous communication via a native smartphone application;
f) is mobile technology, can be used on multiple electronic devices and includes the industry standard built-in application for the two most popular operating systems and a built-in application available to all users;
g) has patient-centric communication and is tracked with date and time stamping;
h) is connected to the appropriate physician resources; and
i) provides data to update cost reports to enhance emergency triage and to treat and transport patients.
96. Requires the grant recipient to demonstrate:
a) that its interoperability software technology solution meets all requirements at least 30 days before applying for the grant; and
b) proof of veteran employment.
97. Requires, for FYs 2026, 2027 and 2028, the grant recipient to provide ADOA a report that provides metrics and quantifies cost and time savings for using an interoperable software solution in health care that complies with HIPAA privacy standards.
98. Directs ADOA, by June 30 of each year, in coordination with AHCCCS, to provide a report on the allocation of grant funding and compiled analysis of the reports provided by the grant recipient to the:
a) President of the Senate;
b) Speaker of the House of Representatives;
c) Chairpersons of the Health and Human Services Committees of the Senate and House of Representatives;
d) Director of the Joint Legislative Budget Committee; and
e) Director of the Governor's Office of Strategic Planning and Budgeting.
99. Specifies that monies appropriated for the grant program do not affect monies appropriated in FY 2023 for interoperability software technology solutions or any grant awarded to or contract with a grant recipient.
100. Repeals the grant program on January 1, 2029.
Arizona Long Term Care System (ALTCS)
101. Requires the ALTCS preadmission screening instrument to assess cognitive needs regarding prompting, monitoring and supervising activities of daily living for applicants who are elderly or adults with physical disabilities.
102. Specifies that the preadmission screening instrument must weigh cognitive impairment and physical impairment at the same weight if the impairment produces a similar level of functional difficulty.
103. Outlines the following FY 2026 county contributions for ALTCS:
|
County |
Contribution Amount |
|
Apache |
$707,000 |
|
Cochise |
$7,510,100 |
|
Coconino |
$2,122,700 |
|
Gila |
$3,173,800 |
|
Graham |
$2,339,400 |
|
Greenlee |
$66,900 |
|
La Paz |
$828,800 |
|
Maricopa |
$275,201,600 |
|
Mohave |
$10,438,200 |
|
Navajo |
$2,926,600 |
|
Pima |
$63,729,700 |
|
Pinal |
$17,094,300 |
|
Santa Cruz |
$2,949,900 |
|
Yavapai |
$7,808,600 |
|
Yuma |
$12,640,000 |
104. Directs the State Treasurer to collect from the counties the difference between the total contribution and the counties' share of the state's actual contribution, if the overall cost for ALTCS exceeds the amount specified in the FY 2026 General Appropriations Act.
105. Requires the counties' share of the state's contribution to comply with any federal maintenance of effort requirements.
106. Requires the Director of AHCCCS to notify the State Treasurer of the counties' share of the state's contribution and report the amount to the Director of the Joint Legislative Budget Committee.
107. Directs the State Treasurer to:
a) withhold from any other monies payable to a county from any available state funding source, excluding the Highway User Revenue Fund (HURF), an amount necessary to fulfill that county's contribution requirement; and
b) deposit the withheld amounts and amounts paid by counties into the ALTCS Fund.
Disproportionate Share Hospital (DSH) Payments
108. Establishes the FY 2026 DSH payments as follows:
a) $28,474,900 for the Arizona State Hospital (ASH), of which the federal portion is deposited in the state General Fund (GF); and
b) $884,800 for private qualifying DSHs, which are hospitals that meet the mandatory definition of qualifying DSHs as defined by the federal Social Security Act (SSA), or DSHs that are located in Yuma County and contain at least 300 beds.
109. Outlines the following requirements once AHCCCS files a claim with the federal government and receives federal financial participation based on the amount certified by ASH:
a) if the certification is for an amount less than $28,474,900, AHCCCS must notify the Governor, the President of the Senate and the Speaker of the House and must deposit the entire amount of federal financial participation in the state GF; and
b) requires the certified public expense (CPE) form to contain both the total amount of qualifying DSH expenditures and the amount limited by the SSA.
110. Stipulates that, after DSH payment distributions are made, the allocation of DSH payments designated to political subdivisions, tribal governments and universities must be provided in the following order of priority to qualifying private hospitals located in a county with a population of:
a) fewer than 400,000 persons;
b) at least 400,000 but fewer than 900,000 persons; and
c) 900,000 persons or more.
111. Requires ASH, by March 31, 2026, to provide a CPE form for qualifying DSH expenditures to AHCCCS.
112. Continues to require AHCCCS to assist ASH in determining the amount of qualifying DSH expenditures.
County Acute Care
113. Outlines the following FY 2026 county acute care contributions:
|
County |
Contribution Amount |
|
Apache |
$268,800 |
|
Cochise |
$2,214,800 |
|
Coconino |
$742,900 |
|
Gila |
$1,413,200 |
|
Graham |
$536,200 |
|
Greenlee |
$190,700 |
|
La Paz |
$212,100 |
|
Maricopa |
$14,783,900 |
|
Mohave |
$1,237,700 |
|
Navajo |
$310,800 |
|
Pima |
$14,951,800 |
|
Pinal |
$2,715,600 |
|
Santa Cruz |
$482,800 |
|
Yavapai |
$1,427,800 |
|
Yuma |
$1,325,100 |
114. Requires the State Treasurer, if a county does not provide funding as specified, to:
a) subtract the amount owed by the county from any payments required to be made by the State Treasurer to the county plus interest on that amount, retroactive to the first day the funding was due; and
b) if the amount withheld is insufficient to meet that county’s funding requirement, withhold from any other monies payable to that county from any available state funding source, excluding HURF, an amount necessary to fulfill that county’s requirement.
115. Requires payments equal to one twelfth of the total amount for county acute care contributions to be made to the State Treasurer by the fifth day of each month and requires the State Treasurer, on request from the Director of AHCCCS, to require that up to three months' payment be made in advance, if necessary.
116. Requires the State Treasurer to deposit the amounts paid and withheld into the AHCCCS Fund and the ALTCS Fund.
117. Allows the Director of AHCCCS, if payments made exceed the amount required to meet the costs incurred by AHCCCS for the hospitalization and medical care of eligible persons, to instruct the State Treasurer to:
a) reduce the remaining payments to be paid by a specified amount; or
b) provide to the counties specified amounts from the AHCCCS Fund and the ALTCS Fund.
118. Declares the Legislature's intent that Maricopa County acute care contributions be reduced in each subsequent year according to the changes in the Gross Domestic Product price deflator.
Miscellaneous
119. Continues to exclude county contributions for Proposition 204 administrative costs from county expenditure limitations.
120. Continues to exclude county contributions related to the costs of inpatient, in-custody competency restoration treatment from county expenditure limitations.
121. Defines terms.
122. Makes technical and conforming changes.
123. Becomes effective on the general effective date.
Governor's Veto Message
The Governor indicates in her veto message that H.B. 2953, and this version of the FY 2026 budget as a whole, does not provide adequate funding for health care coverage and K-12 education and inadequately addresses priorities such as childcare affordability, veteran homelessness and public safety. The Governor encourages working in a productive fashion to deliver a bipartisan solution for Arizonans.
House Action Senate Action
APPROP 6/12/25 DP 11-7-0-0 3rd Read 6/25/25 16-11-3
3rd Read 6/13/25 31-0-29
Vetoed by the Governor on 6/25/25
Prepared by Senate Research
June 26, 2025
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