SB1630 - 572R

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

Section 1. 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 behavioral health therapeutic home" means a residence for individuals who are at least eighteen years of age, have behavioral health issues and need behavioral health services that does all of the following for those individuals:

(a) Provides room and board.

(b) Assists in acquiring daily living skills.

(d) Monitors behaviors.

(e) Assists in the self-administration of medication.

(f) Provides feedback to case managers related to behavior.

4. "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.

5. "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.

6. "Adult foster care home" means a residential setting that provides room and board and adult foster care services for at least one and not 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.

7. "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.

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

9. "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.

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

11. "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 the professional to provide these services.

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

12. "Construction" means building, erecting, fabricating or installing a health care institution.

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

14. "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.

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

16. "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.

17. "Direction" means authoritative policy or procedural guidance to accomplish a function or activity.

18. "Director" means the director of the department.

19. "Direct owner" means a person that has an ownership or control interest in a health care institution totaling fifty-one percent or more.

20. "Enhanced residential treatment facility" means a residential care institution that is licensed to provide programs and services, including behavioral health services, structured support services AND health-related services, to residents who are seriously mentally ill as defined in section 36-550.

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

21. 22. "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 that are 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.

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

23. 24. "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.

24. 25. "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.

25. 26. "Health screening services" means the acquisition, analysis and delivery of health-related data of individuals to aid in determining the need for medical services.

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

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

28. 29. "Hospice service agency" means an agency or organization, or a subdivision of that agency or organization, that provides hospice services at the place of residence of its clients.

29. 30. "Indirect owner":

(a) Means a person that has an ownership or control interest in a direct owner totaling fifty-one percent or more.

(b) Includes an ownership or control interest in an indirect owner totaling fifty-one percent or more and a combination of direct ownership and indirect ownership or control interests totaling fifty-one percent or more in the health care institution.

30. 31. "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.

31. 32. "Intermediate care facility for individuals with intellectual disabilities" has the same meaning prescribed in section 36-551.

32. 33. "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.

33. 34. "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.

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

35. 36. "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.

36. 37. "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.

37. 38. "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.

38. 39. "Nursing-supported group home" means a health care institution that is a community residential setting as defined in section 36-551 for not more than six persons with developmental disabilities, that is operated by a service provider under contract with the department of economic security and that provides room and board, daily habilitation and continuous nursing support and intervention.

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

40. 41. "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.

41. 42. "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.

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

43. 44. "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.

44. 45. "Recidivism reduction staff" means a person who provides recidivism reduction services.

45. 46. "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.

46. 47. "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.

47. 48. "Respite care services" means services that are provided by a licensed health care institution to persons who are 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.

49. "Structured support services" includes services that are available for up to twenty-four-hours per day and case management, crisis intervention, social skills training and budgeting assistance.

48. 50. "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.

49. 51. "Supervision" means directly overseeing and inspecting the act of accomplishing a function or activity.

50. 52. "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 self-administering prescribed medications.

51. 53. "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.

52. 54. "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. 2. Title 36, chapter 4, article 2, Arizona Revised Statutes, is amended by adding section 36-425.10, to read:

START_STATUTE36-425.10. Enhanced residential treatment facilities; licensure; rules

The department shall license enhanced residential treatment facilities consistent with this chapter. The department shall adopt rules for enhanced residential treatment facilities, including licensure standards, staffing requirements and physical plant standards. An enhanced residential treatment facility may provide PROGRAMS AND services, through a combination of facility-based or coordinated community-based services, to residents who are seriously mentally ill as defined in section 36-550. END_STATUTE

Sec. 3. Section 36-2935, Arizona Revised Statutes, is amended to read:

START_STATUTE36-2935. Estate recovery program; liens

A. The director shall adopt rules in accordance with state and federal law to allow the administration to file a claim against a member's estate to recover paid assistance. The administration is also entitled to a lien on a member's property to recover paid assistance the member receives.

B. A member's personal representative must notify the administration of the member's estate or property within three months after the member's death if the member was at least fifty-five years of age and the administration has not already filed a statement of claim in the estate proceedings.

C. As nearly as is possible, the administration shall recover charges pursuant to the procedures prescribed in sections 36-2915 and 36-2916. If both the administration and a county have valid liens for paid assistance provided to the same member, or if both the administration and a special health care district have valid claims for paid assistance provided to the same member, the value of the property shall be divided between the administration, the special health care district and the county pro rata according to the amounts of their respective liens.

D. The administration shall impose liens in a manner consistent with federal law.

E. This section also applies to:

1. Persons who are eligible pursuant to section 36-2901, paragraph 6, subdivision (a) and who receive medical assistance under article 1 of this chapter.

2. Persons who are eligible for the seriously mentally ill enhanced residential treatment pilot program pursuant to article 3.1 of this chapter.END_STATUTE

Sec. 4. Title 36, chapter 29, Arizona Revised Statutes, is amended by adding article 3.1, to read:

ARTICLE 3.1. SERIOUSLY MENTALLY ILL

ENHANCED RESIDENTIAL TREATMENT PILOT PROGRAM

START_STATUTE36-2979. Definitions

In this article, unless the context otherwise requires:

1. "Administration" means the Arizona health care cost containment system administration.

2. "Applicant" means a person who applies for enrollment in the pilot program.

3. "Behavioral health services" has the same meaning prescribed in section 36-401.

4. "Contractor" means an entity that has entered into an agreement with the administration to provide acute care and behavioral health services to seriously mentally ill individuals pursuant to article 1 of this chapter and chapter 34, article 1 of this title.

5. "Eligible individual" means a person who meets the eligibility criteria prescribed in section 36-2979.02.

6. "Enhanced residential treatment facility" has the same meaning prescribed in section 36-401.

7. "Enhanced residential treatment services" means services authorized under federal medicaid authority pursuant to section 36-2979.09 that support individuals in an enhanced residential treatment facility and that include continuous supervision, structured support services, medication administration and monitoring, treatment planning and coordination and personal care services necessary for health and safety.

8. "Member" means an eligible individual who is enrolled in the pilot program.

9. "Pilot program" means the seriously mentally ill enhanced residential treatment pilot program established by section 36-2979.01.

10. "Seriously mentally ill" or "SMI" has the same meaning prescribed in section 36-550.

11. "SMI enhanced level of care" means the functional and behavioral level of care criteria adopted by the administration pursuant to section 36-2979.02.

12. "Structured support services" has the same meaning prescribed in section 36-401.END_STATUTE

START_STATUTE36-2979.01. Seriously mentally ill enhanced residential treatment pilot program; stakeholder work group; semiannual implementation updates; enrollment cap; federal approval

A. Subject to the approval of the centers for medicare and medicaid services, available appropriations and the enrollment cap prescribed in subsection F of this section, the seriously mentally ill enhanced residential treatment pilot program is established for three years from the date that the centers for medicare and medicaid services approve the pilot program consistent with this article. The pilot program operates through and is administered by contractors pursuant to their agreements with the administration under chapter 34, article 1 of this title. The administration shall seek any necessary federal authority to implement the pilot program, including authority under 42 United States code section 1315 or other applicable federal authority, and shall request approval not later than July 1, 2027. The administration shall begin enrolling eligible individuals not later than one year after receiving federal approval, subject to the available appropriations.

B. The administration shall incorporate the requirements of this article into contractor agreements executed pursuant to sections 36-3410 and 36-3412 and shall require contractors to fulfill the obligations of this article as part of their contractual duties.

C. Through the submission of the first annual report required by section 36-2979.08, the administration shall convene a stakeholder work group that includes individuals who are seriously mentally ill and behavioral health providers, family members, caregivers and guardians of individuals who are seriously mentally ill, counties, tribal nations and community organizations to advise on pilot program design and implementation. Stakeholder input shall specifically address the needs of individuals who require complex medication management, enhanced monitoring and structured support services to promote medication continuity and safety.

D. Until the pilot program is implemented, the administration shall provide semiannual implementation updates to the president of the senate, the speaker of the house of representatives and the chairpersons of the senate and house of representatives health and human services committees, or their successor committees.

E. The administration may implement this article through policy, contract requirements and other administrative mechanisms authorized under sections 36-2903, 36-2904 and 36-3412.

F. Subject to the approval of the centers for medicare and medicaid services and to available appropriations, the administration shall implement the pilot program for up to sixty members statewide. The administration may increase the enrollment cap above sixty members during the pilot program if the administration demonstrates, through data reported pursuant to section 36-2979.08, reduced utilization of high-cost services or cost avoidance in state-funded systems that demonstrates that the pilot program appropriation could sustain members beyond the enrollment cap, subject to available appropriations and review by the joint legislative budget committee.

G. A court may recommend participation in the pilot program but may not compel the administration to exceed the enrollment cap specified in subsection F of this section.END_STATUTE

START_STATUTE36-2979.02. Eligibility; financial eligibility; SMI enhanced level of care; criteria

A. Subject to the approval of the centers for medicare and medicaid services, available monies and the enrollment cap prescribed in section 36-2979.01, subsection F, to be eligible for the pilot program, an individual must meet all of the following criteria:

1. Be eighteen years of age or older.

2. Be a resident of this state.

3. have been determined to be seriously mentally ill.

4. meet the SMI enhanced level of care adopted by the administration pursuant to subsection E of this section, as determined pursuant to section 36-2979.03.

5. meet the financial eligibility requirements pursuant to subsection b of this section, as determined by the administration.

B. The administration shall determine financial eligibility for the pilot program and may not delegate that function to a contractor. An individual is financially eligible for the pilot program if the individual's income does not exceed three hundred percent of the federal supplemental security income benefit rate and the individual meets the resource requirement for long-term care programs, as prescribed by 42 United States Code section 1396p.

C. An individual whose income exceeds this standard may establish a qualified trust to achieve financial eligibility, pursuant to section 36-2934.01 and section 1917(d)(4)(A), (b) and (c) of the social security act. For the purposes of this article, the following sections of article 2 of this chapter apply to applicants and members in the same manner that the sections apply to applicants and members in the Arizona long-term care system:

1. Section 36-2934.02 relating to financial instruments.

2. Section 36-2935 relating to estate recovery and liens.

D. To the extent that any provision of article 2 of this chapter as incorporated by reference in subsection C of this section references the Arizona long-term care system, that reference shall be construed to apply to the pilot program established by this article.

E. The administration shall adopt SMI enhanced level of care specific to individuals who are seriously mentally ill. The criteria shall be based on behavioral, functional and safety criteria and may not require physical disability or physical impairment criteria. The criteria may include any of the following:

1. Current or recent court-ordered treatment.

2. Legal guardianship due to psychiatric incapacity.

3. Recent discharge from a jail or prison, the state hospital or a behavioral health residential facility.

4. Repeated psychiatric hospitalizations or crisis episodes.

5. Impaired judgment, disorganization or inability to perform activities of daily living due to psychiatric symptoms.

6. Documented safety risks, including elopement, aggression, delusional behavior, fire or water misuse or exploitation risk.

7. Homelessness or imminent risk of homelessness.

8. High-intensity or complex psychotropic medication regimens requiring enhanced monitoring to ensure adherence and to identify potential adverse effects.

9. Clinical needs that necessitate structured support services to maintain continuity of medication therapy, such as those at elevated risk of relapse, decompensation or hospitalization related to medication nonadherence.

F. The administration may modify the eligibility processes through policy, consistent with this article, subject to any necessary approval by the centers for medicare and medicaid services and available appropriations.END_STATUTE

START_STATUTE36-2979.03. Enrollment in pilot program; application; delegation of clinical eligibility; waitlist management

A. An individual who seeks to enroll in the pilot program shall apply through the individual's contractor. After determining the individual meets the SMI enhanced level of care criteria, the contractor shall forward the application to the administration for financial eligibility determination pursuant to section 36-2979.02, subsection B. If the individual is not yet enrolled with a contractor, the individual may apply through the administration.

B. Subject to the approval of the centers for medicare and medicaid services, available appropriations and the enrollment cap prescribed in section 36-2979.01, subsection F, the administration may delegate to contractors the authority to determine whether an applicant meets the SMI enhanced level of care criteria adopted by the administration pursuant to section 36-2979.02, subsection E and to manage pilot program waitlists, enrollment decisions and capacity prioritization for individuals who have been determined financially eligible by the administration.

C. The administration or a contractor exercising delegated authority under this section shall:

1. Apply the eligibility criteria adopted by the administration pursuant to section 36-2979.02.

2. Implement and maintain one or more waitlists, the total of which may not exceed one hundred applicants, for applicants for whom eligibility has been determined.

3. If the waitlist reaches one hundred applicants, implement an interest list for additional applicants and employ phased enrollment or other utilization controls as necessary to ensure that the enrollment cap prescribed in section 36-2979.01, subsection F is not exceeded.

4. Assign available pilot program capacity by applying the priority factors prescribed in subsection D of this section.

5. Report enrollment data to the administration in the form and frequency required by the administration by policy.

D. If the number of financially and clinically eligible individuals exceeds available pilot program capacity, the contractor shall assign available slots based on the highest clinical acuity and functional impairment defined by a methodology that takes into account the following priority factors:

1. Individuals under court-ordered treatment.

2. Individuals with legal guardianship due to psychiatric incapacity.

3. Individuals recently discharged from jail or prison, the state hospital or a behavioral health residential facility.

4. Individuals who are homeless or at imminent risk of homelessness.

5. Individuals with repeated crisis episodes, psychiatric hospitalizations or public safety involvement.

6. Individuals presenting significant safety risks due to psychiatric symptoms.

7. Individuals with high-intensity or complex psychotropic medication regimens requiring enhanced monitoring to ensure adherence and to identify potential adverse effects.

E. The administration shall retain authority to review and reverse contractor clinical eligibility and enrollment determinations and to audit contractor compliance with eligibility and enrollment requirements.

F. The administration may reserve a portion of available enrollment capacity for emergency or priority placements.END_STATUTE

START_STATUTE36-2979.04. Covered services

A. Subject to the approval of the centers for medicare and medicaid services, available appropriations and the enrollment cap prescribed in section 36-2979.01, subsection F, each contractor shall provide enrolled members with the following services:

1. All services that the contractor is required to provide to seriously mentally ill individuals under the contractor's agreement with the administration pursuant to sections 36-3407 and 36-3410, including behavioral health services, physical health services, crisis services, case management and peer support services.

2. Enhanced residential treatment services.

B. The contractor shall conduct, at minimum, an annual review of the ongoing medical necessity of services for each member and shall engage with the member to plan for transition to a less restrictive setting when clinically appropriate.

C. The administration may add, modify or combine services consistent with federal approval and legislative intent, subject to the approval of monies.END_STATUTE

START_STATUTE36-2979.05. Service plan; assessment

A. The contractor shall develop and maintain a written service plan for each member. The service plan must:

1. Be based on a comprehensive assessment of the member's behavioral health, functional and safety needs.

2. Identify the specific services and support to be provided and the settings in which the services and support will be provided.

3. Include goals for recovery, stability and, if appropriate, transition to less restrictive settings.

4. Be updated at least annually or more frequently if the member's needs change.

B. The member and, if applicable, the member's guardian or authorized representative shall participate in the development and revision of the service plan.END_STATUTE

START_STATUTE36-2979.06. Enhanced residential treatment services; provider requirements; transition and discharge planning protocols; reimbursement

A. Providers of enhanced residential treatment services shall document behavioral interventions, crisis support and staffing adjustments before initiating the discharge of any member.

B. A provider of enhanced residential treatment services shall implement transition and discharge planning protocols and shall obtain approval from the contractor before issuing to a member a nonemergency notice to vacate.

C. The administration may adopt enhanced reimbursement rates for enhanced residential treatment services provided to members under this article. The administration shall incorporate reimbursement rates and methodologies into contractor agreements pursuant to section 36-3412.

D. This section does not:

1. limit the administration's authority to ensure the health and safety of members.

2. Require a provider to continue services when immediate and documented risks to health or safety cannot be mitigated through reasonable clinical interventions.

3. Require a contractor to continue paying for services that are not medically necessary.END_STATUTE

START_STATUTE36-2979.07. Grievance and appeal process

A. A member or applicant aggrieved by an action of the administration or a contractor relating to eligibility, enrollment or services under this article has the right to file a grievance or appeal pursuant to section 36-3413 and, if applicable, to a hearing pursuant to rules adopted pursuant to section 36-2903.01, subsection B.

B. The contractor's grievance and appeal process required under section 36-3413 applies to matters arising under this article, including denials, reductions or terminations of enhanced residential treatment services and contractor clinical eligibility determinations.

C. Appeals of financial eligibility determinations made by the administration pursuant to section 36-2979.02, subsection B shall be heard pursuant to rules adopted pursuant to section 36-2903.01, subsection B.END_STATUTE

START_STATUTE36-2979.08. Annual report

Beginning one year after pilot program implementation and each year thereafter for the duration of the pilot program, the administration shall submit a report to the Governor, the President of the Senate and the Speaker of the House of Representatives that includes:

1. The number of members and the number of individuals who are on the waitlist and the number of individuals who are on the interest list for services and who have not yet been enrolled, if applicable.

2. The percentage of members who are under court-ordered treatment, guardianship or criminal justice supervision.

3. Housing stability outcomes for members.

4. Hospitalization, crisis service, jail, emergency department, evaluation agency and screening agency utilization of members.

5. Provider denials and discharges and the reasons for the denials and discharges of members.

6. The fiscal impact of and estimated cost avoidance related to the pilot program.

7. The number of members who are served in enhanced residential treatment facilities.END_STATUTE

START_STATUTE36-2979.09. Authority to seek and maintain federal approval

A. The administration shall seek and maintain any necessary federal approvals and may operate the pilot program pursuant to one or more approved medicaid state plan authorities, waivers or demonstration authorities, including those authorized under 42 United States Code section 1315 or other applicable federal authority.

B. If the centers for medicare and medicaid services denies or does not approve a request necessary to implement this article, the administration, to the extent allowed by federal law, shall continue to pursue approval through modifications, resubmissions or alternative federal authority and shall report the status of these efforts in the semiannual implementation updates required pursuant to section 36-2979.01. The administration shall obtain legislative approval for modifications or resubmissions that are inconsistent with this article.

c. On federal approval and subject to available appropriations, the administration may implement this article through policy and contract requirements pursuant to sections 36-2903, 36-2904 and 36-3412.

d. This article does not expand or modify standards for involuntary treatment under this title.END_STATUTE

START_STATUTE36-2979.10. Service plan; assessment

A. Services provided under this article shall supplement but not replace any other benefits or services for which a member is otherwise eligible.

B. The administration shall coordinate benefits with other payors, including medicare and private insurance, to the extent required by federal law.

C. A member in the pilot program may not also be enrolled in the Arizona long-term care system pursuant to article 2 of this chapter.END_STATUTE

Sec. 5. Delayed repeal; condition; notice

A. The seriously mentally ill enhanced residential treatment pilot program established by title 36, chapter 29, article 3.1, Arizona Revised Statutes, as added by this act, is repealed three years after the date that the centers for medicare and medicaid services approve the pilot program.

B. The Arizona health care cost containment system administration shall notify the director of the Arizona legislative council in writing of this date.