 |
ARIZONA STATE SENATE
Fifty-Seventh Legislature, Second Regular Session
AMENDED
health
care institutions; licensing; complaints
(NOW: health care institutions; licensing; compliance)
Purpose
Requires the Department of Health Services (DHS) and the Arizona Health Care Cost Containment System (AHCCCS) to coordinate to review each agency's monitoring and compliance functions to identify areas of overlap related to health care institution licensing standards. Establishes minimum qualifications and training requirements for behavioral health technicians (BHTs) and prescribes BHT scope of practice, supervision and duties.
Background
DHS is the agency responsible for licensing and oversight of all health
care institutions in Arizona, including enforcing statutes, rules and
regulations governing health care institutions. DHS may review and approve
plans and specifications, access books and records and conduct inspections and
investigations to determine compliance with licensing standards. DHS may also develop
facility manuals and guides to health care institutions and the general public
(A.R.S.
§ 36-406).
AHCCCS serves as Arizona's Medicaid agency which offers qualifying Arizona residents access to healthcare programs. AHCCCS contracts with health professionals to provide medically necessary health and medical services to eligible members and may establish eligibility and enrollment processes and implement systems related to fraud prevention, quality assurance and contractor compliance (A.R.S. § 36-2903).
BHTs, also referred to as psychiatric technicians or mental health technicians, are health care providers who provide direct care to individuals with mental health conditions and developmental disabilities. BHTs work as part of a health care team under the direction of psychiatrists and other behavioral health providers and may work in hospitals, group homes and other health care settings. BHT duties may include listening to patient concerns, monitoring behavior, recording patient conditions, reporting behavioral changes to medical staff, helping with admission and discharge, monitoring vital signs and assisting with activities of daily living (Cleveland Clinic).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
Review of Agency Compliance and Monitoring Functions
1. Requires DHS to license and monitor the operation of health care institutions to ensure compliance with applicable statutes.
2. Requires DHS and AHCCCS to coordinate to review each agency's monitoring and compliance functions to identify areas of overlap related to health care institution licensing standards.
3. Requires the review, at a minimum, to include:
a) licensing, certification and enrollment requirements;
b) on-site surveys, inspections, audits and other compliance activities;
c) data collection and reporting requirements; and
d) corrective action and enforcement processes relating to health care institutions.
4. Instructs DHS and AHCCCS to:
a) identify opportunities to eliminate or reduce duplicative, redundant or inconsistent requirements while maintaining patient safety and appropriate regulatory oversight; and
b) coordinate or align policies, procedures and operational practices to minimize administrative burdens on health care institutions.
5. Specifies that the review requirement does not require any action inconsistent with federal Medicaid conditions of participation or conditions of payment or other applicable federal requirements.
a) summarizes the findings of the review;
b) identifies areas of duplication or overlap; and
c) includes recommendations for statutory, regulatory or administrative changes.
BHTs
a) be at least 18 years old;
b) possess a minimum of a high school diploma or the equivalent; and
c) successfully complete any required background checks.
8. Requires a BHT, prior to providing supervised direct services, to complete training that addresses:
a) behavioral health system orientation;
b) confidentiality and compliance;
c) professional boundaries and ethics;
d) crisis response and de-escalation techniques and skills; and
e) trauma-informed and recovery-oriented care.
9. Allows behavioral health facilities and hospitals to adopt internal standards for BHTs that exceed statutory minimums
10. Requires behavioral health facilities and hospitals that employ BHTs to provide ongoing training, as required by law or the facility.
11. Authorizes a BHT to provide services consistent with the individual's training, delegation and supervision, including:
a) implementing client treatment, service or recovery plans;
b) providing skills training and supportive counseling to support behavioral, emotional and recovery-oriented functioning of clients;
c) assisting with client self-administration of medication as authorized by law or within an applicable scope of practice;
d) completing documentation and clerical activities related to client care;
e) contributing to client assessments and service planning, including interviewing and recording client history and goals, gathering and recording documentation to assist in developing a service plan and recording strengths, needs, abilities and preferences into the service plan;
f) providing education regarding treatment options and community resources;
g) submitting allowable billing consistent with payer requirements;
h) supporting mobile crisis teams and their interventions, including engagement, de-escalation, safety planning, follow-up coordination, collection of collateral information and assistance with assessment activities;
i) providing client transportation, meal preparation and daily living supports consistent with treatment goals;
j) scheduling client appointments and providing case management support activities;
k) monitoring and documenting client vital signs of clients and other health indicators for which the BHT has received appropriate training and authorization; and
l) providing other supportive or rehabilitative services consistent with the individual's training and supervision and the employing BHT's or hospital's license.
12. Specifies that a BHT is not authorized to diagnose medical or behavioral health conditions, prescribe medications or provide services beyond those delegated to the BHT and supervised by a licensed behavioral health professional or registered nurse.
13. Defines BHT as an individual who:
a) is employed by a behavioral health facility or by a hospital authorized to provide psychiatric services that is a licensed health care institution;
b) provides behavioral health services under the supervision or clinical oversight of either a licensed behavioral health professional or a registered nurse who is working within the nurse's scope of practice and who is providing supervision in a facility that is licensed as a hospital; and
c) performs only delegated clinical and supportive functions consistent with the individual's demonstrated training and competence and the employing behavioral health facility's or hospital's policies and procedures.
14. Requires DHS and AHCCCS, by December 31, 2026, to review their rules and policies relating to behavioral health technicians to ensure alignment with state statute.
15. Becomes effective on the general effective date.
Amendments Adopted by Committee
1. Requires DHS and AHCCCS to coordinate to review each agency's monitoring and compliance functions to identify areas of overlap related to health care institution licensing standards and outlines review requirements.
2. Requires DHS, by December 31, 2026, and October 31 every four years thereafter, to submit a written report to the Health and Humans Services Committees of the Senate and House of Representatives, or their successor committees, that:
a) summarizes the findings of the review;
b) identifies areas of duplication or overlap; and
c) includes recommendations for statutory, regulatory or administrative changes.
3. Removes DHS's ability to conduct an off-site preliminary review of a complaint to determine whether an on-site inspection is necessary.
4. Removes the requirement that DHS close a complaint without further investigation when:
a) the licensee has implemented systems reducing the likelihood of violations and provided sufficient evidence of compliance; or
b) the complaint is received more than 12 months after the incident that triggered the complaint.
Amendments Adopted by the House of Representatives
1. Prescribes scope of practice, training requirements and minimum qualifications for BHTs.
2. Requires DHS and AHCCCS, by December 31, 2026, to review rules and policies relating to behavioral health technicians to ensure alignment with state statute.
3. Makes technical changes.
Senate Action House Action
HHS 2/4/26 DPA 6-0-1 HHS 3/16/26 DPA 11-0-1-0
3rd Read 3/2/26 29-0-1 3rd Read 4/28/26 49-8-2-0-1
Prepared by Senate Research
April 28, 2026
MM/hk