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ARIZONA STATE SENATE
Fifty-Seventh Legislature, Second Regular Session
AMENDED
health
facilities; group homes; resident information
(NOW: residential healthcare; emergencies; study committee)
Purpose
Prescribes criteria for the Department of Health Services (DHS) to conduct an investigation into a health care institution if a patient's or resident's do-not-resuscitate order is not followed after requested emergency medical services. Reestablishes the Vulnerable Adult System Study Committee (Study Committee).
Background
DHS licenses and oversees health care institutions in Arizona. DHS must adopt rules to establish minimum standards and requirements for constructing, modifying and licensing health care institutions necessary to ensure the public health safety and welfare (A.R.S. §§ 36-405 and 36-406).
In 2024, the Legislature established the Study Committee to: 1) develop
and implement a coordinated vulnerable adult delivery system that ensures the
health and safety of vulnerable adults; 2) recommend best practices relating to
responding to and investigating complaints;
3) research best practices related to adult protective services at the state,
municipality and community levels; 4) research and make recommendations on how
the vulnerable adult system can ensure that vulnerable adults receive services
they require after the vulnerable adult system completes its investigatory
duties, including assigning a specific agency with the responsibility to
provide or coordinate case management; 5) research and identify common
statewide outcomes;
6) identify best practices for data collection and data sharing by various
entities involved in providing vulnerable adult services; and 7) review and
recommend changes to the statutes and rules that govern vulnerable adult
services. The Study Committee submitted its initial report with recommendations
on October 1, 2025, including the extension of the Study Committee beyond its
sunset date of January 1, 2026 (Laws 2024, Ch. 100;
Study
Committee Initial Report).
There is no anticipated fiscal impact to the state General Fund associated with this legislation.
Provisions
Patient or Resident Directives
1. Requires each assisted living center or home that contacts an emergency responder on behalf of a resident to:
a) note in the resident’s record that the assisted living center or home provided the written document of patient information required in accordance with statute to the emergency responder; and
b) obtain written or electronic acknowledgement from the emergency responder that the emergency responder received the written document.
2. Requires DHS, if it receives a complaint from an emergency medical care technician or peace officer alleging that a health care institution failed to provide a patient's or resident's do-not-resuscitate order or other advance directive, if on file with the health care institution, after requesting emergency medical services, to determine whether the health care institution:
a) is in compliance with the patient information disclosure requirements in accordance with statute;
b) has policies and procedures established, documented and implemented that cover advance directives, including do-not-resuscitate orders; and
c) complied with the policies and procedures in the situation that was basis for the complaint.
3. Requires DHS, if it receives a complaint from an emergency medical care technician or peace officer alleging that a group home or behavioral supported home failed to provide a resident's do-not-resuscitate order or other advance directive, if on file with the group home or behavioral-supported group home, after requesting emergency medical services, to determine whether the group home or behavioral-supported group home:
a) has policies and procedures established, documented and implemented that cover advance directives, including do-not-resuscitate orders; and
b) complied with the policies and procedures in the situation that was basis for the complaint.
4. States that the compliance requirements for advance directives do not require a patient or resident to have any advance directive, including a do-not-resuscitate order, on file with a health care institution, group home or behavioral-supported group home unless otherwise specified by law.
5.
Requires DHS to adopt rules to ensure compliance with criteria for
investigation into a group home or behavioral supported home if a patient's or
resident's do-not-resuscitate order is not followed after requested emergency
medical services.
Study Committee
6. Reestablishes the Study Committee, consisting of the following members:
a) two members of the Senate who are appointed by the President of the Senate and who are members of different political parties, one of which is designated to serve as Co-Chair;
b) two members of the House of Representatives who are appointed by the Speaker of the House of Representatives and who are members of different political parties, one of which is designated to serve as Co-Chair;
c) the Director of DHS or the Director's designee;
d) the Director of the Arizona Department of Economic Security (DES) or the Director's designee;
e) the Director of the Arizona Health Care Cost Containment System or the Director's designee;
f) one member who represents the Governor's Office and who is appointed by the Governor;
g) one member who represents the Attorney General's Office and who is appointed by the Attorney General;
h) DES's long-term care ombudsman or the ombudsman's designee;
i) one member who currently serves as a public fiduciary and who is appointed by the Governor;
j) two members who are employed by a local law enforcement agency or by a statewide organization that represents law enforcement and who are appointed by the Governor;
k) the Executive Director of the Navajo Area Agency on Aging or the Executive Director's designee;
l) the Executive Director of the Inter-Tribal Council of Arizona or the Executive Director's designee;
m) two members who represent assisted living facilities and who are appointed by the Speaker of the House of Representatives;
n) two members who represent nursing care institutions and who are appointed by the Governor;
o) one member who represents a statewide organization that advocates for elderly vulnerable adults and who is appointed by the President of the Senate;
p) one member who represents a statewide organization that advocates on behalf of persons affected by Alzheimer's disease and who is appointed by the President of the Senate;
q) one member who represents a statewide association that advocates on behalf of persons who provide services to persons with developmental disabilities and who is appointed by the Speaker of the House of Representatives;
r) one licensed health care professional who is appointed by the Speaker of the House of Representatives and who provides health care services to elderly vulnerable adults;
s) one member who is on the Governor's Advisory Council on Aging and who is appointed by the Governor; and
t) one member who represents a statewide association representing firefighters in Arizona and who is appointed by the President of the Senate.
7. Requires the Study Committee to:
a) develop and implement a coordinated vulnerable adult services delivery system that ensures the health and safety of vulnerable adults;
b) recommend best practices relating to responding to and investigating complaints;
c) research best practices related to adult protective services at the state, municipality and community levels;
d) research and make recommendations on how the vulnerable adult system can ensure that vulnerable adults receive services they require after the vulnerable adult system completes its investigatory duties, including assigning a specific agency with the responsibility to provide or coordinate case management;
e) research and identify common statewide outcomes;
f) identify best practices for data collection and data sharing by various entities involved in providing vulnerable adult services; and
g) review and recommend changes to the statutes and rules that govern vulnerable adult services.
8. Allows the co-chairpersons to designate work groups to research, study and make recommendations to the Study Committee.
9. Requires at least two work groups to be established to separately address the needs of persons with developmental disabilities and persons who are elderly or who have a physical disability, including the training requirements for persons who are caring for these populations.
10. Requires DES, once the Study Committee establishes a strategic direction, and in conjunction with the work groups, to develop an action plan for implementation.
11. States that public members of the Study Committee are eligible to receive reimbursement of expenses in accordance with statute.
12. Requires the Study Committee, by October 1, 2026, and each October 1 thereafter, to submit a report of its findings and recommendations to:
a) the Governor;
b) the President of the Senate;
c) the Speaker of the House of Representatives; and
d) the Secretary of State.
13. Repeals the Study Committee on January 1, 2029.
Miscellaneous
14. Defines health care institution as a licensed assisted living center, assisted living home, assisted living facility, hospice, nursing-supported group home, nursing care institution or a residential care institution.
15. Defines emergency medical technician as an individual who has been certified by DHS as an emergency medical technician, an advanced emergency medical technician, an emergency medical technician I-99 or a paramedic.
16. Becomes effective on the general effective date.
Amendments Adopted by Committee
1. Removes the requirement for an employee of a health care institution, group home or behavioral-supported group home who provides direct care to a patient or resident to complete a form prescribed by DHS, which may be electronic, for each patient or resident under the employee's care to update the patient's or resident's information before the end of the employee's workday or shift and another employee assumes the care of the patient or resident.
2. Requires DHS to conduct investigations if it receives a complaint from an emergency medical care technician or emergency medical responder alleging that health care institution failed to provide a patient's or resident's do-not-resuscitate order after requesting emergency medical services.
3. Requires DHS to conduct investigations if it receives a complaint from an emergency medical care technician or emergency medical responder alleging that group home or behavioral supported home failed to provide a patient's or resident's do-not-resuscitate order after requesting emergency medical services.
Amendments Adopted by Committee of the Whole
1. The committee amendment was withdrawn.
2. Requires each assisted living center or home that contacts an emergency responder on behalf of a resident to:
a) note in the resident’s record that the assisted living center or home provided the written document of patient information required in accordance with statute to the emergency responder; and
b) obtain written or electronic acknowledgement from the emergency responder that the emergency responder received the written document.
3. Removes the requirement for an employee of a health care institution, group home or behavioral-supported group home who provides direct care to a patient or resident to complete a form prescribed by the DHS, which may be electronic, for each patient or resident under the employee's care to update the patient's or resident's information before the end of the employee's workday or shift and another employee assumes the care of the patient or resident.
4. Requires DHS, if it receives a complaint from an emergency medical care technician or peace officer alleging that a health care institution failed to provide a patient’s or resident’s do-not-resuscitate order or other advance directive, if on file with the health care institution, after requesting emergency medical services, to determine whether the health care institution:
a) is in compliance with the patient information disclosure requirements in accordance with statute;
b) has policies and procedures established, documented and implemented that cover advance directives, including do-not-resuscitate orders; and
c) complied with the policies and procedures in the situation that was basis for the complaint.
5. Requires DHS, if it receives a complaint from an emergency medical care technician or peace officer alleging that a group home or behavioral-supported group home failed to provide a resident’s do-not-resuscitate order or other advance directive, if on file with the group home or behavioral-supported group home, after requesting emergency medical services, to determine whether the group home or behavioral-supported group home:
a) has policies and procedures established, documented and implemented that cover advance directives, including do-not-resuscitate orders; and
b) complied with the policies and procedures in the situation that was basis for the complaint.
6. States that the compliance requirements for advance directives do not require a patient or resident to have any advance directive, including a do-not-resuscitate order, on file with a health care institution, group home or behavioral-supported group home unless otherwise specified by law.
7. Defines emergency medical technician.
Senate Action
RAGE 2/18/26 DPA 6-0-1
Prepared by Senate Research
March 3, 2026
JT/HD/ci