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ARIZONA STATE SENATE
Fifty-Seventh Legislature, Second Regular Session
AMENDED
technical correction; critical infrastructure information
(NOW: dangerous incompetent defendants; out-of-state facilities)
Purpose
An emergency measure that authorizes, until December 31, 2031, placement of dangerous and incompetent defendants at the Arizona State Hospital (ASH) when there are no beds available in a secure state mental health facility in Arizona. Establishes the Study Committee on Secure State Mental Health Facilities (Study Committee) to make recommendations on the long-term feasibility of secure state mental health facilities or other care models and outlines Study Committee membership, duties and authorities. Requires the Department of Health Services (DHS) to conduct an analysis of the cost to staff and construct or renovate an existing structure to be converted to a new secure state mental health facility on ASH grounds for placement of dangerous, incompetent and nonrestorable defendants.
Background
If a defendant is found incompetent to stand trial and a factfinder subsequently determines the defendant is dangerous and should be involuntarily committed to treatment, the court must dismiss the charges against the defendant without prejudice and commit the defendant to a secure state mental health facility (A.R.S. § 13-4521).
A secure state mental health facility is a secure behavioral health residential facility (SBHRF) that is licensed by DHS to provide secure 24-hour on-site supportive treatment and supervision by staff with behavioral health training for persons who have been determined to be seriously mentally ill, chronically resistant to treatment for a mental disorder and who are placed in the SBHRF pursuant to court order (A.R.S. §§ 13-4501 and 36-425.06).
If there is a cost associated with temporarily placement of dangerous and incompetent defendants at ASH when there are no beds available at a secure state mental health facility in Arizona, there may be a fiscal impact to the state General Fund.
Provisions
ASH Placement of Dangerous, Incompetent and Nonrestorable Defendants
1. Specifies that, until December 31, 2031, if the court issues a commitment order and there are no beds available in a secure mental health facility in Arizona, ASH may accept the defendant at its forensic campus if the defendant:
a) has been deemed dangerous and incompetent and has been involuntarily committed for treatment;
b) has received at least 12 months of restoration to competency services; and
c) has a primary psychiatric condition.
2. Requires an order for placement at the ASH forensic campus to:
a) require that the defendant remain committed to ASH or a secure mental health facility until the court finds that the defendant is either competent to stand trial or no longer dangerous;
b) include authorization for ASH to provide necessary treatment to the defendant, including administering medications as clinically indicated; and
c) allow ASH to issue a standing order for application of restraints as necessary to ensure facility safety and security.
3. Specifies that, if the medical director determines a defendant previously determined to be dangerous, incompetent and nonrestorable is no longer dangerous or incompetent, the proceedings are subject to statutes relating to dangerous and incompetent persons.
4. Requires ASH, as soon as practicable after a secure state mental health facility is licensed in Arizona, to coordinate the transfer of dangerous and incompetent defendants to the facility.
5. Requires the originating county from which a defendant is determined to be dangerous, incompetent and nonrestorable and subsequently admitted to ASH to reimburse DHS for 100 percent of the costs of nonpsychiatric or nonmental health disorder-related services provided to the defendant during admission, including:
a) physical health care services;
b) services to treat co-occurring or comorbid medical conditions;
c) services to treat diagnosed neurocognitive disorders; and
d) services to treat diagnosed neurodevelopmental disorders.
6. Prohibits ASH from accepting more than three defendants with a primary psychiatric condition who have been determined dangerous, incompetent and nonrestorable for care and treatment on its forensic campus.
7. Specifies that, if ASH reaches or is expected to reach the maximum funded capacity for forensic programs, the ASH Superintendent must inform all counties that ASH may not accept any additional defendants and that:
a) DHS may reimburse a county for the actual costs of each day an admission is deferred for a person deemed guilty except insane; and
b) DHS and its officers are not liable or subject to civil sanctions due to ASH’s inability to admit defendants.
8. Requires the Administrative Office of the Courts, beginning October 1, 2026, and every six months thereafter, to report to the Speaker of the House of Representatives, President of the Senate, the Governor and Director of DHS the number of:
a) defendants determined to be incompetent to stand trial and nonrestorable;
b) trials initiated to determine if a defendant is dangerous;
c) defendants determined to be dangerous; and
d) defendants diagnosed with a neurocognitive or neurodevelopmental disorder, including traumatic brain injury, dementia or autism, who were determined to be either incompetent to stand trial and nonrestorable or incompetent, nonrestorable and dangerous.
9. Specifies that the requirements and protocols governing placement of dangerous, incompetent and nonrestorable defendants at ASH applies retroactively to January 1, 2024.
10. Repeals requirements relating to placement of committed defendants at ASH on January 1, 2032.
Study Committee
12. Requires the Study Committee to:
a) identify sustainable and long-term funding sources for persons determined to be dangerous, incompetent and nonrestorable, including the feasibility of state general funded, county-funded and federal Medicaid reimbursement models;
b) determine the appropriate per diem rates to incentivize private providers to build and operate secure state mental-health facilities;
c) evaluate the feasibility of privately operated secure state mental health facilities versus separate and specialized facilities operated directly by ASH;
d) research if commitments of defendants determined to be dangerous, incompetent and nonrestorable remains the most appropriate legal pathway and if a modified civil commitment process provides better clinical outcome and federal funding eligibility;
e) review literature and data to project the growth of the population of defendants determined to be dangerous, incompetent and nonrestorable over the next 10 years;
f) evaluate the costs and logistics associated with entering into an interstate compact or multistate agreement to establish an out of state placement for a defendant determined to be dangerous, incompetent and nonrestorable, if a bed in a secure state mental health facility in Arizona is unavailable.
13. Outlines Study Committee membership as follows:
a) three members of the Senate, not more than two of whom are members of the same political party, appointed by the President of the Senate (President);
b) three members of the House of Representatives, not more than two of whom are members of the same political party, appointed by the Speaker of the House of Representatives (Speaker of the House);
c) the Director of the Arizona Health Care Cost Containment System (AHCCCS) or the Director's designee;
d) the ASH Superintendent or the Superintendent's designee;
e) the Attorney General or a member of the Attorney General's staff with experience in civil commitment procedures for public health and safety and commitment procedures pursuant to the criminal code;
f) one member from a county attorney's office in a county with a population of at least 1,500,000 persons, appointed by the Speaker of the House;
g) one member from a county attorney's office in a county with a population of less than 1,500,000 persons, appointed by the President;
h) at least two private sector providers with experience in operating behavioral health facilities, one of whom is appointed by the Speaker of the House and one of whom is appointed by the President;
i) one public defender in a county with a population of at least 1,500,000 persons, appointed by the President;
j) one public defender in a county with a population of less than 1,500,000 persons, appointed by the Speaker of the House;
k) one member from the Administrative Office of the Courts; and
l) one member from a nonprofit federally mandated protection and advocacy agency for Arizona, appointed by the President.
14. Allows the Study Committee to hold hearings, conduct site visits to existing secure facilities and request data from DHS, AHCCCS and the Administrative Office of the Courts.
15. Specifies that Study Committee members are not eligible to receive compensation but are eligible to receive reimbursement of expenses.
16. Requires the Study Committee to submit a report of its findings and recommendations to the Governor, President, Speaker of the House and the Secretary of State by December 31, 2026.
17. Repeals the Study Committee on January 1, 2027.
Miscellaneous
18. Requires DHS to conduct an analysis of the cost to staff and construct or renovate an existing structure to be converted to a new secure state mental health facility on ASH grounds for defendants determined to be dangerous, incompetent and nonrestorable.
19. Requires DHS, by November 1, 2026, to submit the cost analysis to the President, Speaker of the House, Governor and provide a copy to the Secretary of State.
20. Makes conforming changes.
21. Becomes effective on signature of the Governor, if the emergency clause is enacted.
Amendments Adopted by Committee
1. Removes the requirement that DHS contract with an out-of-state secure mental health facility for the placement of defendants deemed dangerous and incompetent when there are no beds available in a secure state mental health facility in Arizona.
2. Specifies that, until December 31, 2031, if the court issues a commitment order and there are no beds available in a secure mental health facility in Arizona, ASH may accept the defendant at its forensic campus if the defendant:
a) has been deemed dangerous and incompetent and has been involuntarily committed for treatment;
b) has received at least 12 months of restoration to competency services; and
c) has a primary psychiatric condition.
3. Prescribes requirements relating to the placement of a dangerous and incompetent defendant at ASH.
4. Requires ASH, as soon as practicable after a secure state mental health facility is licensed in Arizona, to coordinate the transfer of dangerous and incompetent defendants to the facility.
5. Requires the originating county from which a defendant is determined to be dangerous, incompetent and nonrestorable and subsequently admitted to ASH to reimburse DHS for 100 percent of the costs of nonpsychiatric or nonmental health disorder-related services provided to the defendant during admission, including:
a) physical health care services;
b) services to treat co-occurring or comorbid medical conditions;
c) services to treat diagnosed neurocognitive disorders; and
d) services to treat diagnosed neurodevelopmental disorders.
6. Prohibits ASH from accepting more than three defendants with a primary psychiatric condition who have been determined dangerous, incompetent and nonrestorable for care and treatment on its forensic campus.
7. Specifies that, if ASH reaches or is expected to reach the maximum funded capacity for forensic programs, the ASH Superintendent must inform all counties that ASH may not accept any additional defendants and that:
a) DHS may reimburse a county for the actual costs of each day an admission is deferred for a person deemed guilty except insane; and
b) DHS and its officers are not liable or subject to civil sanctions due to ASH’s inability to admit defendants.
8. Requires the Administrative Office of the Courts, beginning October 1, 2026, and every six months thereafter, to report to the Speaker of the House of Representatives, President of the Senate, the Governor and Director of DHS the number of:
a) defendants determined to be incompetent to stand trial and nonrestorable;
b) trials initiated to determine if a defendant is dangerous;
c) defendants determined to be dangerous; and
d) defendants diagnosed with a neurocognitive or neurodevelopmental disorder, including traumatic brain injury, dementia or autism, who were determined to be either incompetent to stand trial and nonrestorable or incompetent, nonrestorable and dangerous.
9. Specifies that the requirements and protocols governing placement of dangerous, incompetent and nonrestorable defendants at ASH applies retroactively to January 1, 2024.
10. Repeals requirements relating to placement of committed defendants at ASH on January 1, 2032.
11. Requires DHS to conduct an analysis of the cost to staff and construct or renovate an existing structure to be converted to a new secure state mental health facility on ASH grounds for defendants determined to be dangerous, incompetent and nonrestorable and to submit the analysis to the President, Speaker of the House, Governor and the Secretary of State by November 1, 2026.
12. Establishes the Study Committee to make recommendations on the long-term feasibility of secure state mental health facilities or other care models and outlines Study Committee membership, duties and authorities.
13. Adds an emergency clause.
House Action Senate Action
HHS 2/16/26 DPA/SE 6-5-0-1 HHS 2/18/26 DPA 4-3-0
3rd Read 2/18/26 37-20-3
(W/O emergency)
Prepared by Senate Research
March 13, 2026
MM/hk