REFERENCE TITLE: special needs patients; health facilities

 

 

 

 

State of Arizona

House of Representatives

Fifty-seventh Legislature

Second Regular Session

2026

 

 

HB 4012

 

Introduced by

Representative Crews

 

 

 

 

 

 

 

 

AN ACT

 

Amending title 36, Arizona Revised Statutes, by adding chapter 43; relating to patient care.

 

 

(TEXT OF BILL BEGINS ON NEXT PAGE)

 


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

Section 1. Title 36, Arizona Revised Statutes, is amended by adding chapter 43, to read:

CHAPTER 43

PATIENTS WITH SPECIAL NEEDS

ARTICLE 1. GENERAL PROVISIONS

START_STATUTE36-4301. Definitions

In this chapter, unless the context otherwise requires:

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

2. "Health care facility" means a hospital, emergency department, urgent care center or other medical facility that is licensed and regulated pursuant to chapter 4 of this title.

3. "Health care provider" means a licensed professional who is involved in direct patient care.

4. "Nonverbal patient" means an individual who is unable to communicate verbally due to a developmental, neurological, medical or physical condition.

5. "Patient Advocate" means a trained individual who is designated by a health care facility to assist nonverbal patients and patients with special needs during diagnostic and treatment processes.

6. "Patient with special needs" means an individual who has a physical, developmental, intellectual or sensory disability that significantly affects the patient's ability to communicate symptoms or pain. END_STATUTE

START_STATUTE36-4302. Enhanced diagnostic evaluations; deviations

A. When a nonverbal patient or a patient with special needs exhibits symptoms or behaviors that may indicate serious internal illness or injury, a health care provider shall ensure that an enhanced diagnostic evaluation is conducted, consistent with clinical judgment and medically appropriate standards of care.  The evaluation may include, when clinically indicated:

1. Laboratory testing, including blood and urine studies.

2. Diagnostic imaging, including ultrasound, computed tomography scan or magnetic resonance imaging.

3. Additional diagnostic testing necessary to rule out serious conditions.

B. A health care provider may deviate from specific diagnostic elements if the deviation is clinically justified and documented in the patient's medical record. END_STATUTE

START_STATUTE36-4303. Pain assessment; communication

A. EAch Health care facility shall use evidence-based pain assessment tools that are appropriate for nonverbal patients and patients with special needs.

B. Each health care provider shall seek and document input from the family members or caregivers of nonverbal patients or patients with special needs who are familiar with the patient's baseline behavior and typical expressions of pain or distress.

C. Each health care facility shall make reasonable efforts to provide appropriate communication supports, including assistive communication tools or simplified communication methods. END_STATUTE

START_STATUTE36-4304. Training requirements; rules

A. EAch health care facility shall ensure that emergency department staff and other relevant personnel receive annual training on all of the following relating to nonverbal patients and patients with special needs:

1. Atypical symptom presentation.

2. Specialized pain assessment methods.

3. Communication strategies and sensory-sensitive care.

4. Application of enhanced diagnostic evaluation principles.

B. The department shall establish in rule the training requirements for health care facilities under this section.END_STATUTE

START_STATUTE36-4305. Patient advocate program

Each health care facility in this state shall provide access to social work or patient advocacy services for nonverbal patients and patients with special needs, if requested. Social workers and patient advocates shall assist with communication, support caregiver involvement and promote compliance with this article. END_STATUTE

START_STATUTE36-4306. Documentation; reporting

A. EAch health care facility shall ensure that the medical records of nonverbal patients and patients with special needs include documentation of diagnostic decisions, communication methods used, caregiver input and any deviations from enhanced evaluation practices.

B. Each health care facility shall submit annual compliance data to the department in a form prescribed by the department. END_STATUTE

START_STATUTE36-4307. Oversight and enforcement; rules

A. The department shall monitor compliance with this article and may require corrective action or additional training for health care facilities that are found to be noncompliant, consistent with existing enforcement authority pursuant to chapter 4 of this title.

B. The department shall adopt any rules necessary to implement this article. END_STATUTE

Sec. 2. Short title

This act may be cited as "Cito's Law".