The Arizona Revised Statutes have been updated to include the revised sections from the 57th Legislature, 2nd Regular Session. Please note that the next update of this compilation will not take place until after the conclusion of the 58th Legislature, 1st Regular Session, which convenes in January 2027.
This online version of the Arizona Revised Statutes is primarily maintained for legislative drafting purposes and reflects the version of law that is effective on January 1st of the year following the most recent legislative session. The official version of the Arizona Revised Statutes is published by Thomson Reuters.
36-2979.02. Eligibility; financial eligibility; SMI enhanced level of care; criteria
(Conditionally Rpld.)
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.