Assigned to HHS AS PASSED BY COMMITTEE
ARIZONA STATE SENATE
Fifty-Fifth Legislature, Second Regular Session
AMENDED
FACT SHEET FOR S.B. 1113
court-ordered treatment; enhanced services
Purpose
Allows a court to enter an order for patient enhanced treatment services at a
court-designated mental health treatment agency and appropriates $1 million from the state
General Fund (state GF) in FY 2023, FY 2024 and FY2025 to the Arizona Health Care Cost
Containment System Administration (AHCCCS) for enhanced treatment services.
Background
A physician or other person may file a petition for court-ordered treatment on behalf of a
state or county screening, evaluation or mental health treatment agency. The petition must allege:
1) that the patient needs a period of treatment because the patient is a danger to self or to others as
a result of a mental disorder, has a persistent or acute disability or has a grave disability; 2) the
treatment alternatives are appropriate or available; and 3) that the patient is unwilling to accept or
is incapable of accepting treatment voluntarily. A copy of all petitions must be mailed to the
superintendent of the Arizona State Hospital. The petition must include: 1) a summary of the facts
that support the allegations; 2) a request to the court to issue an order requiring the person to
undergo a period of treatment; and 3) the affidavits of two physicians. In cases of grave disability,
the petition must include additional outlined statements and requests. The affidavits must describe
in detail the dangerous behavior and be based on the physician's observations of the patient and
study of patient information. If a prosecutor filed a petition, the petition must be accompanied by
any known criminal history of the person and any previous findings of incompetency (A.R.S. §§
36-503.01 and 36-533).
The court must order the patient to undergo inpatient, outpatient or both inpatient and
outpatient treatment if the court finds by clear and convincing evidence that the proposed patient:
1) is a danger to self or others as a result of a mental disorder; 2) has a persistent or acute disability
or a grave disability and needs treatment; and 3) is either unwilling or unable to accept voluntary
treatment. The court must consider all available and appropriate alternatives for the treatment and
care of the patient. In any proceeding for court-ordered treatment in which the petition alleges that
the patient is in need of a guardian or conservator, and states the grounds for that allegation, the
court may appoint an emergency temporary guardian or conservator, or both (A.R.S. § 36-540).
S.B. 1113 appropriates $1 million from the state GF in FY 2023, FY 2024 and FY2025 to
AHCCCS. The Joint Legislative Budget Committee fiscal note estimates a fiscal impact of $12
million to the state GF (JLBC fiscal note).
FACT SHEET – Amended
S.B. 1113
Page 2
Provisions
1. Allows the court to enter an order for enhanced treatment services as an initial, amended or
renewed order to a court-designated mental health treatment agency.
2. Appropriates $1 million from the state GF in FY 2023, FY 2024 and FY2025 to AHCCCS for
enhanced treatment services.
3. Stipulates that the court may enter an order for enhanced treatment services if the court finds
by clear and convincing evidence that the patient:
a) has demonstrated a continuing unwillingness or inability to comply with treatment, despite
having had treatment offered, prescribed, recommended or ordered by a licensed medical
professional to improve or to prevent a relapse or deterioration of the patient's condition;
and
b) does not comply with treatment, there is a substantial risk that the patient's physical,
emotional or mental condition will deteriorate or continue to deteriorate to the point that it
is likely the patient will inflict physical harm to self or another person in the reasonably
near future or be in danger of suffering serious harm due to the patient's inability to provide
for basic personal needs.
4. Requires the court, in the determination whether to enter an order for enhanced treatment
services, to consider:
a) evidence that the patient's understanding of the need for treatment is impaired to the point
that the patient is unlikely to voluntarily comply with treatment;
b) evidence that, within the 36 months before the petition, excluding any time the patient was
hospitalized or incarcerated, the patient's non-participation in treatment offered, prescribed,
recommended or ordered by a licensed medical professional played a factor in the patient
committing outlined harmful or dangerous behaviors; and
c) any other evidence relevant to the patient's willingness or ability to comply with treatment.
5. Specifies that the outlined harmful or dangerous behaviors include:
a) the patient being, at least two times, taken to a hospital emergency room, a psychiatric
hospital or a crisis center for evaluation, stabilization or treatment;
b) the patient being, at least two times, detained in a jail or detention center charged with a
crime or arrested;
c) the patient committing, attempting to commit or threatening to commit one or more acts of
serious physical harm to self or others; or
d) any combination of outlined events or acts at least two times.
6. Requires the order to incorporate a written enhanced treatment plan prepared by staff familiar
with the patient's case history and approved by the medical director of the person, agency or
organization designated to administer and supervise the patient's treatment program.
FACT SHEET – Amended
S.B. 1113
Page 3
7. Requires the court:
a) to order the designated mental health treatment agency to administer and supervise the
patient's treatment to file written progress reports with the court at least every 60 days; and
b) to advise patients under an order for enhanced treatment services, orally and in writing,
that the approved enhanced treatment plan is part of the court order, the order is enforceable
by the court and that noncompliance with the court's order or the terms and conditions of
the enhanced treatment plan may result in an order for the patient to be placed in inpatient
treatment as well as an order for a peace officer to detain the patient for that purpose.
8. Allows the court to:
a) require the patient and a representative of the treatment team to appear in court at times
designated to address the patient's compliance and the services provided; and
b) change or modify the patient's treatment plan at any such appearance on motion of any
party or on the court's own motion.
9. Specifies that any patient deemed to receive necessary medical or psychiatric treatment in order
to improve the patient's condition and protect the public must be provided with enhanced
treatment regardless of the patient's eligibility for federally funded treatment.
10. Exempts the patient, in order to receive any court-ordered enhanced treatment services, from
the requirements of any agency or provider to agree or consent to treatment if the court
specifically finds that the patient's mental disorder significantly impairs the patient's capacity
to make an informed decision.
11. Requires AHCCCS to provide an enhanced treatment services report for FY 2023, FY 2024
and FY2025 to the:
a) Governor;
b) Senate President;
c) Speaker of the House of Representatives; and
d) Secretary of State.
12. Requires the AHCCCS report to include:
a) denials for requests for housing based on unavailability of housing;
b) denials for enhanced treatment services as ordered by the court based on unavailability of
funding for the services;
c) denials for enhanced treatment services as ordered by the court based on unavailability of
the treatment services; and
d) the costs associated with providing enhanced treatment services as ordered by the court by
individual and by service type.
13. Repeals the AHCCCS reporting requirement on June 30, 2026.
14. Defines enhanced treatment services as services identified in a court-approved, written
treatment plan that includes the:
a) assignment of the patient to a treatment team with an intensive case manager for any
services who is required, among other duties, to have in-person contact with the patient at
such frequency that will facilitate the patient's compliance with the treatment plan and will
allow for regular first-hand assessment of the patient's progress and condition; FACT SHEET – Amended
S.B. 1113
Page 4
b) housing or residential placement that provides the patient with stable, safe and, if
necessary, secure residence to enhance compliance and protect the safety of the patient and
the public; and
c) safe, reliable and adequate transportation for the patient to successfully comply with the
treatment plan.
15. Exempts the appropriations from lapsing.
16. Becomes effective on the general effective date.
Amendments Adopted by Committee
1. Appropriates $1 million from the state GF in FY 2023, FY 2024 and FY2025 to AHCCCS for
enhanced treatment services.
2. Specifies the treatment offered, prescribed, recommended or ordered is done by a licensed
medical professional.
3. Requires AHCCCS to provide an enhanced treatment services report for FY 2023, FY 2024
and FY2025 to the outlined entities.
4. Outlines content requirements of the AHCCCS report.
5. Exempts the appropriations from lapsing.
6. Repeals the AHCCCS reporting requirement and appropriation on June 30, 2026.
Senate Action
HHS 2/16/22 DPA 7-0-1
Prepared by Senate Research
February 18, 2022
MM/MC/sr/slp