SB 1444
Initials AG Page 1 Health & Human Services
ARIZONA HOUSE OF REPRESENTATIVES
Fifty-fifth Legislature
Second Regular Session
Senate: HHS DPA/SE 5-2-1-0 | 3
rd
Read 25-3-2-0
SB 1444: state hospital; administration; oversight
Sponsor: Senator Fann, LD 1
Committee on Health & Human Services
Overview
Prohibits the Arizona State Hospital (ASH) administration and its employees from retaliating
against a patient due to the patient or their families participation in the Independent Oversight
Committee at ASH (ASH-IOC). Requires, by January 1, 2023, the ASH administration to develop
and implement an innovative clinical improvement and human resources development plan.
Expands membership and duties of the Joint Legislative Psychiatric Hospital Review Council
(Council).
History
ASH, a division of the Arizona Department of Health Services, is a 260-bed facility that provides
long-term inpatient psychiatric treatment to individuals with mental illnesses, personality disorders
or emotional conditions who are under a court order to receive treatment. ASH is divided into 3
separate facilities: The Civil Hospital, the Forensic Hospital and the Arizona Community
Protection Center (ACPTC).
Patients receiving treatment at the Civil hospital have been court-ordered to receive involuntary
treatment as a result of having been determined to be a danger to themselves or others, gravely
disabled or persistently and acutely disabled. Patients receiving treatment at the Forensic Hospital
are court-ordered for either pre-trial or post-trial treatment as a result of involvement with the
criminal justice system due to a mental health issue. ACPTC supervises and treats persons
classified as sexually violent persons (A.R.S. Title 36, Chapter 2, Article 1).
ASH-IOC oversees patients who have been determined to have a serious mental illness and who
are hospitalized and receiving behavioral health services at the ASH Civil and Forensic hospitals.
ASH must provide to the ASH-IOC, subject to state and federal law, information regarding: 1)
Seclusion and use of restraints on patients; 2) Incident accident reports; 3) Allegations of illegal,
dangerous or inhumane treatment of patients; 4) Provisions of services to patients in need of
special assistance; 5) Allegations of neglect and abuse; and 6) Allegations of denial of rights
afforded to patients with serious mental illness, except where a right may be restricted for the
patient's safety, ASH or the public (A.R.S. § 41-3803).
Laws 2021, Chapter 402, Sec. 3 created the 10-member Joint Legislative Psychiatric Hospital
Review Council (Council) to review, analyze and make recommendations regarding: 1)
Psychiatric hospital capacity in Arizona, including ASH's bed capacity and other public facilities;
2) The role of private facilities in addressing psychiatric treatment needs; 3) Innovative programs
to ensure public safety while providing clinically appropriate treatment in the most integrated
setting; 4) Legal barriers; 5) Current waiting lists; 6) Barriers to accessing appropriate inpatient
care; 7) Licensing barriers; and 8) Any other issues related to inpatient psychiatric treatment. The
Council must submit a report of its findings and recommendations to the Governor and Legislature
by December 31, 2021 and 2022. SB 1444
Initials AG Page 2 Health & Human Services
Provisions
Arizona State Hospital Independent Oversight Committee
1. Forbids the ASH administration and its employees from retaliating against a patient because
the patient or their family participates in the ASH-IOC meetings. (Sec. 1)
2. Specifies that the aforementioned retaliation prohibition does not preclude the ASH
administration from acting against a patient who violates hospital policies or procedures.
(Sec. 1)
3. Directs the ASH Superintendent and Chief Medical Officer or their designees to:
a) Attend and participate in scheduled ASH-IOC meetings, except for the public comment
period; and
b) Give a report to and respond to questions from the ASH-IOC members. (Sec. 1)
4. Requires the ASH Superintendent to ensure that the ASH administration:
a) Fully cooperates with the ASH-IOC in all aspects of its work;
b) Facilitates ASH-IOC activities related to ASH, pursuant to ADOA rules; and
c) Timely responds to the ASH-IOC with responsive information to each inquiry or respond
in writing as to why the request was denied. (Sec. 1)
Joint Legislative Psychiatric Hospital Review Council
5. Include in the Council's charge the ability to review, analyze and make recommendations
regarding the feasibility of transferring ASH to the Arizona Health Care Cost Containment
System or an alternative oversight entity. (Sec. 2)
6. Expands the Council's membership to include:
a) The Director of the Arizona Department of Corrections, Rehabilitation and Reentry or their
designee;
b) A law enforcement officer appointed by the President of the Senate; and
c) A person with experience as a chief executive officer or chief operating officer of a hospital,
appointed by the Speaker of the House of Representatives. (Sec. 2)
7. Extends the reporting requirements of the Council to December 31, 2022, and December 31,
2023. (Sec. 2)
8. Extends the Council's repeal date from August 31, 2023 to August 31, 2026. (Sec. 2)
ASH Clinical Improvement and Human Resources Development Plan
9. Requires, by January 1, 2023, the ASH administration to develop and provide an evidence-
based and innovative clinical improvement and human resources development plan (Plan)
and the Plan's proposed budget to the following:
a) Governor;
b) President of the Senate;
c) Speaker of the House of Representatives; and
d) Chairpersons of the Senate and House Health and Human Services Committees.
(Sec. 3)
10. Specifies that the Plan and proposed budget be fully implemented by January 1, 2024 and
developed in collaboration with the ASH-IOC, the Independent Oversight Committee on
Mental Health, public and private community resources, community providers and guardians,
families and representatives of patients at ASH. (Sec. 3)
☐ Prop 105 (45 votes) ☐ Prop 108 (40 votes) ☐ Emergency (40 votes) ☐ Fiscal Note SB 1444
Initials AG Page 3 Health & Human Services
11. Requires the Plan to:
a) Identify necessary enhancements to the services, facilities and staff at ASH to provide
statutorily required treatment and services to patients in ASH facilities;
b) Provide options and recommendations to reduce the number of patients statewide seeking
admission to ASH and reduce the waiting time to be admitted to ASH;
c) Identify optimal levels of acuity-based staffing at ASH with full-time employees and
minimal use of contract staff and ways to increase numbers of forensically trained clinical
staff at both the management and staff levels;
d) Include a pandemic response and preparedness plan;
e) Collaborate with community-based treatment facilities to identify levels of service that
assist in transitioning ASH patients into clinically appropriate settings and ways to increase
the number of patients who successfully transition into the community with no readmission
to ASH or other inpatient psychiatric facility; and
f) Identify an independent third-party residing outside of ASH to investigate incident reports
and to whom patients, families and advocates may file complaints. (Sec. 3)
12. Specifies that the pandemic response and preparedness plan must:
a) Create a set of clinical metrics to significantly mitigate the effects of the COVID-19
pandemic and staffing shortages on ASH's implementation of each patient's individual
treatment and discharge plan; and
b) Ensure continuous operation of ASH with minimal or no cessation or disruption of
treatment services in the event of a new or recurrent epidemic or pandemic event.
(Sec. 3)
13. Repeals requirements relating to the Plan on January 1, 2025. (Sec. 3)
14. Makes technical and conforming changes. (Sec. 1, 2)