Assigned to HHS AS PASSED BY COMMITTEE
ARIZONA STATE SENATE
Fifty-Sixth Legislature, Second Regular Session
AMENDED
FACT SHEET FOR S.B. 1311
mental health; oversight; data; documentation.
Purpose
Declares the Arizona Health Care Cost Containment System (AHCCCS) the agency
responsible for monitoring, overseeing and evaluating the regional behavioral health authorities
(RBHAs) and contracted agencies that provide mental health services. Modifies requirements and
procedures relating to mental health prepetition screenings and court-ordered evaluations.
Background
AHCCCS serves as Arizona's Medicaid agency which offers qualifying Arizona residents
access to healthcare programs. AHCCCS's duties include: 1) developing and implementing a
county-by-county system that includes access to hospitalization and medical services for members;
2) contracting, overseeing, reviewing and providing technical assistance to contactors;
3) developing a system of accounts and controls for AHCCCS to prevent the unnecessary use of
covered health and medical services; 4) assisting in the formation of medical care consortiums to
provide covered medical services for a county; 5) establishing and managing a system to ensure
the quality of care delivered by AHCCCS; 6) establishing and managing a system to prevent fraud
by members, subcontractors, contractors and noncontracting providers; 7) coordinating benefits to
any member; 8) developing and maintaining outlined programs and systems; and 9) establishing
the eligibility process for a Medicare low-income subsidy (A.R.S. § 36-2903).
Statute authorizes any individual to apply for a court-ordered evaluation of a person alleged
to be, as a result of a mental disorder, a danger to self or others or a person with a persistent, acute
or grave disability that is unwilling or able to under a voluntary evaluation (A.R.S.
§ 36-520). Upon receiving an application for evaluation, a screening agency, before filing a
petition for court-ordered evaluation, must provide a prepetition screening within 48 business
hours, when possible, to determine: 1) if there is reasonable cause to believe the allegations of the
applicant for the court-ordered evaluation; 2) if the person will voluntarily receive evaluation at a
scheduled time and place; and 3) if the person has a persistent or acute disability, a grave disability
or is likely to present a danger to self or others until the voluntary evaluation (A.R.S. § 36-521).
If there is a cost associated with AHCCCS oversight and evaluation of state agencies
providing mental health services, there may be an impact to the state General Fund.
Provisions
AHCCCS Oversight
1. Declares AHCCCS the agency responsible for monitoring, overseeing and evaluating the
RBHAs and contracted agencies that provide mental health services to ensure that services, FACT SHEET – Amended
S.B. 1311
Page 2
whether provided directly by a county or a contracted service provider, are provided in a
timely, clinically effective and efficient manner and are in compliance with all county, state
and federal laws and rules.
2. Requires AHCCCS mental health oversight authority to be clearly delineated in all applicable
contracts.
3. Directs AHCCCS to audit the performance of state agencies providing mental health services
and impose penalties, including civil penalties, suspension and termination of contracts, on
agencies found to be:
a) noncompliant with county, state or federal law or rule; or
b) not performing services in a timely, effective and efficient manner.
4. Requires the AHCCCS Director to adopt rules and prescribe forms for collecting, reporting
and analyzing information and data for purposes of tracking and analyzing the effective and
efficient use of mental health services provided by the RBHAs and contracted agencies.
5. Requires the AHCCCS Director, in establishing the appropriate information to be collected
and forms to be used, to seek the advice of a representative group of stakeholders, including:
a) screening, evaluation and treatment agencies;
b) regional behavioral health agencies;
c) hospitals and physicians providing behavioral health services;
d) family members; and
e) persons with lived experiences in screening, evaluation and treatment services.
6. Requires AHCCCS, beginning December 31, 2025, to analyze the information and data
collected semi-annually and annually report it to the Governor, President of the Senate and
Speaker of the House of Representatives.
7. Requires the information and data collected by AHCCCS to identify and measure clinical
outcomes of members, including the number of:
a) hospitalizations and rehospitalizations, the facilities where admissions occurred and the
average length of stay by admitting diagnosis;
b) and percentage of members with a dual diagnosis who were admitted and readmitted;
c) admissions to screening or evaluation facilities and the places to which members were
discharged from these facilities;
d) and percentage of members with one arrest and the number and percentage of members
with two or more rearrests;
e) and percentage of members who were arrested and sentenced to jail or prison, the number
and percentage of those sentenced to jail who were released and whether a reentry plan was
in place at the time of release;
f) responses by crisis service to members, including the number of members and the locations
with one response and two or more responses;
g) and percentage of member discharges from screening agencies because a substance use
disorder was deemed to be the primary cause of admission or readmission;
h) member deaths, death rate and cause of death in the preceding year;
i) members who are homeless, unsheltered or inadequately housed and for what period of
time; FACT SHEET – Amended
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j) members residing in a behavioral health residential facility (BHRF), discharged from a
BHRF, including the reason why, as well as members directly admitted to an inpatient
psychiatric hospital within one year after discharge from a BHRF;
k) and percentage of members diagnoses with a serious mental illness who meet specified
criteria;
l) members employed as a peer support specialist, as well as those employed in positions
other than a peer support specialist; and
m) patients who have been discharged from the Arizona State Hospital and admitted to a
contracted psychiatric hospital within the preceding year.
8. Requires AHCCCS rules relating to mental health data oversight to be implemented by October
1, 2025.
9. Directs AHCCCS to file, with the Governor, President of the Senate and Speaker of the House
of Representatives:
a) by December 31, 2024, an interim report that describes AHCCCS's plan to complete
requirements associated with mental health oversight; and
b) by December 31, 2025, a final report confirming the completion of all requirements.
Mental Health Screening and Evaluation
10. Removes the requirement that a screening agency destroy an application that has not been acted
on for six months.
11. Stipulates that, if it is determined that a proposed patient does not need evaluation, the medical
director of the screening agency or the medical director's designee must:
a) make a written statement of the reasons why the proposed patient does not need an
evaluation; and
b) retain the application together with the medical director's statement and any records or
reports concerning the prepetition screening.
12. Removes the requirement that a screening agency consider whether there is reasonable cause
to believe the allegations of the individual applying for court-ordered evaluation and instead
requires the agency to consider whether the person is a danger to self or others as a result of a
mental disorder.
13. Requires a screening agency that denies an evaluation to state the denial in writing on the
application form and include confirmation by the medical director of the agency or a designee.
14. Requires a screening agency to assist a proposed patient with finding specific evaluation or
treatment services available, including direct referrals, if the person:
a) does not meet the criteria for court-ordered evaluation;
b) provides reasonable grounds to believe has a mental disorder;
c) is in need of further evaluation or treatment; and
d) is able and willing to pursue private or public evaluation or treatment services available in
the community.
15. Requires the medical director of a screening agency who determines that a person no longer
needs an evaluation after a petition has already been prepared to: FACT SHEET – Amended
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Page 4
a) make a written statement of the reasons why the evaluation was determined to be no longer
necessary; and
b) retain the petition together with the medical director's statement.
16. Requires the medical director of an evaluation agency or the medical director's designee to
retain an application for which emergency admission was denied and to state the reasons for
the denial.
17. Specifies that an application for emergency admission must be retained after the admitted
person has been released, together with a written statement by the medical director of the
evaluation agency stating why the release was appropriate.
18. Requires the medical director of an evaluation agency, after the release of a person being
evaluated on an inpatient basis, to make a written statement explaining why further evaluation
was not appropriate and why release was.
19. Requires copies of written statements by evaluation agency medical directors explaining the
release of a patient to be:
a) filed with the court that entered the order for evaluation;
b) filed as a part of the court record; and
c) made a part of the patient's medical record.
Miscellaneous
20. Defines member.
21. Makes technical and conforming changes.
22. Becomes effective on the general effective date.
Amendments Adopted by Committee
1. Provides AHCCCS oversight over the RBHAs and contracted agencies that provide mental
health services.
2. Requires the information and data collected by AHCCCS to identify and measure specified
clinical outcomes of members.
3. Removes the requirement that AHCCCS review and revise its data collection forms annually.
4. Requires AHCCCS to analyze collected mental health data and information only semi-
annually, rather than monthly.
5. Moves up the date by which AHCCCS must implement rules related to mental health data
oversight from December 31, 2025, to October 1, 2025.
6. Requires AHCCCS, in its interim report to the Governor and Legislature, to describe its plan
to complete mental health data oversight requirements, rather than its current progress. FACT SHEET – Amended
S.B. 1311
Page 5
Senate Action
HHS 2/6/24 DPA 7-0-0
Prepared by Senate Research
February 7, 2024
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