ARIZONA STATE SENATE
RESEARCH STAFF
TO: MEMBERS OF THE SENATE
HEALTH & HUMAN SERVICES
COMMITTEE
DATE: February 9, 2024
SUBJECT: Strike everything amendment to S.B. 1609, relating to behavioral health;
AHCCCS; health facilities
Purpose
Establishes requirements of the Arizona Health Care Cost Containment System related to
peer specialist oversight and services for individuals with a serious mental illness (SMI). Requires
a health care institution that is transferring or discharging a patient with an SMI to another health
care institution to provide the patient with a 30-day supply of all medication that the patient was
given in the previous 10 days.
Background
An SMI is a mental disorder that causes an individual to exhibit emotional or behavioral
functioning that is so impaired as to interfere substantially with their capacity to remain in the
community without supportive treatment or services of a long-term or indefinite duration. In these
persons, mental disability is severe and persistent, resulting in a long-term limitation of functional
capacities for primary activities of daily living such as interpersonal relationships, homemaking,
self-care, employment and recreation (AHCCCS).
Individuals with an SMI that are seeking services through AHCCCS must go through a
determination process to formally receive an SMI designation. This process requires the individual
to submit documentation of mental illness and how it has affected the person's quality of life. It is
also possible the individual may be required to meet face-to-face with a clinician for assessment.
Additionally, the SMI must result in 1) an inability to live independently without adequate support;
2) a risk of serious harm to self or others; 3) a dysfunction in role performance; or 4) a risk of
deterioration if adequate supports and services are not provided. An individual with an SMI
designation who is at least 18 years old has access to services that may help improve quality of life
and the ability to live independently (AHCCCS).
AHCCCS provides peer support services to members who may need more personalized
support than natural supports or community-based recovery groups, such as 12 Step groups, can
provide. Peer specialists generally have a personal history of behavioral health recovery and utilize
lived experiences to help people by promoting recovery-oriented environments. Peer specialists
work with individuals throughout recovery by sharing skills, coaching and providing support
(AHCCCS).
If there is a cost associated with the monitoring and training of peer specialists or the
development of an SMI member survey, there may be a cost to the state General Fund.
Provisions
SMI Medication
1. Requires a health care institution that is transferring or discharging a patient with an SMI to
another health care institution to provide the patient with a 30-day supply of all medication,
both prescription and over-the-counter, that the patient was given in the previous 10 days,
whether ongoing or to be taken as needed.
MICHAEL MADDEN
LEGISLATIVE RESEARCH ANALYST
HEALTH & HUMAN SERVICES COMMITTEE
Telephone: (602) 926-3171 STRIKER MEMO
S.B. 1609
Page 2
2. Requires each medication to include clear, documented instructions that are signed by the
patient or the patient's parent or guardian, the discharge team and the intake team.
Personal Health Information
3. Directs AHCCCS to require its contractors to review and minimize duplicative paperwork
requirements and limit the number of contractors and entities that unnecessarily receive
personal health information of members with an SMI who are receiving services.
4. Prohibits contractors from selling or benefiting financially from any member's personal health
information.
Peer Specialists
5. Requires AHCCCS to develop and implement processes to monitor its contractors' oversight
of peer specialists to ensure that peer specialists meet qualifications and receive required
supervision.
6. Requires peer specialists to complete training developed by AHCCCS that includes
psychosis-specific content, including anosognosia.
7. Requires AHCCCS, beginning November 1, 2024, to annually submit a report to the Governor,
President of the Senate and Speaker of the House of Representatives regarding:
a) the development and implementation of required peer specialist monitoring; and
b) the monitoring and outcomes of using peer specialists in providing behavioral health
services to members.
Miscellaneous
8. Requires AHCCCS to develop and implement a real-time automated survey for members with
SMI and the member's parent, guardian or caregiver, if applicable, to collect feedback, identify
quality of care issues and respond to member needs.
9. Makes technical changes.
10. Becomes effective on the general effective date.