Arizona 2024 Regular Session

Arizona Senate Bill SB1624 Compare Versions

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11 REFERENCE TITLE: sober living; residential care; regulation State of Arizona Senate Fifty-sixth Legislature Second Regular Session 2024 SB 1624 Introduced by Senators Hatathlie: Bennett, Gonzales, Hernandez, Miranda, Rogers, Shamp An Act amending sections 36-405, 36-413, 36-414, 36-422, 36-422.01, 36-424 and 36-425, Arizona Revised Statutes; amending title 36, chapter 4, article 2, Arizona Revised Statutes, by adding sections 36-425.10 and 36-425.11; amending sections 36-431.01 and 36-431.02, Arizona Revised Statutes; amending title 36, chapter 4, article 2, ARIZONA Revised Statutes, by adding sections 36-431.03 and 36-431.04; amending title 36, chapter 18, article 4, Arizona Revised Statutes, by adding sections 36-2062.01 and 36-2062.02; amending sections 36-2063 and 36-2066, Arizona Revised Statutes; amending title 36, chapter 18, article 4, Arizona Revised Statutes, by adding sections 36-2068, 36-2069 and 36-2070; amending sections 41-619.51, 41-1758 and 41-1758.01, Arizona Revised Statutes; relating to residential care. (TEXT OF BILL BEGINS ON NEXT PAGE)
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6666 amending sections 36-405, 36-413, 36-414, 36-422, 36-422.01, 36-424 and 36-425, Arizona Revised Statutes; amending title 36, chapter 4, article 2, Arizona Revised Statutes, by adding sections 36-425.10 and 36-425.11; amending sections 36-431.01 and 36-431.02, Arizona Revised Statutes; amending title 36, chapter 4, article 2, ARIZONA Revised Statutes, by adding sections 36-431.03 and 36-431.04; amending title 36, chapter 18, article 4, Arizona Revised Statutes, by adding sections 36-2062.01 and 36-2062.02; amending sections 36-2063 and 36-2066, Arizona Revised Statutes; amending title 36, chapter 18, article 4, Arizona Revised Statutes, by adding sections 36-2068, 36-2069 and 36-2070; amending sections 41-619.51, 41-1758 and 41-1758.01, Arizona Revised Statutes; relating to residential care.
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7676 Be it enacted by the Legislature of the State of Arizona: Section 1. Section 36-405, Arizona Revised Statutes, is amended to read: START_STATUTE36-405. Powers and duties of the director A. The director shall adopt rules to establish minimum standards and requirements for constructing, modifying and licensing health care institutions necessary to ensure the public health, safety and welfare. The standards and requirements shall relate to the construction, equipment, sanitation, staffing for medical, nursing and personal care services, and recordkeeping pertaining to administering medical, nursing, behavioral health and personal care services, in accordance with generally accepted practices of health care. The standards shall require that a physician who is licensed pursuant to title 32, chapter 13 or 17 medically discharge patients from surgery and shall allow an outpatient surgical center to require that either an anesthesia provider who is licensed pursuant to title 32, chapter 13, 15 or 17 or a physician who is licensed pursuant to title 32, chapter 13 or 17 remain present on the premises until all patients are discharged from the recovery room. Except as otherwise provided in this subsection, the director shall use the current standards adopted by the joint commission on accreditation of hospitals and the commission on accreditation of the American osteopathic association or those adopted by any recognized accreditation organization approved by the department as guidelines in prescribing minimum standards and requirements under this section. B. The director, by rule, may: 1. Classify and subclassify health care institutions according to character, size, range of services provided, medical or dental specialty offered, duration of care and standard of patient care required for the purposes of licensure. Classes of health care institutions may include hospitals, infirmaries, outpatient treatment centers, health screening services centers and residential care facilities. Whenever the director reasonably deems distinctions in rules and standards to be appropriate among different classes or subclasses of health care institutions, the director may make such distinctions. 2. Prescribe standards for determining a health care institution's substantial compliance with licensure requirements. 3. Prescribe the criteria for the licensure inspection process. 4. Prescribe standards for selecting health care-related demonstration projects. 5. Establish nonrefundable application and licensing fees for health care institutions, including a grace period and a fee for the late payment of licensing fees. 6. Establish a process for the department to notify a licensee of the licensee's licensing fee due date. 7. Establish a process for a licensee to request a different licensing fee due date, including any limits on the number of requests by the licensee. 7. Establish an additional monitoring fee for health care institutions that are not in compliance with the requirements of this chapter and the rules adopted pursuant to this chapter. C. The director, by rule, shall adopt licensing provisions that facilitate the colocation and integration of outpatient treatment centers that provide medical, nursing and health-related services with behavioral health services consistent with article 3.1 of this chapter. D. Ninety percent of the fees collected pursuant to this section shall be deposited, pursuant to sections 35-146 and 35-147, in the health services licensing fund established by section 36-414 and ten percent of the fees collected pursuant to this section shall be deposited, pursuant to sections 35-146 and 35-147, in the state general fund. E. Subsection B, paragraph 5 of this section does not apply to a health care institution operated by a state agency pursuant to state or federal law or to adult foster care residential settings. END_STATUTE Sec. 2. Section 36-413, Arizona Revised Statutes, is amended to read: START_STATUTE36-413. Nutrition and feeding assistants; training programs; regulation; civil penalty; definition A. The department may adopt rules to prescribe minimum standards for training programs for nutrition and feeding assistants in licensed skilled nursing facilities, including instructor qualifications, and may grant, deny, suspend and revoke approval of any training program that violates these standards. These standards must include: 1. Screening requirements. 2. Initial qualifications. 3. Continuing education requirements. 4. Testing requirements to assure ensure competency. 5. Supervision requirements. 6. Requirements for additional training based on patient needs. 7. Maintenance of records. 8. Special feeding requirements based on level of care. B. Pursuant to section 36-431.01, the department may shall impose a civil penalty on a training program that violates standards adopted by the department. C. If the department adopts standards for training programs pursuant to subsection A of this section, the department, as part of its routine inspection of a health care facility that provides a training program, shall determine the facility's compliance with these standards. D. For the purposes of this section, "nutrition and feeding assistant" has the same meaning as paid feeding assistant as defined in 42 Code of Federal Regulations part 483 and section 488.301.END_STATUTE Sec. 3. Section 36-414, Arizona Revised Statutes, is amended to read: START_STATUTE36-414. Health services licensing fund; exemption A. The health services licensing fund is established consisting of monies deposited pursuant to sections 30-654, 32-1308, 32-2805, 36-405, 36-431.01, 36-765.05, 36-766.06, 36-851.01, 36-882, 36-897.01, and 36-1903 and 36-2063. The department of health services shall administer the fund. B. Monies in the fund are subject to legislative appropriation. C. Monies in the fund are exempt from the provisions of section 35-190 relating to lapsing of appropriations. END_STATUTE Sec. 4. Section 36-422, Arizona Revised Statutes, is amended to read: START_STATUTE36-422. Application for license; notification of proposed change in status; joint licenses; definitions A. A person who wishes to apply for a license to operate a health care institution pursuant to this chapter shall submit to the department all of the following: 1. An application on a written or electronic form that is prescribed, prepared and furnished by the department and that contains all of the following: (a) The name and location of the health care institution. (b) Whether the health care institution is to be operated as a proprietary or nonproprietary institution. (c) The name of the governing authority. The applicant shall be the governing authority having the operative ownership of, or the governmental agency charged with the administration of, the health care institution sought to be licensed. If the applicant is a partnership that is not a limited partnership, the partners shall apply jointly, and the partners are jointly the governing authority for purposes of this article. (d) The name and business or residential address of each controlling person and an affirmation that none of the controlling persons has been denied a license or certificate by a health profession regulatory board pursuant to title 32 or by a state agency pursuant to chapter 6, article 7 or chapter 17 of this title or a license to operate a health care institution in this state or another state or has had a license or certificate issued by a health profession regulatory board pursuant to title 32 or issued by a state agency pursuant to chapter 6, article 7 or chapter 17 of this title or a license to operate a health care institution revoked. If a controlling person has been denied a license or certificate by a health profession regulatory board pursuant to title 32 or by a state agency pursuant to chapter 6, article 7 or chapter 17 of this title or a license to operate a health care institution in this state or another state or has had a health care professional license or a license to operate a health care institution revoked, the controlling person shall include in the application a comprehensive description of the circumstances for the denial or the revocation. (e) The class or subclass of health care institution to be established or operated. (f) The types and extent of the health care services to be provided, including emergency services, community health services and services to indigent patients. (g) The name and qualifications of the chief administrative officer implementing direction in that specific health care institution. (h) Other pertinent information required by the department for the proper administration of this chapter and department rules. 2. The attestation required by section 36-421, subsection A. 3. The applicable application fee. B. An application submitted pursuant to this section shall contain the written or electronic signature of: 1. If the applicant is an individual, the owner of the health care institution. 2. If the applicant is a partnership, limited liability company or corporation, two of the officers of the corporation or managing members of the partnership or limited liability company or the sole member of the limited liability company if it has only one member. 3. If the applicant is a governmental unit, the head of the governmental unit. C. An application for licensure shall be submitted at least sixty but not more than one hundred twenty days before the anticipated date of operation. An application for a substantial compliance survey submitted pursuant to section 36-425, subsection G shall be submitted at least thirty days before the date on which the substantial compliance survey is requested. D. If a current licensee intends to terminate the operation of a licensed health care institution or if a change of ownership is planned, the current licensee shall notify the director in writing at least thirty days before the termination of operation or change in ownership is to take place. The current licensee is responsible for preventing any interruption of services required to sustain the life, health and safety of the patients or residents. A new owner shall not begin operating the health care institution until the director issues a license to the new owner. E. A licensed health care institution for which operations have not been terminated for more than thirty days may be relicensed pursuant to the codes and standards for architectural plans and specifications that were applicable under its most recent license. F. If a person operates a hospital in a county with a population of more than five hundred thousand persons in a setting that includes satellite facilities of the hospital that are located separately from the main hospital building, the department at the request of the applicant or licensee shall issue a single group license to the hospital and its designated satellite facilities located within one-half mile of the main hospital building if all of the facilities meet or exceed department licensure requirements for the designated facilities. At the request of the applicant or licensee, the department shall also issue a single group license that includes the hospital and its designated satellite facilities that are located farther than one-half mile from the main hospital building if all of these facilities meet or exceed applicable department licensure requirements. Each facility included under a single group license is subject to the department's licensure requirements that are applicable to that category of facility. Subject to compliance with applicable licensure or accreditation requirements, the department shall reissue individual licenses for the facility of a hospital located in separate buildings from the main hospital building when requested by the hospital. This subsection does not apply to nursing care institutions and residential care institutions. The department is not limited in conducting inspections of an accredited health care institution to ensure that the institution meets department licensure requirements. If a person operates a hospital in a county with a population of five hundred thousand persons or less in a setting that includes satellite facilities of the hospital that are located separately from the main hospital building, the department at the request of the applicant or licensee shall issue a single group license to the hospital and its designated satellite facilities located within thirty-five miles of the main hospital building if all of the facilities meet or exceed department licensure requirements for the designated facilities. At the request of the applicant or licensee, the department shall also issue a single group license that includes the hospital and its designated satellite facilities that are located farther than thirty-five miles from the main hospital building if all of these facilities meet or exceed applicable department licensure requirements. G. If a county with a population of more than one million persons or a special health care district in a county with a population of more than one million persons operates an accredited hospital that includes the hospital's accredited facilities that are located separately from the main hospital building and the accrediting body's standards as applied to all facilities meet or exceed the department's licensure requirements, the department shall issue a single license to the hospital and its facilities if requested to do so by the hospital. If a hospital complies with applicable licensure or accreditation requirements, the department shall reissue individual licenses for each hospital facility that is located in a separate building from the main hospital building if requested to do so by the hospital. This subsection does not limit the department's duty to inspect a health care institution to determine its compliance with department licensure standards. This subsection does not apply to nursing care institutions and residential care institutions. H. An applicant or licensee must notify the department within thirty days after any change regarding a controlling person and provide the information and affirmation required pursuant to subsection A, paragraph 1, subdivision (d) of this section. I. A behavioral health residential facility that provides services to children must notify the department within thirty days after the facility begins contracting exclusively with the federal government, receives only federal monies and does not contract with this state. J. This section does not limit the application of federal laws and regulations to an applicant or licensee that is certified as a medicare or an Arizona health care cost containment system provider under federal law. K. Except for an outpatient treatment center that provides dialysis services or abortion procedures or that is exempt from licensure pursuant to section 36-402, subsection A, paragraph 12, a person wishing to begin operating an outpatient treatment center before a licensing inspection is completed shall submit all of the following: 1. The license application required pursuant to this section. 2. All applicable application and license fees. 3. A written request for a temporary license that includes: (a) The anticipated date of operation. (b) An attestation signed by the applicant that the applicant and the facility comply with and will continue to comply with the applicable licensing statutes and rules. L. Within seven days after the department's receipt of the items required in subsection K of this section, but not before the anticipated operation date submitted pursuant to subsection C of this section, the department shall issue a temporary license that includes: 1. The name of the facility. 2. The name of the licensee. 3. The facility's class or subclass. 4. The temporary license's effective date. 5. The location of the licensed premises. M. A facility may begin operating on the effective date of the temporary license. N. The director may cease the issuance of temporary licenses at any time if the director believes that public health and safety is endangered. O. An outpatient treatment center that is exempt from licensure pursuant to section 36-402, subsection A, paragraph 12 is subject to reasonable inspection by the department if the director has reasonable cause to believe that patient harm is or may be occurring at that outpatient treatment center. A substantiated complaint that harm is occurring at an exempt outpatient treatment center is a violation of this chapter against the license of the hospital listed in the notice required by section 36-402, subsection A, paragraph 12. P. Each hospital that is licensed pursuant to this chapter shall provide to and maintain with the department a current list of exempt outpatient treatment centers that have the same direct owner or indirect owner as the hospital. Q. For the purposes of this section: 1. "Accredited" means accredited by a nationally recognized accreditation organization. 2. "Satellite facility" means an outpatient facility at which the hospital provides outpatient medical services.END_STATUTE Sec. 5. Section 36-422.01, Arizona Revised Statutes, is amended to read: START_STATUTE36-422.01. Health care institutions; termination of operation; medical records; civil penalties; definition A. In addition to the requirements prescribed in section 36-422, subsection D, if a current licensee intends to terminate the operation of a licensed health care institution, the current licensee shall do one of the following before the health care institution ceases operation: 1. Provide each patient of the health care institution with the patient's medical records. 2. Transfer the health care institution's medical records to a third-party entity to ensure patient access to the medical records. B. If a patient or a patient's health care decision maker requests access to or copies of the patient's medical records, the health care institution or third-party entity in possession of the medical records shall provide access to or copies of the medical records to the patient or the patient's health care decision maker in accordance with title 12, chapter 13, article 7.1. C. A licensee that fails to comply with subsection A of this section is subject to a civil penalty of not more than $10,000. The director may use a licensee's failure to comply with subsection A of this section as grounds to deny a subsequent license pursuant to section 36-425, subsection K L. D. For the purposes of this section, "medical record" has the same meaning prescribed in section 36-2201. END_STATUTE Sec. 6. Section 36-424, Arizona Revised Statutes, is amended to read: START_STATUTE36-424. Inspections; suspension or revocation of license; report to board of examiners of nursing care institution administrators and assisted living facility managers A. Except as provided in subsection B of this section, the director shall inspect the premises of the health care institution and investigate the character and other qualifications of the applicant to ascertain whether the applicant and the health care institution are in substantial compliance with the requirements of this chapter and the rules established pursuant to this chapter. The director may prescribe rules regarding department background investigations into an applicant's character and qualifications. B. The director may accept proof that a health care institution is an accredited hospital or is an accredited health care institution in lieu of all compliance inspections required by this chapter if the director receives a copy of the health care institution's accreditation report for the licensure period and the health care institution is accredited by an independent, nonprofit accrediting organization approved by the secretary of the United States department of health and human services. If the health care institution's accreditation report is not valid for the entire licensure period, the department may conduct a compliance inspection of the health care institution during the time period the department does not have a valid accreditation report for the health care institution. For the purposes of this subsection, each licensed premises of a health care institution must have its own accreditation report. The director may not accept an accreditation report in lieu of a compliance inspection of: 1. An intermediate care facility for individuals with intellectual disabilities. 2. A nursing-supported group home. 3. A health care institution if the health care institution has been subject to an enforcement action pursuant to section 36-427 or 36-431.01 or to a criminal penalty pursuant to title 13 within the year preceding the annual licensing fee anniversary date five years. 4. A residential care institution. C. On a determination by the director that there is reasonable cause to believe a health care institution is not adhering to the licensing requirements of this chapter, the director and any duly designated employee or agent of the director, including county health representatives and county or municipal fire inspectors, consistent with standard medical practices, may enter on and into the premises of any health care institution that is licensed or required to be licensed pursuant to this chapter at any reasonable time for the purpose of determining the state of compliance with this chapter, the rules adopted pursuant to this chapter and local fire ordinances or rules. Any application for licensure under this chapter constitutes permission for and complete acquiescence in any entry or inspection of the premises during the pendency of the application and, if licensed, during the term of the license. If an inspection reveals that the health care institution is not adhering to the licensing requirements established pursuant to this chapter, the director may take action authorized by this chapter. Any health care institution, including an accredited hospital, whose license has been suspended or revoked in accordance with this section is subject to inspection on application for relicensure or reinstatement of license. D. The director shall immediately report to the board of examiners of nursing care institution administrators and assisted living facility managers information identifying that a nursing care institution administrator's conduct may be grounds for disciplinary action pursuant to section 36-446.07. END_STATUTE Sec. 7. Section 36-425, Arizona Revised Statutes, is amended to read: START_STATUTE36-425. Inspections; issuance of license; posting requirements; provisional license; violation; classification; civil penalty; denial of license A. On receipt of a properly completed application for a health care institution license, the director shall conduct an inspection of the health care institution as prescribed by this chapter. If an application for a license is submitted due to a planned change of ownership, the director shall determine the need for an inspection of the health care institution. Based on the results of the inspection and after the submission of the applicable licensing fee, the director shall either deny the license or issue a regular or provisional license. A license issued by the department shall be posted in a conspicuous location in the reception area of that health care institution. B. The director shall issue a license if the director determines that an applicant and the health care institution for which the license is sought substantially comply complies with the requirements of this chapter and rules adopted pursuant to this chapter and the applicant agrees to carry out a plan acceptable to the director to eliminate any deficiencies. The director shall not require a health care institution that was designated as a critical access hospital to make any modifications required by this chapter or rules adopted pursuant to this chapter in order to obtain an amended license with the same licensed capacity the health care institution had before it was designated as a critical access hospital if all of the following are true: 1. The health care institution has subsequently terminated its critical access hospital designation. 2. The licensed capacity of the health care institution does not exceed its licensed capacity before its designation as a critical access hospital. 3. The health care institution remains in compliance with the applicable codes and standards that were in effect at the time the facility was originally licensed with the higher licensed capacity. C. A health care institution license does not expire and remains valid unless: 1. The department subsequently revokes or suspends the license. 2. The license is considered void because the licensee did not pay the licensing fee, any civil penalties or the provider agreement fees assessed before the licensing fee due date. D. Except as provided in section 36-424, subsection B and subsection E of this section, the department shall conduct a compliance inspection of a health care institution to determine compliance with this chapter and rules adopted pursuant to this chapter at least once annually. E. If the department determines a facility to be deficiency free on a compliance survey, the department shall not conduct a compliance survey of that facility for twenty-four months after the date of the deficiency free survey. This subsection does not: 1. Prohibit the department from enforcing licensing requirements as authorized by section 36-424. 2. Apply to residential care institutions. F. A hospital licensed as a rural general hospital may provide intensive care services. G. The director shall issue a provisional license for a period of not more than one year if an inspection or investigation of a currently licensed health care institution or a health care institution for which an applicant is seeking a license reveals that the health care institution is not in substantial compliance with department licensure requirements and the director believes that the immediate interests of the patients and the general public are best served if the health care institution is given an opportunity to correct deficiencies. The applicant or licensee shall agree to carry out a corrective action plan to eliminate deficiencies that is acceptable to the director. The director shall not issue consecutive provisional licenses to a single health care institution. The director shall not issue a license to the current licensee or a successor applicant before the expiration of the provisional license unless the health care institution submits an application for a substantial compliance survey and is found to be in substantial compliance. The director may issue a license only if the director determines that the health care institution is in substantial compliance with the licensure requirements of the department and this chapter. This subsection does not prevent the director from taking action to protect the safety of patients pursuant to section 36-427. H. A residential care institution that operates in this state without a license in violation of this chapter is guilty of a class 6 felony and the director shall assess a civil penalty of at least $5,000 and not more than $10,000 for each violation. Each day the residential care institution operates without a license is a separate violation. H. I. Subject to the confidentiality requirements of articles 4 and 5 of this chapter, title 12, chapter 13, article 7.1 and section 12-2235, the licensee shall keep current department inspection reports at the health care institution. Unless federal law requires otherwise, the licensee shall post in a conspicuous location a notice that identifies the location at that health care institution where the inspection reports are available for review. I. J. A health care institution shall immediately notify the department in writing when there is a change of the chief administrative officer specified in section 36-422, subsection A, paragraph 1, subdivision (g). J. K. When the department issues an original license or an original provisional license to a health care institution, it shall notify the owners and lessees of any agricultural land within one-fourth mile of the health care institution. The health care institution shall provide the department with the names and addresses of owners or lessees of agricultural land within one-fourth mile of the proposed health care institution. K. L. In addition to the grounds for denial of licensure prescribed pursuant to subsection A of this section, the director may shall deny a license because an applicant or anyone in a business relationship with the applicant, including stockholders and controlling persons, has had a license to operate a health care institution denied, revoked or suspended or a license or certificate issued by a health profession regulatory board pursuant to title 32 or issued by a state agency pursuant to chapter 6, article 7 or chapter 17 of this title denied, revoked or suspended or has a licensing history of recent serious violations occurring in this state or in another state that posed a direct risk to the life, health or safety of patients or residents. L. M. In addition to the requirements of this chapter, the director may prescribe by rule other licensure requirements. END_STATUTE Sec. 8. Title 36, chapter 4, article 2, Arizona Revised Statutes, is amended by adding sections 36-425.10 and 36-425.11, to read: START_STATUTE36-425.10. Behavioral health residential facilities; admittance; notification of family; conditions for transportation A. When a resident is admitted for initial evaluation, a behavioral health residential facility shall notify the resident's family or next of kin within seventy-two hours after the initial evaluation. The notification shall be documented in the resident's medical record. B. A behavioral health residential facility may not coordinate, facilitate, arrange for or solicit transportation of a person to the behavioral health residential facility if the person is intoxicated or under the influence of alcohol or other substances, unless the person is referred by an approved provider of a tribal health care program or a regional behavioral health authority or is court-ordered. END_STATUTE START_STATUTE36-425.11. Behavioral health residential facilities; resident discharge; transportation; documentation A behavioral health residential facility shall inquire, both verbally and in writing, whether a resident wants to be transported to the resident's place of residence or an alternative safe living space in this state as requested by the resident after discharge from the behavioral health residential facility. The resident's wishes regarding transportation shall be documented on a form prescribed by the department, signed by the resident and retained in the resident's medical record. The behavioral health residential facility shall ensure safe and reliable transportation, as determined by the department, for a resident who wishes to be transported to the resident's place of residence or an alternative safe living space in this state as requested by the resident on discharge. END_STATUTE Sec. 9. Section 36-431.01, Arizona Revised Statutes, is amended to read: START_STATUTE36-431.01. Violations; civil penalties; enforcement; use of monies A. The director may shall assess a civil penalty against a person who violates this chapter or a rule adopted pursuant to this chapter in an amount of not to exceed five hundred dollars at least $5,000 and not more than $10,000 for each violation. Each day that a violation occurs constitutes a separate violation. B. The director may shall issue a notice of assessment that shall include the proposed amount of the assessment. A person may appeal the assessment by requesting a hearing pursuant to title 41, chapter 6, article 10. When an assessment is appealed, the director shall take no further action to enforce and collect the assessment until after the hearing. C. In determining the amount of the civil penalty pursuant to subsection A of this section, the department shall consider the following: 1. Repeated violations of statutes or rules. 2. Patterns of noncompliance. 3. Types of violations. 4. The severity of violations. 5. The potential for and occurrences of actual harm. 6. Threats to health and safety. 7. The number of persons affected by the violations. 8. The number of violations. 9. The size of the facility. 10. The length of time that the violations have been occurring. 11. The number of injuries caused. 12. The severity of the injuries caused. 13. The number of deaths caused. 14. The cause of deaths. D. Pursuant to interagency agreement specified in section 36-409, the director may shall assess a civil penalty, including interest, in accordance with 42 United States Code section 1396r. A person may appeal this assessment by requesting a hearing before the director in accordance with subsection B of this section. Civil penalty amounts may be established by rules adopted by the director that conform to guidelines or regulations adopted by the secretary of the United States department of health and human services pursuant to 42 United States Code section 1396r. E. Actions to enforce the collection of penalties assessed pursuant to subsections A and D of this section shall be brought by the attorney general or the county attorney in the name of the state in the justice court or the superior court in the county in which the violation occurred. F. Penalties assessed under subsection D of this section are in addition to and not in limitation of other penalties imposed pursuant to this chapter. All civil penalties and interest assessed pursuant to subsection D of this section shall be deposited, pursuant to sections 35-146 and 35-147, in the nursing care institution resident protection revolving fund established by section 36-431.02. The director shall use these monies for the purposes prescribed by 42 United States Code section 1396r, including payment for the costs of relocation of residents to other facilities, maintenance of operation of a facility pending correction of the deficiencies or closure and reimbursement of residents for personal monies lost. G. The department shall transmit deposit penalties assessed under subsection A of this section to in the state general fund following funds as follows: 1. Eighty percent in the indigenous peoples protection revolving fund established by section 36-431.03. 2. five percent in the health services licensing fund established by section 36-414. The department shall use the monies deposited in the health services licensing fund pursuant to this paragraph for inspections and enforcement relating to residential care institutions. 3. fifteen percent in the nursing care institution resident protection revolving fund established by section 36-431.02. END_STATUTE Sec. 10. Section 36-431.02, Arizona Revised Statutes, is amended to read: START_STATUTE36-431.02. Nursing care institution resident protection revolving fund; use; nonreversion A. The nursing care institution resident protection revolving fund is established. The fund consists of monies received from civil penalties collected by the director pursuant to section 36-431.01, subsection D. B. The director shall use monies in the fund for the purposes prescribed in section 36-431.01, subsection F, subject to legislative appropriation. C. Monies in the fund are exempt from the provisions of section 35-190 relating to the lapsing of appropriations.END_STATUTE Sec. 11. Title 36, chapter 4, article 2, Arizona Revised Statutes, is amended by adding sections 36-431.03 and 36-431.04, to read: START_STATUTE36-431.03. Indigenous peoples protection revolving fund A. The indigenous peoples protection revolving fund is established to support resiliency and healing of indigenous peoples in this state. the fund consists of monies deposited pursuant to section 36-431.01. Monies in the fund are continuously appropriated and are exempt from the provisions of section 35-190 relating to the lapsing of appropriations. The director shall administer the fund. B. The monies in the fund shall be used annually as follows: 1. Forty percent shall be transferred to tribal colleges in this state for programming in social work and behavioral health. 2. Twenty percent shall provide restitution payments for families of deceased victims of this state's behavioral health system and sober living homes. Each family of a deceased victim shall receive a minimum of $3,000 and the repatriation of the victim's human remains and expenses. 3. Forty percent shall be distributed to tribal communities for behavioral health treatment services and programs or residential homes, including behavioral health residential facilities, sober living homes and transitional homes. END_STATUTE START_STATUTE36-431.04. Legal action or sale; effect on licensure A. The department shall not approve an application for licensure of a currently licensed health care institution while any enforcement or court action related to health care institution licensure is pending against that health care institution's current licensee. B. The director shall continue to pursue any court, administrative or enforcement action against the licensee even though the health care institution is in the process of being sold or transferred to a new owner. C. The department shall not approve a change in ownership unless the department determines that there has been a transfer of all legal and equitable interests, control and authority in the health care institution so that persons other than the transferring licensee, that licensee's agent or other parties exercising authority or supervision over the health care institution's daily operations or staff are responsible for and have control over the health care institution. END_STATUTE Sec. 12. Title 36, chapter 18, article 4, Arizona Revised Statutes, is amended by adding sections 36-2062.01 and 36-2062.02, to read: START_STATUTE36-2062.01. Fingerprinting requirements as a condition of licensure or continued licensure of a sober living home and as a condition of employment in a sober living home, employees and owners of sober living homes, contracted persons of sober living homes and volunteers of sober living homes shall both: 1. submit a full set of fingerprints to the department of HEALTH services for the purpose of obtaining a state and federal criminal records check pursuant to section 41-1750 and Public Law 92-544. The department of public safety may exchange this fingerprint data with the federal bureau of investigation. The department of health services may charge the cost of each criminal background check to the applicant. 2. Have a valid fingerprint clearance card that is issued pursuant to title 41, chapter 12, article 3.1. END_STATUTE START_STATUTE36-2062.02. Staff education and training; staff ratios; supervision A. The department shall establish by rule annual continuing education and training requirements for employees, volunteers and contractors who work in sober living homes, including peer support specialists and behavioral health technicians. B. A sober living home shall maintain a staff ratio of two staff members, who provide monitoring or assistance to residents at the sober living home, for every six residents. C. A staff member who is an employee of the sober living home and who provides monitoring or assistance to residents of the sober living home must supervise the sober living home twenty-four hours a day. END_STATUTE Sec. 13. Section 36-2063, Arizona Revised Statutes, is amended to read: START_STATUTE36-2063. Fees; licensure; inspections; investigation; violation; classification; civil penalty; sanctions A. The department shall establish fees for initial licensure and license renewal and a fee for the late payment of licensing fees that includes a grace period. The department shall deposit, pursuant to sections 35-146 and 35-147, ninety percent of the fees collected pursuant to this section in the health services licensing fund established by section 36-414 and ten percent of the fees collected pursuant to this section in the state general fund. B. On a determination by the director that there is reasonable cause to believe a sober living home is not adhering to the licensing requirements of this article, the director and any duly designated employee or agent of the director may shall enter on and into the premises of any sober living home that is licensed or required to be licensed pursuant to this article at any reasonable time for the purpose of determining the state of compliance with this article, the rules adopted pursuant to this article and local fire ordinances or rules. Any application for licensure under this article constitutes permission for and complete acquiescence in any entry or inspection of the premises during the pendency of the application and, if licensed, during the term of the license. If an inspection reveals that the sober living home is not adhering to the licensing requirements established pursuant to this article, the director may shall take action authorized by this article. C. Any sober living home whose license has been suspended or revoked in accordance with this article is subject to inspection on application for relicensure or reinstatement of the license. If a sober living home license is revoked in this state or any other state, the licensee of the sober living home whose license was revoked may not reapply for any license issued pursuant to this title for a period of at least five years. D. A sober living home that operates in this state without a license in violation of this article is guilty of a class 6 felony and the director shall assess a civil penalty of at least $5,000 and not more than $10,000 for each violation. Each day the sober living home operates without a license is a separate violation. C. E. The director may shall impose a civil penalty on a person that violates this article or the rules adopted pursuant to this article in an amount of at least $5,000 and not more than five hundred dollars $10,000 for each violation. Each day that a violation occurs constitutes a separate violation. The director may shall issue a notice that includes the proposed amount of the civil penalty assessment. If a person requests a hearing to appeal an assessment, the director may not take further action to enforce and collect the assessment until the hearing process is complete. The director shall impose a civil penalty only for those days for which the violation has been documented by the department. D. F. The department may impose sanctions and commence disciplinary actions against a licensed sober living home, including revoking the license. A license may not be suspended or revoked under this article without affording the licensee notice and an opportunity for a hearing as provided in title 41, chapter 6, article 10. E. G. The department may contract with a third party to assist the department with licensure and inspections. END_STATUTE Sec. 14. Section 36-2066, Arizona Revised Statutes, is amended to read: START_STATUTE36-2066. Posting; sober living homes; update The department shall post on its public website the name, and address, telephone number, department-issued license number, local jurisdiction business license number and licensure status of each certified and licensed sober living home in this state and shall update the list quarterly. The department may not disclose the address of a certified or licensed sober living home except to a local jurisdiction for zoning purposes, local law enforcement and emergency personnel. A sober living home's address is not a public record and is not subject to title 39, chapter 1, article 2. END_STATUTE Sec. 15. Title 36, chapter 18, article 4, Arizona Revised Statutes, is amended by adding sections 36-2068, 36-2069 and 36-2070, to read: START_STATUTE36-2068. Resident acceptance; notification of family; conditions for transportation A. At the time of accepting a resident into a sober living home, the sober living home shall notify the resident's family or next of kin within seventy-two hours after accepting the resident. The notification shall be documented in the resident's record. B. A sober living home may not coordinate, facilitate, arrange for or solicit transportation of a person to the sober living home if the person is intoxicated or under the influence of alcohol or other substances, unless the person is referred by an approved provider of a tribal health care program or a regional behavioral health authority or is court-ordered. END_STATUTE START_STATUTE36-2069. Resident discharge; transportation; documentation A sober living home shall inquire, both verbally and in writing, whether a resident wants to be transported to the resident's place of residence or an alternative safe living space in this state as requested by the resident after discharge from the sober living home. The resident's wishes regarding transportation shall be documented on a form prescribed by the department of health services, signed by the resident and retained in the resident's record. The sober living home shall ensure safe and reliable transportation, as determined by the department of health services, for a resident who wishes to be transported to the resident's place of residence or an alternative safe living space in this state as requested by the resident on discharge.END_STATUTE START_STATUTE36-2070. Notification requirements; rules; sex offender registration A. A manager or staff of a sober living home shall notify the department, in a department-provided format, immediately and not more than six hours after any of the following occurs: 1. The death of a resident, including whether the death may have been drug-related. 2. A resident needed immediate intervention by an Emergency medical provider or other health care provider for a possible overdose or other drug or alcohol-related illness. 3. A sex-related crime may have been committed at the sober living home. 4. Any other incident specified in rule by the department. B. Sober living home managers and staff may not have a personal or intimate relationship with a resident of the sober living home. C. The manager or staff of a sober living home shall contact law enforcement if the manager or staff is informed that a resident of the sober living home may have been involved in a sex-related crime. D. A sober living licensee shall ensure that any resident of the licensee's sober living home who is required to register pursuant to section 13-3821 registers within the statutorily required time frame after admission to the sober living home.END_STATUTE Sec. 16. Section 41-619.51, Arizona Revised Statutes, is amended to read: START_STATUTE41-619.51. Definitions In this article, unless the context otherwise requires: 1. "Agency" means the supreme court, the department of economic security, the department of child safety, the department of education, the department of health services, the department of juvenile corrections, the department of emergency and military affairs, the department of public safety, the department of transportation, the state real estate department, the department of insurance and financial institutions, the Arizona game and fish department, the Arizona department of agriculture, the board of examiners of nursing care institution administrators and assisted living facility managers, the state board of dental examiners, the Arizona state board of pharmacy, the board of physical therapy, the state board of psychologist examiners, the board of athletic training, the board of occupational therapy examiners, the state board of podiatry examiners, the acupuncture board of examiners, the state board of technical registration, or the board of massage therapy or the Arizona department of housing. 2. "Board" means the board of fingerprinting. 3. "Central registry exception" means notification to the department of economic security, the department of child safety or the department of health services, as appropriate, pursuant to section 41-619.57 that the person is not disqualified because of a central registry check conducted pursuant to section 8-804. 4. "Expedited review" means an examination, in accordance with board rule, of the documents an applicant submits by the board or its hearing officer without the applicant being present. 5. "Good cause exception" means the issuance of a fingerprint clearance card to an employee pursuant to section 41-619.55. 6. "Person" means a person who is required to be fingerprinted pursuant to this article or who is subject to a central registry check and any of the following: (a) Section 3-314. (b) Section 8-105. (c) Section 8-322. (d) Section 8-463. (e) Section 8-509. (f) Section 8-802. (g) Section 8-804. (h) Section 15-183. (i) Section 15-503. (j) Section 15-512. (k) Section 15-534. (l) Section 15-763.01. (m) Section 15-782.02. (n) Section 15-1330. (o) Section 15-1881. (p) Section 17-215. (q) Section 28-3228. (r) Section 28-3413. (s) Section 32-122.02. (t) Section 32-122.05. (u) Section 32-122.06. (v) Section 32-823. (w) Section 32-1232. (x) Section 32-1276.01. (y) Section 32-1284. (z) Section 32-1297.01. (aa) Section 32-1904. (bb) Section 32-1941. (cc) Section 32-1982. (dd) Section 32-2022. (ee) Section 32-2063. (ff) Section 32-2108.01. (gg) Section 32-2123. (hh) Section 32-2371. (ii) Section 32-3430. (jj) Section 32-3620. (kk) Section 32-3668. (ll) Section 32-3669. (mm) Section 32-3922. (nn) Section 32-3924. (oo) Section 32-4222. (pp) Section 32-4128. (qq) Section 36-113. (rr) Section 36-207. (ss) Section 36-411. (tt) Section 36-425.03. (uu) Section 36-446.04. (vv) Section 36-594.01. (ww) Section 36-594.02. (xx) Section 36-766.01. (yy) Section 36-882. (zz) Section 36-883.02. (aaa) Section 36-897.01. (bbb) Section 36-897.03. (ccc) Section 36-2062.01. (ccc) (ddd) Section 36-3008. (ddd) (eee) Section 41-619.53. (eee) (fff) Section 41-1964. (fff) (ggg) Section 41-1967.01. (ggg) (hhh) Section 41-1968. (hhh) (iii) Section 41-1969. (iii) (jjj) Section 41-2814. (jjj) (kkk) Section 41-4025. (kkk) (lll) Section 46-141, subsection A or B. (lll) (mmm) Section 46-321.END_STATUTE Sec. 17. Section 41-1758, Arizona Revised Statutes, is amended to read: START_STATUTE41-1758. Definitions In this article, unless the context otherwise requires: 1. "Agency" means the supreme court, the department of economic security, the department of child safety, the department of education, the department of health services, the department of juvenile corrections, the department of emergency and military affairs, the department of public safety, the department of transportation, the state real estate department, the department of insurance and financial institutions, the board of fingerprinting, the Arizona game and fish department, the Arizona department of agriculture, the board of examiners of nursing care institution administrators and assisted living facility managers, the state board of dental examiners, the Arizona state board of pharmacy, the board of physical therapy, the state board of psychologist examiners, the board of athletic training, the board of occupational therapy examiners, the state board of podiatry examiners, the acupuncture board of examiners, the state board of technical registration, or the board of massage therapy or the Arizona department of housing. 2. "Division" means the fingerprinting division in the department of public safety. 3. "Electronic or internet-based fingerprinting services" means a secure system for digitizing applicant fingerprints and transmitting the applicant data and fingerprints of a person or entity submitting fingerprints to the department of public safety for any authorized purpose under this title. For the purposes of this paragraph, "secure system" means a system that complies with the information technology security policy approved by the department of public safety. 4. "Good cause exception" means the issuance of a fingerprint clearance card to an applicant pursuant to section 41-619.55. 5. "Person" means a person who is required to be fingerprinted pursuant to any of the following: (a) Section 3-314. (b) Section 8-105. (c) Section 8-322. (d) Section 8-463. (e) Section 8-509. (f) Section 8-802. (g) Section 15-183. (h) Section 15-503. (i) Section 15-512. (j) Section 15-534. (k) Section 15-763.01. (l) Section 15-782.02. (m) Section 15-1330. (n) Section 15-1881. (o) Section 17-215. (p) Section 28-3228. (q) Section 28-3413. (r) Section 32-122.02. (s) Section 32-122.05. (t) Section 32-122.06. (u) Section 32-823. (v) Section 32-1232. (w) Section 32-1276.01. (x) Section 32-1284. (y) Section 32-1297.01. (z) Section 32-1904. (aa) Section 32-1941. (bb) Section 32-1982. (cc) Section 32-2022. (dd) Section 32-2063. (ee) Section 32-2108.01. (ff) Section 32-2123. (gg) Section 32-2371. (hh) Section 32-3430. (ii) Section 32-3620. (jj) Section 32-3668. (kk) Section 32-3669. (ll) Section 32-3922. (mm) Section 32-3924. (nn) Section 32-4128. (oo) Section 32-4222. (pp) Section 36-113. (qq) Section 36-207. (rr) Section 36-411. (ss) Section 36-425.03. (tt) Section 36-446.04. (uu) Section 36-594.01. (vv) Section 36-594.02. (ww) Section 36-766.01. (xx) Section 36-882. (yy) Section 36-883.02. (zz) Section 36-897.01. (aaa) Section 36-897.03. (bbb) Section 36-2062.01. (bbb) (ccc) Section 36-3008. (ccc) (ddd) Section 41-619.52. (ddd) (eee) Section 41-619.53. (eee) (fff) Section 41-1964. (fff) (ggg) Section 41-1967.01. (ggg) (hhh) Section 41-1968. (hhh) (iii) Section 41-1969. (iii) (jjj) Section 41-2814. (jjj) (kkk) Section 41-4025. (kkk) (lll) Section 46-141, subsection A or B. (lll) (mmm) Section 46-321. 6. "Vulnerable adult" has the same meaning prescribed in section 13-3623. END_STATUTE Sec. 18. Section 41-1758.01, Arizona Revised Statutes, is amended to read: START_STATUTE41-1758.01. Fingerprinting division; powers and duties A. The fingerprinting division is established in the department of public safety and shall: 1. Conduct fingerprint background checks for persons and applicants who are seeking licenses from state agencies, employment with licensees, contract providers and state agencies or employment or educational opportunities with agencies that require fingerprint background checks pursuant to sections 3-314, 8-105, 8-322, 8-463, 8-509, 8-802, 15-183, 15-503, 15-512, 15-534, 15-763.01, 15-782.02, 15-1330, 15-1881, 17-215, 28-3228, 28-3413, 32-122.02, 32-122.05, 32-122.06, 32-823, 32-1232, 32-1276.01, 32-1284, 32-1297.01, 32-1904, 32-1941, 32-1982, 32-2022, 32-2063, 32-2108.01, 32-2123, 32-2371, 32-3430, 32-3620, 32-3668, 32-3669, 32-3922, 32-3924, 32-4128, 32-4222, 36-113, 36-207, 36-411, 36-425.03, 36-446.04, 36-594.01, 36-594.02, 36-766.01, 36-882, 36-883.02, 36-897.01, 36-897.03, 36-2062.01, 36-3008, 41-619.52, 41-619.53, 41-1964, 41-1967.01, 41-1968, 41-1969, 41-2814, and 41-4025, section 46-141, subsection A or B and section 46-321. 2. Issue fingerprint clearance cards. On issuance, a fingerprint clearance card becomes the personal property of the cardholder and the cardholder shall retain possession of the fingerprint clearance card. 3. On submission of an application for a fingerprint clearance card, collect the fees established by the board of fingerprinting pursuant to section 41-619.53 and deposit, pursuant to sections 35-146 and 35-147, the monies collected in the board of fingerprinting fund. 4. Inform in writing each person who submits fingerprints for a fingerprint background check of the right to petition the board of fingerprinting for a good cause exception pursuant to section 41-1758.03, 41-1758.04 or 41-1758.07. 5. If after conducting a state and federal criminal history records check the division determines that it is not authorized to issue a fingerprint clearance card to a person, inform the person in writing that the division is not authorized to issue a fingerprint clearance card. The notice shall include the criminal history information on which the denial was based. This criminal history information is subject to dissemination restrictions pursuant to section 41-1750 and Public Law 92-544. 6. Notify the person in writing if the division suspends, revokes or places a driving restriction notation on a fingerprint clearance card pursuant to section 41-1758.04. The notice shall include the criminal history information on which the suspension, revocation or placement of the driving restriction notation was based. This criminal history information is subject to dissemination restrictions pursuant to section 41-1750 and Public Law 92-544. 7. Administer and enforce this article. B. The fingerprinting division may contract for electronic or internet-based fingerprinting services through an entity or entities for the acquisition and transmission of applicant fingerprint and data submissions to the department, including identity verified fingerprints pursuant to section 15-106. The entity or entities contracted by the department of public safety may charge the applicant a fee for services provided pursuant to this article. The entity or entities contracted by the department of public safety shall comply with: 1. All information privacy and security measures and submission standards established by the department of public safety. 2. The information technology security policy approved by the department of public safety.END_STATUTE Sec. 19. Rulemaking exemption; intent A. Notwithstanding any other law, for the purposes of this act and amending the rules relating to behavioral health residential facilities and sober living homes, the department of health services is exempt from the rulemaking requirements of title 41, chapters 6 and 6.1, Arizona Revised Statutes, through June 30, 2025. B. The legislature intends for the department of health services to review and amend the rules for behavioral health residential facilities and sober living homes to ensure that there are adequate and proper requirements for staffing, care and oversight.
7777
7878 Be it enacted by the Legislature of the State of Arizona:
7979
8080 Section 1. Section 36-405, Arizona Revised Statutes, is amended to read:
8181
8282 START_STATUTE36-405. Powers and duties of the director
8383
8484 A. The director shall adopt rules to establish minimum standards and requirements for constructing, modifying and licensing health care institutions necessary to ensure the public health, safety and welfare. The standards and requirements shall relate to the construction, equipment, sanitation, staffing for medical, nursing and personal care services, and recordkeeping pertaining to administering medical, nursing, behavioral health and personal care services, in accordance with generally accepted practices of health care. The standards shall require that a physician who is licensed pursuant to title 32, chapter 13 or 17 medically discharge patients from surgery and shall allow an outpatient surgical center to require that either an anesthesia provider who is licensed pursuant to title 32, chapter 13, 15 or 17 or a physician who is licensed pursuant to title 32, chapter 13 or 17 remain present on the premises until all patients are discharged from the recovery room. Except as otherwise provided in this subsection, the director shall use the current standards adopted by the joint commission on accreditation of hospitals and the commission on accreditation of the American osteopathic association or those adopted by any recognized accreditation organization approved by the department as guidelines in prescribing minimum standards and requirements under this section.
8585
8686 B. The director, by rule, may:
8787
8888 1. Classify and subclassify health care institutions according to character, size, range of services provided, medical or dental specialty offered, duration of care and standard of patient care required for the purposes of licensure. Classes of health care institutions may include hospitals, infirmaries, outpatient treatment centers, health screening services centers and residential care facilities. Whenever the director reasonably deems distinctions in rules and standards to be appropriate among different classes or subclasses of health care institutions, the director may make such distinctions.
8989
9090 2. Prescribe standards for determining a health care institution's substantial compliance with licensure requirements.
9191
9292 3. Prescribe the criteria for the licensure inspection process.
9393
9494 4. Prescribe standards for selecting health care-related demonstration projects.
9595
9696 5. Establish nonrefundable application and licensing fees for health care institutions, including a grace period and a fee for the late payment of licensing fees.
9797
9898 6. Establish a process for the department to notify a licensee of the licensee's licensing fee due date.
9999
100100 7. Establish a process for a licensee to request a different licensing fee due date, including any limits on the number of requests by the licensee.
101101
102102 7. Establish an additional monitoring fee for health care institutions that are not in compliance with the requirements of this chapter and the rules adopted pursuant to this chapter.
103103
104104 C. The director, by rule, shall adopt licensing provisions that facilitate the colocation and integration of outpatient treatment centers that provide medical, nursing and health-related services with behavioral health services consistent with article 3.1 of this chapter.
105105
106106 D. Ninety percent of the fees collected pursuant to this section shall be deposited, pursuant to sections 35-146 and 35-147, in the health services licensing fund established by section 36-414 and ten percent of the fees collected pursuant to this section shall be deposited, pursuant to sections 35-146 and 35-147, in the state general fund.
107107
108108 E. Subsection B, paragraph 5 of this section does not apply to a health care institution operated by a state agency pursuant to state or federal law or to adult foster care residential settings. END_STATUTE
109109
110110 Sec. 2. Section 36-413, Arizona Revised Statutes, is amended to read:
111111
112112 START_STATUTE36-413. Nutrition and feeding assistants; training programs; regulation; civil penalty; definition
113113
114114 A. The department may adopt rules to prescribe minimum standards for training programs for nutrition and feeding assistants in licensed skilled nursing facilities, including instructor qualifications, and may grant, deny, suspend and revoke approval of any training program that violates these standards. These standards must include:
115115
116116 1. Screening requirements.
117117
118118 2. Initial qualifications.
119119
120120 3. Continuing education requirements.
121121
122122 4. Testing requirements to assure ensure competency.
123123
124124 5. Supervision requirements.
125125
126126 6. Requirements for additional training based on patient needs.
127127
128128 7. Maintenance of records.
129129
130130 8. Special feeding requirements based on level of care.
131131
132132 B. Pursuant to section 36-431.01, the department may shall impose a civil penalty on a training program that violates standards adopted by the department.
133133
134134 C. If the department adopts standards for training programs pursuant to subsection A of this section, the department, as part of its routine inspection of a health care facility that provides a training program, shall determine the facility's compliance with these standards.
135135
136136 D. For the purposes of this section, "nutrition and feeding assistant" has the same meaning as paid feeding assistant as defined in 42 Code of Federal Regulations part 483 and section 488.301.END_STATUTE
137137
138138 Sec. 3. Section 36-414, Arizona Revised Statutes, is amended to read:
139139
140140 START_STATUTE36-414. Health services licensing fund; exemption
141141
142142 A. The health services licensing fund is established consisting of monies deposited pursuant to sections 30-654, 32-1308, 32-2805, 36-405, 36-431.01, 36-765.05, 36-766.06, 36-851.01, 36-882, 36-897.01, and 36-1903 and 36-2063. The department of health services shall administer the fund.
143143
144144 B. Monies in the fund are subject to legislative appropriation.
145145
146146 C. Monies in the fund are exempt from the provisions of section 35-190 relating to lapsing of appropriations. END_STATUTE
147147
148148 Sec. 4. Section 36-422, Arizona Revised Statutes, is amended to read:
149149
150150 START_STATUTE36-422. Application for license; notification of proposed change in status; joint licenses; definitions
151151
152152 A. A person who wishes to apply for a license to operate a health care institution pursuant to this chapter shall submit to the department all of the following:
153153
154154 1. An application on a written or electronic form that is prescribed, prepared and furnished by the department and that contains all of the following:
155155
156156 (a) The name and location of the health care institution.
157157
158158 (b) Whether the health care institution is to be operated as a proprietary or nonproprietary institution.
159159
160160 (c) The name of the governing authority. The applicant shall be the governing authority having the operative ownership of, or the governmental agency charged with the administration of, the health care institution sought to be licensed. If the applicant is a partnership that is not a limited partnership, the partners shall apply jointly, and the partners are jointly the governing authority for purposes of this article.
161161
162162 (d) The name and business or residential address of each controlling person and an affirmation that none of the controlling persons has been denied a license or certificate by a health profession regulatory board pursuant to title 32 or by a state agency pursuant to chapter 6, article 7 or chapter 17 of this title or a license to operate a health care institution in this state or another state or has had a license or certificate issued by a health profession regulatory board pursuant to title 32 or issued by a state agency pursuant to chapter 6, article 7 or chapter 17 of this title or a license to operate a health care institution revoked. If a controlling person has been denied a license or certificate by a health profession regulatory board pursuant to title 32 or by a state agency pursuant to chapter 6, article 7 or chapter 17 of this title or a license to operate a health care institution in this state or another state or has had a health care professional license or a license to operate a health care institution revoked, the controlling person shall include in the application a comprehensive description of the circumstances for the denial or the revocation.
163163
164164 (e) The class or subclass of health care institution to be established or operated.
165165
166166 (f) The types and extent of the health care services to be provided, including emergency services, community health services and services to indigent patients.
167167
168168 (g) The name and qualifications of the chief administrative officer implementing direction in that specific health care institution.
169169
170170 (h) Other pertinent information required by the department for the proper administration of this chapter and department rules.
171171
172172 2. The attestation required by section 36-421, subsection A.
173173
174174 3. The applicable application fee.
175175
176176 B. An application submitted pursuant to this section shall contain the written or electronic signature of:
177177
178178 1. If the applicant is an individual, the owner of the health care institution.
179179
180180 2. If the applicant is a partnership, limited liability company or corporation, two of the officers of the corporation or managing members of the partnership or limited liability company or the sole member of the limited liability company if it has only one member.
181181
182182 3. If the applicant is a governmental unit, the head of the governmental unit.
183183
184184 C. An application for licensure shall be submitted at least sixty but not more than one hundred twenty days before the anticipated date of operation. An application for a substantial compliance survey submitted pursuant to section 36-425, subsection G shall be submitted at least thirty days before the date on which the substantial compliance survey is requested.
185185
186186 D. If a current licensee intends to terminate the operation of a licensed health care institution or if a change of ownership is planned, the current licensee shall notify the director in writing at least thirty days before the termination of operation or change in ownership is to take place. The current licensee is responsible for preventing any interruption of services required to sustain the life, health and safety of the patients or residents. A new owner shall not begin operating the health care institution until the director issues a license to the new owner.
187187
188188 E. A licensed health care institution for which operations have not been terminated for more than thirty days may be relicensed pursuant to the codes and standards for architectural plans and specifications that were applicable under its most recent license.
189189
190190 F. If a person operates a hospital in a county with a population of more than five hundred thousand persons in a setting that includes satellite facilities of the hospital that are located separately from the main hospital building, the department at the request of the applicant or licensee shall issue a single group license to the hospital and its designated satellite facilities located within one-half mile of the main hospital building if all of the facilities meet or exceed department licensure requirements for the designated facilities. At the request of the applicant or licensee, the department shall also issue a single group license that includes the hospital and its designated satellite facilities that are located farther than one-half mile from the main hospital building if all of these facilities meet or exceed applicable department licensure requirements. Each facility included under a single group license is subject to the department's licensure requirements that are applicable to that category of facility. Subject to compliance with applicable licensure or accreditation requirements, the department shall reissue individual licenses for the facility of a hospital located in separate buildings from the main hospital building when requested by the hospital. This subsection does not apply to nursing care institutions and residential care institutions. The department is not limited in conducting inspections of an accredited health care institution to ensure that the institution meets department licensure requirements. If a person operates a hospital in a county with a population of five hundred thousand persons or less in a setting that includes satellite facilities of the hospital that are located separately from the main hospital building, the department at the request of the applicant or licensee shall issue a single group license to the hospital and its designated satellite facilities located within thirty-five miles of the main hospital building if all of the facilities meet or exceed department licensure requirements for the designated facilities. At the request of the applicant or licensee, the department shall also issue a single group license that includes the hospital and its designated satellite facilities that are located farther than thirty-five miles from the main hospital building if all of these facilities meet or exceed applicable department licensure requirements.
191191
192192 G. If a county with a population of more than one million persons or a special health care district in a county with a population of more than one million persons operates an accredited hospital that includes the hospital's accredited facilities that are located separately from the main hospital building and the accrediting body's standards as applied to all facilities meet or exceed the department's licensure requirements, the department shall issue a single license to the hospital and its facilities if requested to do so by the hospital. If a hospital complies with applicable licensure or accreditation requirements, the department shall reissue individual licenses for each hospital facility that is located in a separate building from the main hospital building if requested to do so by the hospital. This subsection does not limit the department's duty to inspect a health care institution to determine its compliance with department licensure standards. This subsection does not apply to nursing care institutions and residential care institutions.
193193
194194 H. An applicant or licensee must notify the department within thirty days after any change regarding a controlling person and provide the information and affirmation required pursuant to subsection A, paragraph 1, subdivision (d) of this section.
195195
196196 I. A behavioral health residential facility that provides services to children must notify the department within thirty days after the facility begins contracting exclusively with the federal government, receives only federal monies and does not contract with this state.
197197
198198 J. This section does not limit the application of federal laws and regulations to an applicant or licensee that is certified as a medicare or an Arizona health care cost containment system provider under federal law.
199199
200200 K. Except for an outpatient treatment center that provides dialysis services or abortion procedures or that is exempt from licensure pursuant to section 36-402, subsection A, paragraph 12, a person wishing to begin operating an outpatient treatment center before a licensing inspection is completed shall submit all of the following:
201201
202202 1. The license application required pursuant to this section.
203203
204204 2. All applicable application and license fees.
205205
206206 3. A written request for a temporary license that includes:
207207
208208 (a) The anticipated date of operation.
209209
210210 (b) An attestation signed by the applicant that the applicant and the facility comply with and will continue to comply with the applicable licensing statutes and rules.
211211
212212 L. Within seven days after the department's receipt of the items required in subsection K of this section, but not before the anticipated operation date submitted pursuant to subsection C of this section, the department shall issue a temporary license that includes:
213213
214214 1. The name of the facility.
215215
216216 2. The name of the licensee.
217217
218218 3. The facility's class or subclass.
219219
220220 4. The temporary license's effective date.
221221
222222 5. The location of the licensed premises.
223223
224224 M. A facility may begin operating on the effective date of the temporary license.
225225
226226 N. The director may cease the issuance of temporary licenses at any time if the director believes that public health and safety is endangered.
227227
228228 O. An outpatient treatment center that is exempt from licensure pursuant to section 36-402, subsection A, paragraph 12 is subject to reasonable inspection by the department if the director has reasonable cause to believe that patient harm is or may be occurring at that outpatient treatment center. A substantiated complaint that harm is occurring at an exempt outpatient treatment center is a violation of this chapter against the license of the hospital listed in the notice required by section 36-402, subsection A, paragraph 12.
229229
230230 P. Each hospital that is licensed pursuant to this chapter shall provide to and maintain with the department a current list of exempt outpatient treatment centers that have the same direct owner or indirect owner as the hospital.
231231
232232 Q. For the purposes of this section:
233233
234234 1. "Accredited" means accredited by a nationally recognized accreditation organization.
235235
236236 2. "Satellite facility" means an outpatient facility at which the hospital provides outpatient medical services.END_STATUTE
237237
238238 Sec. 5. Section 36-422.01, Arizona Revised Statutes, is amended to read:
239239
240240 START_STATUTE36-422.01. Health care institutions; termination of operation; medical records; civil penalties; definition
241241
242242 A. In addition to the requirements prescribed in section 36-422, subsection D, if a current licensee intends to terminate the operation of a licensed health care institution, the current licensee shall do one of the following before the health care institution ceases operation:
243243
244244 1. Provide each patient of the health care institution with the patient's medical records.
245245
246246 2. Transfer the health care institution's medical records to a third-party entity to ensure patient access to the medical records.
247247
248248 B. If a patient or a patient's health care decision maker requests access to or copies of the patient's medical records, the health care institution or third-party entity in possession of the medical records shall provide access to or copies of the medical records to the patient or the patient's health care decision maker in accordance with title 12, chapter 13, article 7.1.
249249
250250 C. A licensee that fails to comply with subsection A of this section is subject to a civil penalty of not more than $10,000. The director may use a licensee's failure to comply with subsection A of this section as grounds to deny a subsequent license pursuant to section 36-425, subsection K L.
251251
252252 D. For the purposes of this section, "medical record" has the same meaning prescribed in section 36-2201. END_STATUTE
253253
254254 Sec. 6. Section 36-424, Arizona Revised Statutes, is amended to read:
255255
256256 START_STATUTE36-424. Inspections; suspension or revocation of license; report to board of examiners of nursing care institution administrators and assisted living facility managers
257257
258258 A. Except as provided in subsection B of this section, the director shall inspect the premises of the health care institution and investigate the character and other qualifications of the applicant to ascertain whether the applicant and the health care institution are in substantial compliance with the requirements of this chapter and the rules established pursuant to this chapter. The director may prescribe rules regarding department background investigations into an applicant's character and qualifications.
259259
260260 B. The director may accept proof that a health care institution is an accredited hospital or is an accredited health care institution in lieu of all compliance inspections required by this chapter if the director receives a copy of the health care institution's accreditation report for the licensure period and the health care institution is accredited by an independent, nonprofit accrediting organization approved by the secretary of the United States department of health and human services. If the health care institution's accreditation report is not valid for the entire licensure period, the department may conduct a compliance inspection of the health care institution during the time period the department does not have a valid accreditation report for the health care institution. For the purposes of this subsection, each licensed premises of a health care institution must have its own accreditation report. The director may not accept an accreditation report in lieu of a compliance inspection of:
261261
262262 1. An intermediate care facility for individuals with intellectual disabilities.
263263
264264 2. A nursing-supported group home.
265265
266266 3. A health care institution if the health care institution has been subject to an enforcement action pursuant to section 36-427 or 36-431.01 or to a criminal penalty pursuant to title 13 within the year preceding the annual licensing fee anniversary date five years.
267267
268268 4. A residential care institution.
269269
270270 C. On a determination by the director that there is reasonable cause to believe a health care institution is not adhering to the licensing requirements of this chapter, the director and any duly designated employee or agent of the director, including county health representatives and county or municipal fire inspectors, consistent with standard medical practices, may enter on and into the premises of any health care institution that is licensed or required to be licensed pursuant to this chapter at any reasonable time for the purpose of determining the state of compliance with this chapter, the rules adopted pursuant to this chapter and local fire ordinances or rules. Any application for licensure under this chapter constitutes permission for and complete acquiescence in any entry or inspection of the premises during the pendency of the application and, if licensed, during the term of the license. If an inspection reveals that the health care institution is not adhering to the licensing requirements established pursuant to this chapter, the director may take action authorized by this chapter. Any health care institution, including an accredited hospital, whose license has been suspended or revoked in accordance with this section is subject to inspection on application for relicensure or reinstatement of license.
271271
272272 D. The director shall immediately report to the board of examiners of nursing care institution administrators and assisted living facility managers information identifying that a nursing care institution administrator's conduct may be grounds for disciplinary action pursuant to section 36-446.07. END_STATUTE
273273
274274 Sec. 7. Section 36-425, Arizona Revised Statutes, is amended to read:
275275
276276 START_STATUTE36-425. Inspections; issuance of license; posting requirements; provisional license; violation; classification; civil penalty; denial of license
277277
278278 A. On receipt of a properly completed application for a health care institution license, the director shall conduct an inspection of the health care institution as prescribed by this chapter. If an application for a license is submitted due to a planned change of ownership, the director shall determine the need for an inspection of the health care institution. Based on the results of the inspection and after the submission of the applicable licensing fee, the director shall either deny the license or issue a regular or provisional license. A license issued by the department shall be posted in a conspicuous location in the reception area of that health care institution.
279279
280280 B. The director shall issue a license if the director determines that an applicant and the health care institution for which the license is sought substantially comply complies with the requirements of this chapter and rules adopted pursuant to this chapter and the applicant agrees to carry out a plan acceptable to the director to eliminate any deficiencies. The director shall not require a health care institution that was designated as a critical access hospital to make any modifications required by this chapter or rules adopted pursuant to this chapter in order to obtain an amended license with the same licensed capacity the health care institution had before it was designated as a critical access hospital if all of the following are true:
281281
282282 1. The health care institution has subsequently terminated its critical access hospital designation.
283283
284284 2. The licensed capacity of the health care institution does not exceed its licensed capacity before its designation as a critical access hospital.
285285
286286 3. The health care institution remains in compliance with the applicable codes and standards that were in effect at the time the facility was originally licensed with the higher licensed capacity.
287287
288288 C. A health care institution license does not expire and remains valid unless:
289289
290290 1. The department subsequently revokes or suspends the license.
291291
292292 2. The license is considered void because the licensee did not pay the licensing fee, any civil penalties or the provider agreement fees assessed before the licensing fee due date.
293293
294294 D. Except as provided in section 36-424, subsection B and subsection E of this section, the department shall conduct a compliance inspection of a health care institution to determine compliance with this chapter and rules adopted pursuant to this chapter at least once annually.
295295
296296 E. If the department determines a facility to be deficiency free on a compliance survey, the department shall not conduct a compliance survey of that facility for twenty-four months after the date of the deficiency free survey. This subsection does not:
297297
298298 1. Prohibit the department from enforcing licensing requirements as authorized by section 36-424.
299299
300300 2. Apply to residential care institutions.
301301
302302 F. A hospital licensed as a rural general hospital may provide intensive care services.
303303
304304 G. The director shall issue a provisional license for a period of not more than one year if an inspection or investigation of a currently licensed health care institution or a health care institution for which an applicant is seeking a license reveals that the health care institution is not in substantial compliance with department licensure requirements and the director believes that the immediate interests of the patients and the general public are best served if the health care institution is given an opportunity to correct deficiencies. The applicant or licensee shall agree to carry out a corrective action plan to eliminate deficiencies that is acceptable to the director. The director shall not issue consecutive provisional licenses to a single health care institution. The director shall not issue a license to the current licensee or a successor applicant before the expiration of the provisional license unless the health care institution submits an application for a substantial compliance survey and is found to be in substantial compliance. The director may issue a license only if the director determines that the health care institution is in substantial compliance with the licensure requirements of the department and this chapter. This subsection does not prevent the director from taking action to protect the safety of patients pursuant to section 36-427.
305305
306306 H. A residential care institution that operates in this state without a license in violation of this chapter is guilty of a class 6 felony and the director shall assess a civil penalty of at least $5,000 and not more than $10,000 for each violation. Each day the residential care institution operates without a license is a separate violation.
307307
308308 H. I. Subject to the confidentiality requirements of articles 4 and 5 of this chapter, title 12, chapter 13, article 7.1 and section 12-2235, the licensee shall keep current department inspection reports at the health care institution. Unless federal law requires otherwise, the licensee shall post in a conspicuous location a notice that identifies the location at that health care institution where the inspection reports are available for review.
309309
310310 I. J. A health care institution shall immediately notify the department in writing when there is a change of the chief administrative officer specified in section 36-422, subsection A, paragraph 1, subdivision (g).
311311
312312 J. K. When the department issues an original license or an original provisional license to a health care institution, it shall notify the owners and lessees of any agricultural land within one-fourth mile of the health care institution. The health care institution shall provide the department with the names and addresses of owners or lessees of agricultural land within one-fourth mile of the proposed health care institution.
313313
314314 K. L. In addition to the grounds for denial of licensure prescribed pursuant to subsection A of this section, the director may shall deny a license because an applicant or anyone in a business relationship with the applicant, including stockholders and controlling persons, has had a license to operate a health care institution denied, revoked or suspended or a license or certificate issued by a health profession regulatory board pursuant to title 32 or issued by a state agency pursuant to chapter 6, article 7 or chapter 17 of this title denied, revoked or suspended or has a licensing history of recent serious violations occurring in this state or in another state that posed a direct risk to the life, health or safety of patients or residents.
315315
316316 L. M. In addition to the requirements of this chapter, the director may prescribe by rule other licensure requirements. END_STATUTE
317317
318318 Sec. 8. Title 36, chapter 4, article 2, Arizona Revised Statutes, is amended by adding sections 36-425.10 and 36-425.11, to read:
319319
320320 START_STATUTE36-425.10. Behavioral health residential facilities; admittance; notification of family; conditions for transportation
321321
322322 A. When a resident is admitted for initial evaluation, a behavioral health residential facility shall notify the resident's family or next of kin within seventy-two hours after the initial evaluation. The notification shall be documented in the resident's medical record.
323323
324324 B. A behavioral health residential facility may not coordinate, facilitate, arrange for or solicit transportation of a person to the behavioral health residential facility if the person is intoxicated or under the influence of alcohol or other substances, unless the person is referred by an approved provider of a tribal health care program or a regional behavioral health authority or is court-ordered. END_STATUTE
325325
326326 START_STATUTE36-425.11. Behavioral health residential facilities; resident discharge; transportation; documentation
327327
328328 A behavioral health residential facility shall inquire, both verbally and in writing, whether a resident wants to be transported to the resident's place of residence or an alternative safe living space in this state as requested by the resident after discharge from the behavioral health residential facility. The resident's wishes regarding transportation shall be documented on a form prescribed by the department, signed by the resident and retained in the resident's medical record. The behavioral health residential facility shall ensure safe and reliable transportation, as determined by the department, for a resident who wishes to be transported to the resident's place of residence or an alternative safe living space in this state as requested by the resident on discharge. END_STATUTE
329329
330330 Sec. 9. Section 36-431.01, Arizona Revised Statutes, is amended to read:
331331
332332 START_STATUTE36-431.01. Violations; civil penalties; enforcement; use of monies
333333
334334 A. The director may shall assess a civil penalty against a person who violates this chapter or a rule adopted pursuant to this chapter in an amount of not to exceed five hundred dollars at least $5,000 and not more than $10,000 for each violation. Each day that a violation occurs constitutes a separate violation.
335335
336336 B. The director may shall issue a notice of assessment that shall include the proposed amount of the assessment. A person may appeal the assessment by requesting a hearing pursuant to title 41, chapter 6, article 10. When an assessment is appealed, the director shall take no further action to enforce and collect the assessment until after the hearing.
337337
338338 C. In determining the amount of the civil penalty pursuant to subsection A of this section, the department shall consider the following:
339339
340340 1. Repeated violations of statutes or rules.
341341
342342 2. Patterns of noncompliance.
343343
344344 3. Types of violations.
345345
346346 4. The severity of violations.
347347
348348 5. The potential for and occurrences of actual harm.
349349
350350 6. Threats to health and safety.
351351
352352 7. The number of persons affected by the violations.
353353
354354 8. The number of violations.
355355
356356 9. The size of the facility.
357357
358358 10. The length of time that the violations have been occurring.
359359
360360 11. The number of injuries caused.
361361
362362 12. The severity of the injuries caused.
363363
364364 13. The number of deaths caused.
365365
366366 14. The cause of deaths.
367367
368368 D. Pursuant to interagency agreement specified in section 36-409, the director may shall assess a civil penalty, including interest, in accordance with 42 United States Code section 1396r. A person may appeal this assessment by requesting a hearing before the director in accordance with subsection B of this section. Civil penalty amounts may be established by rules adopted by the director that conform to guidelines or regulations adopted by the secretary of the United States department of health and human services pursuant to 42 United States Code section 1396r.
369369
370370 E. Actions to enforce the collection of penalties assessed pursuant to subsections A and D of this section shall be brought by the attorney general or the county attorney in the name of the state in the justice court or the superior court in the county in which the violation occurred.
371371
372372 F. Penalties assessed under subsection D of this section are in addition to and not in limitation of other penalties imposed pursuant to this chapter. All civil penalties and interest assessed pursuant to subsection D of this section shall be deposited, pursuant to sections 35-146 and 35-147, in the nursing care institution resident protection revolving fund established by section 36-431.02. The director shall use these monies for the purposes prescribed by 42 United States Code section 1396r, including payment for the costs of relocation of residents to other facilities, maintenance of operation of a facility pending correction of the deficiencies or closure and reimbursement of residents for personal monies lost.
373373
374374 G. The department shall transmit deposit penalties assessed under subsection A of this section to in the state general fund following funds as follows:
375375
376376 1. Eighty percent in the indigenous peoples protection revolving fund established by section 36-431.03.
377377
378378 2. five percent in the health services licensing fund established by section 36-414. The department shall use the monies deposited in the health services licensing fund pursuant to this paragraph for inspections and enforcement relating to residential care institutions.
379379
380380 3. fifteen percent in the nursing care institution resident protection revolving fund established by section 36-431.02. END_STATUTE
381381
382382 Sec. 10. Section 36-431.02, Arizona Revised Statutes, is amended to read:
383383
384384 START_STATUTE36-431.02. Nursing care institution resident protection revolving fund; use; nonreversion
385385
386386 A. The nursing care institution resident protection revolving fund is established. The fund consists of monies received from civil penalties collected by the director pursuant to section 36-431.01, subsection D.
387387
388388 B. The director shall use monies in the fund for the purposes prescribed in section 36-431.01, subsection F, subject to legislative appropriation.
389389
390390 C. Monies in the fund are exempt from the provisions of section 35-190 relating to the lapsing of appropriations.END_STATUTE
391391
392392 Sec. 11. Title 36, chapter 4, article 2, Arizona Revised Statutes, is amended by adding sections 36-431.03 and 36-431.04, to read:
393393
394394 START_STATUTE36-431.03. Indigenous peoples protection revolving fund
395395
396396 A. The indigenous peoples protection revolving fund is established to support resiliency and healing of indigenous peoples in this state. the fund consists of monies deposited pursuant to section 36-431.01. Monies in the fund are continuously appropriated and are exempt from the provisions of section 35-190 relating to the lapsing of appropriations. The director shall administer the fund.
397397
398398 B. The monies in the fund shall be used annually as follows:
399399
400400 1. Forty percent shall be transferred to tribal colleges in this state for programming in social work and behavioral health.
401401
402402 2. Twenty percent shall provide restitution payments for families of deceased victims of this state's behavioral health system and sober living homes. Each family of a deceased victim shall receive a minimum of $3,000 and the repatriation of the victim's human remains and expenses.
403403
404404 3. Forty percent shall be distributed to tribal communities for behavioral health treatment services and programs or residential homes, including behavioral health residential facilities, sober living homes and transitional homes. END_STATUTE
405405
406406 START_STATUTE36-431.04. Legal action or sale; effect on licensure
407407
408408 A. The department shall not approve an application for licensure of a currently licensed health care institution while any enforcement or court action related to health care institution licensure is pending against that health care institution's current licensee.
409409
410410 B. The director shall continue to pursue any court, administrative or enforcement action against the licensee even though the health care institution is in the process of being sold or transferred to a new owner.
411411
412412 C. The department shall not approve a change in ownership unless the department determines that there has been a transfer of all legal and equitable interests, control and authority in the health care institution so that persons other than the transferring licensee, that licensee's agent or other parties exercising authority or supervision over the health care institution's daily operations or staff are responsible for and have control over the health care institution. END_STATUTE
413413
414414 Sec. 12. Title 36, chapter 18, article 4, Arizona Revised Statutes, is amended by adding sections 36-2062.01 and 36-2062.02, to read:
415415
416416 START_STATUTE36-2062.01. Fingerprinting requirements
417417
418418 as a condition of licensure or continued licensure of a sober living home and as a condition of employment in a sober living home, employees and owners of sober living homes, contracted persons of sober living homes and volunteers of sober living homes shall both:
419419
420420 1. submit a full set of fingerprints to the department of HEALTH services for the purpose of obtaining a state and federal criminal records check pursuant to section 41-1750 and Public Law 92-544. The department of public safety may exchange this fingerprint data with the federal bureau of investigation. The department of health services may charge the cost of each criminal background check to the applicant.
421421
422422 2. Have a valid fingerprint clearance card that is issued pursuant to title 41, chapter 12, article 3.1. END_STATUTE
423423
424424 START_STATUTE36-2062.02. Staff education and training; staff ratios; supervision
425425
426426 A. The department shall establish by rule annual continuing education and training requirements for employees, volunteers and contractors who work in sober living homes, including peer support specialists and behavioral health technicians.
427427
428428 B. A sober living home shall maintain a staff ratio of two staff members, who provide monitoring or assistance to residents at the sober living home, for every six residents.
429429
430430 C. A staff member who is an employee of the sober living home and who provides monitoring or assistance to residents of the sober living home must supervise the sober living home twenty-four hours a day. END_STATUTE
431431
432432 Sec. 13. Section 36-2063, Arizona Revised Statutes, is amended to read:
433433
434434 START_STATUTE36-2063. Fees; licensure; inspections; investigation; violation; classification; civil penalty; sanctions
435435
436436 A. The department shall establish fees for initial licensure and license renewal and a fee for the late payment of licensing fees that includes a grace period. The department shall deposit, pursuant to sections 35-146 and 35-147, ninety percent of the fees collected pursuant to this section in the health services licensing fund established by section 36-414 and ten percent of the fees collected pursuant to this section in the state general fund.
437437
438438 B. On a determination by the director that there is reasonable cause to believe a sober living home is not adhering to the licensing requirements of this article, the director and any duly designated employee or agent of the director may shall enter on and into the premises of any sober living home that is licensed or required to be licensed pursuant to this article at any reasonable time for the purpose of determining the state of compliance with this article, the rules adopted pursuant to this article and local fire ordinances or rules. Any application for licensure under this article constitutes permission for and complete acquiescence in any entry or inspection of the premises during the pendency of the application and, if licensed, during the term of the license. If an inspection reveals that the sober living home is not adhering to the licensing requirements established pursuant to this article, the director may shall take action authorized by this article.
439439
440440 C. Any sober living home whose license has been suspended or revoked in accordance with this article is subject to inspection on application for relicensure or reinstatement of the license. If a sober living home license is revoked in this state or any other state, the licensee of the sober living home whose license was revoked may not reapply for any license issued pursuant to this title for a period of at least five years.
441441
442442 D. A sober living home that operates in this state without a license in violation of this article is guilty of a class 6 felony and the director shall assess a civil penalty of at least $5,000 and not more than $10,000 for each violation. Each day the sober living home operates without a license is a separate violation.
443443
444444 C. E. The director may shall impose a civil penalty on a person that violates this article or the rules adopted pursuant to this article in an amount of at least $5,000 and not more than five hundred dollars $10,000 for each violation. Each day that a violation occurs constitutes a separate violation. The director may shall issue a notice that includes the proposed amount of the civil penalty assessment. If a person requests a hearing to appeal an assessment, the director may not take further action to enforce and collect the assessment until the hearing process is complete. The director shall impose a civil penalty only for those days for which the violation has been documented by the department.
445445
446446 D. F. The department may impose sanctions and commence disciplinary actions against a licensed sober living home, including revoking the license. A license may not be suspended or revoked under this article without affording the licensee notice and an opportunity for a hearing as provided in title 41, chapter 6, article 10.
447447
448448 E. G. The department may contract with a third party to assist the department with licensure and inspections. END_STATUTE
449449
450450 Sec. 14. Section 36-2066, Arizona Revised Statutes, is amended to read:
451451
452452 START_STATUTE36-2066. Posting; sober living homes; update
453453
454454 The department shall post on its public website the name, and address, telephone number, department-issued license number, local jurisdiction business license number and licensure status of each certified and licensed sober living home in this state and shall update the list quarterly. The department may not disclose the address of a certified or licensed sober living home except to a local jurisdiction for zoning purposes, local law enforcement and emergency personnel. A sober living home's address is not a public record and is not subject to title 39, chapter 1, article 2. END_STATUTE
455455
456456 Sec. 15. Title 36, chapter 18, article 4, Arizona Revised Statutes, is amended by adding sections 36-2068, 36-2069 and 36-2070, to read:
457457
458458 START_STATUTE36-2068. Resident acceptance; notification of family; conditions for transportation
459459
460460 A. At the time of accepting a resident into a sober living home, the sober living home shall notify the resident's family or next of kin within seventy-two hours after accepting the resident. The notification shall be documented in the resident's record.
461461
462462 B. A sober living home may not coordinate, facilitate, arrange for or solicit transportation of a person to the sober living home if the person is intoxicated or under the influence of alcohol or other substances, unless the person is referred by an approved provider of a tribal health care program or a regional behavioral health authority or is court-ordered. END_STATUTE
463463
464464 START_STATUTE36-2069. Resident discharge; transportation; documentation
465465
466466 A sober living home shall inquire, both verbally and in writing, whether a resident wants to be transported to the resident's place of residence or an alternative safe living space in this state as requested by the resident after discharge from the sober living home. The resident's wishes regarding transportation shall be documented on a form prescribed by the department of health services, signed by the resident and retained in the resident's record. The sober living home shall ensure safe and reliable transportation, as determined by the department of health services, for a resident who wishes to be transported to the resident's place of residence or an alternative safe living space in this state as requested by the resident on discharge.END_STATUTE
467467
468468 START_STATUTE36-2070. Notification requirements; rules; sex offender registration
469469
470470 A. A manager or staff of a sober living home shall notify the department, in a department-provided format, immediately and not more than six hours after any of the following occurs:
471471
472472 1. The death of a resident, including whether the death may have been drug-related.
473473
474474 2. A resident needed immediate intervention by an Emergency medical provider or other health care provider for a possible overdose or other drug or alcohol-related illness.
475475
476476 3. A sex-related crime may have been committed at the sober living home.
477477
478478 4. Any other incident specified in rule by the department.
479479
480480 B. Sober living home managers and staff may not have a personal or intimate relationship with a resident of the sober living home.
481481
482482 C. The manager or staff of a sober living home shall contact law enforcement if the manager or staff is informed that a resident of the sober living home may have been involved in a sex-related crime.
483483
484484 D. A sober living licensee shall ensure that any resident of the licensee's sober living home who is required to register pursuant to section 13-3821 registers within the statutorily required time frame after admission to the sober living home.END_STATUTE
485485
486486 Sec. 16. Section 41-619.51, Arizona Revised Statutes, is amended to read:
487487
488488 START_STATUTE41-619.51. Definitions
489489
490490 In this article, unless the context otherwise requires:
491491
492492 1. "Agency" means the supreme court, the department of economic security, the department of child safety, the department of education, the department of health services, the department of juvenile corrections, the department of emergency and military affairs, the department of public safety, the department of transportation, the state real estate department, the department of insurance and financial institutions, the Arizona game and fish department, the Arizona department of agriculture, the board of examiners of nursing care institution administrators and assisted living facility managers, the state board of dental examiners, the Arizona state board of pharmacy, the board of physical therapy, the state board of psychologist examiners, the board of athletic training, the board of occupational therapy examiners, the state board of podiatry examiners, the acupuncture board of examiners, the state board of technical registration, or the board of massage therapy or the Arizona department of housing.
493493
494494 2. "Board" means the board of fingerprinting.
495495
496496 3. "Central registry exception" means notification to the department of economic security, the department of child safety or the department of health services, as appropriate, pursuant to section 41-619.57 that the person is not disqualified because of a central registry check conducted pursuant to section 8-804.
497497
498498 4. "Expedited review" means an examination, in accordance with board rule, of the documents an applicant submits by the board or its hearing officer without the applicant being present.
499499
500500 5. "Good cause exception" means the issuance of a fingerprint clearance card to an employee pursuant to section 41-619.55.
501501
502502 6. "Person" means a person who is required to be fingerprinted pursuant to this article or who is subject to a central registry check and any of the following:
503503
504504 (a) Section 3-314.
505505
506506 (b) Section 8-105.
507507
508508 (c) Section 8-322.
509509
510510 (d) Section 8-463.
511511
512512 (e) Section 8-509.
513513
514514 (f) Section 8-802.
515515
516516 (g) Section 8-804.
517517
518518 (h) Section 15-183.
519519
520520 (i) Section 15-503.
521521
522522 (j) Section 15-512.
523523
524524 (k) Section 15-534.
525525
526526 (l) Section 15-763.01.
527527
528528 (m) Section 15-782.02.
529529
530530 (n) Section 15-1330.
531531
532532 (o) Section 15-1881.
533533
534534 (p) Section 17-215.
535535
536536 (q) Section 28-3228.
537537
538538 (r) Section 28-3413.
539539
540540 (s) Section 32-122.02.
541541
542542 (t) Section 32-122.05.
543543
544544 (u) Section 32-122.06.
545545
546546 (v) Section 32-823.
547547
548548 (w) Section 32-1232.
549549
550550 (x) Section 32-1276.01.
551551
552552 (y) Section 32-1284.
553553
554554 (z) Section 32-1297.01.
555555
556556 (aa) Section 32-1904.
557557
558558 (bb) Section 32-1941.
559559
560560 (cc) Section 32-1982.
561561
562562 (dd) Section 32-2022.
563563
564564 (ee) Section 32-2063.
565565
566566 (ff) Section 32-2108.01.
567567
568568 (gg) Section 32-2123.
569569
570570 (hh) Section 32-2371.
571571
572572 (ii) Section 32-3430.
573573
574574 (jj) Section 32-3620.
575575
576576 (kk) Section 32-3668.
577577
578578 (ll) Section 32-3669.
579579
580580 (mm) Section 32-3922.
581581
582582 (nn) Section 32-3924.
583583
584584 (oo) Section 32-4222.
585585
586586 (pp) Section 32-4128.
587587
588588 (qq) Section 36-113.
589589
590590 (rr) Section 36-207.
591591
592592 (ss) Section 36-411.
593593
594594 (tt) Section 36-425.03.
595595
596596 (uu) Section 36-446.04.
597597
598598 (vv) Section 36-594.01.
599599
600600 (ww) Section 36-594.02.
601601
602602 (xx) Section 36-766.01.
603603
604604 (yy) Section 36-882.
605605
606606 (zz) Section 36-883.02.
607607
608608 (aaa) Section 36-897.01.
609609
610610 (bbb) Section 36-897.03.
611611
612612 (ccc) Section 36-2062.01.
613613
614614 (ccc) (ddd) Section 36-3008.
615615
616616 (ddd) (eee) Section 41-619.53.
617617
618618 (eee) (fff) Section 41-1964.
619619
620620 (fff) (ggg) Section 41-1967.01.
621621
622622 (ggg) (hhh) Section 41-1968.
623623
624624 (hhh) (iii) Section 41-1969.
625625
626626 (iii) (jjj) Section 41-2814.
627627
628628 (jjj) (kkk) Section 41-4025.
629629
630630 (kkk) (lll) Section 46-141, subsection A or B.
631631
632632 (lll) (mmm) Section 46-321.END_STATUTE
633633
634634 Sec. 17. Section 41-1758, Arizona Revised Statutes, is amended to read:
635635
636636 START_STATUTE41-1758. Definitions
637637
638638 In this article, unless the context otherwise requires:
639639
640640 1. "Agency" means the supreme court, the department of economic security, the department of child safety, the department of education, the department of health services, the department of juvenile corrections, the department of emergency and military affairs, the department of public safety, the department of transportation, the state real estate department, the department of insurance and financial institutions, the board of fingerprinting, the Arizona game and fish department, the Arizona department of agriculture, the board of examiners of nursing care institution administrators and assisted living facility managers, the state board of dental examiners, the Arizona state board of pharmacy, the board of physical therapy, the state board of psychologist examiners, the board of athletic training, the board of occupational therapy examiners, the state board of podiatry examiners, the acupuncture board of examiners, the state board of technical registration, or the board of massage therapy or the Arizona department of housing.
641641
642642 2. "Division" means the fingerprinting division in the department of public safety.
643643
644644 3. "Electronic or internet-based fingerprinting services" means a secure system for digitizing applicant fingerprints and transmitting the applicant data and fingerprints of a person or entity submitting fingerprints to the department of public safety for any authorized purpose under this title. For the purposes of this paragraph, "secure system" means a system that complies with the information technology security policy approved by the department of public safety.
645645
646646 4. "Good cause exception" means the issuance of a fingerprint clearance card to an applicant pursuant to section 41-619.55.
647647
648648 5. "Person" means a person who is required to be fingerprinted pursuant to any of the following:
649649
650650 (a) Section 3-314.
651651
652652 (b) Section 8-105.
653653
654654 (c) Section 8-322.
655655
656656 (d) Section 8-463.
657657
658658 (e) Section 8-509.
659659
660660 (f) Section 8-802.
661661
662662 (g) Section 15-183.
663663
664664 (h) Section 15-503.
665665
666666 (i) Section 15-512.
667667
668668 (j) Section 15-534.
669669
670670 (k) Section 15-763.01.
671671
672672 (l) Section 15-782.02.
673673
674674 (m) Section 15-1330.
675675
676676 (n) Section 15-1881.
677677
678678 (o) Section 17-215.
679679
680680 (p) Section 28-3228.
681681
682682 (q) Section 28-3413.
683683
684684 (r) Section 32-122.02.
685685
686686 (s) Section 32-122.05.
687687
688688 (t) Section 32-122.06.
689689
690690 (u) Section 32-823.
691691
692692 (v) Section 32-1232.
693693
694694 (w) Section 32-1276.01.
695695
696696 (x) Section 32-1284.
697697
698698 (y) Section 32-1297.01.
699699
700700 (z) Section 32-1904.
701701
702702 (aa) Section 32-1941.
703703
704704 (bb) Section 32-1982.
705705
706706 (cc) Section 32-2022.
707707
708708 (dd) Section 32-2063.
709709
710710 (ee) Section 32-2108.01.
711711
712712 (ff) Section 32-2123.
713713
714714 (gg) Section 32-2371.
715715
716716 (hh) Section 32-3430.
717717
718718 (ii) Section 32-3620.
719719
720720 (jj) Section 32-3668.
721721
722722 (kk) Section 32-3669.
723723
724724 (ll) Section 32-3922.
725725
726726 (mm) Section 32-3924.
727727
728728 (nn) Section 32-4128.
729729
730730 (oo) Section 32-4222.
731731
732732 (pp) Section 36-113.
733733
734734 (qq) Section 36-207.
735735
736736 (rr) Section 36-411.
737737
738738 (ss) Section 36-425.03.
739739
740740 (tt) Section 36-446.04.
741741
742742 (uu) Section 36-594.01.
743743
744744 (vv) Section 36-594.02.
745745
746746 (ww) Section 36-766.01.
747747
748748 (xx) Section 36-882.
749749
750750 (yy) Section 36-883.02.
751751
752752 (zz) Section 36-897.01.
753753
754754 (aaa) Section 36-897.03.
755755
756756 (bbb) Section 36-2062.01.
757757
758758 (bbb) (ccc) Section 36-3008.
759759
760760 (ccc) (ddd) Section 41-619.52.
761761
762762 (ddd) (eee) Section 41-619.53.
763763
764764 (eee) (fff) Section 41-1964.
765765
766766 (fff) (ggg) Section 41-1967.01.
767767
768768 (ggg) (hhh) Section 41-1968.
769769
770770 (hhh) (iii) Section 41-1969.
771771
772772 (iii) (jjj) Section 41-2814.
773773
774774 (jjj) (kkk) Section 41-4025.
775775
776776 (kkk) (lll) Section 46-141, subsection A or B.
777777
778778 (lll) (mmm) Section 46-321.
779779
780780 6. "Vulnerable adult" has the same meaning prescribed in section 13-3623. END_STATUTE
781781
782782 Sec. 18. Section 41-1758.01, Arizona Revised Statutes, is amended to read:
783783
784784 START_STATUTE41-1758.01. Fingerprinting division; powers and duties
785785
786786 A. The fingerprinting division is established in the department of public safety and shall:
787787
788788 1. Conduct fingerprint background checks for persons and applicants who are seeking licenses from state agencies, employment with licensees, contract providers and state agencies or employment or educational opportunities with agencies that require fingerprint background checks pursuant to sections 3-314, 8-105, 8-322, 8-463, 8-509, 8-802, 15-183, 15-503, 15-512, 15-534, 15-763.01, 15-782.02, 15-1330, 15-1881, 17-215, 28-3228, 28-3413, 32-122.02, 32-122.05, 32-122.06, 32-823, 32-1232, 32-1276.01, 32-1284, 32-1297.01, 32-1904, 32-1941, 32-1982, 32-2022, 32-2063, 32-2108.01, 32-2123, 32-2371, 32-3430, 32-3620, 32-3668, 32-3669,
789789
790790 32-3922, 32-3924, 32-4128, 32-4222, 36-113, 36-207, 36-411, 36-425.03, 36-446.04, 36-594.01, 36-594.02, 36-766.01, 36-882, 36-883.02, 36-897.01, 36-897.03, 36-2062.01, 36-3008, 41-619.52, 41-619.53, 41-1964, 41-1967.01, 41-1968, 41-1969, 41-2814, and 41-4025, section 46-141, subsection A or B and section 46-321.
791791
792792 2. Issue fingerprint clearance cards. On issuance, a fingerprint clearance card becomes the personal property of the cardholder and the cardholder shall retain possession of the fingerprint clearance card.
793793
794794 3. On submission of an application for a fingerprint clearance card, collect the fees established by the board of fingerprinting pursuant to section 41-619.53 and deposit, pursuant to sections 35-146 and 35-147, the monies collected in the board of fingerprinting fund.
795795
796796 4. Inform in writing each person who submits fingerprints for a fingerprint background check of the right to petition the board of fingerprinting for a good cause exception pursuant to section 41-1758.03, 41-1758.04 or 41-1758.07.
797797
798798 5. If after conducting a state and federal criminal history records check the division determines that it is not authorized to issue a fingerprint clearance card to a person, inform the person in writing that the division is not authorized to issue a fingerprint clearance card. The notice shall include the criminal history information on which the denial was based. This criminal history information is subject to dissemination restrictions pursuant to section 41-1750 and Public Law 92-544.
799799
800800 6. Notify the person in writing if the division suspends, revokes or places a driving restriction notation on a fingerprint clearance card pursuant to section 41-1758.04. The notice shall include the criminal history information on which the suspension, revocation or placement of the driving restriction notation was based. This criminal history information is subject to dissemination restrictions pursuant to section 41-1750 and Public Law 92-544.
801801
802802 7. Administer and enforce this article.
803803
804804 B. The fingerprinting division may contract for electronic or internet-based fingerprinting services through an entity or entities for the acquisition and transmission of applicant fingerprint and data submissions to the department, including identity verified fingerprints pursuant to section 15-106. The entity or entities contracted by the department of public safety may charge the applicant a fee for services provided pursuant to this article. The entity or entities contracted by the department of public safety shall comply with:
805805
806806 1. All information privacy and security measures and submission standards established by the department of public safety.
807807
808808 2. The information technology security policy approved by the department of public safety.END_STATUTE
809809
810810 Sec. 19. Rulemaking exemption; intent
811811
812812 A. Notwithstanding any other law, for the purposes of this act and amending the rules relating to behavioral health residential facilities and sober living homes, the department of health services is exempt from the rulemaking requirements of title 41, chapters 6 and 6.1, Arizona Revised Statutes, through June 30, 2025.
813813
814814 B. The legislature intends for the department of health services to review and amend the rules for behavioral health residential facilities and sober living homes to ensure that there are adequate and proper requirements for staffing, care and oversight.