| 67 | | - | Be it enacted by the Legislature of the State of Arizona: Section 1. Title 10, chapter 1, article 2, Arizona Revised Statutes, is amended by adding section 10-126, to read: START_STATUTE10-126. Sober living homes; incorporating documents; time frame before conducting business; license number; corporation commission; identification check A. A sober living home as defined in section 36-2061.01 that incorporates pursuant to this title must: 1. File all documents as required for incorporation pursuant to this title within ten business days before the sober living home opens to conduct business. 2. Display the number of the sober living home's license that is issued pursuant to title 36, chapter 18, article 4 on all documents. B. The commission shall check identification documents of a person that files incorporating documents pursuant to this title for a behavioral health entity, or a sober living home as defined in section 36-2061.01. The identification check must occur at the commission. C. Within ten days after receiving the following information relating to a behavioral health entity or a sober living home as defined in section 36-2061.01 and that is incorporated pursuant to this title, the Arizona health care cost containment system administration, the attorney general and the department of health services shall notify the commission of: 1. A license denial, expiration, suspension termination or revocation. 2. The issuance of a central authorization file notice. 3. A bankruptcy filing. 4. Litigation. 5. criminal charges or conviction. END_STATUTE Sec. 2. Title 10, chapter 1, article 3, Arizona Revised Statutes, is amended by adding section 10-131, to read: START_STATUTE10-131. Behavioral health entities; sober living homes; residential services; expedited filing; certificates of good standing; notarized declaration A. The commission shall provide a special designation to a behavioral health entity, or a sober living home as defined in section 36-2061.01, and that files for incorporation pursuant to this title. B. Notwithstanding any other law, for a behavioral health entity that is described pursuant to subsection a of this section, any change in ownership, name or license status must be coordinated and approved by the commission in writing in cooperation with the department of health services. C. Notwithstanding section 10-122 or 10-3122, expedited filing does not apply to documents and services related to a behavioral health entity or a sober living home as defined in section 36-2061.01. D. The commission may not issue a certificate of good standing under section 10-128, subsection A or section 10-3128, subsection A to a domestic or foreign corporation if the corporation is a behavioral health entity or a sober living home as defined in section 36-2061, and the CORPORATION does not COMPLY with title 36. E. If the certificate of disclosure declaration PRESCRIBED in section 10-202, subsection D, paragraph 5 and section 10-3202, subsection D, paragraph 5 is for a corporation that is a behavioral health entity or a sober living home as defined in section 36-2061.01, the signature on the declaration must be notarized. END_STATUTE Sec. 3. Section 10-401, Arizona Revised Statutes, is amended to read: START_STATUTE10-401. Corporate name A. A corporate name: 1. Shall contain the word "association", "bank", "company", "corporation", "limited" or "incorporated" or an abbreviation of one of these words or words or abbreviations of like import in another language. 2. Shall not contain language stating or implying that the corporation is organized for a purpose other than that allowed by section 10-301 and its articles of incorporation. 3. Notwithstanding paragraph 1 of this subsection, shall not include the words "bank", "deposit", "credit union", "trust" or "trust company" separately or in combination to indicate or convey the idea that the corporation is engaged in a banking or trust business unless the corporation is to be and becomes actively and substantially engaged in the banking, credit union or trust business or the corporation is a holding company holding substantial interest in companies actively and substantially engaged in the banking or trust business. 4. Shall not contain the words "limited liability company" or "limited company" or the abbreviations "L.L.C.", "L.C.", "LLC" or "LC", in uppercase or lowercase letters. 5. Shall contain the words "sober living home" if the corporation is a sober living home as defined in section 36-2061.01. B. Except as authorized by subsections C and D of this section, a corporate name shall be distinguishable from all of the following: 1. The corporate name of a corporation incorporated in this state or a foreign corporation authorized to transact business in this state. 2. A corporate name reserved under section 10-402 or registered under section 10-403. 3. A fictitious name adopted by a foreign corporation under section 10-1506. 4. The corporate name of a nonprofit corporation incorporated under this title or a foreign nonprofit or not for profit corporation authorized to conduct affairs in this state. 5. The partnership name of a limited partnership organized and registered under the laws of this state or of a foreign limited partnership authorized to transact business in this state. 6. The name of a limited liability company organized under title 29 or a foreign limited liability company authorized to transact business in this state. 7. A trade name registered pursuant to title 44, chapter 10, article 3.1. 8. The name of a registered limited liability partnership registered under title 29, chapter 5, article 10 or a foreign registered limited liability partnership authorized to transact business in this state. C. A corporation may apply to the commission for authorization to use a name that is not distinguishable from one or more of the names described in subsection B of this section. The commission shall authorize use of the name applied for if either: 1. The other entity consents to the use in writing and submits an undertaking in a form satisfactory to the commission to change its name to a name that is distinguishable from the name of the applying corporation. 2. The applicant delivers to the commission a certified copy of the final judgment of a court of competent jurisdiction establishing the applicant's right to use the name applied for in this state. D. A corporation may use the name, including a fictitious name, of another domestic or foreign corporation that is used in this state if the other corporation is incorporated or authorized to transact business in this state and the proposed user corporation either has: 1. Merged with the other corporation. 2. Been formed by reorganization of the other corporation. 3. Acquired all or substantially all of the assets, including the corporate name, of the other corporation. E. Chapters 1 through 17 of this title do not control the use of fictitious names. END_STATUTE Sec. 4. Section 10-501, Arizona Revised Statutes, is amended to read: START_STATUTE10-501. Known place of business and statutory agent A. Each corporation shall continuously maintain in this state both: 1. A known place of business that may be the address of its statutory agent. 2. A statutory agent who may be either: (a) An individual who resides in this state. (b) A domestic corporation formed under this title. (c) A foreign corporation authorized to transact business in this state. (d) A limited liability company formed under title 29. (e) A limited liability company authorized to transact business in this state. B. If the corporation is a behavioral health entity or a sober living home as defined in section 36-2061.01: 1. The address of the place of business and statutory agent: (a) May not be a post office box or statutory agent. (b) Must be located in this state. (c) Must be located in the county where the behavioral health entity is located. 2. The statutory agent must be an independent third-party, that is at least 18 years of age and that resides in this state. the statutory agent shall not be a direct or indirect owner or a relative or spouse thereof, or a controlling person, or party with a conflict of interest. END_STATUTE Sec. 5. Section 10-3401, Arizona Revised Statutes, is amended to read: START_STATUTE10-3401. Corporate name A. A corporate name shall not contain language that states or implies that the corporation is organized for a purpose other than the purpose allowed by section 10-3301 and in its articles of incorporation. If the corporation is a sober living home as defined in section 36-2061.01, A corporate name Shall contain the words "sober living home". B. Except as authorized by subsections C and D of this section, a corporate name must be distinguishable from all of the following: 1. The corporate name of a corporation incorporated in this state or a foreign corporation authorized to conduct affairs in this state. 2. A corporate name reserved under section 10-402 or 10-3402 or registered under section 10-403 or 10-3403. 3. A fictitious name of a foreign corporation under section 10-1506 or 10-11506. 4. The corporate name of a business corporation incorporated under this title or a foreign business corporation authorized to transact business in this state. 5. The partnership name of a limited partnership organized and registered under the laws of this state or of a foreign limited partnership authorized to transact business in this state. 6. The name of a limited liability company organized under title 29 or a foreign limited liability company authorized to transact business in this state. 7. A trade name registered pursuant to title 44, chapter 10, article 3.1. 8. The name of a registered limited liability partnership registered under title 29, chapter 5, article 10 or a foreign registered limited liability partnership authorized to transact business in this state. C. A corporation may apply to the commission for authorization to use a name that is not distinguishable from one or more of the names described in subsection B of this section. The commission shall authorize use of the name applied for if either: 1. The other corporation consents to the use in writing and submits an undertaking in a form satisfactory to the commission to change its name to a name that is distinguishable from the name of the applying corporation. 2. The applicant delivers to the commission a certified copy of a final judgment of a court of competent jurisdiction establishing the applicant's right to use the name applied for in this state. D. A corporation may use the name, including a fictitious name, of another domestic or foreign business or nonprofit corporation that is used in this state if the other corporation is incorporated or authorized to transact business or conduct affairs in this state and the proposed user corporation either has: 1. Merged with the other corporation. 2. Been formed by reorganization of the other corporation. 3. Acquired all or substantially all of the assets, including the corporate name, of the other corporation. E. Chapters 24 through 42 of this title do not control the use of fictitious names. END_STATUTE Sec. 6. Section 10-3501, Arizona Revised Statutes, is amended to read: START_STATUTE10-3501. Known place of business and statutory agent A. Each corporation shall continuously maintain in this state both: 1. A known place of business that may be the address of its statutory agent. 2. A statutory agent who may be either: (a) An individual who resides in this state. (b) A domestic business or nonprofit corporation formed under this title. (c) A foreign business or nonprofit corporation authorized to transact business or conduct affairs in this state. (d) A limited liability company formed under title 29. (e) A limited liability company authorized to transact business in this state. B. If the corporation is a behavioral health entity or a sober living home as defined in section 36-2061.01, that provides residential services: 1. the address: (a) May not be a post office box or a mailbox rental service. (b) Must be located in this state. (c) Must be located in the county where the behavioral health entity or the sober living home is located. 2. The statutory agent must be an independent third-party, that is at least 18 years of age and that resides in this state. the statutory agent shall not be a direct or indirect owner or a relative or spouse thereof, a controlling person, or party with a conflict of interest. END_STATUTE Sec. 7. Section 36-401, Arizona Revised Statutes, is amended to read: START_STATUTE36-401. Definitions; adult foster care A. In this chapter, unless the context otherwise requires: 1. "Accredited health care institution" means a health care institution, other than a hospital, that is currently accredited by a nationally recognized accreditation organization. 2. "Accredited hospital" means a hospital that is currently accredited by a nationally recognized organization on hospital accreditation. 3. "Adult behavioral health therapeutic home" means a residence for individuals who are at least eighteen years of age, have behavioral health issues and need behavioral health services that does all of the following for those individuals: (a) Provides room and board. (b) Assists in acquiring daily living skills. (c) Coordinates transportation to scheduled appointments. (d) Monitors behaviors. (e) Assists in the self-administration of medication. (f) Provides feedback to case managers related to behavior. 4. "Adult day health care facility" means a facility that provides adult day health services during a portion of a continuous twenty-four-hour period for compensation on a regular basis for five or more adults who are not related to the proprietor. 5. "Adult day health services" means a program that provides planned care supervision and activities, personal care, personal living skills training, meals and health monitoring in a group setting during a portion of a continuous twenty-four-hour period. Adult day health services may also include preventive, therapeutic and restorative health-related services that do not include behavioral health services. 6. "Adult foster care home" means a residential setting that provides room and board and adult foster care services for at least one and not more than four adults who are participants in the Arizona long-term care system pursuant to chapter 29, article 2 of this title or contracts for services with the United States department of veterans affairs and in which the sponsor or the manager resides with the residents and integrates the residents who are receiving adult foster care into that person's family. 7. "Adult foster care services" means supervision, assistance with eating, bathing, toileting, dressing, self-medication and other routines of daily living or services authorized by rules adopted pursuant to section 36-405 and section 36-2939, subsection C. 8. "Assisted living center" means an assisted living facility that provides resident rooms or residential units to eleven or more residents. 9. "Assisted living facility" means a residential care institution, including an adult foster care home, that provides or contracts to provide supervisory care services, personal care services or directed care services on a continuous basis. 10. "Assisted living home" means an assisted living facility that provides resident rooms to ten or fewer residents. 11. "BEHAVIORAL HEALTH ENTITY" MEANS AN ADULT BEHAVIORAL HEALTH THERAPEUTIC HOME, BEHAVIORAL HEALTH INPATIENT FACILITY, BEHAVIORAL HEALTH RESIDENTiAL FACILITY, SUBSTANCE ABUSE TRANSITIONAL FACILITY OR ANY PERSON THAT PROVIDES BEHAVIORAL HEALTH SERVICES RELATED TO SUBSTANCE USE DISORDER, SUBSTANCE ABUSE, ALCOHOL, DRUG ABUSE, OR OTHER BEHAVIORAL HEALTH SERVICES AND THAT RECEIVES FEDERAL FUNDS, OR ANY FEDERAL HEALTHCARE PROGRAM. 11. 12. "Behavioral health services" means services that pertain to mental health and substance use disorders and that are either: (a) Performed by or under the supervision of a professional who is licensed pursuant to title 32 and whose scope of practice allows the professional to provide these services. (b) Performed on behalf of patients by behavioral health staff as prescribed by rule. 12. 13. "Construction" means building, erecting, fabricating or installing a health care institution. 13. 14. "Continuous" means available at all times without cessation, break or interruption. 14. 15. "Controlling person" means a person who: (a) Through ownership, has the power to vote at least ten percent of the outstanding voting securities. (b) If the applicant or licensee is a partnership, is the general partner or a limited partner who holds at least ten percent of the voting rights of the partnership. (c) If the applicant or licensee is a corporation, an association or a limited liability company, is the president, the chief executive officer, the incorporator or any person who owns or controls at least ten percent of the voting securities. For the purposes of this subdivision, corporation does not include nonprofit corporations. (d) Holds a beneficial interest in ten percent or more of the liabilities of the applicant or the licensee. 15. 16. "Department" means the department of health services. 16. 17. "Directed care services" means programs and services, including supervisory and personal care services, that are provided to persons who are incapable of recognizing danger, summoning assistance, expressing need or making basic care decisions. 17. 18. "Direction" means authoritative policy or procedural guidance to accomplish a function or activity. 18. 19. "Director" means the director of the department. 19. 20. "Direct owner" means a person that has an ownership or control interest in a health care institution totaling fifty-one percent or more. 20. 21. "Facilities" means buildings that are used by a health care institution for providing any of the types of services as defined in this chapter. 21. 22. "Freestanding urgent care center": (a) Means an outpatient treatment center that, regardless of its posted or advertised name, meets any of the following requirements: (i) Is open twenty-four hours a day, excluding at its option weekends or certain holidays, but is not licensed as a hospital. (ii) Claims to provide unscheduled medical services that are not otherwise routinely available in primary care physician offices. (iii) By its posted or advertised name, gives the impression to the public that it provides medical care for urgent, immediate or emergency conditions. (iv) Routinely provides ongoing unscheduled medical services for more than eight consecutive hours for an individual patient. (b) Does not include the following: (i) A medical facility that is licensed under a hospital's license and that uses the hospital's medical provider number. (ii) A qualifying community health center pursuant to section 36-2907.06. (iii) Any other health care institution licensed pursuant to this chapter. (iv) A physician's office that offers extended hours or same-day appointments to existing and new patients and that does not meet the requirements of subdivision (a), item (i), (iii) or (iv) of this paragraph. 22. 23. "Governing authority" means the individual, agency, partners, group or corporation, whether appointed, elected or otherwise designated, in which the ultimate responsibility and authority for the conduct of the health care institution are vested. 23. 24. "Health care institution" means every place, institution, building or agency, whether organized for profit or not, that provides facilities with medical services, nursing services, behavioral health services, health screening services, other health-related services, supervisory care services, personal care services or directed care services and includes home health agencies as defined in section 36-151, outdoor behavioral health care programs and hospice service agencies. 24. 25. "Health-related services" means services, other than medical, that pertain to general supervision, protective, preventive and personal care services, supervisory care services or directed care services. 25. 26. "Health screening services" means the acquisition, analysis and delivery of health-related data of individuals to aid in determining the need for medical services. 26. 27. "Hospice" means a hospice service agency or the provision of hospice services in an inpatient facility. 27. 28. "Hospice service" means a program of palliative and supportive care for terminally ill persons and their families or caregivers. 28. 29. "Hospice service agency" means an agency or organization, or a subdivision of that agency or organization, that provides hospice services at the place of residence of its clients. 29. 30. "Indirect owner": (a) Means a person that has an ownership or control interest in a direct owner totaling fifty-one percent or more. (b) Includes an ownership or control interest in an indirect owner totaling fifty-one percent or more and a combination of direct ownership and indirect ownership or control interests totaling fifty-one percent or more in the health care institution. 30. 31. "Inpatient beds" or "resident beds" means accommodations with supporting services, such as food, laundry and housekeeping, for patients or residents who generally stay in excess of twenty-four hours. 31. 32. "Intermediate care facility for individuals with intellectual disabilities" has the same meaning prescribed in section 36-551. 32. 33. "Licensed capacity" means the total number of persons for whom the health care institution is authorized by the department to provide services as required pursuant to this chapter if the person is expected to stay in the health care institution for more than twenty-four hours. For a hospital, licensed capacity means only those beds specified on the hospital license. 33. 34. "Medical services" means the services that pertain to medical care and that are performed at the direction of a physician on behalf of patients by physicians, dentists, nurses and other professional and technical personnel. 34. 35. "Modification" means the substantial improvement, enlargement, reduction or alteration of or other change in a health care institution. 35. 36. "Nonproprietary institution" means any health care institution that is organized and operated exclusively for charitable purposes, no part of the net earnings of which inures to the benefit of any private shareholder or individual, or that is operated by the state or any political subdivision of the state. 36. 37. "Nursing care institution" means a health care institution that provides inpatient beds or resident beds and nursing services to persons who need continuous nursing services but who do not require hospital care or direct daily care from a physician. 37. 38. "Nursing services" means those services that pertain to the curative, restorative and preventive aspects of nursing care and that are performed at the direction of a physician by or under the supervision of a registered nurse licensed in this state. 38. 39. "Nursing-supported group home" means a health care institution that is a community residential setting as defined in section 36-551 for not more than six persons with developmental disabilities, that is operated by a service provider under contract with the department of economic security and that provides room and board, daily habilitation and continuous nursing support and intervention. 40. "Obviously intoxicated" means inebriated to the extent that a person's physical faculties are substantially impaired and the impairment is shown by significantly uncoordinated physical action or significant physical dysfunction that would have been obvious to a reasonable person. 39. 41. "Organized medical staff" means a formal organization of physicians, and dentists if appropriate, with the delegated authority and responsibility to maintain proper standards of medical care and to plan for continued betterment of that care. 40. 42. "Outdoor behavioral health care program" means an agency that provides behavioral health services in an outdoor environment as an alternative to behavioral health services that are provided in a health care institution with facilities. Outdoor behavioral health care programs do not include: (a) Programs, facilities or activities that are operated by a government entity or that are licensed by the department as a child care program pursuant to chapter 7.1 of this title. (b) Outdoor activities for youth that are designated to be primarily recreational and that are organized by church groups, scouting organizations or similar groups. (c) Outdoor youth programs that are licensed by the department of economic security. 43. "PERSON" MEANS ANY CORPORATION, BUSINESS, INDIVIDUAL, UNION, COMMITTEE, CLUB, OR ORGANIZATION, OR GROUP OF INDIVIDUALS. 41. 44. "Personal care services" means assistance with activities of daily living that can be performed by persons without professional skills or professional training and includes the coordination or provision of intermittent nursing services and the administration of medications and treatments by a nurse who is licensed pursuant to title 32, chapter 15 or as otherwise provided by law. 42. 45. "Physician" means any person who is licensed pursuant to title 32, chapter 13 or 17. 43. 46. "Recidivism reduction services" means services that are delivered by an adult residential care institution to its residents to encourage lawful behavior and to discourage or prevent residents who are suspected of, charged with or convicted of one or more criminal offenses, or whose mental health and substance use can be reasonably expected to place them at risk for the future threat of prosecution, diversion or incarceration, from engaging in future unlawful behavior. 44. 47. "Recidivism reduction staff" means a person who provides recidivism reduction services. 45. 48. "Residential care institution" means a health care institution other than a hospital or a nursing care institution that provides resident beds or residential units, supervisory care services, personal care services, behavioral health services, directed care services or health-related services for persons who do not need continuous nursing services. 46. 49. "Residential unit" means a private apartment, unless otherwise requested by a resident, that includes a living and sleeping space, kitchen area, private bathroom and storage area. 47. 50. "Respite care services" means services that are provided by a licensed health care institution to persons who are otherwise cared for in foster homes and in private homes to provide an interval of rest or relief of not more than thirty days to operators of foster homes or to family members. 48. 51. "Substantial compliance" means that the nature or number of violations revealed by any type of inspection or investigation of a health care institution does not pose a direct risk to the life, health or safety of patients or residents. 49. 52. "Supervision" means directly overseeing and inspecting the act of accomplishing a function or activity. 50. 53. "Supervisory care services" means general supervision, including daily awareness of resident functioning and continuing needs, the ability to intervene in a crisis and assistance in self-administering prescribed medications. 51. 54. "Temporary license" means a license that is issued by the department to operate a class or subclass of a health care institution at a specific location and that is valid until an initial licensing inspection. 52. 55. "Unscheduled medical services" means medically necessary periodic health care services that are unanticipated or cannot reasonably be anticipated and that require medical evaluation or treatment before the next business day. 56. "VULNERABLE ADULT" MEANS AN INDIVIDUAL WHO IS EIGHTEEN YEARS OF AGE OR OLDER AND WHO IS UNABLE TO PROTECT HIMSELF OR HERSELF FROM ABUSE, NEGLECT, OR EXPLOITATION BY OTHERS BECAUSE OF A MENTAL OR PHYSICAL IMPAIRMENT. B. If there are fewer than four Arizona long-term care system participants receiving adult foster care in an adult foster care home, nonparticipating adults may receive other types of services that are authorized by law to be provided in the adult foster care home as long as the number of adults served, including the Arizona long-term care system participants, does not exceed four. C. Nursing care services may be provided by the adult foster care licensee if the licensee is a nurse who is licensed pursuant to title 32, chapter 15 and the services are limited to those allowed pursuant to law. The licensee shall keep a record of nursing services rendered. END_STATUTE Sec. 8. 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 shall: 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 thirty-day 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. C. The director, by rule, shall establish a monitoring program for behavioral health entities that identifies the circumstances when the department shall assign department staff on a temporary basis to monitor and provide professional assistance to a licensee that is not in substantial compliance with the licensing requirements applicable to that licensee. The rules shall establish staffing levels based on monitoring needs and the corresponding fees based on a cost assessment calculating the duration of the monitoring schedule, a pre-disclosed hourly rate, and actual costs. C. D. 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. E. 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. F. 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. 9. 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 at least $5,000 and 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. 10. 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 behavioral health entity. 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. 11. 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 with the requirements of this chapter and rules adopted pursuant to this chapter and the applicant agrees to carry out a corrective action 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 BEHAVIORAL HEALTH ENTITIES. 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 MORE THAN TWO NONCONSECUTIVE 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 person that operates, OR MAINTAINS A BEHAVIORAL HEALTH ENTITY 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, WHICH MAY BE ASSESSED FOR EACH RESIDENT OR PATIENT WHO THE DEPARTMENT DETERMINES WAS IMPACTED BY THE VIOLATION. EACH DAY THE BEHAVIORAL HEALTH ENTITY OPERATES WITHOUT A CURRENT AND VALID LICENSE IS A SEPARATE CIVIL VIOLATION. THE DIRECTOR, THROUGH THE STATE ATTORNEY GENERAL, SHALL BRING AN ACTION FOR AN INJUNCTION TO RESTRAIN SUCH VIOLATION OR TO ENJOIN THE FUTURE OPERATION OR MAINTENANCE OF ANY SUCH BEHAVIORAL HEALTH ENTITY. Each day the residential care institution operates without a license is a separate civil 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 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. 12. Title 36, chapter 4, article 2, Arizona Revised Statutes, is amended by adding section 36-425.10, to read: START_STATUTE36-425.10. Behavioral health entities; licensure; admittance; notification; conditions for transportation; resident discharge; documentation; definition A. In addition to all other licensing standards and requirements in this article, the department, by rule, shall establish a designated license for a behavioral health entity that uses funds received directly or indirectly, from any federal health care program as defined in 42 u.s.c.a. 1320a. The behavioral health entity license shall be for a term of one year. The department shall not: 1. Issue a behavioral health entity a license with an expiration date of greater than 12-months from the initial date of issuance. 2. Issue a temporary license to a behavioral health applicant or licensee. 3. Assess a civil penalty to a behavioral health entity, in an amount less than $5,000 or more than $10,000 for each violation. 4. Rescind, in whole or in part, sanctions imposed on a behavioral health entity, pursuant to section 36-427. 5. Authorize or approve the removal of a behavioral health entity licensee and appoint another person to continue operation of the behavioral health entity pending further action under section 36-429, absent good cause and risk of the life, health, or safety of a patient. 6. Authorize or approve an application for licensure of a currently licensed behavioral health entity while any enforcement or court action related to the behavioral health entity's licensure is pending against that behavioral health entity's current owner or licensee. B. To the extent allowed by federal law, when a resident is admitted for initial evaluation, a behavioral health entity shall obtain and document a list of the resident's medications, allergies and emergency contact information on or before the date of the resident's arrival. a behavioral health entity shall USE BEST EFFORTS to notify the resident's family, next of kin, OR RESPONSIBLE PERSON AS DESIGNATED BY THE RESIDENT within seventy-two hours after the initial evaluation. The notification shall be documented in the resident's medical record. C. A behavioral health entity may not coordinate, facilitate, arrange for or solicit transportation of a person to the behavioral health entity if the person is obviously 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. The notification requirement in this subsection is waived if the resident voluntarily signs a written waiver on a form prescribed by the department, that requests that the behavioral health entity not notify the resident's family, next of kin, or responsible person of the resident's admission. D. For a resident who is at least eighteen years of age, a behavioral health entity shall inquire, both verbally and in writing, whether the 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 entity. For a resident who is at least eighteen years of age, 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. E. For a resident who is at least eighteen years of age, the behavioral health entity shall USE GOOD FAITH IN ATTEMPTING TO ARRANGE FOR safe and reliable transportation, IF REASONABLY AVAILABLE as determined by the department, if the resident wishes to be transported to the resident's place of residence or an alternative safe living space IF REASONABLY AVAILABLE in this state as requested by the resident on discharge. A BEHAVIORAL HEALTH ENTITY SHALL CONTACT THE STATEWIDE SOCIAL SERVICE PROVIDER AND AREA SHELTERS TO COMPLY WITH THE PROVISIONS OF THIS SECTION. F. For a resident who is under eighteen years of age, the behavioral health entity shall coordinate with the resident's parent or legal guardian and the clinical social worker handling the resident's case regarding transportation to the resident's place of residence or an alternative safe living space in this state after discharge from the behavioral health entity. G. For the purposes of this section, a patient, resident, prospective patient or resident of a behavioral health entity is a vulnerable adult as defined in section 36-401, and the director shall adopt rules that prescribe procedures consistent with this section. END_STATUTE Sec. 13. Section 36-431.01, Arizona Revised Statutes, is amended to read: START_STATUTE36-431.01. Violations; civil penalties; enforcement A. The director may 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 $1,500 and not more than $10,000 for each violation, . Which may be assessed for each resident, or patient, who the department determines was impacted by the violation. Each day that a violation occurs constitutes a separate violation. In addition to any other civil penalty, absent a demonstration of good cause by the behavioral health entity, the director shall assess a civil penalty against a behavioral health entity with repeated violations of this chapter or rules adopted pursuant to this chapter in an amount of not less than $5,000 and not more than $10,000 for each violation, which will be assessed for each resident, or patient, who the department determines was impacted by the 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. END_STATUTE Sec. 14. Title 36, chapter 18, article 4, Arizona Revised Statutes, is amended by adding section 36-2061.01, to read: START_STATUTE36-2061.01. Sober living home; federal funds; definition FOR PURPOSES OF THIS ARTICLE "PUBLICLY FUNDED SOBER LIVING HOME" MEANS A SOBER LIVING HOME AS DEFINED IN SECTION 36-2062 AND THAT DIRECTLY OR INDIRECTLY RECEIVES FEDERAL MONIES OR FEDERAL RESOURCES OR FEDERAL BENEFITS DERIVED FROM ANY SOURCE INCLUDING BUT NOT LIMITED TO ANY FEDERAL HEALTH CARE PROGRAM AND THE AMERICAN INDIAN HEALTH PLAN. END_STATUTE Sec. 15. Section 36-2062, Arizona Revised Statutes, is amended to read: START_STATUTE36-2062. Licensure; standards; civil penalties; use of title A. The director shall adopt rules to establish minimum standards and requirements for the licensure of sober living homes in this state necessary to ensure the public health, safety and welfare. The director may use the current standards adopted by any recognized national organization approved by the department as guidelines in prescribing the minimum standards and requirements under this subsection. The standards shall include: 1. A requirement that each sober living home to develop policies and procedures to allow individuals who are on medication-assisted treatment to continue to receive this treatment while living in the sober living home. 2. Consistent and fair practices for drug and alcohol testing, including frequency, that promote the residents' recovery. 3. Policies and procedures for the residence to maintain an environment that promotes the safety of the surrounding neighborhood and the community at large. 4. Policies and procedures for discharge planning of persons living in the residence that do not negatively impact the surrounding community. 5. A good neighbor policy to address neighborhood concerns and complaints. 6. A requirement that the operator of each sober living home have available for emergency personnel an up-to-date list of current medications and medical conditions of each person living in the home. 7. A policy that ensures residents are informed of all sober living home rules, residency requirements and resident agreements. 8. Policies and procedures for the management of managing all monies received and spent by the sober living home in accordance with standard accounting practices, including monies received from residents of the sober living home. 9. A requirement that each sober living home post a statement of resident rights that includes the right to file a complaint about the residence or provider and information about how to file a complaint. 10. Policies that promote recovery by requiring residents to participate in treatment, self-help groups or other recovery supports. 11. Policies requiring abstinence from alcohol and illicit drugs. 12. Procedures regarding the appropriate use and security of medication by a resident. 13. Policies regarding the maintenance of sober living homes, including the installation of functioning smoke detectors, carbon monoxide detectors and fire extinguishers and compliance with local fire codes applicable to comparable dwellings occupied by single families. 14. Policies and procedures that prohibit a sober living home owner, employee or administrator from requiring a resident to sign any document for the purpose of relinquishing the resident's public assistance benefits, including medical assistance benefits, cash assistance and supplemental nutrition assistance program benefits. 15. Policies and procedures for managing complaints about sober living homes. 16. Requirements for the notification of notifying a family member or other emergency contact designated by a resident under certain circumstances, including death due to an overdose. 17. a requirement that the business license be issued at least ten business days before the sober living home as defined in section 36-2061.01 opens to conduct business. B. The licensure of a sober living home under this article is for one year. A person operating a sober living home in this state that has failed to attain or maintain licensure of the sober living home shall pay a civil penalty of up to one thousand dollars civil penalties as prescribed in section 36-2063 for each violation. C. To receive and maintain licensure, a sober living home must comply with all federal, state and local laws, including the Americans with disabilities act of 1990 and the health insurance portability and accountability act. D. A treatment facility that is licensed by the department for the treatment of to treat substance use disorders and that has one or more sober living homes on the same campus as the facility's program shall obtain licensure for each sober living home pursuant to this article. E. Once the director adopts the minimum standards as required in subsection A of this section, A person may not establish, conduct or maintain in this state a sober living home unless that person holds a current and valid license issued by the department or is certified as prescribed in section 36-2064. The license is valid only for the establishment, operation and maintenance of the sober living home. The licensee may not: 1. Imply by advertising, or directory listing or otherwise imply that the licensee is authorized to perform services more specialized or of a higher degree of care than is authorized by this article and the underlying adopted rules for sober living homes. 2. Transfer or assign the license. A license is valid only for the premises occupied by the sober living home at the time of its issuance. END_STATUTE Sec. 16. 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 recovery support specialists. B. A sober living home shall maintain a staff to resident ratio of two paid staff members, who provide monitoring or assistance to residents at the sober living home, for every six residents. C. A sober living home shall have employees responsible for the direct care and supervision of the sober living home residents, on-site twenty-four consecutive hours per day, seven days per week. D. A sober living home licensee shall provide verification to the department that naloxone is accessible at each sober living home, and staff are knowledgeable and trained in its use. E. The director, by rule, shall establish a monitoring program for behavioral health entities that identifies the circumstances when the department shall assign department staff on a temporary basis to monitor and provide professional assistance to a licensee that is not in substantial compliance with the licensing requirements applicable to that licensee. The rules shall establish staffing levels based on monitoring needs and the corresponding fees based on a cost assessment calculating the duration of the monitoring schedule, a pre-disclosed hourly rate, and actual costs. F. A resident of a sober living home is a vulnerable adult. for the purposes of this article, "vulnerable adult" means an individual who is eighteen years of age or older and who is unable to protect himself or herself from abuse, neglect, or exploitation by others because of a mental or physical impairment. END_STATUTE Sec. 17. Section 36-2063, Arizona Revised Statutes, is amended to read: START_STATUTE36-2063. Fees; licensure; inspections; complaints; investigation; 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 person that establishes, maintains or operates a sober living home that operates in this state without a current and valid license in violation of this article is guilty of a class 6 felony and the director shall assess a civil penalty in an amount not less than $5,000 and not more than $10,000 for each violation, which may be assessed for each resident, or patient, who the department determines was impacted by the violation. each day the sober living home operates without a license is a separate civil 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, which may be assessed for each resident, or patient, who the department determines was impacted by the 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. 18. Section 36-2066, Arizona Revised Statutes, is amended to read: START_STATUTE36-2066. Posting; sober living homes; update A. The department shall post on its public website the name and telephone number 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. B. Except a sober living home as defined in section 36-2061.01, the department shall post on the parent page of its public website, the name, address, telephone number, department-issued license number, national provider identification number, if applicable, local jurisdiction business license number and licensure status of each certified and licensed sober living home that directly or indirectly receives federal resources, federal monies or payment on behalf of beneficiaries with federal health care program benefits, including but not limited to the American Indian health plan. sober living homes, as defined in section 36-2061.01 are exempt from confidentiality requirements and the department shall disclose the address. The address of a sober living home as defined in section 36-2601.01, is a public record and is subject to title 39, chapter 1, article 2. END_STATUTE Sec. 19. 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; transportation A. To the extent allowed by federal law, 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. Sober living home may not coordinate, facilitate, arrange for or solicit transportation of a person to the sober living home if the person is obviously 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. 20. 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. 21. 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. 22. 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. 23. Rulemaking exemption; intent Notwithstanding any other law, for the purposes of this act and amending the rules relating to behavioral health entities and sober living homes as defined in sections 36-401 and 36-2061, Arizona Revised Statutes, respectively. 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. |
|---|
| 78 | + | 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. Rulemaking exemption; intent A. Notwithstanding any other law, for the purposes of this act and amending the rules relating to residential care institutions, 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 to ensure that there are adequate and proper requirements for staffing, care and oversight. |
|---|