| 69 | | - | Be it enacted by the Legislature of the State of Arizona: Section 1. Section 36-501, Arizona Revised Statutes, is amended to read: START_STATUTE36-501. Definitions In this chapter, unless the context otherwise requires: 1. "Administration" means the Arizona health care cost containment system administration. 2. "Admitting officer" means a psychiatrist or other physician or psychiatric and mental health nurse practitioner with experience in performing psychiatric examinations who has been designated as an admitting officer of the evaluation agency by the person in charge of the evaluation agency. 3. "Authorized transporter" means a transportation entity that is contracted with a city, town or county to provide services pursuant to this chapter and that is either: (a) An ambulance service that holds a valid certificate of necessity. (b) A transportation provider authorized by this state to provide safe behavioral health transportation for individuals requiring transportation pursuant to this chapter. 4. "Chief medical officer" means the chief medical officer under the supervision of the superintendent of the state hospital. 5. "Contraindicated" means that access is reasonably likely to endanger the life or physical safety of the patient or another person. 6. "Court" means the superior court in the county in this state in which the patient resides or was found before screening or emergency admission under this title. 7. "Criminal history" means police reports, lists of prior arrests and convictions, criminal case pleadings and court orders, including a determination that the person has been found incompetent to stand trial pursuant to section 13-4510. 8. "Danger to others" means that the judgment of a person who has a mental disorder is so impaired that the person is unable to understand the person's need for treatment and as a result of the person's mental disorder the person's continued behavior can reasonably be expected, on the basis of competent medical opinion, to result in serious physical harm. 9. "Danger to self": (a) Means behavior that, as a result of a mental disorder: (i) Constitutes a danger of inflicting serious physical harm on oneself, including attempted suicide or the serious threat thereof, if the threat is such that, when considered in the light of its context and in light of the individual's previous acts, it is substantially supportive of an expectation that the threat will be carried out. (ii) Without hospitalization will result in serious physical harm or serious illness to the person. (b) Does not include behavior that establishes only the condition of having a grave disability. 10. "Department" means the department of health services. 11. "Detention" means the taking into custody of a patient or proposed patient. 12. "Director" means the director of the administration. 13. "Evaluation" means: (a) A professional multidisciplinary analysis that may include firsthand observations or remote observations by interactive audiovisual media and that is based on data describing the person's identity, biography and medical, psychological and social conditions carried out by a group of persons consisting of at least the following: (i) Two licensed physicians who are qualified psychiatrists, if possible, or at least experienced in psychiatric matters, who shall examine and report their findings independently. The person against whom a petition has been filed shall be notified that the person may select one of the physicians. A psychiatric resident in a training program approved by the American medical association or by the American osteopathic association may examine the person in place of one of the psychiatrists if the resident is supervised in the examination and preparation of the affidavit and testimony in court by a qualified psychiatrist appointed to assist in the resident's training, and if the supervising psychiatrist is available for discussion with the attorneys for all parties and for court appearance and testimony if requested by the court or any of the attorneys. (ii) Two other individuals, one of whom, if available, is a psychologist and in any event a social worker familiar with mental health and human services that may be available placement alternatives appropriate for treatment. An evaluation may be conducted on an inpatient basis, an outpatient basis or a combination of both, and every reasonable attempt shall be made to conduct the evaluation in any language preferred by the person. (b) A physical examination that is consistent with the existing standards of care and that is performed by one of the evaluating physicians or by or under the supervision of a physician who is licensed pursuant to title 32, chapter 13 or 17 or a registered nurse practitioner who is licensed pursuant to title 32, chapter 15 if the results of that examination are reviewed or augmented by one of the evaluating physicians. 14. "Evaluation agency" means either of the following: (a) A health care agency that is licensed by the department and that has been approved pursuant to this title to provide the services required of that agency by this chapter. (b) A facility that is exempt from licensure pursuant to section 36-402, that possesses an accreditation from either a national commission on correctional health care or an American correctional association and that has been approved pursuant to this title to provide the services required of that facility by this chapter or chapter 18, article 5 of this title. 15. "Family member" means a spouse, parent, adult child, adult sibling or other blood relative of a person undergoing treatment or evaluation pursuant to this chapter. 16. "Grave disability" means a condition evidenced by behavior in which a person, as a result of a mental disorder, is likely to come to serious physical harm or serious illness because the person is unable to provide for the person's own basic physical needs. 17. "Health care decision maker" has the same meaning prescribed in section 12-2801. 18. "Health care entity" means a health care provider, the department, the administration or a regional behavioral health authority that is under contract with the administration. 19. "Health care provider" means a health care institution as defined in section 36-401 that is licensed as a behavioral health provider pursuant to department rules or a mental health provider. 20. "Independent evaluator" means a licensed physician, psychiatric and mental health nurse practitioner or psychologist who is selected by the person to be evaluated or by the person's attorney. 21. "Informed consent" means a voluntary decision following presentation of all facts necessary to form the basis of an intelligent consent by the patient or guardian with no minimizing of known dangers of any procedures. 22. "Least restrictive treatment alternative" means the treatment plan and setting that infringe in the least possible degree with the patient's right to liberty and that are consistent with providing needed treatment in a safe and humane manner. 23. "Licensed physician" means any medical doctor or doctor of osteopathy who is either: (a) Licensed in this state. (b) A full-time hospital physician licensed in another state and serving on the staff of a hospital operated or licensed by the United States government. 24. "Medical director of an evaluation agency" means a psychiatrist, or other licensed physician experienced in psychiatric matters, who is designated in writing by the governing body of the agency as the person in charge of the medical services of the agency for the purposes of this chapter and may include the chief medical officer of the state hospital. 25. "Medical director of a mental health treatment agency" means a psychiatrist, or other licensed physician experienced in psychiatric matters, who is designated in writing by the governing body of the agency as the person in charge of the medical services of the agency for the purposes of this chapter and includes the chief medical officer of the state hospital. 26. "Mental disorder" means a substantial disorder of the person's emotional processes, thought, cognition or memory. Mental disorder is distinguished from: (a) Conditions that are primarily those of drug abuse, alcoholism or intellectual disability, unless, in addition to one or more of these conditions, the person has a mental disorder. (b) The declining mental abilities that directly accompany impending death. (c) Character and personality disorders characterized by lifelong and deeply ingrained antisocial behavior patterns, including sexual behaviors that are abnormal and prohibited by statute unless the behavior results from a mental disorder. 27. "Mental health provider" means any physician or provider of mental health or behavioral health services who is involved in evaluating, caring for, treating or rehabilitating a patient. 28. "Mental health treatment agency" means any of the following: (a) The state hospital. (b) A health care agency that is licensed by the department and that provides the services that are required of the agency by this chapter. (c) A facility that is exempt from licensure pursuant to section 36-402, that possesses an accreditation from either a national commission on correctional health care or an American correctional association and that provides the services that are required of the facility by this chapter. 29. "Outpatient treatment" or "combined inpatient and outpatient treatment" means any treatment program not requiring continuous inpatient hospitalization. 30. "Outpatient treatment plan" means a treatment plan that does not require continuous inpatient hospitalization. 31. "Patient" means any person who is undergoing examination, evaluation or behavioral or mental health treatment under this chapter. 32. "Peace officers" means sheriffs of counties, constables, marshals and policemen of cities and towns. 33. "Persistent or acute disability" means a severe mental disorder that meets all the following criteria: (a) Significantly impairs judgment, reason, behavior or capacity to recognize reality. (b) If not treated, has a substantial probability of causing the person to suffer or continue to suffer severe and abnormal mental, emotional or physical harm. (c) Substantially impairs the person's capacity to make an informed decision regarding treatment, and this impairment causes the person to be incapable of understanding and expressing an understanding of the advantages and disadvantages of accepting treatment and understanding and expressing an understanding of the alternatives to the particular treatment offered after the advantages, disadvantages and alternatives are explained to that person. (d) Has a reasonable prospect of being treatable by outpatient, inpatient or combined inpatient and outpatient treatment. 34. "Prepetition screening" means the review of each application requesting court-ordered evaluation, including an investigation of facts alleged in the application, an interview with each applicant and an interview, if possible, with the proposed patient. The purpose of the interview with the proposed patient is to assess the problem, explain the application and, when indicated, attempt to persuade the proposed patient to receive, on a voluntary basis, evaluation or other services. 35. "Prescribed form" means a form established by a court or the rules of the administration in accordance with the laws of this state. 36. "Professional" means a physician who is licensed pursuant to title 32, chapter 13 or 17, a psychologist who is licensed pursuant to title 32, chapter 19.1 or a psychiatric and mental health nurse practitioner who is certified pursuant to title 32, chapter 15. 37. "Proposed patient" means a person for whom an application for evaluation has been made or a petition for court-ordered evaluation has been filed. 38. "Prosecuting agency" means the county attorney, attorney general or city attorney who applied or petitioned for an evaluation or treatment pursuant to this chapter. 39. "Psychiatric and mental health nurse practitioner" means a registered nurse practitioner as defined in section 32-1601 who has completed an adult or family psychiatric and mental health nurse practitioner program and who is certified as an adult or family psychiatric and mental health nurse practitioner by the state board of nursing. 40. "Psychiatrist" means a licensed physician who has completed three years of graduate training in psychiatry in a program approved by the American medical association or the American osteopathic association. 41. "Psychologist" means a person who is licensed under title 32, chapter 19.1 and who is experienced in the practice of clinical psychology. 42. "Records" means all communications that are recorded in any form or medium and that relate to patient examination, evaluation or behavioral or mental health treatment. Records include medical records that are prepared by a health care provider or other providers. Records do not include: (a) Materials that are prepared in connection with utilization review, peer review or quality assurance activities, including records that a health care provider prepares pursuant to section 36-441, 36-445, 36-2402 or 36-2917. (b) Recorded telephone and radio calls to and from a publicly operated emergency dispatch office relating to requests for emergency services or reports of suspected criminal activity. 43. "Regional behavioral health authority" has the same meaning prescribed in section 36-3401. 44. "Screening agency" means a health care agency that is licensed by the department and that provides those services required of the agency by this chapter. 45. "Social worker" means a person who has completed two years of graduate training in social work in a program approved by the council of social work education and who has experience in mental health. 46. "State hospital" means the Arizona state hospital. 47. "Superintendent" means the superintendent of the state hospital. 48. "Voluntary evaluation" means the ongoing collection and analysis of a person's medical, psychological, psychiatric and social conditions in order to initially determine if a health disorder exists and if there is a need for behavioral health services and, on an ongoing basis, to ensure that the person's service plan is designed to meet the person's and the person's family's current needs and long-term goals.END_STATUTE Sec. 2. Section 36-526, Arizona Revised Statutes, is amended to read: START_STATUTE36-526. Emergency admission; examination; petition for court-ordered evaluation A. On presentation of the person for emergency admission, an admitting officer of an evaluation agency shall perform an examination of the person's psychiatric and physical condition and may admit the person to the agency as an emergency patient if the admitting officer finds, as a result of the examination and investigation of the application for emergency admission, that there is reasonable cause to believe that the person, as a result of a mental disorder, is a danger to self or others, has a persistent or acute disability or a grave disability and is unable or unwilling to undergo voluntary evaluation and that during the time necessary to complete the prepetition screening procedures set forth in sections 36-520 and 36-521 the person is likely without immediate hospitalization to suffer serious physical harm or serious illness or to inflict serious physical harm on another person. If a person is hospitalized pursuant to this section, the admitting officer may notify a screening agency and seek its assistance or guidance in developing alternatives to involuntary confinement and in counseling the person and the person's family. B. On the same or a succeeding court day, the medical director in charge of the agency shall file a petition for a court-ordered evaluation, unless the person has been discharged or has become a voluntary patient. The petition need not comply with the provisions of this chapter requiring preparation and filing of a prepetition screening report but shall meet all other requirements and shall seek an appropriate order pursuant to section 36-529. C. If the admitting officer, after an examination or evaluation, determines that the proposed patient is an impaired person as defined in section 36-2081, the admitting officer may file a petition for court-ordered stabilization pursuant to section 36-2083. END_STATUTE Sec. 3. Title 36, chapter 18, Arizona Revised Statutes, is amended by adding article 5, to read: ARTICLE 5. INVOLUNTARY STABILIZATION START_STATUTE36-2081. Definitions In this article, unless the context otherwise requires: 1. "Administration" means the Arizona health care cost containment system administration. 2. "Admitting officer" has the same meaning prescribed in section 36-501. 3. "Chief medical officer" means the chief medical officer of an evaluation agency. 4. "Department" means the department of HEALTH services. 5. "Detain" means to involuntary admit a patient, proposed patient or impaired person to an evaluation agency. 6. "Evaluation agency" has the same meaning prescribed in section 36-501. 7. "Impaired person" means an individual who, as a result of intoxication, withdrawal or substance-induced symptoms, has impaired judgment causing the individual to be incapable of making or communicating rational decisions with regard to the individual's safety, health or basic personal needs, such as food, clothing, shelter or medical care. 8. "Psychiatric and mental health nurse practitioner" has the same meaning prescribed in section 36-501. 9. "Psychiatrist" has the same meaning as prescribed in section 36-501. 10. "Stabilization period" means the time period for which an impaired person may be admitted involuntarily to an evaluation agency for the purposes of allowing the effects of substances to resolve such that the person no longer meets the definition of impaired person. END_STATUTE START_STATUTE36-2082. Impaired persons; civil and legal rights An impaired person who is involuntarily admitted for a stabilization period pursuant to this article has all of the civil and legal rights enumerated in chapter 5, article 2 of this title.END_STATUTE START_STATUTE36-2083. Petition for court-ordered stabilization A. A petition for court-ordered stabilization may be filed by an admitting officer based on a personal assessment and review of an individual's medical record and must be accompanied by an affidavit from the admitting officer detailing all of the following: 1. That the individual is an impaired person and the clinical facts that support that conclusion. 2. That the individual is either unable or unwilling to consent to voluntary admission. 3. The reasons why discharging the individual would be unsafe. 4. The reasons why proceedings under chapter 5 of this title are inappropriate. 5. The date the individual was initially involuntarily admitted to the evaluation agency pursuant to chapter 5 of this title. B. The petition for court-ordered stabilization shall request that the court issue an order admitting the impaired person to the evaluation agency for a stabilization period of not more than five calendar days after the date the individual was involuntarily admitted to the evaluation agency pursuant to chapter 5 of this title. C. A petition for court-ordered stabilization may not be filed solely to detain an individual who is at risk of using substances but who is not currently intoxicated, in withdrawal or having substance-induced symptoms.END_STATUTE START_STATUTE36-2084. Order for stabilization period; duty of counsel; personal service A. If THE COURT, after reviewing the petition for court-ordered stabilization, DETERMINEs THAT inSUFFICIENT EVIDENCE HAS BEEN PRESENTED TO FIND THAT THE INDIVIDUAL IS AN IMPAIRED PERSON, THE court shall deny the PETITION FOR COURT-ORDERED STABILIZATION AND THE EVALUATION AGENCY shall immediate release THE IMPAIRED PERSON. B. IF the court, after reviewing the petition for court-ordered stabilization, DETERMINEs that THERE IS REASONABLE CAUSE TO BELIEVE THAT THE INDIVIDUAL IS AN IMPAIRED PERSON, THE court shall grant the PETITION FOR COURT-ORDERED STABILIZATION FOR A PERIOD of not more than FIVE CALENDAR DAYS after THE DATE THE IMPAIRED PERSON WAS INVOLUNTARILY ADMITTED TO THE EVALUATION AGENCY pursuant to chapter 5 of this title. C. THE COURT shall APPOINT COUNSEL FOR THE IMPAIRED PERSON AT THE TIME of issuing THE ORDER FOR STABILIZATION. An attorney who is appointed to represent the impaired person shall confer with the impaired person within twenty-four hours after appointment and inform the impaired person of the person's rights. D. A COPY OF ANY ORDER ISSUED BY THE COURT PURSUANT TO THIS SECTION, TOGETHER WITH A COPY OF THE PETITION FOR COURT-ORDERED STABILIZATION, shall BE PERSONALLY SERVED ON THE IMPAIRED PERSON AS PRESCRIBED BY LAW OR COURT RULE OR AS ORDERED BY THE COURT. E. If an impaired person is involuntarily detained for stabilization, the impaired person shall be informed by the impaired person's appointed attorney of the right to a hearing to determine whether the impaired person should be involuntarily detained for stabilization and to be represented at the hearing by an attorney. If the impaired person requests a hearing to determine whether the impaired person should be involuntarily detained for stabilization, the court shall schedule a hearing at its earliest opportunity.END_STATUTE START_STATUTE36-2085. Duty of evaluation agency A. Each day that an impaired person is detained under an order for stabilization the impaired person must be offered treatment for The impaired person's impairment to which they may consent. The impaired person may not be treated for impairment without The impaired person's express consent, except that seclusion and mechanical or pharmacological restraints may be employed as emergency measures for the safety of the impaired person or others pursuant to section 36-2087. B. The evaluation agency shall assess the impaired person each day to determine whether the person remains impaired. If the person no longer meets the definition of an impaired person, the evaluation agency shall either release the person from the court-ordered stabilization period and discharge the person from the facility or admit the person to the evaluation agency on a voluntary basis. C. The evaluation agency shall comply with the quality of treatment provisions prescribed in section 36-2086, as applicable. END_STATUTE START_STATUTE36-2086. Quality of treatment; clinical records; postrelease plan of care A. Subject to the right to refuse psychiatric and medical treatment pursuant to sections 36-512 and 36-513 and pursuant to rules of the administration, each impaired person undergoing stabilization care pursuant to this article shall receive physical care and treatment that is delivered in a manner that allows the impaired person's family members or guardian, if applicable, to participate in the care and treatment, when appropriate, for the full period the impaired person is detained. The evaluation agency providing care and treatment shall keep a clinical record for each impaired person that details all medical evaluations and all care and treatment received by the impaired person. B. An evaluation agency administering observation or inpatient stabilization care and treatment, in conjunction with the community treatment agency, if applicable, and before the release of an impaired person, shall prepare a plan for the impaired person's care after release and shall provide the plan to the impaired person's guardian, if applicable. END_STATUTE START_STATUTE36-2087. Seclusion; restraint; treatment An impaired person undergoing stabilization pursuant to this article shall not be subjected to seclusion or mechanical or pharmacological restraints except in the case of an emergency for the safety of the impaired person or others or as a part of a written plan for the stabilization of the impaired person that is prepared by staff members responsible for the impaired person's care and pursuant to rules adopted by the department. Any instance of seclusion or restraint must be properly recorded in the impaired person's medical record. The use of any restraint or seclusion measure shall be governed by written procedures of the evaluation agency caring for the impaired person and is subject to the rules of the department.END_STATUTE START_STATUTE36-2088. Maximum time of stabilization period; chief medical officer; discharge; release; immunity A. An impaired person who is undergoing a court-ordered stabilization period may not be detained for more than five calendar days after the date the impaired person was involuntarily admitted to the evaluation agency. B. An impaired person who is admitted for a stabilization period may be released at any time if in the opinion of the chief medical officer release is appropriate. The chief medical officer is not civilly liable for any act committed by a released person if the chief medical officer has in good faith followed the requirements of this article. The person may continue care and treatment on a voluntary basis at any time and must be provided the opportunity for voluntary admission each day. C. If an impaired person who is admitted for a stabilization period is released, the petition for court-ordered stabilization must be retained together with a written statement by the chief medical officer stating the reason the release was appropriate. END_STATUTE START_STATUTE36-2089. County attorney; duties When a physician or other person files a petition for court-ordered stabilization on behalf of an evaluation agency, the county attorney for the county in which the proceeding is initiated shall represent the person who filed the petition or the evaluation agency in any judicial proceeding for court-ordered stabilization and shall defend all challenges to the detention.END_STATUTE START_STATUTE36-2090. Costs; financial responsibility A. The costs of the court proceedings and services provided under this article shall be charged to the administration or, if available, to another third-party payor. The impaired person may not be charged for services provided under this article. B. An evaluation agency is not financially responsible for serving the documents required by section 36-2084, subsection D. END_STATUTE |
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| 80 | + | Be it enacted by the Legislature of the State of Arizona: Section 1. Section 36-501, Arizona Revised Statutes, is amended to read: START_STATUTE36-501. Definitions In this chapter, unless the context otherwise requires: 1. "Administration" means the Arizona health care cost containment system administration. 2. "Admitting officer" means a psychiatrist or other physician or psychiatric and mental health nurse practitioner with experience in performing psychiatric examinations who has been designated as an admitting officer of the evaluation agency by the person in charge of the evaluation agency. 3. "Authorized transporter" means a transportation entity that is contracted with a city, town or county to provide services pursuant to this chapter and that is either: (a) An ambulance service that holds a valid certificate of necessity. (b) A transportation provider authorized by this state to provide safe behavioral health transportation for individuals requiring transportation pursuant to this chapter. 4. "Chief medical officer" means the chief medical officer under the supervision of the superintendent of the state hospital. 5. "Contraindicated" means that access is reasonably likely to endanger the life or physical safety of the patient or another person. 6. "Court" means the superior court in the county in this state in which the patient resides or was found before screening or emergency admission under this title. 7. "Criminal history" means police reports, lists of prior arrests and convictions, criminal case pleadings and court orders, including a determination that the person has been found incompetent to stand trial pursuant to section 13-4510. 8. "Danger to others" means that the judgment of a person who has a mental disorder is so impaired that the person is unable to understand the person's need for treatment and as a result of the person's mental disorder the person's continued behavior can reasonably be expected, on the basis of competent medical opinion, to result in serious physical harm. 9. "Danger to self": (a) Means behavior that, as a result of a mental disorder: (i) Constitutes a danger of inflicting serious physical harm on oneself, including attempted suicide or the serious threat thereof, if the threat is such that, when considered in the light of its context and in light of the individual's previous acts, it is substantially supportive of an expectation that the threat will be carried out. (ii) Without hospitalization will result in serious physical harm or serious illness to the person. (b) Does not include behavior that establishes only the condition of having a grave disability. 10. "Department" means the department of health services. 11. "Detention" means the taking into custody of a patient or proposed patient. 12. "Director" means the director of the administration. 13. "Evaluation" means: (a) A professional multidisciplinary analysis that may include firsthand observations or remote observations by interactive audiovisual media and that is based on data describing the person's identity, biography and medical, psychological and social conditions carried out by a group of persons consisting of at least the following: (i) Two licensed physicians who are qualified psychiatrists, if possible, or at least experienced in psychiatric matters, who shall examine and report their findings independently. The person against whom a petition has been filed shall be notified that the person may select one of the physicians. A psychiatric resident in a training program approved by the American medical association or by the American osteopathic association may examine the person in place of one of the psychiatrists if the resident is supervised in the examination and preparation of the affidavit and testimony in court by a qualified psychiatrist appointed to assist in the resident's training, and if the supervising psychiatrist is available for discussion with the attorneys for all parties and for court appearance and testimony if requested by the court or any of the attorneys. (ii) Two other individuals, one of whom, if available, is a psychologist and in any event a social worker familiar with mental health and human services that may be available placement alternatives appropriate for treatment. An evaluation may be conducted on an inpatient basis, an outpatient basis or a combination of both, and every reasonable attempt shall be made to conduct the evaluation in any language preferred by the person. (b) A physical examination that is consistent with the existing standards of care and that is performed by one of the evaluating physicians or by or under the supervision of a physician who is licensed pursuant to title 32, chapter 13 or 17 or a registered nurse practitioner who is licensed pursuant to title 32, chapter 15 if the results of that examination are reviewed or augmented by one of the evaluating physicians. 14. "Evaluation agency" means either of the following: (a) A health care agency that is licensed by the department and that has been approved pursuant to this title to provide the services required of that agency by this chapter. (b) A facility that is exempt from licensure pursuant to section 36-402, that possesses an accreditation from either a national commission on correctional health care or an American correctional association and that has been approved pursuant to this title to provide the services required of that facility by this chapter or chapter 18, article 5 of this title. 15. "Family member" means a spouse, parent, adult child, adult sibling or other blood relative of a person undergoing treatment or evaluation pursuant to this chapter. 16. "Grave disability" means a condition evidenced by behavior in which a person, as a result of a mental disorder, is likely to come to serious physical harm or serious illness because the person is unable to provide for the person's own basic physical needs. 17. "Health care decision maker" has the same meaning prescribed in section 12-2801. 18. "Health care entity" means a health care provider, the department, the administration or a regional behavioral health authority that is under contract with the administration. 19. "Health care provider" means a health care institution as defined in section 36-401 that is licensed as a behavioral health provider pursuant to department rules or a mental health provider. 20. "Independent evaluator" means a licensed physician, psychiatric and mental health nurse practitioner or psychologist who is selected by the person to be evaluated or by the person's attorney. 21. "Informed consent" means a voluntary decision following presentation of all facts necessary to form the basis of an intelligent consent by the patient or guardian with no minimizing of known dangers of any procedures. 22. "Least restrictive treatment alternative" means the treatment plan and setting that infringe in the least possible degree with the patient's right to liberty and that are consistent with providing needed treatment in a safe and humane manner. 23. "Licensed physician" means any medical doctor or doctor of osteopathy who is either: (a) Licensed in this state. (b) A full-time hospital physician licensed in another state and serving on the staff of a hospital operated or licensed by the United States government. 24. "Medical director of an evaluation agency" means a psychiatrist, or other licensed physician experienced in psychiatric matters, who is designated in writing by the governing body of the agency as the person in charge of the medical services of the agency for the purposes of this chapter and may include the chief medical officer of the state hospital. 25. "Medical director of a mental health treatment agency" means a psychiatrist, or other licensed physician experienced in psychiatric matters, who is designated in writing by the governing body of the agency as the person in charge of the medical services of the agency for the purposes of this chapter and includes the chief medical officer of the state hospital. 26. "Mental disorder" means a substantial disorder of the person's emotional processes, thought, cognition or memory. Mental disorder is distinguished from: (a) Conditions that are primarily those of drug abuse, alcoholism or intellectual disability, unless, in addition to one or more of these conditions, the person has a mental disorder. (b) The declining mental abilities that directly accompany impending death. (c) Character and personality disorders characterized by lifelong and deeply ingrained antisocial behavior patterns, including sexual behaviors that are abnormal and prohibited by statute unless the behavior results from a mental disorder. 27. "Mental health provider" means any physician or provider of mental health or behavioral health services who is involved in evaluating, caring for, treating or rehabilitating a patient. 28. "Mental health treatment agency" means any of the following: (a) The state hospital. (b) A health care agency that is licensed by the department and that provides the services that are required of the agency by this chapter. (c) A facility that is exempt from licensure pursuant to section 36-402, that possesses an accreditation from either a national commission on correctional health care or an American correctional association and that provides the services that are required of the facility by this chapter. 29. "Outpatient treatment" or "combined inpatient and outpatient treatment" means any treatment program not requiring continuous inpatient hospitalization. 30. "Outpatient treatment plan" means a treatment plan that does not require continuous inpatient hospitalization. 31. "Patient" means any person who is undergoing examination, evaluation or behavioral or mental health treatment under this chapter. 32. "Peace officers" means sheriffs of counties, constables, marshals and policemen of cities and towns. 33. "Persistent or acute disability" means a severe mental disorder that meets all the following criteria: (a) Significantly impairs judgment, reason, behavior or capacity to recognize reality. (b) If not treated, has a substantial probability of causing the person to suffer or continue to suffer severe and abnormal mental, emotional or physical harm. (c) Substantially impairs the person's capacity to make an informed decision regarding treatment, and this impairment causes the person to be incapable of understanding and expressing an understanding of the advantages and disadvantages of accepting treatment and understanding and expressing an understanding of the alternatives to the particular treatment offered after the advantages, disadvantages and alternatives are explained to that person. (d) Has a reasonable prospect of being treatable by outpatient, inpatient or combined inpatient and outpatient treatment. 34. "Prepetition screening" means the review of each application requesting court-ordered evaluation, including an investigation of facts alleged in the application, an interview with each applicant and an interview, if possible, with the proposed patient. The purpose of the interview with the proposed patient is to assess the problem, explain the application and, when indicated, attempt to persuade the proposed patient to receive, on a voluntary basis, evaluation or other services. 35. "Prescribed form" means a form established by a court or the rules of the administration in accordance with the laws of this state. 36. "Professional" means a physician who is licensed pursuant to title 32, chapter 13 or 17, a psychologist who is licensed pursuant to title 32, chapter 19.1 or a psychiatric and mental health nurse practitioner who is certified pursuant to title 32, chapter 15. 37. "Proposed patient" means a person for whom an application for evaluation has been made or a petition for court-ordered evaluation has been filed. 38. "Prosecuting agency" means the county attorney, attorney general or city attorney who applied or petitioned for an evaluation or treatment pursuant to this chapter. 39. "Psychiatric and mental health nurse practitioner" means a registered nurse practitioner as defined in section 32-1601 who has completed an adult or family psychiatric and mental health nurse practitioner program and who is certified as an adult or family psychiatric and mental health nurse practitioner by the state board of nursing. 40. "Psychiatrist" means a licensed physician who has completed three years of graduate training in psychiatry in a program approved by the American medical association or the American osteopathic association. 41. "Psychologist" means a person who is licensed under title 32, chapter 19.1 and who is experienced in the practice of clinical psychology. 42. "Records" means all communications that are recorded in any form or medium and that relate to patient examination, evaluation or behavioral or mental health treatment. Records include medical records that are prepared by a health care provider or other providers. Records do not include: (a) Materials that are prepared in connection with utilization review, peer review or quality assurance activities, including records that a health care provider prepares pursuant to section 36-441, 36-445, 36-2402 or 36-2917. (b) Recorded telephone and radio calls to and from a publicly operated emergency dispatch office relating to requests for emergency services or reports of suspected criminal activity. 43. "Regional behavioral health authority" has the same meaning prescribed in section 36-3401. 44. "Screening agency" means a health care agency that is licensed by the department and that provides those services required of the agency by this chapter. 45. "Social worker" means a person who has completed two years of graduate training in social work in a program approved by the council of social work education and who has experience in mental health. 46. "State hospital" means the Arizona state hospital. 47. "Superintendent" means the superintendent of the state hospital. 48. "Voluntary evaluation" means the ongoing collection and analysis of a person's medical, psychological, psychiatric and social conditions in order to initially determine if a health disorder exists and if there is a need for behavioral health services and, on an ongoing basis, to ensure that the person's service plan is designed to meet the person's and the person's family's current needs and long-term goals.END_STATUTE Sec. 2. Section 36-526, Arizona Revised Statutes, is amended to read: START_STATUTE36-526. Emergency admission; examination; petition for court-ordered evaluation A. On presentation of the person for emergency admission, an admitting officer of an evaluation agency shall perform an examination of the person's psychiatric and physical condition and may admit the person to the agency as an emergency patient if the admitting officer finds, as a result of the examination and investigation of the application for emergency admission, that there is reasonable cause to believe that the person, as a result of a mental disorder, is a danger to self or others, has a persistent or acute disability or a grave disability and is unable or unwilling to undergo voluntary evaluation and that during the time necessary to complete the prepetition screening procedures set forth in sections 36-520 and 36-521 the person is likely without immediate hospitalization to suffer serious physical harm or serious illness or to inflict serious physical harm on another person. If a person is hospitalized pursuant to this section, the admitting officer may notify a screening agency and seek its assistance or guidance in developing alternatives to involuntary confinement and in counseling the person and the person's family. B. On the same or a succeeding court day, the medical director in charge of the agency shall file a petition for a court-ordered evaluation, unless the person has been discharged or has become a voluntary patient. The petition need not comply with the provisions of this chapter requiring preparation and filing of a prepetition screening report but shall meet all other requirements and shall seek an appropriate order pursuant to section 36-529. C. If the admitting officer, after an examination or evaluation, determines that the proposed patient is an impaired person as defined in section 36-2081, the admitting officer may file a petition for court-ordered stabilization pursuant to section 36-2083. END_STATUTE Sec. 3. Title 36, chapter 18, Arizona Revised Statutes, is amended by adding article 5, to read: ARTICLE 5. INVOLUNTARY STABILIZATION START_STATUTE36-2081. Definitions In this article, unless the context otherwise requires: 1. "Administration" means the Arizona health care cost containment system administration. 2. "Admitting officer" means a psychiatrist or other physician who is licensed pursuant to title 32, chapter 13 or 17, a psychiatric and mental health nurse practitioner who is licensed pursuant to title 32, chapter 15 or a physician assistant who is licensed pursuant to title 32, chapter 25, who has experience in performing psychiatric examinations and who has been designated as an admitting officer of the evaluation agency by the person in charge of the evaluation agency. 3. "Chief medical officer" means the chief medical officer of an evaluation agency. 4. "Department" means the department of HEALTH services. 5. "Detain" means to involuntary admit a patient, proposed patient or impaired person to an evaluation agency. 6. "Evaluation agency" has the same meaning prescribed in section 36-501. 7. "Impaired person" means an individual who, as a result of intoxication, withdrawal or substance-induced symptoms, has impaired judgment causing the individual to be incapable of making or communicating rational decisions with regard to the individual's safety, health or basic personal needs, such as food, clothing, shelter or medical care. 8. "Psychiatric and mental health nurse practitioner" has the same meaning prescribed in section 36-501. 9. "Psychiatrist" has the same meaning as prescribed in section 36-501. 10. "Stabilization period" means the time period for which an impaired person may be admitted involuntarily to an evaluation agency for the purposes of allowing the effects of substances to resolve such that the person no longer meets the definition of impaired person. END_STATUTE START_STATUTE36-2082. Impaired persons; civil and legal rights An impaired person who is involuntarily admitted for a stabilization period pursuant to this article has all of the civil and legal rights enumerated in chapter 5, article 2 of this title.END_STATUTE START_STATUTE36-2083. Petition for court-ordered stabilization A. A petition for court-ordered stabilization may be filed by an admitting officer based on a personal assessment and review of an individual's medical record and must be accompanied by an affidavit from the admitting officer detailing all of the following: 1. That the individual is an impaired person and the clinical facts that support that conclusion. 2. That the individual is either unable or unwilling to consent to voluntary admission. 3. The reasons why discharging the individual would be unsafe. 4. The reasons why proceedings under chapter 5 of this title are inappropriate. 5. The date the individual was initially involuntarily admitted to the evaluation agency pursuant to chapter 5 of this title. B. The petition for court-ordered stabilization shall request that the court issue an order admitting the impaired person to the evaluation agency for a stabilization period of not more than five calendar days after the date the individual was involuntarily admitted to the evaluation agency pursuant to chapter 5 of this title. C. A petition for court-ordered stabilization may not be filed solely to detain an individual who is at risk of using substances but who is not currently intoxicated, in withdrawal or having substance-induced symptoms.END_STATUTE START_STATUTE36-2084. Order for stabilization period; duty of counsel; personal service A. If THE COURT, after reviewing the petition for court-ordered stabilization, DETERMINEs THAT inSUFFICIENT EVIDENCE HAS BEEN PRESENTED TO FIND THAT THE INDIVIDUAL IS AN IMPAIRED PERSON, THE court shall deny the PETITION FOR COURT-ORDERED STABILIZATION AND THE EVALUATION AGENCY shall immediate release THE IMPAIRED PERSON. B. IF the court, after reviewing the petition for court-ordered stabilization, DETERMINEs that THERE IS REASONABLE CAUSE TO BELIEVE THAT THE INDIVIDUAL IS AN IMPAIRED PERSON, THE court shall grant the PETITION FOR COURT-ORDERED STABILIZATION FOR A PERIOD of not more than FIVE CALENDAR DAYS after THE DATE THE IMPAIRED PERSON WAS INVOLUNTARILY ADMITTED TO THE EVALUATION AGENCY pursuant to chapter 5 of this title. C. THE COURT shall APPOINT COUNSEL FOR THE IMPAIRED PERSON AT THE TIME of issuing THE ORDER FOR STABILIZATION. An attorney who is appointed to represent the impaired person shall confer with the impaired person within twenty-four hours after appointment and inform the impaired person of the person's rights. D. A COPY OF ANY ORDER ISSUED BY THE COURT PURSUANT TO THIS SECTION, TOGETHER WITH A COPY OF THE PETITION FOR COURT-ORDERED STABILIZATION, shall BE PERSONALLY SERVED ON THE IMPAIRED PERSON AS PRESCRIBED BY LAW OR COURT RULE OR AS ORDERED BY THE COURT.END_STATUTE START_STATUTE36-2085. Duty of evaluation agency A. Each day that an impaired person is detained under an order for stabilization the impaired person must be offered treatment for The impaired person's impairment to which they may consent. The impaired person may not be treated for impairment without The impaired person's express consent, except that seclusion and mechanical or pharmacological restraints may be employed as emergency measures for the safety of the impaired person or others pursuant to section 36-2087. B. The evaluation agency shall assess the impaired person each day to determine whether the person remains impaired. If the person no longer meets the definition of an impaired person, the evaluation agency shall either release the person from the court-ordered stabilization period and discharge the person from the facility or admit the person to the evaluation agency on a voluntary basis. C. The evaluation agency shall comply with the quality of treatment provisions prescribed in section 36-2086, as applicable. END_STATUTE START_STATUTE36-2086. Quality of treatment; clinical records; postrelease plan of care A. Subject to the right to refuse psychiatric and medical treatment pursuant to sections 36-512 and 36-513 and pursuant to rules of the administration, each impaired person undergoing stabilization care pursuant to this article shall receive physical care and treatment that is delivered in a manner that allows the impaired person's family members or guardian, if applicable, to participate in the care and treatment, when appropriate, for the full period the impaired person is detained. The evaluation agency providing care and treatment shall keep a clinical record for each impaired person that details all medical evaluations and all care and treatment received by the impaired person. B. An evaluation agency administering observation or inpatient stabilization care and treatment, in conjunction with the community treatment agency and before the release of an impaired person, shall prepare a plan for the impaired person's care after release and shall provide the plan to the impaired person's guardian, if applicable. END_STATUTE START_STATUTE36-2087. Seclusion; restraint; treatment An impaired person undergoing stabilization pursuant to this article shall not be subjected to seclusion or mechanical or pharmacological restraints except in the case of an emergency for the safety of the impaired person or others or as a part of a written plan for the stabilization of the impaired person that is prepared by staff members responsible for the impaired person's care and pursuant to rules adopted by the department. Any instance of seclusion or restraint must be properly recorded in the impaired person's medical record. The use of any restraint or seclusion measure shall be governed by written procedures of the evaluation agency caring for the impaired person and is subject to the rules of the department.END_STATUTE START_STATUTE36-2088. Maximum time of stabilization period; chief medical officer; discharge; release; immunity A. An impaired person who is undergoing a court-ordered stabilization period may not be detained for more than five calendar days after the date the impaired person was involuntarily admitted to the evaluation agency. B. An impaired person who is admitted for a stabilization period may be released at any time if in the opinion of the chief medical officer release is appropriate. The chief medical officer is not civilly liable for any act committed by a released person if the chief medical officer has in good faith followed the requirements of this article. The person may continue care and treatment on a voluntary basis at any time and must be provided the opportunity for voluntary admission each day. C. If an impaired person who is admitted for a stabilization period is released, the petition for court-ordered stabilization must be retained together with a written statement by the chief medical officer stating the reason the release was appropriate. END_STATUTE START_STATUTE36-2089. County attorney; duties When a physician or other person files a petition for court-ordered stabilization on behalf of an evaluation agency, the county attorney for the county in which the proceeding is initiated shall represent the person who filed the petition or the evaluation agency in any judicial proceeding for court-ordered stabilization and shall defend all challenges to the detention.END_STATUTE START_STATUTE36-2090. Costs; financial responsibility A. The costs of the court proceedings and services provided under this article shall be charged to the administration or, if available, to another third-party payor. The impaired person may not be charged for services provided under this article. B. An evaluation agency is not financially responsible for serving the documents required by section 36-2084, subsection D. END_STATUTE |
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| 70 | 81 | | |
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| 71 | 82 | | Be it enacted by the Legislature of the State of Arizona: |
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| 72 | 83 | | |
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| 73 | 84 | | Section 1. Section 36-501, Arizona Revised Statutes, is amended to read: |
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| 74 | 85 | | |
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| 75 | 86 | | START_STATUTE36-501. Definitions |
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| 76 | 87 | | |
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| 77 | 88 | | In this chapter, unless the context otherwise requires: |
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| 78 | 89 | | |
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| 79 | 90 | | 1. "Administration" means the Arizona health care cost containment system administration. |
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| 80 | 91 | | |
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| 81 | 92 | | 2. "Admitting officer" means a psychiatrist or other physician or psychiatric and mental health nurse practitioner with experience in performing psychiatric examinations who has been designated as an admitting officer of the evaluation agency by the person in charge of the evaluation agency. |
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| 82 | 93 | | |
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| 83 | 94 | | 3. "Authorized transporter" means a transportation entity that is contracted with a city, town or county to provide services pursuant to this chapter and that is either: |
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| 84 | 95 | | |
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| 85 | 96 | | (a) An ambulance service that holds a valid certificate of necessity. |
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| 86 | 97 | | |
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| 87 | 98 | | (b) A transportation provider authorized by this state to provide safe behavioral health transportation for individuals requiring transportation pursuant to this chapter. |
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| 88 | 99 | | |
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| 89 | 100 | | 4. "Chief medical officer" means the chief medical officer under the supervision of the superintendent of the state hospital. |
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| 90 | 101 | | |
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| 91 | 102 | | 5. "Contraindicated" means that access is reasonably likely to endanger the life or physical safety of the patient or another person. |
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| 92 | 103 | | |
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| 93 | 104 | | 6. "Court" means the superior court in the county in this state in which the patient resides or was found before screening or emergency admission under this title. |
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| 94 | 105 | | |
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| 95 | 106 | | 7. "Criminal history" means police reports, lists of prior arrests and convictions, criminal case pleadings and court orders, including a determination that the person has been found incompetent to stand trial pursuant to section 13-4510. |
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| 96 | 107 | | |
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| 97 | 108 | | 8. "Danger to others" means that the judgment of a person who has a mental disorder is so impaired that the person is unable to understand the person's need for treatment and as a result of the person's mental disorder the person's continued behavior can reasonably be expected, on the basis of competent medical opinion, to result in serious physical harm. |
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| 98 | 109 | | |
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| 99 | 110 | | 9. "Danger to self": |
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| 100 | 111 | | |
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| 101 | 112 | | (a) Means behavior that, as a result of a mental disorder: |
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| 102 | 113 | | |
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| 103 | 114 | | (i) Constitutes a danger of inflicting serious physical harm on oneself, including attempted suicide or the serious threat thereof, if the threat is such that, when considered in the light of its context and in light of the individual's previous acts, it is substantially supportive of an expectation that the threat will be carried out. |
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| 104 | 115 | | |
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| 105 | 116 | | (ii) Without hospitalization will result in serious physical harm or serious illness to the person. |
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| 106 | 117 | | |
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| 107 | 118 | | (b) Does not include behavior that establishes only the condition of having a grave disability. |
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| 108 | 119 | | |
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| 109 | 120 | | 10. "Department" means the department of health services. |
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| 110 | 121 | | |
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| 111 | 122 | | 11. "Detention" means the taking into custody of a patient or proposed patient. |
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| 112 | 123 | | |
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| 113 | 124 | | 12. "Director" means the director of the administration. |
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| 114 | 125 | | |
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| 115 | 126 | | 13. "Evaluation" means: |
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| 116 | 127 | | |
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| 117 | 128 | | (a) A professional multidisciplinary analysis that may include firsthand observations or remote observations by interactive audiovisual media and that is based on data describing the person's identity, biography and medical, psychological and social conditions carried out by a group of persons consisting of at least the following: |
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| 118 | 129 | | |
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| 119 | 130 | | (i) Two licensed physicians who are qualified psychiatrists, if possible, or at least experienced in psychiatric matters, who shall examine and report their findings independently. The person against whom a petition has been filed shall be notified that the person may select one of the physicians. A psychiatric resident in a training program approved by the American medical association or by the American osteopathic association may examine the person in place of one of the psychiatrists if the resident is supervised in the examination and preparation of the affidavit and testimony in court by a qualified psychiatrist appointed to assist in the resident's training, and if the supervising psychiatrist is available for discussion with the attorneys for all parties and for court appearance and testimony if requested by the court or any of the attorneys. |
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| 120 | 131 | | |
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| 121 | 132 | | (ii) Two other individuals, one of whom, if available, is a psychologist and in any event a social worker familiar with mental health and human services that may be available placement alternatives appropriate for treatment. An evaluation may be conducted on an inpatient basis, an outpatient basis or a combination of both, and every reasonable attempt shall be made to conduct the evaluation in any language preferred by the person. |
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| 122 | 133 | | |
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| 123 | 134 | | (b) A physical examination that is consistent with the existing standards of care and that is performed by one of the evaluating physicians or by or under the supervision of a physician who is licensed pursuant to title 32, chapter 13 or 17 or a registered nurse practitioner who is licensed pursuant to title 32, chapter 15 if the results of that examination are reviewed or augmented by one of the evaluating physicians. |
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| 124 | 135 | | |
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| 125 | 136 | | 14. "Evaluation agency" means either of the following: |
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| 126 | 137 | | |
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| 127 | 138 | | (a) A health care agency that is licensed by the department and that has been approved pursuant to this title to provide the services required of that agency by this chapter. |
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| 128 | 139 | | |
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| 129 | 140 | | (b) A facility that is exempt from licensure pursuant to section 36-402, that possesses an accreditation from either a national commission on correctional health care or an American correctional association and that has been approved pursuant to this title to provide the services required of that facility by this chapter or chapter 18, article 5 of this title. |
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| 130 | 141 | | |
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| 131 | 142 | | 15. "Family member" means a spouse, parent, adult child, adult sibling or other blood relative of a person undergoing treatment or evaluation pursuant to this chapter. |
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| 132 | 143 | | |
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| 133 | 144 | | 16. "Grave disability" means a condition evidenced by behavior in which a person, as a result of a mental disorder, is likely to come to serious physical harm or serious illness because the person is unable to provide for the person's own basic physical needs. |
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| 134 | 145 | | |
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| 135 | 146 | | 17. "Health care decision maker" has the same meaning prescribed in section 12-2801. |
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| 136 | 147 | | |
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| 137 | 148 | | 18. "Health care entity" means a health care provider, the department, the administration or a regional behavioral health authority that is under contract with the administration. |
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| 138 | 149 | | |
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| 139 | 150 | | 19. "Health care provider" means a health care institution as defined in section 36-401 that is licensed as a behavioral health provider pursuant to department rules or a mental health provider. |
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| 140 | 151 | | |
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| 141 | 152 | | 20. "Independent evaluator" means a licensed physician, psychiatric and mental health nurse practitioner or psychologist who is selected by the person to be evaluated or by the person's attorney. |
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| 142 | 153 | | |
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| 143 | 154 | | 21. "Informed consent" means a voluntary decision following presentation of all facts necessary to form the basis of an intelligent consent by the patient or guardian with no minimizing of known dangers of any procedures. |
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| 144 | 155 | | |
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| 145 | 156 | | 22. "Least restrictive treatment alternative" means the treatment plan and setting that infringe in the least possible degree with the patient's right to liberty and that are consistent with providing needed treatment in a safe and humane manner. |
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| 146 | 157 | | |
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| 147 | 158 | | 23. "Licensed physician" means any medical doctor or doctor of osteopathy who is either: |
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| 148 | 159 | | |
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| 149 | 160 | | (a) Licensed in this state. |
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| 150 | 161 | | |
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| 151 | 162 | | (b) A full-time hospital physician licensed in another state and serving on the staff of a hospital operated or licensed by the United States government. |
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| 152 | 163 | | |
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| 153 | 164 | | 24. "Medical director of an evaluation agency" means a psychiatrist, or other licensed physician experienced in psychiatric matters, who is designated in writing by the governing body of the agency as the person in charge of the medical services of the agency for the purposes of this chapter and may include the chief medical officer of the state hospital. |
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| 154 | 165 | | |
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| 155 | 166 | | 25. "Medical director of a mental health treatment agency" means a psychiatrist, or other licensed physician experienced in psychiatric matters, who is designated in writing by the governing body of the agency as the person in charge of the medical services of the agency for the purposes of this chapter and includes the chief medical officer of the state hospital. |
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| 156 | 167 | | |
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| 157 | 168 | | 26. "Mental disorder" means a substantial disorder of the person's emotional processes, thought, cognition or memory. Mental disorder is distinguished from: |
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| 158 | 169 | | |
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| 159 | 170 | | (a) Conditions that are primarily those of drug abuse, alcoholism or intellectual disability, unless, in addition to one or more of these conditions, the person has a mental disorder. |
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| 160 | 171 | | |
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| 161 | 172 | | (b) The declining mental abilities that directly accompany impending death. |
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| 162 | 173 | | |
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| 163 | 174 | | (c) Character and personality disorders characterized by lifelong and deeply ingrained antisocial behavior patterns, including sexual behaviors that are abnormal and prohibited by statute unless the behavior results from a mental disorder. |
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| 164 | 175 | | |
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| 165 | 176 | | 27. "Mental health provider" means any physician or provider of mental health or behavioral health services who is involved in evaluating, caring for, treating or rehabilitating a patient. |
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| 166 | 177 | | |
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| 167 | 178 | | 28. "Mental health treatment agency" means any of the following: |
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| 168 | 179 | | |
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| 169 | 180 | | (a) The state hospital. |
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| 170 | 181 | | |
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| 171 | 182 | | (b) A health care agency that is licensed by the department and that provides the services that are required of the agency by this chapter. |
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| 172 | 183 | | |
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| 173 | 184 | | (c) A facility that is exempt from licensure pursuant to section 36-402, that possesses an accreditation from either a national commission on correctional health care or an American correctional association and that provides the services that are required of the facility by this chapter. |
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| 174 | 185 | | |
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| 175 | 186 | | 29. "Outpatient treatment" or "combined inpatient and outpatient treatment" means any treatment program not requiring continuous inpatient hospitalization. |
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| 176 | 187 | | |
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| 177 | 188 | | 30. "Outpatient treatment plan" means a treatment plan that does not require continuous inpatient hospitalization. |
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| 178 | 189 | | |
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| 179 | 190 | | 31. "Patient" means any person who is undergoing examination, evaluation or behavioral or mental health treatment under this chapter. |
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| 180 | 191 | | |
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| 181 | 192 | | 32. "Peace officers" means sheriffs of counties, constables, marshals and policemen of cities and towns. |
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| 182 | 193 | | |
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| 183 | 194 | | 33. "Persistent or acute disability" means a severe mental disorder that meets all the following criteria: |
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| 184 | 195 | | |
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| 185 | 196 | | (a) Significantly impairs judgment, reason, behavior or capacity to recognize reality. |
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| 186 | 197 | | |
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| 187 | 198 | | (b) If not treated, has a substantial probability of causing the person to suffer or continue to suffer severe and abnormal mental, emotional or physical harm. |
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| 188 | 199 | | |
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| 189 | 200 | | (c) Substantially impairs the person's capacity to make an informed decision regarding treatment, and this impairment causes the person to be incapable of understanding and expressing an understanding of the advantages and disadvantages of accepting treatment and understanding and expressing an understanding of the alternatives to the particular treatment offered after the advantages, disadvantages and alternatives are explained to that person. |
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| 190 | 201 | | |
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| 191 | 202 | | (d) Has a reasonable prospect of being treatable by outpatient, inpatient or combined inpatient and outpatient treatment. |
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| 192 | 203 | | |
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| 193 | 204 | | 34. "Prepetition screening" means the review of each application requesting court-ordered evaluation, including an investigation of facts alleged in the application, an interview with each applicant and an interview, if possible, with the proposed patient. The purpose of the interview with the proposed patient is to assess the problem, explain the application and, when indicated, attempt to persuade the proposed patient to receive, on a voluntary basis, evaluation or other services. |
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| 194 | 205 | | |
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| 195 | 206 | | 35. "Prescribed form" means a form established by a court or the rules of the administration in accordance with the laws of this state. |
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| 196 | 207 | | |
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| 197 | 208 | | 36. "Professional" means a physician who is licensed pursuant to title 32, chapter 13 or 17, a psychologist who is licensed pursuant to title 32, chapter 19.1 or a psychiatric and mental health nurse practitioner who is certified pursuant to title 32, chapter 15. |
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| 198 | 209 | | |
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| 199 | 210 | | 37. "Proposed patient" means a person for whom an application for evaluation has been made or a petition for court-ordered evaluation has been filed. |
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| 200 | 211 | | |
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| 201 | 212 | | 38. "Prosecuting agency" means the county attorney, attorney general or city attorney who applied or petitioned for an evaluation or treatment pursuant to this chapter. |
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| 202 | 213 | | |
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| 203 | 214 | | 39. "Psychiatric and mental health nurse practitioner" means a registered nurse practitioner as defined in section 32-1601 who has completed an adult or family psychiatric and mental health nurse practitioner program and who is certified as an adult or family psychiatric and mental health nurse practitioner by the state board of nursing. |
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| 204 | 215 | | |
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| 205 | 216 | | 40. "Psychiatrist" means a licensed physician who has completed three years of graduate training in psychiatry in a program approved by the American medical association or the American osteopathic association. |
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| 206 | 217 | | |
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| 207 | 218 | | 41. "Psychologist" means a person who is licensed under title 32, chapter 19.1 and who is experienced in the practice of clinical psychology. |
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| 208 | 219 | | |
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| 209 | 220 | | 42. "Records" means all communications that are recorded in any form or medium and that relate to patient examination, evaluation or behavioral or mental health treatment. Records include medical records that are prepared by a health care provider or other providers. Records do not include: |
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| 210 | 221 | | |
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| 211 | 222 | | (a) Materials that are prepared in connection with utilization review, peer review or quality assurance activities, including records that a health care provider prepares pursuant to section 36-441, 36-445, 36-2402 or 36-2917. |
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| 212 | 223 | | |
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| 213 | 224 | | (b) Recorded telephone and radio calls to and from a publicly operated emergency dispatch office relating to requests for emergency services or reports of suspected criminal activity. |
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| 214 | 225 | | |
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| 215 | 226 | | 43. "Regional behavioral health authority" has the same meaning prescribed in section 36-3401. |
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| 216 | 227 | | |
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| 217 | 228 | | 44. "Screening agency" means a health care agency that is licensed by the department and that provides those services required of the agency by this chapter. |
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| 218 | 229 | | |
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| 219 | 230 | | 45. "Social worker" means a person who has completed two years of graduate training in social work in a program approved by the council of social work education and who has experience in mental health. |
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| 220 | 231 | | |
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| 221 | 232 | | 46. "State hospital" means the Arizona state hospital. |
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| 222 | 233 | | |
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| 223 | 234 | | 47. "Superintendent" means the superintendent of the state hospital. |
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| 224 | 235 | | |
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| 225 | 236 | | 48. "Voluntary evaluation" means the ongoing collection and analysis of a person's medical, psychological, psychiatric and social conditions in order to initially determine if a health disorder exists and if there is a need for behavioral health services and, on an ongoing basis, to ensure that the person's service plan is designed to meet the person's and the person's family's current needs and long-term goals.END_STATUTE |
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| 226 | 237 | | |
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| 227 | 238 | | Sec. 2. Section 36-526, Arizona Revised Statutes, is amended to read: |
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| 228 | 239 | | |
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| 229 | 240 | | START_STATUTE36-526. Emergency admission; examination; petition for court-ordered evaluation |
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| 230 | 241 | | |
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| 231 | 242 | | A. On presentation of the person for emergency admission, an admitting officer of an evaluation agency shall perform an examination of the person's psychiatric and physical condition and may admit the person to the agency as an emergency patient if the admitting officer finds, as a result of the examination and investigation of the application for emergency admission, that there is reasonable cause to believe that the person, as a result of a mental disorder, is a danger to self or others, has a persistent or acute disability or a grave disability and is unable or unwilling to undergo voluntary evaluation and that during the time necessary to complete the prepetition screening procedures set forth in sections 36-520 and 36-521 the person is likely without immediate hospitalization to suffer serious physical harm or serious illness or to inflict serious physical harm on another person. If a person is hospitalized pursuant to this section, the admitting officer may notify a screening agency and seek its assistance or guidance in developing alternatives to involuntary confinement and in counseling the person and the person's family. |
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| 232 | 243 | | |
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| 233 | 244 | | B. On the same or a succeeding court day, the medical director in charge of the agency shall file a petition for a court-ordered evaluation, unless the person has been discharged or has become a voluntary patient. The petition need not comply with the provisions of this chapter requiring preparation and filing of a prepetition screening report but shall meet all other requirements and shall seek an appropriate order pursuant to section 36-529. |
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| 234 | 245 | | |
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| 235 | 246 | | C. If the admitting officer, after an examination or evaluation, determines that the proposed patient is an impaired person as defined in section 36-2081, the admitting officer may file a petition for court-ordered stabilization pursuant to section 36-2083. END_STATUTE |
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| 236 | 247 | | |
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| 237 | 248 | | Sec. 3. Title 36, chapter 18, Arizona Revised Statutes, is amended by adding article 5, to read: |
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| 238 | 249 | | |
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| 239 | 250 | | ARTICLE 5. INVOLUNTARY STABILIZATION |
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| 240 | 251 | | |
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| 241 | 252 | | START_STATUTE36-2081. Definitions |
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| 242 | 253 | | |
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| 243 | 254 | | In this article, unless the context otherwise requires: |
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| 244 | 255 | | |
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| 245 | 256 | | 1. "Administration" means the Arizona health care cost containment system administration. |
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| 246 | 257 | | |
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| 248 | 259 | | |
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| 249 | 260 | | 3. "Chief medical officer" means the chief medical officer of an evaluation agency. |
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| 250 | 261 | | |
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| 251 | 262 | | 4. "Department" means the department of HEALTH services. |
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| 252 | 263 | | |
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| 253 | 264 | | 5. "Detain" means to involuntary admit a patient, proposed patient or impaired person to an evaluation agency. |
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| 254 | 265 | | |
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| 255 | 266 | | 6. "Evaluation agency" has the same meaning prescribed in section 36-501. |
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| 256 | 267 | | |
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| 257 | 268 | | 7. "Impaired person" means an individual who, as a result of intoxication, withdrawal or substance-induced symptoms, has impaired judgment causing the individual to be incapable of making or communicating rational decisions with regard to the individual's safety, health or basic personal needs, such as food, clothing, shelter or medical care. |
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| 258 | 269 | | |
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| 259 | 270 | | 8. "Psychiatric and mental health nurse practitioner" has the same meaning prescribed in section 36-501. |
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| 260 | 271 | | |
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| 261 | 272 | | 9. "Psychiatrist" has the same meaning as prescribed in section 36-501. |
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| 262 | 273 | | |
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| 263 | 274 | | 10. "Stabilization period" means the time period for which an impaired person may be admitted involuntarily to an evaluation agency for the purposes of allowing the effects of substances to resolve such that the person no longer meets the definition of impaired person. END_STATUTE |
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| 264 | 275 | | |
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| 265 | 276 | | START_STATUTE36-2082. Impaired persons; civil and legal rights |
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| 266 | 277 | | |
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| 267 | 278 | | An impaired person who is involuntarily admitted for a stabilization period pursuant to this article has all of the civil and legal rights enumerated in chapter 5, article 2 of this title.END_STATUTE |
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| 268 | 279 | | |
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| 269 | 280 | | START_STATUTE36-2083. Petition for court-ordered stabilization |
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| 270 | 281 | | |
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| 271 | 282 | | A. A petition for court-ordered stabilization may be filed by an admitting officer based on a personal assessment and review of an individual's medical record and must be accompanied by an affidavit from the admitting officer detailing all of the following: |
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| 272 | 283 | | |
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| 273 | 284 | | 1. That the individual is an impaired person and the clinical facts that support that conclusion. |
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| 274 | 285 | | |
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| 275 | 286 | | 2. That the individual is either unable or unwilling to consent to voluntary admission. |
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| 276 | 287 | | |
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| 277 | 288 | | 3. The reasons why discharging the individual would be unsafe. |
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| 278 | 289 | | |
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| 279 | 290 | | 4. The reasons why proceedings under chapter 5 of this title are inappropriate. |
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| 280 | 291 | | |
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| 281 | 292 | | 5. The date the individual was initially involuntarily admitted to the evaluation agency pursuant to chapter 5 of this title. |
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| 282 | 293 | | |
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| 283 | 294 | | B. The petition for court-ordered stabilization shall request that the court issue an order admitting the impaired person to the evaluation agency for a stabilization period of not more than five calendar days after the date the individual was involuntarily admitted to the evaluation agency pursuant to chapter 5 of this title. |
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| 284 | 295 | | |
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| 285 | 296 | | C. A petition for court-ordered stabilization may not be filed solely to detain an individual who is at risk of using substances but who is not currently intoxicated, in withdrawal or having substance-induced symptoms.END_STATUTE |
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| 286 | 297 | | |
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| 287 | 298 | | START_STATUTE36-2084. Order for stabilization period; duty of counsel; personal service |
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| 288 | 299 | | |
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| 289 | 300 | | A. If THE COURT, after reviewing the petition for court-ordered stabilization, DETERMINEs THAT inSUFFICIENT EVIDENCE HAS BEEN PRESENTED TO FIND THAT THE INDIVIDUAL IS AN IMPAIRED PERSON, THE court shall deny the PETITION FOR COURT-ORDERED STABILIZATION AND THE EVALUATION AGENCY shall immediate release THE IMPAIRED PERSON. |
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| 290 | 301 | | |
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| 291 | 302 | | B. IF the court, after reviewing the petition for court-ordered stabilization, DETERMINEs that THERE IS REASONABLE CAUSE TO BELIEVE THAT THE INDIVIDUAL IS AN IMPAIRED PERSON, THE court shall grant the PETITION FOR COURT-ORDERED STABILIZATION FOR A PERIOD of not more than FIVE CALENDAR DAYS after THE DATE THE IMPAIRED PERSON WAS INVOLUNTARILY ADMITTED TO THE EVALUATION AGENCY pursuant to chapter 5 of this title. |
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| 292 | 303 | | |
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| 293 | 304 | | C. THE COURT shall APPOINT COUNSEL FOR THE IMPAIRED PERSON AT THE TIME of issuing THE ORDER FOR STABILIZATION. An attorney who is appointed to represent the impaired person shall confer with the impaired person within twenty-four hours after appointment and inform the impaired person of the person's rights. |
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| 294 | 305 | | |
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