| 1 | 1 | | REFERENCE TITLE: clozapine; access; treatment protocols State of Arizona Senate Fifty-seventh Legislature First Regular Session 2025 SB 1720 Introduced by Senators Kuby: Miranda An Act amending title 20, Arizona Revised Statutes, by adding chapter 10; amending title 31, chapter 1, article 4, Arizona Revised Statutes, by adding section 31-166; amending title 31, chapter 2, article 2, Arizona Revised Statutes, by adding section 31-243; amending title 36, chapter 29, article 1, Arizona Revised Statutes, by adding section 36-2903.17; amending sections 36-2939 and 36-3431, Arizona Revised Statutes; relating to mental health services. (TEXT OF BILL BEGINS ON NEXT PAGE) |
|---|
| 2 | 2 | | |
|---|
| 3 | 3 | | |
|---|
| 4 | 4 | | |
|---|
| 5 | 5 | | |
|---|
| 6 | 6 | | |
|---|
| 7 | 7 | | |
|---|
| 8 | 8 | | |
|---|
| 9 | 9 | | REFERENCE TITLE: clozapine; access; treatment protocols |
|---|
| 10 | 10 | | State of Arizona Senate Fifty-seventh Legislature First Regular Session 2025 |
|---|
| 11 | 11 | | SB 1720 |
|---|
| 12 | 12 | | Introduced by Senators Kuby: Miranda |
|---|
| 13 | 13 | | |
|---|
| 14 | 14 | | REFERENCE TITLE: clozapine; access; treatment protocols |
|---|
| 15 | 15 | | |
|---|
| 16 | 16 | | |
|---|
| 17 | 17 | | |
|---|
| 18 | 18 | | |
|---|
| 19 | 19 | | |
|---|
| 20 | 20 | | |
|---|
| 21 | 21 | | |
|---|
| 22 | 22 | | |
|---|
| 23 | 23 | | |
|---|
| 24 | 24 | | State of Arizona |
|---|
| 25 | 25 | | |
|---|
| 26 | 26 | | Senate |
|---|
| 27 | 27 | | |
|---|
| 28 | 28 | | Fifty-seventh Legislature |
|---|
| 29 | 29 | | |
|---|
| 30 | 30 | | First Regular Session |
|---|
| 31 | 31 | | |
|---|
| 32 | 32 | | 2025 |
|---|
| 33 | 33 | | |
|---|
| 34 | 34 | | |
|---|
| 35 | 35 | | |
|---|
| 36 | 36 | | |
|---|
| 37 | 37 | | |
|---|
| 38 | 38 | | |
|---|
| 39 | 39 | | |
|---|
| 40 | 40 | | SB 1720 |
|---|
| 41 | 41 | | |
|---|
| 42 | 42 | | |
|---|
| 43 | 43 | | |
|---|
| 44 | 44 | | Introduced by |
|---|
| 45 | 45 | | |
|---|
| 46 | 46 | | Senators Kuby: Miranda |
|---|
| 47 | 47 | | |
|---|
| 48 | 48 | | |
|---|
| 49 | 49 | | |
|---|
| 50 | 50 | | |
|---|
| 51 | 51 | | |
|---|
| 52 | 52 | | |
|---|
| 53 | 53 | | |
|---|
| 54 | 54 | | |
|---|
| 55 | 55 | | |
|---|
| 56 | 56 | | |
|---|
| 57 | 57 | | |
|---|
| 58 | 58 | | |
|---|
| 59 | 59 | | |
|---|
| 60 | 60 | | |
|---|
| 61 | 61 | | |
|---|
| 62 | 62 | | |
|---|
| 63 | 63 | | |
|---|
| 64 | 64 | | An Act |
|---|
| 65 | 65 | | |
|---|
| 66 | 66 | | |
|---|
| 67 | 67 | | |
|---|
| 68 | 68 | | amending title 20, Arizona Revised Statutes, by adding chapter 10; amending title 31, chapter 1, article 4, Arizona Revised Statutes, by adding section 31-166; amending title 31, chapter 2, article 2, Arizona Revised Statutes, by adding section 31-243; amending title 36, chapter 29, article 1, Arizona Revised Statutes, by adding section 36-2903.17; amending sections 36-2939 and 36-3431, Arizona Revised Statutes; relating to mental health services. |
|---|
| 69 | 69 | | |
|---|
| 70 | 70 | | |
|---|
| 71 | 71 | | |
|---|
| 72 | 72 | | |
|---|
| 73 | 73 | | |
|---|
| 74 | 74 | | (TEXT OF BILL BEGINS ON NEXT PAGE) |
|---|
| 75 | 75 | | |
|---|
| 76 | 76 | | |
|---|
| 77 | 77 | | |
|---|
| 78 | 78 | | Be it enacted by the Legislature of the State of Arizona: Section 1. Title 20, Arizona Revised Statutes, is amended by adding chapter 10, to read: CHAPTER 10 HEALTH INSURER TREATMENT FOR PSYCHIATRIC DISORDERS ARTICLE 1. CLOZAPINE TREATMENT START_STATUTE20-2001. Definitions In this article, unless the context otherwise requires: 1. "Health insurer": (a) Means a disability insurer, group disability insurer, blanket disability insurer, health care services organization, hospital service corporation, medical service corporation or hospital, medical, dental and optometric service corporation and includes the health insurer's designee. (b) Does not include a pharmacy benefit manager as defined in section 20-3321. 2. "Participating provider" means a provider that has been credentialed by a health insurer or its designee to provide health care items or services to subscribers in at least one of the health insurer's provider networks. 3. "Provider" means a physician, hospital, behavioral health facility or other person or health care institution that is licensed in this state or that is otherwise authorized to furnish health care services in this state. 4. "Subscriber" means a person who is eligible to receive health care benefits pursuant to a health insurance policy or coverage issued or provided by a health insurer. END_STATUTE START_STATUTE20-2002. Clozapine; psychiatric disorders; access; treatment protocol; continuing education A. A health insurer shall provide reimbursement for treatment and services that are unique to subscribers who are prescribed clozapine, as follows: 1. Due to the inherent complexity of clozapine treatment, all psychiatric examinations of subscribers who are prescribed clozapine may be billed at the highest level of complexity, and the health insurer may not restrict the number or frequency of psychiatric visits. 2. During the first twelve months that a subscriber receives clozapine treatment, psychiatric examinations shall be reimbursed with an enhanced case rate that includes an additional thirty percent above the high complexity visit to compensate for administrative tasks and care management associated with additional laboratory testing and patient monitoring. 3. Medical weight management shall be provided to treat and prevent clozapine-induced weight gain and other metabolic disorders associated with clozapine treatment. 4. Specialty interventions, such as botulinum toxin injections in salivary glands, for refractory excessive salivation that does not respond to topical or oral treatments shall be provided, if necessary, including administration by a trained specialist and all necessary office visits. 5. A subscriber who is prescribed clozapine shall have access to less-invasive means of hematological monitoring, such as finger-stick absolute neutrophil count devices, including individual devices for a subscriber, if requested by the subscriber or the subscriber's guardian, as a reasonable accommodation for the subscriber's disability. Clinical assistance and supplies associated with the administration of finger-stick patient monitoring shall be provided. 6. Mobile phlebotomy services shall be provided, if requested by the subscriber or the subscriber's guardian, for necessary hematological testing. 7. Genetic testing shall be provided, as necessary, to identify genes associated with benign ethnic neutropenia and genes linked to increased risk of clozapine-induced neutropenia and to guide hematological monitoring frequency and neutrophil parameters of subscribers who are prescribed clozapine. 8. Prescription drug coverage shall include clozapine for emergency use outside of the standard refill utilization requirements, if requested by the subscriber or the subscriber's guardian. B. The health insurer shall establish criteria to proactively identify participating providers that may be underutilizing clozapine, including identifying prescribers who treat subscribers diagnosed with schizophrenia or schizoaffective disorder and who are not prescribing clozapine. participating providers who demonstrate poor clozapine utilization shall be notified, at a minimum, on a quarterly basis. C. The health insurer shall offer Clozapine-specific training for all participating providers who provide behavioral health treatment. The training shall include information regarding barriers to and the management of clozapine treatment, adherence to treatment protocols and side effects of clozapine treatment. D. In the delivery of care and services for subscribers with a serious mental illness designation or a serious emotional disturbance designation, the health insurer shall: 1. Offer in-home hematological monitoring, if requested by the subscriber, the subscriber's guardian or the subscriber's participating provider, including mobile phlebotomy services or a trained care manager to assist homebound subscribers with finger-stick testing of absolute neutrophil count. 2. Cover medication delivery or mail order medication services if the participating provider determines the service and delivery conditions are appropriate for the subscriber. 3. Provide a level of support services that accommodates additional medication assistance, including medication prompting, observation, administration and oversight of a subscriber's medication plan, as necessary, for a subscriber who is prescribed clozapine to ensure consistency and adherence, regardless of the subscriber's level of support for a serious mental illness designation or a serious emotional disturbance designation. These support services shall be provided to a subscriber who is being discharged from an inpatient facility, a behavioral health residential facility or any twenty-four-hour supervised program. E. The health insurer shall require a participating provider that is an inpatient behavioral health facility that has a pharmacy and that serves subscribers with psychiatric needs to maintain clozapine in stock.END_STATUTE Sec. 2. Title 31, chapter 1, article 4, Arizona Revised Statutes, is amended by adding section 31-166, to read: START_STATUTE31-166. Inmates with psychiatric disorders; clozapine; access; treatment protocols A county jail shall provide an inmate who is prescribed clozapine with access to clozapine and the related treatment protocols as prescribed in section 36-2903.17, subsection A, paragraphs 3, 4, 5, 6 and 8 and the training prescribed in section 36-2903.17, subsection C.END_STATUTE Sec. 3. Title 31, chapter 2, article 2, Arizona Revised Statutes, is amended by adding section 31-243, to read: START_STATUTE31-243. Inmates with psychiatric disorders; clozapine; access; treatment protocols The department or a private prison provider that is contracted by the department shall provide an inmate who is prescribed clozapine with access to clozapine and the related treatment protocols as prescribed in section 36-2903.17, subsection A, paragraphs 3, 4, 5, 6 and 8 and the training prescribed in section 36-2903.17, subsection C.END_STATUTE Sec. 4. Title 36, chapter 29, article 1, Arizona Revised Statutes, is amended by adding section 36-2903.17, to read: START_STATUTE36-2903.17. Clozapine; psychiatric disorders; access; treatment protocol; continuing education A. The administration and its contractors shall provide reimbursement for treatment and services that are unique to members who are prescribed clozapine, as follows: 1. Due to the inherent complexity of clozapine treatment, all psychiatric examinations of members who are prescribed clozapine may be billed at the highest level of complexity, and the administration or contractor may not restrict the number or frequency of psychiatric visits. 2. During the first twelve months that a member receives clozapine treatment, psychiatric examinations shall be reimbursed with an enhanced case rate that includes an additional thirty percent above the high complexity visit to compensate for administrative tasks and care management associated with additional laboratory testing and patient monitoring. 3. Medical weight management shall be provided to treat and prevent clozapine-induced weight gain and other metabolic disorders associated with clozapine treatment. 4. Specialty interventions, such as botulinum toxin injections in salivary glands, for refractory excessive salivation that does not respond to topical or oral treatments shall be provided, if necessary, including administration by a trained specialist and all necessary office visits. 5. A member who is prescribed clozapine shall have access to less-invasive means of hematological monitoring, such as finger-stick absolute neutrophil count devices, including individual devices for a member, if requested by the member or the member's guardian, as a reasonable accommodation for the member's disability. Clinical assistance and supplies associated with the administration of finger-stick patient monitoring shall be provided. 6. Mobile phlebotomy services shall be provided, if requested by the member or the member's guardian, for necessary hematological testing. 7. Genetic testing shall be provided, as necessary, to identify genes associated with benign ethnic neutropenia and genes linked to increased risk of clozapine-induced neutropenia and to guide hematological monitoring frequency and neutrophil parameters of members who are prescribed clozapine. 8. Prescription drug coverage shall include clozapine for emergency use outside of the standard refill utilization requirements, if requested by the member or the member's guardian. B. The administration and its contractors shall establish criteria to proactively identify health care facilities and providers that may be underutilizing clozapine, including identifying prescribers who treat members diagnosed with schizophrenia or schizoaffective disorder and who are not prescribing clozapine. Health care facilities and providers who demonstrate poor clozapine utilization shall be notified, at a minimum, on a quarterly basis. C. The administration shall offer Clozapine-specific training for all behavioral health providers who participate in the system. The training shall include information regarding barriers to and the management of clozapine treatment, adherence to treatment protocols and side effects of clozapine treatment. D. In the delivery of care and services for members with a serious mental illness designation or a serious emotional disturbance designation, the administration and its contracted regional behavioral health authorities shall: 1. Offer single-case agreements for non-title XIV members to receive services from private out-of-network providers who prescribe clozapine when medically necessary or to promote timely access to care, if the prescribing health professional is licensed in this state and is registered with the administration. 2. Designate all members who are prescribed clozapine as a special assistance member, unless the designation is declined by the member or member's guardian. 3. Offer in-home hematological monitoring, if requested by the member, the member's guardian or the member's health care provider, including mobile phlebotomy services or a trained care manager to assist homebound members with finger-stick testing of absolute neutrophil count. 4. Cover medication delivery or mail order medication services if the health care provider determines the service and delivery conditions are appropriate for the member. 5. Provide a level of support services that accommodates additional medication assistance, including medication prompting, observation, administration and oversight of a member's medication plan, as necessary, for a member who is prescribed clozapine to ensure consistency and adherence, regardless of the member's level of support for a serious mental illness designation or a serious emotional disturbance designation. These support services shall be provided to a member who is being discharged from an inpatient facility, a behavioral health residential facility or any twenty-four-hour supervised program. E. The administration and its contractors shall require any inpatient behavioral health facility that has a pharmacy and that serves members with psychiatric needs to maintain clozapine in stock. END_STATUTE Sec. 5. Section 36-2939, Arizona Revised Statutes, is amended to read: START_STATUTE36-2939. Long-term care system services; definition A. The following services shall be provided by the program contractors to members who are determined to need institutional services pursuant to this article: 1. Nursing facility services other than services in an institution for tuberculosis or mental disease. 2. Notwithstanding any other law, behavioral health services if these services are not duplicative of long-term care services provided as of January 30, 1993 under this subsection and are authorized by the program contractor through the long-term care case management system. If the administration is the program contractor, the administration may authorize these services. 3. Hospice services. For the purposes of this paragraph, "hospice" means a program of palliative and supportive care for terminally ill members and their families or caregivers. 4. Case management services as provided in section 36-2938. 5. Health and medical services as provided in section 36-2907. 6. Dental services as follows: (a) Except as provided in subdivision (b) of this paragraph, in an annual amount of not more than $1,000 per member. (b) Subject to approval by the centers for medicare and medicaid services, for persons treated at an Indian health service or tribal facility, adult dental services that are eligible for a federal medical assistance percentage of one hundred percent and that are in excess of the limit prescribed in subdivision (a) of this paragraph. 7. Clozapine access and Treatment protocols as prescribed in section 36-2903.17 for members who are prescribed clozapine. B. In addition to the services prescribed in subsection A of this section, the department, as a program contractor, shall provide the following services if appropriate to members who have a developmental disability as defined in section 36-551 and who are determined to need institutional services pursuant to this article: 1. Intermediate care facility services for a member who has a developmental disability as defined in section 36-551. For purposes of this article, a facility shall meet all federally approved standards and may only include the Arizona training program facilities, a state owned and operated service center, state owned or operated community residential settings and private facilities that contract with the department. 2. Home and community based services that may be provided in a member's home, at an alternative residential setting as prescribed in section 36-591 or at other behavioral health alternative residential facilities licensed by the department of health services and approved by the director of the Arizona health care cost containment system administration and that may include: (a) Home health, which means the provision of nursing services, licensed health aide services, home health aide services or medical supplies, equipment and appliances, that are provided on a part-time or intermittent basis by a licensed home health agency within a member's residence based on a physician's or allowed practitioner's orders and in accordance with federal law. Physical therapy, occupational therapy, or speech and audiology services provided by a home health agency may be provided in accordance with federal law. Home health agencies shall comply with federal bonding requirements in a manner prescribed by the administration. (b) Licensed health aide services, which means a home health agency service provided pursuant to subsection G of this section that is ordered by a physician or an allowed practitioner on the member's plan of care and provided by a licensed health aide who is licensed pursuant to title 32, chapter 15. (c) Home health aide, which means a service that provides intermittent health maintenance, continued treatment or monitoring of a health condition and supportive care for activities of daily living provided within a member's residence. (d) Homemaker, which means a service that provides assistance in the performance of activities related to household maintenance within a member's residence. (e) Personal care, which means a service that provides assistance to meet essential physical needs within a member's residence. (f) Day care for persons with developmental disabilities, which means a service that provides planned care supervision and activities, personal care, activities of daily living skills training and habilitation services in a group setting during a portion of a continuous twenty-four-hour period. (g) Habilitation, which means the provision of physical therapy, occupational therapy, speech or audiology services or training in independent living, special developmental skills, sensory-motor development, behavior intervention, and orientation and mobility in accordance with federal law. (h) Respite care, which means a service that provides short-term care and supervision available on a twenty-four-hour basis. (i) Transportation, which means a service that provides or assists in obtaining transportation for the member. (j) Other services or licensed or certified settings approved by the director. C. In addition to services prescribed in subsection A of this section, home and community based services may be provided in a member's home, in an adult foster care home as prescribed in section 36-401, in an assisted living home or assisted living center as defined in section 36-401 or in a level one or level two behavioral health alternative residential facility approved by the director by program contractors to all members who do not have a developmental disability as defined in section 36-551 and are determined to need institutional services pursuant to this article. Members residing in an assisted living center must be provided the choice of single occupancy. The director may also approve other licensed residential facilities as appropriate on a case-by-case basis for traumatic brain injured members. Home and community based services may include the following: 1. Home health, which means the provision of nursing services, home health aide services or medical supplies, equipment and appliances, that are provided on a part-time or intermittent basis by a licensed home health agency within a member's residence based on a physician's or allowed practitioner's orders and in accordance with federal law. Physical therapy, occupational therapy, or speech and audiology services provided by a home health agency may be provided in accordance with federal law. Home health agencies shall comply with federal bonding requirements in a manner prescribed by the administration. 2. Licensed health aide services, which means a home health agency service provided pursuant to subsection G of this section that is ordered by a physician or an allowed practitioner on the member's plan of care and provided by a licensed health aide who is licensed pursuant to title 32, chapter 15. 3. Home health aide, which means a service that provides intermittent health maintenance, continued treatment or monitoring of a health condition and supportive care for activities of daily living provided within a member's residence. 4. Homemaker, which means a service that provides assistance in the performance of activities related to household maintenance within a member's residence. 5. Personal care, which means a service that provides assistance to meet essential physical needs within a member's residence. 6. Adult day health, which means a service 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 may also include preventive, therapeutic and restorative health related services that do not include behavioral health services. 7. Habilitation, which means the provision of physical therapy, occupational therapy, speech or audiology services or training in independent living, special developmental skills, sensory-motor development, behavior intervention, and orientation and mobility in accordance with federal law. 8. Respite care, which means a service that provides short-term care and supervision available on a twenty-four-hour basis. 9. Transportation, which means a service that provides or assists in obtaining transportation for the member. 10. Home delivered meals, which means a service that provides for a nutritious meal that contains at least one-third of the recommended dietary allowance for an individual and that is delivered to the member's residence. 11. Other services or licensed or certified settings approved by the director. D. The amount of monies expended by program contractors on home and community based services pursuant to subsection C of this section shall be limited by the director in accordance with the federal monies made available to this state for home and community based services pursuant to subsection C of this section. The director shall establish methods for allocating monies for home and community based services to program contractors and shall monitor expenditures on home and community based services by program contractors. E. Notwithstanding subsections A, B, C, F and G of this section, a service may not be provided that does not qualify for federal monies available under title XIX of the social security act or the section 1115 waiver. F. In addition to services provided pursuant to subsections A, B and C of this section, the director may implement a demonstration project to provide home and community based services to special populations, including persons with disabilities who are eighteen years of age or younger, are medically fragile, reside at home and would be eligible for supplemental security income for the aged, blind or disabled or the state supplemental payment program, except for the amount of their parent's income or resources. In implementing this project, the director may provide for parental contributions for the care of their child. G. Consistent with the services provided pursuant to subsections A, B, C and F of this section and subject to approval by the centers for medicare and medicaid services, the director shall implement a program under which licensed health aide services may be provided to members who are under twenty-one years of age, who are eligible pursuant to section 36-2934, including members with developmental disabilities as defined in chapter 5.1, article 1 of this title, and who require continuous skilled nursing or skilled nursing respite care services. The licensed health aide services may be provided only by a parent, guardian or family member who is a licensed health aide employed by a medicare-certified home health agency service provider. Not later than sixty days after the approval of the rules implementing section 32-1645, subsection C, the director shall request any necessary approvals from the centers for medicare and medicaid services to implement this subsection and to qualify for federal monies available under title XIX of the social security act or the section 1115 waiver. The reimbursement rate for services provided under this subsection shall reflect the special skills needed to meet the health care needs of these members and shall exceed the reimbursement rate for home health aide services. H. Subject to section 36-562, the administration by rule shall prescribe a deductible schedule for programs provided to members who are eligible pursuant to subsection B of this section, except that the administration shall implement a deductible based on family income. In determining deductible amounts and whether a family is required to have deductibles, the department shall use adjusted gross income. Families whose adjusted gross income is at least four hundred percent and less than or equal to five hundred percent of the federal poverty guidelines shall have a deductible of two percent of adjusted gross income. Families whose adjusted gross income is more than five hundred percent of adjusted gross income shall have a deductible of four percent of adjusted gross income. Only families whose children are under eighteen years of age and who are members who are eligible pursuant to subsection B of this section may be required to have a deductible for services. For the purposes of this subsection, "deductible" means an amount a family, whose children are under eighteen years of age and who are members who are eligible pursuant to subsection B of this section, pays for services, other than departmental case management and acute care services, before the department will pay for services other than departmental case management and acute care services. I. For the purposes of this section, "allowed practitioner" means a nurse practitioner who is certified pursuant to title 32, chapter 15, a clinical nurse specialist who is certified pursuant to title 32, chapter 15 or a physician assistant who is certified pursuant to title 32, chapter 25.END_STATUTE Sec. 6. Section 36-3431, Arizona Revised Statutes, is amended to read: START_STATUTE36-3431. Comprehensive behavioral health service system for children; administration duties A. The administration shall develop and implement a comprehensive behavioral health service system for children that includes the following: 1. Annual needs assessment and resource assessment studies. 2. Annual planning to develop policy issues, programs and services. 3. Community education to increase public awareness of the needs of children. 4. Centralized and coordinated screening and intake. 5. Coordinated case management. 6. A continuum of treatment services, which may include the following: (a) Home-based services. (b) Prevention and early intervention. (c) Psychological evaluation and consultation. (d) Ancillary support services. (e) Crisis intervention. (f) Outpatient counseling. (g) Independent living services. (h) Secure residential treatment services for seriously emotionally disturbed children. (i) Residential treatment services for children's substance abuse. (j) Psychiatric hospitalization services. 7. Clozapine access and Treatment protocols as prescribed in section 36-2903.17 for children who are prescribed clozapine. 7. 8. Evaluation that determines both cost effectiveness and client outcome. B. Subject to legislative appropriation, the administration shall maintain the system identified in subsection A of this section. C. For the purposes of developing needs assessments and resource assessments and for planning, the administration may consult and coordinate with any state agency established for that purpose. END_STATUTE |
|---|
| 79 | 79 | | |
|---|
| 80 | 80 | | Be it enacted by the Legislature of the State of Arizona: |
|---|
| 81 | 81 | | |
|---|
| 82 | 82 | | Section 1. Title 20, Arizona Revised Statutes, is amended by adding chapter 10, to read: |
|---|
| 83 | 83 | | |
|---|
| 84 | 84 | | CHAPTER 10 |
|---|
| 85 | 85 | | |
|---|
| 86 | 86 | | HEALTH INSURER TREATMENT FOR PSYCHIATRIC DISORDERS |
|---|
| 87 | 87 | | |
|---|
| 88 | 88 | | ARTICLE 1. CLOZAPINE TREATMENT |
|---|
| 89 | 89 | | |
|---|
| 90 | 90 | | START_STATUTE20-2001. Definitions |
|---|
| 91 | 91 | | |
|---|
| 92 | 92 | | In this article, unless the context otherwise requires: |
|---|
| 93 | 93 | | |
|---|
| 94 | 94 | | 1. "Health insurer": |
|---|
| 95 | 95 | | |
|---|
| 96 | 96 | | (a) Means a disability insurer, group disability insurer, blanket disability insurer, health care services organization, hospital service corporation, medical service corporation or hospital, medical, dental and optometric service corporation and includes the health insurer's designee. |
|---|
| 97 | 97 | | |
|---|
| 98 | 98 | | (b) Does not include a pharmacy benefit manager as defined in section 20-3321. |
|---|
| 99 | 99 | | |
|---|
| 100 | 100 | | 2. "Participating provider" means a provider that has been credentialed by a health insurer or its designee to provide health care items or services to subscribers in at least one of the health insurer's provider networks. |
|---|
| 101 | 101 | | |
|---|
| 102 | 102 | | 3. "Provider" means a physician, hospital, behavioral health facility or other person or health care institution that is licensed in this state or that is otherwise authorized to furnish health care services in this state. |
|---|
| 103 | 103 | | |
|---|
| 104 | 104 | | 4. "Subscriber" means a person who is eligible to receive health care benefits pursuant to a health insurance policy or coverage issued or provided by a health insurer. END_STATUTE |
|---|
| 105 | 105 | | |
|---|
| 106 | 106 | | START_STATUTE20-2002. Clozapine; psychiatric disorders; access; treatment protocol; continuing education |
|---|
| 107 | 107 | | |
|---|
| 108 | 108 | | A. A health insurer shall provide reimbursement for treatment and services that are unique to subscribers who are prescribed clozapine, as follows: |
|---|
| 109 | 109 | | |
|---|
| 110 | 110 | | 1. Due to the inherent complexity of clozapine treatment, all psychiatric examinations of subscribers who are prescribed clozapine may be billed at the highest level of complexity, and the health insurer may not restrict the number or frequency of psychiatric visits. |
|---|
| 111 | 111 | | |
|---|
| 112 | 112 | | 2. During the first twelve months that a subscriber receives clozapine treatment, psychiatric examinations shall be reimbursed with an enhanced case rate that includes an additional thirty percent above the high complexity visit to compensate for administrative tasks and care management associated with additional laboratory testing and patient monitoring. |
|---|
| 113 | 113 | | |
|---|
| 114 | 114 | | 3. Medical weight management shall be provided to treat and prevent clozapine-induced weight gain and other metabolic disorders associated with clozapine treatment. |
|---|
| 115 | 115 | | |
|---|
| 116 | 116 | | 4. Specialty interventions, such as botulinum toxin injections in salivary glands, for refractory excessive salivation that does not respond to topical or oral treatments shall be provided, if necessary, including administration by a trained specialist and all necessary office visits. |
|---|
| 117 | 117 | | |
|---|
| 118 | 118 | | 5. A subscriber who is prescribed clozapine shall have access to less-invasive means of hematological monitoring, such as finger-stick absolute neutrophil count devices, including individual devices for a subscriber, if requested by the subscriber or the subscriber's guardian, as a reasonable accommodation for the subscriber's disability. Clinical assistance and supplies associated with the administration of finger-stick patient monitoring shall be provided. |
|---|
| 119 | 119 | | |
|---|
| 120 | 120 | | 6. Mobile phlebotomy services shall be provided, if requested by the subscriber or the subscriber's guardian, for necessary hematological testing. |
|---|
| 121 | 121 | | |
|---|
| 122 | 122 | | 7. Genetic testing shall be provided, as necessary, to identify genes associated with benign ethnic neutropenia and genes linked to increased risk of clozapine-induced neutropenia and to guide hematological monitoring frequency and neutrophil parameters of subscribers who are prescribed clozapine. |
|---|
| 123 | 123 | | |
|---|
| 124 | 124 | | 8. Prescription drug coverage shall include clozapine for emergency use outside of the standard refill utilization requirements, if requested by the subscriber or the subscriber's guardian. |
|---|
| 125 | 125 | | |
|---|
| 126 | 126 | | B. The health insurer shall establish criteria to proactively identify participating providers that may be underutilizing clozapine, including identifying prescribers who treat subscribers diagnosed with schizophrenia or schizoaffective disorder and who are not prescribing clozapine. participating providers who demonstrate poor clozapine utilization shall be notified, at a minimum, on a quarterly basis. |
|---|
| 127 | 127 | | |
|---|
| 128 | 128 | | C. The health insurer shall offer Clozapine-specific training for all participating providers who provide behavioral health treatment. The training shall include information regarding barriers to and the management of clozapine treatment, adherence to treatment protocols and side effects of clozapine treatment. |
|---|
| 129 | 129 | | |
|---|
| 130 | 130 | | D. In the delivery of care and services for subscribers with a serious mental illness designation or a serious emotional disturbance designation, the health insurer shall: |
|---|
| 131 | 131 | | |
|---|
| 132 | 132 | | 1. Offer in-home hematological monitoring, if requested by the subscriber, the subscriber's guardian or the subscriber's participating provider, including mobile phlebotomy services or a trained care manager to assist homebound subscribers with finger-stick testing of absolute neutrophil count. |
|---|
| 133 | 133 | | |
|---|
| 134 | 134 | | 2. Cover medication delivery or mail order medication services if the participating provider determines the service and delivery conditions are appropriate for the subscriber. |
|---|
| 135 | 135 | | |
|---|
| 136 | 136 | | 3. Provide a level of support services that accommodates additional medication assistance, including medication prompting, observation, administration and oversight of a subscriber's medication plan, as necessary, for a subscriber who is prescribed clozapine to ensure consistency and adherence, regardless of the subscriber's level of support for a serious mental illness designation or a serious emotional disturbance designation. These support services shall be provided to a subscriber who is being discharged from an inpatient facility, a behavioral health residential facility or any twenty-four-hour supervised program. |
|---|
| 137 | 137 | | |
|---|
| 138 | 138 | | E. The health insurer shall require a participating provider that is an inpatient behavioral health facility that has a pharmacy and that serves subscribers with psychiatric needs to maintain clozapine in stock.END_STATUTE |
|---|
| 139 | 139 | | |
|---|
| 140 | 140 | | Sec. 2. Title 31, chapter 1, article 4, Arizona Revised Statutes, is amended by adding section 31-166, to read: |
|---|
| 141 | 141 | | |
|---|
| 142 | 142 | | START_STATUTE31-166. Inmates with psychiatric disorders; clozapine; access; treatment protocols |
|---|
| 143 | 143 | | |
|---|
| 144 | 144 | | A county jail shall provide an inmate who is prescribed clozapine with access to clozapine and the related treatment protocols as prescribed in section 36-2903.17, subsection A, paragraphs 3, 4, 5, 6 and 8 and the training prescribed in section 36-2903.17, subsection C.END_STATUTE |
|---|
| 145 | 145 | | |
|---|
| 146 | 146 | | Sec. 3. Title 31, chapter 2, article 2, Arizona Revised Statutes, is amended by adding section 31-243, to read: |
|---|
| 147 | 147 | | |
|---|
| 148 | 148 | | START_STATUTE31-243. Inmates with psychiatric disorders; clozapine; access; treatment protocols |
|---|
| 149 | 149 | | |
|---|
| 150 | 150 | | The department or a private prison provider that is contracted by the department shall provide an inmate who is prescribed clozapine with access to clozapine and the related treatment protocols as prescribed in section 36-2903.17, subsection A, paragraphs 3, 4, 5, 6 and 8 and the training prescribed in section 36-2903.17, subsection C.END_STATUTE |
|---|
| 151 | 151 | | |
|---|
| 152 | 152 | | Sec. 4. Title 36, chapter 29, article 1, Arizona Revised Statutes, is amended by adding section 36-2903.17, to read: |
|---|
| 153 | 153 | | |
|---|
| 154 | 154 | | START_STATUTE36-2903.17. Clozapine; psychiatric disorders; access; treatment protocol; continuing education |
|---|
| 155 | 155 | | |
|---|
| 156 | 156 | | A. The administration and its contractors shall provide reimbursement for treatment and services that are unique to members who are prescribed clozapine, as follows: |
|---|
| 157 | 157 | | |
|---|
| 158 | 158 | | 1. Due to the inherent complexity of clozapine treatment, all psychiatric examinations of members who are prescribed clozapine may be billed at the highest level of complexity, and the administration or contractor may not restrict the number or frequency of psychiatric visits. |
|---|
| 159 | 159 | | |
|---|
| 160 | 160 | | 2. During the first twelve months that a member receives clozapine treatment, psychiatric examinations shall be reimbursed with an enhanced case rate that includes an additional thirty percent above the high complexity visit to compensate for administrative tasks and care management associated with additional laboratory testing and patient monitoring. |
|---|
| 161 | 161 | | |
|---|
| 162 | 162 | | 3. Medical weight management shall be provided to treat and prevent clozapine-induced weight gain and other metabolic disorders associated with clozapine treatment. |
|---|
| 163 | 163 | | |
|---|
| 164 | 164 | | 4. Specialty interventions, such as botulinum toxin injections in salivary glands, for refractory excessive salivation that does not respond to topical or oral treatments shall be provided, if necessary, including administration by a trained specialist and all necessary office visits. |
|---|
| 165 | 165 | | |
|---|
| 166 | 166 | | 5. A member who is prescribed clozapine shall have access to less-invasive means of hematological monitoring, such as finger-stick absolute neutrophil count devices, including individual devices for a member, if requested by the member or the member's guardian, as a reasonable accommodation for the member's disability. Clinical assistance and supplies associated with the administration of finger-stick patient monitoring shall be provided. |
|---|
| 167 | 167 | | |
|---|
| 168 | 168 | | 6. Mobile phlebotomy services shall be provided, if requested by the member or the member's guardian, for necessary hematological testing. |
|---|
| 169 | 169 | | |
|---|
| 170 | 170 | | 7. Genetic testing shall be provided, as necessary, to identify genes associated with benign ethnic neutropenia and genes linked to increased risk of clozapine-induced neutropenia and to guide hematological monitoring frequency and neutrophil parameters of members who are prescribed clozapine. |
|---|
| 171 | 171 | | |
|---|
| 172 | 172 | | 8. Prescription drug coverage shall include clozapine for emergency use outside of the standard refill utilization requirements, if requested by the member or the member's guardian. |
|---|
| 173 | 173 | | |
|---|
| 174 | 174 | | B. The administration and its contractors shall establish criteria to proactively identify health care facilities and providers that may be underutilizing clozapine, including identifying prescribers who treat members diagnosed with schizophrenia or schizoaffective disorder and who are not prescribing clozapine. Health care facilities and providers who demonstrate poor clozapine utilization shall be notified, at a minimum, on a quarterly basis. |
|---|
| 175 | 175 | | |
|---|
| 176 | 176 | | C. The administration shall offer Clozapine-specific training for all behavioral health providers who participate in the system. The training shall include information regarding barriers to and the management of clozapine treatment, adherence to treatment protocols and side effects of clozapine treatment. |
|---|
| 177 | 177 | | |
|---|
| 178 | 178 | | D. In the delivery of care and services for members with a serious mental illness designation or a serious emotional disturbance designation, the administration and its contracted regional behavioral health authorities shall: |
|---|
| 179 | 179 | | |
|---|
| 180 | 180 | | 1. Offer single-case agreements for non-title XIV members to receive services from private out-of-network providers who prescribe clozapine when medically necessary or to promote timely access to care, if the prescribing health professional is licensed in this state and is registered with the administration. |
|---|
| 181 | 181 | | |
|---|
| 182 | 182 | | 2. Designate all members who are prescribed clozapine as a special assistance member, unless the designation is declined by the member or member's guardian. |
|---|
| 183 | 183 | | |
|---|
| 184 | 184 | | 3. Offer in-home hematological monitoring, if requested by the member, the member's guardian or the member's health care provider, including mobile phlebotomy services or a trained care manager to assist homebound members with finger-stick testing of absolute neutrophil count. |
|---|
| 185 | 185 | | |
|---|
| 186 | 186 | | 4. Cover medication delivery or mail order medication services if the health care provider determines the service and delivery conditions are appropriate for the member. |
|---|
| 187 | 187 | | |
|---|
| 188 | 188 | | 5. Provide a level of support services that accommodates additional medication assistance, including medication prompting, observation, administration and oversight of a member's medication plan, as necessary, for a member who is prescribed clozapine to ensure consistency and adherence, regardless of the member's level of support for a serious mental illness designation or a serious emotional disturbance designation. These support services shall be provided to a member who is being discharged from an inpatient facility, a behavioral health residential facility or any twenty-four-hour supervised program. |
|---|
| 189 | 189 | | |
|---|
| 190 | 190 | | E. The administration and its contractors shall require any inpatient behavioral health facility that has a pharmacy and that serves members with psychiatric needs to maintain clozapine in stock. END_STATUTE |
|---|
| 191 | 191 | | |
|---|
| 192 | 192 | | Sec. 5. Section 36-2939, Arizona Revised Statutes, is amended to read: |
|---|
| 193 | 193 | | |
|---|
| 194 | 194 | | START_STATUTE36-2939. Long-term care system services; definition |
|---|
| 195 | 195 | | |
|---|
| 196 | 196 | | A. The following services shall be provided by the program contractors to members who are determined to need institutional services pursuant to this article: |
|---|
| 197 | 197 | | |
|---|
| 198 | 198 | | 1. Nursing facility services other than services in an institution for tuberculosis or mental disease. |
|---|
| 199 | 199 | | |
|---|
| 200 | 200 | | 2. Notwithstanding any other law, behavioral health services if these services are not duplicative of long-term care services provided as of January 30, 1993 under this subsection and are authorized by the program contractor through the long-term care case management system. If the administration is the program contractor, the administration may authorize these services. |
|---|
| 201 | 201 | | |
|---|
| 202 | 202 | | 3. Hospice services. For the purposes of this paragraph, "hospice" means a program of palliative and supportive care for terminally ill members and their families or caregivers. |
|---|
| 203 | 203 | | |
|---|
| 204 | 204 | | 4. Case management services as provided in section 36-2938. |
|---|
| 205 | 205 | | |
|---|
| 206 | 206 | | 5. Health and medical services as provided in section 36-2907. |
|---|
| 207 | 207 | | |
|---|
| 208 | 208 | | 6. Dental services as follows: |
|---|
| 209 | 209 | | |
|---|
| 210 | 210 | | (a) Except as provided in subdivision (b) of this paragraph, in an annual amount of not more than $1,000 per member. |
|---|
| 211 | 211 | | |
|---|
| 212 | 212 | | (b) Subject to approval by the centers for medicare and medicaid services, for persons treated at an Indian health service or tribal facility, adult dental services that are eligible for a federal medical assistance percentage of one hundred percent and that are in excess of the limit prescribed in subdivision (a) of this paragraph. |
|---|
| 213 | 213 | | |
|---|
| 214 | 214 | | 7. Clozapine access and Treatment protocols as prescribed in section 36-2903.17 for members who are prescribed clozapine. |
|---|
| 215 | 215 | | |
|---|
| 216 | 216 | | B. In addition to the services prescribed in subsection A of this section, the department, as a program contractor, shall provide the following services if appropriate to members who have a developmental disability as defined in section 36-551 and who are determined to need institutional services pursuant to this article: |
|---|
| 217 | 217 | | |
|---|
| 218 | 218 | | 1. Intermediate care facility services for a member who has a developmental disability as defined in section 36-551. For purposes of this article, a facility shall meet all federally approved standards and may only include the Arizona training program facilities, a state owned and operated service center, state owned or operated community residential settings and private facilities that contract with the department. |
|---|
| 219 | 219 | | |
|---|
| 220 | 220 | | 2. Home and community based services that may be provided in a member's home, at an alternative residential setting as prescribed in section 36-591 or at other behavioral health alternative residential facilities licensed by the department of health services and approved by the director of the Arizona health care cost containment system administration and that may include: |
|---|
| 221 | 221 | | |
|---|
| 222 | 222 | | (a) Home health, which means the provision of nursing services, licensed health aide services, home health aide services or medical supplies, equipment and appliances, that are provided on a part-time or intermittent basis by a licensed home health agency within a member's residence based on a physician's or allowed practitioner's orders and in accordance with federal law. Physical therapy, occupational therapy, or speech and audiology services provided by a home health agency may be provided in accordance with federal law. Home health agencies shall comply with federal bonding requirements in a manner prescribed by the administration. |
|---|
| 223 | 223 | | |
|---|
| 224 | 224 | | (b) Licensed health aide services, which means a home health agency service provided pursuant to subsection G of this section that is ordered by a physician or an allowed practitioner on the member's plan of care and provided by a licensed health aide who is licensed pursuant to title 32, chapter 15. |
|---|
| 225 | 225 | | |
|---|
| 226 | 226 | | (c) Home health aide, which means a service that provides intermittent health maintenance, continued treatment or monitoring of a health condition and supportive care for activities of daily living provided within a member's residence. |
|---|
| 227 | 227 | | |
|---|
| 228 | 228 | | (d) Homemaker, which means a service that provides assistance in the performance of activities related to household maintenance within a member's residence. |
|---|
| 229 | 229 | | |
|---|
| 230 | 230 | | (e) Personal care, which means a service that provides assistance to meet essential physical needs within a member's residence. |
|---|
| 231 | 231 | | |
|---|
| 232 | 232 | | (f) Day care for persons with developmental disabilities, which means a service that provides planned care supervision and activities, personal care, activities of daily living skills training and habilitation services in a group setting during a portion of a continuous twenty-four-hour period. |
|---|
| 233 | 233 | | |
|---|
| 234 | 234 | | (g) Habilitation, which means the provision of physical therapy, occupational therapy, speech or audiology services or training in independent living, special developmental skills, sensory-motor development, behavior intervention, and orientation and mobility in accordance with federal law. |
|---|
| 235 | 235 | | |
|---|
| 236 | 236 | | (h) Respite care, which means a service that provides short-term care and supervision available on a twenty-four-hour basis. |
|---|
| 237 | 237 | | |
|---|
| 238 | 238 | | (i) Transportation, which means a service that provides or assists in obtaining transportation for the member. |
|---|
| 239 | 239 | | |
|---|
| 240 | 240 | | (j) Other services or licensed or certified settings approved by the director. |
|---|
| 241 | 241 | | |
|---|
| 242 | 242 | | C. In addition to services prescribed in subsection A of this section, home and community based services may be provided in a member's home, in an adult foster care home as prescribed in section 36-401, in an assisted living home or assisted living center as defined in section 36-401 or in a level one or level two behavioral health alternative residential facility approved by the director by program contractors to all members who do not have a developmental disability as defined in section 36-551 and are determined to need institutional services pursuant to this article. Members residing in an assisted living center must be provided the choice of single occupancy. The director may also approve other licensed residential facilities as appropriate on a case-by-case basis for traumatic brain injured members. Home and community based services may include the following: |
|---|
| 243 | 243 | | |
|---|
| 244 | 244 | | 1. Home health, which means the provision of nursing services, home health aide services or medical supplies, equipment and appliances, that are provided on a part-time or intermittent basis by a licensed home health agency within a member's residence based on a physician's or allowed practitioner's orders and in accordance with federal law. Physical therapy, occupational therapy, or speech and audiology services provided by a home health agency may be provided in accordance with federal law. Home health agencies shall comply with federal bonding requirements in a manner prescribed by the administration. |
|---|
| 245 | 245 | | |
|---|
| 246 | 246 | | 2. Licensed health aide services, which means a home health agency service provided pursuant to subsection G of this section that is ordered by a physician or an allowed practitioner on the member's plan of care and provided by a licensed health aide who is licensed pursuant to title 32, chapter 15. |
|---|
| 247 | 247 | | |
|---|
| 248 | 248 | | 3. Home health aide, which means a service that provides intermittent health maintenance, continued treatment or monitoring of a health condition and supportive care for activities of daily living provided within a member's residence. |
|---|
| 249 | 249 | | |
|---|
| 250 | 250 | | 4. Homemaker, which means a service that provides assistance in the performance of activities related to household maintenance within a member's residence. |
|---|
| 251 | 251 | | |
|---|
| 252 | 252 | | 5. Personal care, which means a service that provides assistance to meet essential physical needs within a member's residence. |
|---|
| 253 | 253 | | |
|---|
| 254 | 254 | | 6. Adult day health, which means a service 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 may also include preventive, therapeutic and restorative health related services that do not include behavioral health services. |
|---|
| 255 | 255 | | |
|---|
| 256 | 256 | | 7. Habilitation, which means the provision of physical therapy, occupational therapy, speech or audiology services or training in independent living, special developmental skills, sensory-motor development, behavior intervention, and orientation and mobility in accordance with federal law. |
|---|
| 257 | 257 | | |
|---|
| 258 | 258 | | 8. Respite care, which means a service that provides short-term care and supervision available on a twenty-four-hour basis. |
|---|
| 259 | 259 | | |
|---|
| 260 | 260 | | 9. Transportation, which means a service that provides or assists in obtaining transportation for the member. |
|---|
| 261 | 261 | | |
|---|
| 262 | 262 | | 10. Home delivered meals, which means a service that provides for a nutritious meal that contains at least one-third of the recommended dietary allowance for an individual and that is delivered to the member's residence. |
|---|
| 263 | 263 | | |
|---|
| 264 | 264 | | 11. Other services or licensed or certified settings approved by the director. |
|---|
| 265 | 265 | | |
|---|
| 266 | 266 | | D. The amount of monies expended by program contractors on home and community based services pursuant to subsection C of this section shall be limited by the director in accordance with the federal monies made available to this state for home and community based services pursuant to subsection C of this section. The director shall establish methods for allocating monies for home and community based services to program contractors and shall monitor expenditures on home and community based services by program contractors. |
|---|
| 267 | 267 | | |
|---|
| 268 | 268 | | E. Notwithstanding subsections A, B, C, F and G of this section, a service may not be provided that does not qualify for federal monies available under title XIX of the social security act or the section 1115 waiver. |
|---|
| 269 | 269 | | |
|---|
| 270 | 270 | | F. In addition to services provided pursuant to subsections A, B and C of this section, the director may implement a demonstration project to provide home and community based services to special populations, including persons with disabilities who are eighteen years of age or younger, are medically fragile, reside at home and would be eligible for supplemental security income for the aged, blind or disabled or the state supplemental payment program, except for the amount of their parent's income or resources. In implementing this project, the director may provide for parental contributions for the care of their child. |
|---|
| 271 | 271 | | |
|---|
| 272 | 272 | | G. Consistent with the services provided pursuant to subsections A, B, C and F of this section and subject to approval by the centers for medicare and medicaid services, the director shall implement a program under which licensed health aide services may be provided to members who are under twenty-one years of age, who are eligible pursuant to section 36-2934, including members with developmental disabilities as defined in chapter 5.1, article 1 of this title, and who require continuous skilled nursing or skilled nursing respite care services. The licensed health aide services may be provided only by a parent, guardian or family member who is a licensed health aide employed by a medicare-certified home health agency service provider. Not later than sixty days after the approval of the rules implementing section 32-1645, subsection C, the director shall request any necessary approvals from the centers for medicare and medicaid services to implement this subsection and to qualify for federal monies available under title XIX of the social security act or the section 1115 waiver. The reimbursement rate for services provided under this subsection shall reflect the special skills needed to meet the health care needs of these members and shall exceed the reimbursement rate for home health aide services. |
|---|
| 273 | 273 | | |
|---|
| 274 | 274 | | H. Subject to section 36-562, the administration by rule shall prescribe a deductible schedule for programs provided to members who are eligible pursuant to subsection B of this section, except that the administration shall implement a deductible based on family income. In determining deductible amounts and whether a family is required to have deductibles, the department shall use adjusted gross income. Families whose adjusted gross income is at least four hundred percent and less than or equal to five hundred percent of the federal poverty guidelines shall have a deductible of two percent of adjusted gross income. Families whose adjusted gross income is more than five hundred percent of adjusted gross income shall have a deductible of four percent of adjusted gross income. Only families whose children are under eighteen years of age and who are members who are eligible pursuant to subsection B of this section may be required to have a deductible for services. For the purposes of this subsection, "deductible" means an amount a family, whose children are under eighteen years of age and who are members who are eligible pursuant to subsection B of this section, pays for services, other than departmental case management and acute care services, before the department will pay for services other than departmental case management and acute care services. |
|---|
| 275 | 275 | | |
|---|
| 276 | 276 | | I. For the purposes of this section, "allowed practitioner" means a nurse practitioner who is certified pursuant to title 32, chapter 15, a clinical nurse specialist who is certified pursuant to title 32, chapter 15 or a physician assistant who is certified pursuant to title 32, chapter 25.END_STATUTE |
|---|
| 277 | 277 | | |
|---|
| 278 | 278 | | Sec. 6. Section 36-3431, Arizona Revised Statutes, is amended to read: |
|---|
| 279 | 279 | | |
|---|
| 280 | 280 | | START_STATUTE36-3431. Comprehensive behavioral health service system for children; administration duties |
|---|
| 281 | 281 | | |
|---|
| 282 | 282 | | A. The administration shall develop and implement a comprehensive behavioral health service system for children that includes the following: |
|---|
| 283 | 283 | | |
|---|
| 284 | 284 | | 1. Annual needs assessment and resource assessment studies. |
|---|
| 285 | 285 | | |
|---|
| 286 | 286 | | 2. Annual planning to develop policy issues, programs and services. |
|---|
| 287 | 287 | | |
|---|
| 288 | 288 | | 3. Community education to increase public awareness of the needs of children. |
|---|
| 289 | 289 | | |
|---|
| 290 | 290 | | 4. Centralized and coordinated screening and intake. |
|---|
| 291 | 291 | | |
|---|
| 292 | 292 | | 5. Coordinated case management. |
|---|
| 293 | 293 | | |
|---|
| 294 | 294 | | 6. A continuum of treatment services, which may include the following: |
|---|
| 295 | 295 | | |
|---|
| 296 | 296 | | (a) Home-based services. |
|---|
| 297 | 297 | | |
|---|
| 298 | 298 | | (b) Prevention and early intervention. |
|---|
| 299 | 299 | | |
|---|
| 300 | 300 | | (c) Psychological evaluation and consultation. |
|---|
| 301 | 301 | | |
|---|
| 302 | 302 | | (d) Ancillary support services. |
|---|
| 303 | 303 | | |
|---|
| 304 | 304 | | (e) Crisis intervention. |
|---|
| 305 | 305 | | |
|---|
| 306 | 306 | | (f) Outpatient counseling. |
|---|
| 307 | 307 | | |
|---|
| 308 | 308 | | (g) Independent living services. |
|---|
| 309 | 309 | | |
|---|
| 310 | 310 | | (h) Secure residential treatment services for seriously emotionally disturbed children. |
|---|
| 311 | 311 | | |
|---|
| 312 | 312 | | (i) Residential treatment services for children's substance abuse. |
|---|
| 313 | 313 | | |
|---|
| 314 | 314 | | (j) Psychiatric hospitalization services. |
|---|
| 315 | 315 | | |
|---|
| 316 | 316 | | 7. Clozapine access and Treatment protocols as prescribed in section 36-2903.17 for children who are prescribed clozapine. |
|---|
| 317 | 317 | | |
|---|
| 318 | 318 | | 7. 8. Evaluation that determines both cost effectiveness and client outcome. |
|---|
| 319 | 319 | | |
|---|
| 320 | 320 | | B. Subject to legislative appropriation, the administration shall maintain the system identified in subsection A of this section. |
|---|
| 321 | 321 | | |
|---|
| 322 | 322 | | C. For the purposes of developing needs assessments and resource assessments and for planning, the administration may consult and coordinate with any state agency established for that purpose. END_STATUTE |
|---|