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HB2980 - 572R - I Ver
CORRECTED�� Feb 02 2026
REFERENCE TITLE:
home; community-based services; mental illness.
State of Arizona
House of Representatives
Fifty-seventh Legislature
Second Regular Session
2026
HB 2980
Introduced by
Representative
Carter P
AN
ACT
Amending title 36, chapter 29, Arizona
Revised Statutes, by adding article 3.1; relating to the Arizona health care
cost containment system.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it enacted by the Legislature of the State of Arizona:
Section 1. Title 36, chapter 29, Arizona
Revised Statutes, is amended by adding article 3.1, to read:
ARTICLE 3.1. HOME AND
COMMUNITY-BASED SERVICES FOR PERSONS
WITH SERIOUS MENTAL ILLNESS
START_STATUTE
36-2979.
Definitions
In this article, unless the context otherwise
requires:
1. "Administration" means
the Arizona health care cost containment system administration.
2. "Behavioral health
residential facility" means a health care institution that is licensed
pursuant to this title to provide level I or II behavioral health residential
services.
3. "High-acuity seriously
mentally ill individual" means a person who meets a serious mental illness
level of care and one or more priority criteria listed in section 36-2979.04,
subsection B.
4. "Home and community-based
services":
(
a
) means
services authorized under one or more medicaid state plan authorities, waivers
or demonstration authorities, including those authorized under 42 United States
Code section 1315 or 1396
n,
that support individuals in
the community as an alternative to institutionalization.
(
b
) includes
services that provide assistance with activities of daily living, medication
administration, supervision and structured supports comparable to assisted
living models.
5. "Member" means a person
who is enrolled in the program.
6. "Program" means the home
and community-based service program for adults who are seriously mentally
ill.
7. "Qualified income trust"
means a trust as described in 42 United States Code section 1396
p
(
d
)(4)(B).
8. "Seriously mentally ill"
has the meaning prescribed in section 36-550.
9. "Serious mental illness level
of care" means the behavioral health institutional level of care adopted
by the administration pursuant to section 36-2979.02.
END_STATUTE
START_STATUTE
36-2979.01.
Home and community-based service program for adults who are
seriously mentally ill; request for federal approval; stakeholder workgroup;
quarterly updates
A. The home and community-based
service program for adults who are seriously mentally ill is established.� The
administration shall develop and request authority from the centers for
medicare and medicaid services to implement a dedicated home and community-based
services benefit for adults who are determined to be seriously mentally ill.
B. The administration shall convene a
stakeholder workgroup that includes representatives from behavioral health
providers, family members, caregivers and guardians of individuals who are
seriously mentally ill, counties, tribal nations and community organizations to
advise on program design and implementation. Stakeholder input shall
specifically address the needs of individuals who require complex medication
management, enhanced monitoring and structured community-based supports,
including assisted living-type models, to promote medication continuity
and safety.
C. The administration shall request
approval from the centers for medicare and medicaid services for the program
not later than July 1, 2027 and shall begin implementing the program not later
than one year after the approval by the centers for medicare and medicaid
services.
D. Until the program is implemented,
the administration shall provide quarterly implementation updates to the
president of the senate, the speaker of the house of representatives and the
chairpersons of the senate and house of representatives health and human
services committees, or their successor committees.
END_STATUTE
START_STATUTE
36-2979.02.
Eligibility; financial eligibility; serious mental illness level
of care; criteria
A. To be eligible for the program, an
individual must meet all of the following:
1. have been determined to be
seriously mentally ill.
2. meet the serious mental illness
level of care adopted by the administration pursuant to subsection C of this
section.
3. require home and community-based
services in order to avoid placement in a behavioral health residential
facility or psychiatric institution.
4. meet the financial eligibility
requirements pursuant to subsection b of this section.
B. An individual who meets the
Serious mental illness level of care adopted by the administration pursuant to
subsection C of this section is financially eligible for the program if the
individual's income does not exceed three hundred percent of the federal
supplemental security income benefit rate. An individual whose
income exceeds this standard may establish a qualified income trust to achieve
eligibility. Resource and spousal impoverishment standards shall be
the same as required pursuant to article 2 of this chapter for enrollees in the
Arizona long-term care system home and community-based services.
C. The administration shall adopt a
serious mental illness level of care specific to individuals who are seriously
mentally ill that is based on behavioral, functional and safety criteria, which
may include any of the following:
1. Current or recent court-ordered
treatment.
2. Legal guardianship due to
psychiatric incapacity.
3. Recent discharge from a jail or
prison, the state hospital or a behavioral health residential facility.
4. Repeated psychiatric
hospitalizations or crisis episodes.
5. Impaired judgment, disorganization
or inability to perform activities of daily living due to psychiatric symptoms.
6. Documented safety risks, including
elopement, fire or water misuse, aggression, delusional behavior or
exploitation risk.
7. Homelessness or imminent risk of
homelessness.
8. High-intensity or complex
psychotropic medication regimens requiring enhanced monitoring to ensure
adherence and to identify potential adverse effects.
9. Clinical needs that necessitate
structured community-based supports, including assisted living-type
supports, to maintain continuity of medication therapy, such as those at
elevated risk of relapse, decompensation or hospitalization related to
medication nonadherence.
D. The Serious mental illness level
of care adopted pursuant to subsection C of this section may not require a
nursing facility level of care or physical disability or physical impairment
criteria and may not use a preadmission screening tool.
E. The administration may refine the
assessment criteria and processes through rule or policy, consistent with
legislative intent, including adjustment to assessment tools, thresholds or
processes.
END_STATUTE
START_STATUTE
36-2979.03.
Covered services; modification
A. Subject to the approval of the
centers for medicare and medicaid services, the administration shall provide
home and community-based services that are comparable to those authorized
under article 2 of this chapter, with modifications appropriate for behavioral
health needs.� The home and community-based services shall include:
1. Attendant care and personal care.
2. Habilitation with behavior
management.
3. Adult day health care with a
behavioral health focus.
4. Supervised community living
services, including assisted living-type supports.
5. Respite care.
6. Home-delivered meals.
7. Nursing, home health and
medication administration services.
8. Nonemergency transportation.
B. The administration shall establish
service descriptions and scope and staffing standards through rule or policy.
C. Home and community-based
services may be delivered in any residential setting authorized under state law
when an individual is subject to a valid court order, guardianship or involuntary
treatment authority pursuant to this title, if:
1. Medicaid reimbursement under this
article is limited to covered home and community-based services and does
not include room, board, supervision for custody or enforcement of court
orders.
2. The
individual is afforded periodic review and planning for transition to a less
restrictive setting when clinically appropriate.
D. The
administration may add, modify or combine services consistent with federal
approval and legislative intent.
END_STATUTE
START_STATUTE
36-2979.04.
Program capacity; priority; emergency placements
A. Subject to the approval of the
centers for medicare and medicaid services, enrollment in the program is
limited to five hundred members, including temporary emergency placements.
B. When capacity is limited, the
administration shall assign available slots based on the following order of
priority:
1. Individuals under court-ordered
treatment.
2. Individuals with legal
guardianship due to psychiatric incapacity.
3. Individuals discharged from a jail
or prison, the state hospital or a behavioral health residential facility.
4. Individuals who are homeless or at
imminent risk of homelessness.
5. Individuals with repeated crisis
episodes, psychiatric hospitalizations or public safety involvement.
6. Individuals presenting significant
safety risks due to psychiatric symptoms.
7. Individuals with high-intensity
or complex psychotropic medication regimens requiring enhanced monitoring to
ensure adherence and to identify potential adverse effects.
C. A court may recommend
participation in the program but may not compel the administration to exceed
the enrollment cap.
D. The administration may reserve a
portion of available capacity for emergency or priority placements.
END_STATUTE
START_STATUTE
36-2979.05.
Provider requirements; enhanced reimbursement rates
A. Providers shall document
behavioral interventions, crisis supports and staffing adjustments before
initiating discharge.
B. A provider that receives
reimbursement under the program shall implement eviction-prevention
protocols and obtain regional behavioral health authority approval before
issuing nonemergency notices to vacate.
C. The administration may adopt
enhanced reimbursement rates for high-acuity seriously mentally ill
individuals who are receiving home and community-based services.
D. This section does not limit the
administration's authority to ensure the health and safety of participants.
E. This section does not require a
provider to continue services when immediate and documented risks to health or
safety cannot be mitigated through reasonable clinical interventions.
END_STATUTE
START_STATUTE
36-2979.06.
Annual report
Beginning one
year after program implementation and each year thereafter, the administration
shall submit a report to the Governor, the President of the Senate and the
Speaker of the House of Representatives that includes:
1. The number of enrolled members and
the number of individuals who are on the waitlist.
2. The percentage of members who are
under court-ordered treatment, guardianship or criminal justice
supervision.
3. Housing stability outcomes for
members.
4. Hospitalization, crisis service
and jail utilization of members.
5. Provider denials and discharges
and the reasons for the denials and discharges of members.
6. The fiscal impact of and estimated
cost avoidance related to the program.
END_STATUTE
START_STATUTE
36-2979.07.
Authority to seek and maintain federal approval; rules
A
.
The
administration shall seek and maintain any necessary federal approvals and may
operate the program pursuant to one or more approved medicaid state plan
authorities, waivers or demonstration authorities, including those authorized
under 42 United States Code section 1315 or 1396
n
.
B. The administration shall adopt
rules to implement this article.
C. This article does not expand or
modify standards for involuntary treatment under this title.
END_STATUTE