HB4012 special needs patients; health facilities

Plain English Breakdown

The official text states that specific training requirements will be established by rules from the Department of Health Services, meaning some details may not be final until those rules are written.

HB4012: Cito's Law for Special Needs Patient Care

This law requires Arizona health facilities to use special tools, training, and staff support when treating patients who cannot speak or have disabilities that make it hard to show pain.

What This Bill Does

Requires doctors to do extra tests like blood work or scans if a nonverbal patient shows signs of serious illness.
Mandates the use of special tools and methods to check for pain in patients who cannot speak clearly.
Asks hospitals to get input from family members or caregivers about how a patient usually acts when hurt.
Requires annual training for hospital staff on recognizing symptoms, assessing pain, and communicating with these patients.
Creates a rule that facilities must offer social workers or patient advocates if the patient's family asks for them.

Who It Names or Affects

Hospitals, emergency rooms, urgent care centers, and other licensed medical facilities in Arizona.
Doctors, nurses, and staff who treat patients with special needs or nonverbal conditions.
Patients who have physical, developmental, intellectual, or sensory disabilities that affect communication.

Terms To Know

Nonverbal patient: A person who cannot speak because of a medical condition affecting their brain, body, or development.
Patient with special needs: Someone whose disability makes it hard for them to tell doctors about pain or symptoms.
Enhanced diagnostic evaluation: Extra medical tests, such as blood work or scans, used when a patient cannot clearly describe their illness.

Limits and Unknowns

The law does not say exactly which specific tools hospitals must use for pain assessment.
Doctors can skip certain test steps if they write down why it was medically safe to do so.
Patient advocates are only required when the patient or family asks for them.

Official Summary Text

HB4012 - special needs patients; health facilities

Current Bill Text

Read the full stored bill text

HB4012 - 572R - I Ver

REFERENCE TITLE:
special needs patients; health facilities

State of Arizona

House of Representatives

Fifty-seventh Legislature

Second Regular Session

2026

HB 4012

Introduced by

Representative
Crews

AN
ACT

Amending title 36, Arizona Revised
Statutes, by adding chapter 43; relating to patient care.

(TEXT OF BILL BEGINS ON NEXT PAGE)

Be it enacted by the Legislature of the State of Arizona:

Section 1. Title 36, Arizona Revised Statutes,
is amended by adding chapter 43, to read:

CHAPTER 43

PATIENTS WITH SPECIAL NEEDS

ARTICLE 1. GENERAL PROVISIONS

START_STATUTE
36-4301.

Definitions

In this chapter, unless the context otherwise
requires:

1. "Department" means the
department of health services.

2. "Health care facility"
means a hospital, emergency department, urgent care center or other medical
facility that is licensed and regulated pursuant to chapter 4 of this title.

3. "Health care provider"
means a licensed professional who is involved in direct patient care.

4. "Nonverbal patient"
means an individual who is unable to communicate verbally due to a
developmental, neurological, medical or physical condition.

5. "Patient Advocate" means
a trained individual who is designated by a health care facility to assist
nonverbal patients and patients with special needs during diagnostic and
treatment processes.

6. "Patient with special
needs" means an individual who has a physical, developmental, intellectual
or sensory disability that significantly affects the patient's ability to
communicate symptoms or pain.
END_STATUTE

START_STATUTE
36-4302.

Enhanced diagnostic evaluations; deviations

A. When a nonverbal patient or a
patient with special needs exhibits symptoms or behaviors that may indicate
serious internal illness or injury, a health care provider shall ensure that an
enhanced diagnostic evaluation is conducted, consistent with clinical judgment
and medically appropriate standards of care.� The evaluation may include, when
clinically indicated:

1. Laboratory testing, including
blood and urine studies.

2. Diagnostic imaging, including
ultrasound, computed tomography scan or magnetic resonance imaging.

3. Additional diagnostic testing
necessary to rule out serious conditions.

B. A health care provider may deviate
from specific diagnostic elements if the deviation is clinically justified and
documented in the patient's medical record.
END_STATUTE

START_STATUTE
36-4303.

Pain assessment; communication

A. EAch Health care facility shall
use evidence-based pain assessment tools that are appropriate for
nonverbal patients and patients with special needs.

B. Each health care provider shall
seek and document input from the family members or caregivers of nonverbal
patients or patients with special needs who are familiar with the patient's
baseline behavior and typical expressions of pain or distress.

C. Each health care facility shall
make reasonable efforts to provide appropriate communication supports,
including assistive communication tools or simplified communication methods.
END_STATUTE

START_STATUTE
36-4304.

Training requirements; rules

A. EAch health care facility shall
ensure that emergency department staff and other relevant personnel receive
annual training on all of the following relating to nonverbal patients and
patients with special needs:

1. Atypical symptom presentation.

2. Specialized pain assessment
methods.

3. Communication strategies and
sensory-sensitive care.

4. Application of enhanced diagnostic
evaluation principles.

B. The department shall establish in
rule the training requirements for health care facilities under this section.
END_STATUTE

START_STATUTE
36-4305.

Patient advocate program

Each health care facility in this state shall
provide access to social work or patient advocacy services for nonverbal
patients and patients with special needs, if requested. Social
workers and patient advocates shall assist with communication, support
caregiver involvement and promote compliance with this article.
END_STATUTE

START_STATUTE
36-4306.

Documentation; reporting

A. EAch health care facility shall
ensure that the medical records of nonverbal patients and patients with special
needs include documentation of diagnostic decisions, communication methods
used, caregiver input and any deviations from enhanced evaluation practices.

B. Each health care facility shall
submit annual compliance data to the department in a form prescribed by the
department.
END_STATUTE

START_STATUTE
36-4307.

Oversight and enforcement; rules

A. The department shall monitor
compliance with this article and may require corrective action or additional
training for health care facilities that are found to be noncompliant,
consistent with existing enforcement authority pursuant to chapter 4 of this
title.

B. The department shall adopt any
rules necessary to implement this article.
END_STATUTE

Sec. 2.
Short title

This act may be cited as "Cito's
Law".