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SB1242 - 572R - H Ver
House Engrossed
Senate Bill
mental health;
hearings; audiovisual technology
State of Arizona
Senate
Fifty-seventh Legislature
Second Regular Session
2026
SENATE BILL 1242
AN
ACT
Amending sections 36-501, 36-505,
36-539, 36-540, 36-543 and 36-550.09, Arizona Revised
Statutes; relating to mental health services.
(TEXT OF BILL BEGINS ON NEXT PAGE)
Be it
enacted by the Legislature of the State of Arizona:
Section 1. Section 36-501, Arizona Revised
Statutes, is amended to read:
START_STATUTE
36-501.
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.
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
the
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"
:
(
a
)
Means any of the following:
(a)
(
i
)
The state hospital.
(b)
(
ii
)
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)
(
iii
)
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.
(
b
) Does not
include a secure behavioral health residential facility that provides services
only to persons placed in the facility pursuant to a court order issued
pursuant to section 36-550.09.
29. "Outpatient treatment" or
"combined inpatient and outpatient treatment" means any treatment
program
that does
not
requiring
require
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 36-505, Arizona Revised
Statutes, is amended to read:
START_STATUTE
36-505.
Rights at hearing; virtual proceedings
A.
At all hearings conducted
pursuant to this chapter, persons shall have the right to an analysis of their
psychological condition by an independent evaluator.
B. In any proceeding held pursuant to
this chapter, the court, on its own or for good cause shown by a party, may
order the hearing to be conducted or
may allow a witness
or party to appear and give testimony virtually through the use of telephone,
videoconferencing or other audiovisual technology if the court finds that this
procedure will not unfairly prejudice a party or witness. In
determining whether a proceeding should be conducted wholly or partially with
the use of telephone, videoconferencing or other audiovisual technology, the
court shall consider the inconvenience to or burden on a party or witness to
attend the proceeding in person and the ability of all parties to be heard by
other parties in attendance, including the judicial officer and, if applicable,
the certified reporter or an electronic recording system.� The supreme court
may adopt rules to govern the procedures to be used in conducting proceedings
virtually pursuant to this chapter.
END_STATUTE
Sec. 3. Section 36-539, Arizona Revised
Statutes, is amended to read:
START_STATUTE
36-539.
Conduct of hearing; record; transcript
A. The medical director of the evaluation agency
shall issue instructions to the physicians or the psychiatric and mental health
nurse practitioner of the evaluation agency who is treating the proposed
patient to take all reasonable precautions to ensure that at the time of the
hearing the proposed patient is not so under the influence of or does not so
suffer the effects of drugs, medication or other treatment as to be hampered in
preparing for or participating in the hearing. If the proposed
patient is being treated as an inpatient by the evaluation agency, the court at
the time of the hearing shall be presented a record of all drugs, medication or
other treatment that the person has received during the seventy-two hours
immediately before the hearing.
B. The patient and the patient's attorney shall be
present at all hearings, and the patient's attorney may subpoena and cross-examine
witnesses and present evidence.
The court, for good
cause shown, may allow the patient, the patient's attorney or any witness to
appear and present testimony in open court through the use of telephone,
videoconferencing or other audiovisual technology.
The
patient may choose to not attend the hearing or the patient's attorney may
waive the patient's presence. The evidence presented by the
petitioner or the patient shall include the testimony of two or more witnesses,
regardless of the witnesses' professional licensure, if any, who observed or
were acquainted with the patient at the time of the alleged mental disorder before
the submission of the current application for evaluation pursuant to section 36-520
or, if after the submission of the current application, who were not formal
participants in the evaluation process. The testimony of the witnesses shall be
limited to observed facts and may not include expert opinion or
conclusions. The witness testimony may be satisfied by a statement
agreed on by the parties and testimony of the two physicians or other health
professionals who participated in the evaluation of the patient pursuant to
section 36-533, which may be satisfied by stipulating to the admission of
the affidavits as required pursuant to section 36-533, subsection
B. The evaluating physicians or other health professionals shall
testify as to their personal observations of the patient. They shall
also testify as to their opinions concerning whether the patient is, as a
result of mental disorder, a danger to self or to others or has a persistent or
acute disability or a grave disability and as to whether the patient requires
treatment. Such testimony shall state specifically the nature and
extent of the danger to self or to others, the persistent or acute disability
or the grave disability. If the patient has a grave disability, the
evaluating physicians or other health professionals shall testify concerning
the need for guardianship or conservatorship, or both, and whether or not the
need is for immediate appointment. Other persons who have
participated in the evaluation of the patient or, if further treatment was
requested by a mental health treatment agency, persons of that agency who are
directly involved in the care of the patient shall testify at the request of
the court or of the patient's attorney. Witnesses shall testify as to placement
alternatives appropriate and available for the care and treatment of the
patient. The clinical record of the patient for the current
admission shall be available and may be presented in full or in part as
evidence at the request of the court, the county attorney or the patient's
attorney.
C. If the patient, for medical or psychiatric
reasons, is unable to be present at the hearing and cannot appear by other
reasonably feasible means, the court shall require clear and convincing
evidence that the patient is unable to be present at the hearing and on such a
finding may proceed with the hearing in the patient's absence.
D. The requirements of subsection B of this section
are in addition to all rules of evidence and the Arizona rules of civil
procedure, not inconsistent with subsection B of this section.
E. A verbatim record of all proceedings under this
section shall be made by stenographic means by a court reporter if a written
request for a court reporter is made by any party to the proceedings at least
twenty-four hours in advance of such proceedings. If
stenographic means are not requested in the manner provided by this subsection,
electronic means shall be directed by the presiding judge. The
stenographic notes or electronic tape shall be retained as provided by statute.
F. A patient who has been ordered to undergo
treatment may request a certified transcript of the hearing. To
obtain a copy, the patient shall pay for a transcript or shall file an
affidavit that the patient is without means to pay for a
transcript. If the affidavit is found true by the court, the expense
of the transcript is a charge on the county in which the proceedings were held,
or, if an intergovernmental agreement by the counties has required evaluation
in a county other than that of the patient's residence, such expense may be
charged to the county of the patient's residence or in which the patient was
found before evaluation.
END_STATUTE
Sec. 4. Section 36-540, Arizona Revised
Statutes, is amended to read:
START_STATUTE
36-540.
Court options; immunity; rules
A. If the court finds by clear and convincing
evidence that the proposed patient, as a result of mental disorder, is a danger
to self, is a danger to others or has a persistent or acute disability or a
grave disability and is in need of treatment, and is either unwilling or unable
to accept voluntary treatment, the court shall order the patient to undergo one
of the following:
1. Treatment in a program of outpatient treatment.
2. Treatment in a program consisting of combined
inpatient and outpatient treatment.
3. Inpatient treatment in a mental health treatment
agency, in a hospital operated by or under contract with the United States
department of veterans affairs to provide treatment to eligible veterans
pursuant to article 9 of this chapter, in the state hospital or in a private
hospital, if the private hospital agrees, subject to the limitations of section
36-541.
B. The court shall consider all available and
appropriate alternatives for the treatment and care of the patient. The court
shall order the least restrictive treatment alternative available.
C. The court may order the proposed patient to
undergo outpatient
treatment
or combined inpatient and outpatient treatment pursuant to subsection A,
paragraph 1 or 2 of this section if the court:
1. Determines that all of the following apply:
(a) The patient does not require continuous
inpatient hospitalization.
(b) The patient will be more appropriately treated
in an outpatient treatment program or in a combined inpatient and outpatient
treatment program.
(c) The patient will follow a prescribed outpatient
treatment plan.
(d) The patient will not likely become dangerous or
suffer more serious physical harm or serious illness or further deterioration
if the patient follows a prescribed outpatient treatment plan.
2. Is presented with and approves a written
treatment plan that conforms with the requirements of section 36-540.01,
subsection B.
If the court determines that the patient
meets the requirements of section 36-550.09, the court may order the
patient to be placed in a secure behavioral health residential facility that is
licensed by the department pursuant to section 36-425.06.
� If the
treatment plan presented to the court pursuant to this subsection provides for
supervision of the patient under court order by a mental health
treatment
agency that is other than the mental health
treatment
agency that petitioned or requested the county attorney to petition the court
for treatment pursuant to section 36-531, the treatment plan must be
approved by the medical director of the mental health
treatment
agency that will supervise the treatment pursuant to subsection E of this
section.
D. An order to receive treatment pursuant to
subsection A, paragraph 1 or 2 of this section shall not exceed three hundred
sixty-five days. The period of inpatient treatment under a
combined
inpatient and outpatient
treatment order
pursuant to subsection A, paragraph 2 of this section shall not exceed the
maximum period allowed for an order for inpatient treatment pursuant to
subsection F of this section.
E. If the court enters an order for treatment
pursuant to subsection A, paragraph 1 or 2 of this section, all of the
following apply:
1. The court shall designate the medical director of
the mental health treatment agency that will supervise and administer the
patient's treatment program.
2. The medical director
of the mental
health treatment agency
shall not use the services of any person, agency
or organization to supervise a patient's outpatient treatment program unless
the person, agency or organization has agreed to provide these services in the
individual patient's case and unless the department has determined that the
person, agency or organization is capable and competent to do so.
3. The person, agency or organization assigned to
supervise an outpatient treatment program or the outpatient portion of a
combined
inpatient and outpatient
treatment program shall
be notified at least three days before a referral. The medical director
of the mental health treatment agency
making the referral and
the person, agency or organization assigned to supervise the treatment program
shall share relevant information about the patient to provide continuity of
treatment.
4. The court may order the medical director
of the mental health treatment agency
to provide notice to the
court of any noncompliance with the terms of a treatment order.
5. If the court determines that the
patient meets the requirements of section 36-550.09 and orders the
patient to be placed in a secure behavioral health residential facility that is
licensed by the department pursuant to section 36-425.06, the mental
health treatment agency that will supervise the treatment pursuant to this
subsection and the secure behavioral health residential facility shall
coordinate the care of the patient pursuant to rules adopted by the department
or as required by the administration.
5.
6.
During
any period of outpatient treatment under subsection A, paragraph 2 of this
section, if the court, on its own motion, on request of a guardian pursuant to
paragraph
7
8
of this
subsection or on motion by the medical director of the patient's outpatient
mental health treatment facility, determines that the patient is not complying
with the terms of the order or that the outpatient treatment plan is no longer
appropriate and the patient needs inpatient treatment, the court, without a
hearing and based on the court record, the patient's medical record, the
affidavits and recommendations of the medical director
of the mental health treatment agency
, and the advice of staff
and physicians or the psychiatric and mental health nurse practitioner familiar
with the treatment of the patient, may enter an order amending its original
order. The amended order may alter the outpatient treatment plan or order the
patient to inpatient treatment pursuant to subsection A, paragraph 3 of this
section. The amended order shall not increase the total period of commitment
originally ordered by the court or, when added to the period of inpatient
treatment provided by the original order and any other amended orders, exceed
the maximum period allowed for an order for inpatient treatment pursuant to
subsection F of this section. If the patient refuses to comply with
an amended order for inpatient treatment, the court, on its own motion or on
the request of the medical director
of the
mental health treatment agency
, may authorize and direct a peace officer
to take the patient into protective custody and transport the patient to the
mental health treatment
agency for inpatient
treatment. Any authorization, directive or order issued to a peace
officer to take the patient into protective custody shall include the patient's
criminal history and the name and telephone numbers of the patient's case
manager, guardian, spouse, next of kin or significant other, as applicable.
When reporting to or being returned to a
mental health
treatment
agency for inpatient treatment pursuant to an amended order, the patient shall
be informed of the patient's right to judicial review and the patient's right
to consult with counsel pursuant to section 36-546.
6.
7.
During
any period of outpatient treatment under subsection A, paragraph 2 of this
section, if the medical director of the outpatient treatment facility in charge
of the patient's care determines, in concert with the medical director of an
inpatient mental health treatment facility who has agreed to accept the
patient, that the patient is in need of immediate acute inpatient psychiatric
care because of behavior that is dangerous to self or to others, the medical
director of the outpatient treatment facility may order a peace officer to
apprehend and transport the patient to the inpatient treatment facility pending
a court determination on an amended order under paragraph
5
6
of this subsection. The patient may be detained and
treated at the inpatient treatment facility for a period of not more than forty-eight
hours,
exclusive of
excluding
weekends
and holidays, from the time that the patient is taken to the inpatient
treatment facility. The medical director of the outpatient treatment
facility shall file the motion for an amended court order requesting inpatient
treatment not later than the next working day following the patient being taken
to the inpatient treatment facility. Any period of detention within the
inpatient treatment facility pending issuance of an amended order shall not
increase the total period of commitment originally ordered by the court or,
when added to the period of inpatient treatment provided by the original order
and any other amended orders, exceed the maximum period allowed for an order
for inpatient treatment pursuant to subsection F of this section. If
a patient is ordered to undergo inpatient treatment pursuant to an amended
order, the medical director of the outpatient treatment facility shall inform
the patient of the patient's right to judicial review and to consult with an
attorney pursuant to section 36-546.
7.
8.
If
there is a court order for treatment and a guardianship with additional mental
health authority pursuant to section 14-5312.01 existing at the same
time, the treatment and placement decisions made by the
mental
health
treatment agency assigned by the court to supervise and
administer the patient's treatment program pursuant to the court order for
treatment are controlling unless the court orders otherwise. During
any period of outpatient treatment, the guardian of a patient may file a report
with the court that addresses whether the patient is complying with the terms
of the order, whether the outpatient treatment plan is still appropriate and
whether the patient needs inpatient treatment.� The report shall state in
detail the facts on which the guardian relies and may include other supporting
documents. A copy of the report and other supporting documents shall
be given to the patient's attorney and the outpatient
mental
health
treatment agency. After reviewing the report and any
supporting documents filed with the report, if the court determines that there
is reasonable cause to believe that the patient is not complying with the terms
of the order, that the outpatient treatment plan is no longer appropriate or
that the patient needs inpatient treatment, the court must set a conference or
a hearing or take other action described in paragraph
5
6
of this subsection.
F. The maximum periods of inpatient treatment that
the court may order, subject to the limitations of section 36-541,
subsection D, are as follows:
1. Ninety days for a person found to be a danger to
self.
2. One hundred eighty days for a person found to be
a danger to others.
3. One hundred eighty days for a person found to
have a persistent or acute disability.
4. Three hundred sixty-five days for a person
found to have a grave disability.
G. If, on finding that the patient meets the
criteria for court-ordered treatment pursuant to subsection A of this
section, the court also finds that there is reasonable cause to believe that
the patient is an incapacitated person as defined in section 14-5101 or
is a person in need of protection pursuant to section 14-5401 and that
the patient is or may be in need of guardianship or conservatorship, or both,
the court may order an investigation concerning the need for a guardian or
conservator, or both, and may appoint a suitable person or agency to conduct
the investigation. The appointee may include a court-appointed
guardian ad litem, an investigator appointed pursuant to section 14-5308
or the public fiduciary if there is no person willing and qualified to act in
that capacity.� The court shall give notice of the appointment to the appointee
within three days after the appointment. The appointee shall submit
the report of the investigation to the court within twenty-one
days. The report shall include recommendations as to who should be
guardian or who should be conservator, or both, and a report of the findings
and reasons for the recommendation. If the investigation and report
so indicate, the court shall order the appropriate person to submit a petition
to become the guardian or conservator, or both, of the patient.
H. In any proceeding for court-ordered
treatment in which the petition alleges that the patient is in need of a
guardian or conservator and states the grounds for that allegation, the court
may appoint an emergency temporary guardian or conservator, or both, for a
specific purpose or purposes identified in its order and for a specific period
of time not to exceed thirty days if the court finds that all of the following
are true:
1. The patient meets the criteria for court-ordered
treatment pursuant to subsection A of this section.
2. There is reasonable cause to believe that the
patient is an incapacitated person as defined in section 14-5101 or is in
need of protection pursuant to section 14-5401, paragraph 2.
3. The patient does not have a guardian or
conservator and the welfare of the patient requires immediate action to protect
the patient or the ward's property.
4. The conditions prescribed pursuant to section 14-5310,
subsection B or section 14-5401.01, subsection B have been met.
I. The court may appoint as a temporary guardian or
conservator pursuant to subsection H of this section a suitable person or the
public fiduciary if there is no person qualified and willing to act in that
capacity. The court shall issue an order for an investigation as
prescribed pursuant to subsection G of this section and, unless the patient is
represented by independent counsel, the court shall appoint an attorney to
represent the patient in further proceedings regarding the appointment of a
guardian or conservator. The court shall schedule a further hearing
within fourteen days on the appropriate court calendar of a court that has
authority over guardianship or conservatorship matters pursuant to this title
to consider the continued need for an emergency temporary guardian or
conservator and the appropriateness of the temporary guardian or conservator
appointed, and shall order the appointed guardian or conservator to give notice
to persons entitled to notice pursuant to section 14-5309, subsection A or
section 14-5405, subsection A. The court shall authorize
certified letters of temporary emergency guardianship or conservatorship to be
issued on presentation of a copy of the court's order. If a
temporary emergency conservator other than the public fiduciary is appointed
pursuant to this subsection, the court shall order that the use of the monies
and property of the patient by the conservator be restricted and not be sold,
used, transferred or encumbered, except that the court may authorize the conservator
to use monies or property of the patient specifically identified as needed to
pay an expense to provide for the care, treatment or welfare of the patient
pending further hearing. This subsection and subsection H of this section do
not:
1. Prevent the evaluation
agency
or
mental health
treatment agency from seeking
guardianship and conservatorship in any other manner allowed by law at any time
during the period of court-ordered evaluation and treatment.
2. Relieve the evaluation
agency
or
mental health
treatment agency from its obligations
concerning the suspected abuse of a vulnerable adult pursuant to title 46,
chapter 4.
J. If, on finding that a patient meets the criteria
for court-ordered treatment pursuant to subsection A of this section, the
court also learns that the patient has a guardian appointed under title 14, the
court with notice may impose on the existing guardian additional duties
pursuant to section 14-5312.01. If the court imposes
additional duties on an existing guardian as prescribed in this subsection, the
court may determine that the patient needs to continue treatment under a court
order for treatment and may issue the order or determine that the patient's
needs can be adequately met by the guardian with the additional duties pursuant
to section 14-5312.01 and decline to issue the court order for
treatment. If at any time after the issuance of a court order for
treatment the court finds that the patient's needs can be adequately met by the
guardian with the additional duties pursuant to section 14-5312.01 and
that a court order for treatment is no longer necessary to ensure compliance
with necessary treatment, the court may terminate the court order for
treatment.
K. The court shall file a report as part of the
court record on its findings of alternatives for treatment.
L. Treatment shall not include psychosurgery,
lobotomy or any other brain surgery without specific informed consent of the
patient or the patient's legal guardian and an order of the superior court in
the county in which the treatment is proposed, approving with specificity the
use of the treatment.
M. The medical director
of a mental
health treatment agency
or any person, agency or organization used by
the medical director
of a mental health treatment agency
to supervise the terms of an outpatient treatment plan is not civilly liable
for any acts committed by a patient while on outpatient treatment if the
medical director
of the mental health treatment agency
,
person, agency or organization has in good faith followed the requirements of
this section.
N. A peace officer who in good faith apprehends and
transports a patient to an inpatient treatment facility on the order of the
medical director of the outpatient treatment facility pursuant to subsection E,
paragraph
6
7
of this section
is not subject to civil liability.
O. If a person has been found, as a result of a
mental disorder, to constitute a danger to self or others or to have a
persistent or acute disability or a grave disability and the court enters an
order for treatment pursuant to subsection A of this section, the court shall
transmit the person's name, sex, date of birth, social security number, if
available, and date of the order for treatment to the supreme court. The
supreme court shall transmit the information to the department of public safety
to comply with the requirements of title 13, chapter 31 and title 32, chapter
26. The department of public safety shall transmit the information
to the national instant criminal background check system. The superior court
may access the information of a person who is ordered into treatment to enforce
or facilitate a treatment order.
P. On request, the clerk of the court shall provide
certified copies of the commitment order to a law enforcement or prosecuting
agency that is investigating or prosecuting a prohibited possessor as defined
in section 13-3101.
Q. If the court does not find a person to be in need
of treatment and a prosecutor filed a petition pursuant to section 13-4517,
the evaluation agency, within twenty-four hours, shall notify the
prosecuting agency of its finding. The court shall order the medical
director
of the evaluation agency
to detain the person
for an additional twenty-four hours to allow the prosecuting agency to be
notified. If the court has retained jurisdiction pursuant to section
13-4517, subsection C, the court may remand the person to the custody of
the sheriff for further disposition pursuant to section 13-4517,
subsection A, paragraph 2 or 3.
R. After an order for treatment has been issued
pursuant to this section, the superior court in a county where a patient under
a court order for treatment is found or resides has concurrent jurisdiction
with the court in the county that issued the court order for treatment for the
purposes of enforcing the court order for treatment, ordering changes to the
treatment plan or amending the order to require the patient to undergo further
inpatient treatment. If the court in which proceedings are commenced
to enforce or administer the order for treatment is not the court that
originally entered the order for treatment, unless prevented by an emergency,
the court in which the proceedings are pending shall consult with the court of
original entry and determine whether to hold hearings and enter orders to
facilitate enforcement or administration of the court order, whether to refer
the case back to the court of original entry for further proceedings or whether
to transfer the entire case to the court of original entry in that county for
all further proceedings. The supreme court may adopt rules to govern the
procedures to be used in enforcing and administering court orders for treatment
in the various counties of this state and the transfer of cases between counties
involving court orders for treatment.
S. Pursuant to the authority granted in subsection R
of this section, for the purpose of enforcing or facilitating treatment of a
patient under an active order for treatment, the supreme court shall adopt a
rule to establish a program to enable the judges of the superior court, county
attorneys, patients' attorneys, health care institutions as defined in section
36-401 that provide services subject to the emergency medical treatment
and labor act (P.L. 99-272; 100 Stat. 164; 42 United States Code section
1395dd),
the regional behavioral health
authority and behavioral health service providers in any county to determine
the existence of an active court order for treatment and the history of court
orders for treatment entered for a patient by a superior court in any county in
this state. The program shall ensure that the information shared with other
persons or entities is necessary only for the purposes stated in this
subsection and shall require that the information shared be maintained as
confidential by the receiving person or entity.
END_STATUTE
Sec. 5. Section 36-543, Arizona Revised
Statutes, is amended to read:
START_STATUTE
36-543.
Annual review; patients with a grave disability or a persistent
or acute disability; notice; court order for continued treatment; rules;
immunity
A. Within ninety days before the expiration of a
court order for treatment, the medical director of the mental health treatment
agency shall conduct an annual review of a patient who has been found to have a
grave disability or a persistent or acute disability and who is undergoing
court-ordered treatment to determine whether the continuation of court-ordered
treatment is appropriate and to assess the needs of the patient for
guardianship or conservatorship, or both. The annual review shall
consist of the mental health treatment and clinical records contained in the
patient's treatment file.� The mental health treatment agency shall keep a
record of the annual review. If the medical director
of the mental health treatment agency
believes that a continuation of
court-ordered treatment is appropriate, the medical director of the
mental health treatment agency shall appoint one or more psychiatrists to carry
out a psychiatric examination of the patient. In any proceeding
conducted pursuant to this section, a patient has the right to have an analysis
of the patient's mental condition by an independent evaluation pursuant to
section 36-538.
B. Each examiner participating in the psychiatric
examination of the patient shall submit a report to the medical director of the
mental health treatment agency that includes the following:
1. The examiner's opinions as to whether the patient
continues to have a grave disability or a persistent or acute disability as the
result of a mental disorder and be in need of continued court-ordered
treatment. In evaluating the patient's need for continued court-ordered
treatment, the examiner must consider, along with all other evidence, the
patient's history before and during the current period of court-ordered
treatment, the patient's compliance with recommended treatment and any other
evidence relevant to the patient's ability and willingness to follow
recommended treatment with or without a court order.
2. A statement as to whether suitable alternatives
to court-ordered treatment are available.
3. A statement as to whether voluntary treatment
would be appropriate.
4. A review of the patient's status as to
guardianship or conservatorship, or both, the adequacy of existing protections
of the patient and the continued need for guardianship or conservatorship, or both. If
the examiner concludes that the patient's needs in these areas are not being
adequately met, the examiner's report shall recommend that the court order an
investigation into the patient's needs.
5. If the patient has an existing guardian who does
not have the mental health powers authorized pursuant to section 14-5312.01,
a recommendation as to whether the additional mental health powers authorized
by section 14-5312.01 should be imposed on the existing guardian and
whether the patient's needs can be adequately addressed by a guardian with
mental health powers without the need for a court order for treatment or
whether the court order for treatment should continue regardless of the
additional mental health powers imposed on the guardian.
6. The results of any physical examination conducted
during the period of court-ordered treatment if relevant to the
psychiatric condition of the patient.
C. After conducting the annual review as prescribed
in this section, if the medical director
of the mental health
treatment agency
believes that continued court-ordered treatment
is necessary or appropriate, not later than thirty days before the expiration
of the court order for treatment, the medical director
of the
mental health treatment agency
shall file with the court an application
for continued court-ordered treatment alleging the basis for the
application and shall file simultaneously with the application any psychiatric
examination conducted as part of the annual review. If the patient
is under guardianship, the medical director
of the mental health
treatment agency
shall mail a copy of the application to the patient's
guardian.
D. If an application for continued court-ordered
treatment is filed, all of the following apply:
1. If the patient does not have an attorney, the
court shall appoint an attorney to represent the patient.
2. Within ten days after appointment, an attorney
appointed pursuant to this subsection, to the extent possible, shall fulfill
the duties imposed pursuant to section 36-537, review the
medical
director's
report
of the medical director of the mental
health treatment agency
and the patient's medical records, interview any
physician who prepared a report on the annual review and file a response
requesting a hearing or submitting the matter to the court for a ruling based
on the record without a hearing.
3. If a hearing is not requested, the court shall
rule on the application or set the matter for hearing. If a hearing is
requested, the hearing shall be held within three weeks after the request for
hearing is filed. The hearing may be continued for good cause on motion of a
party or on the court's own motion, and the expiration of the current court
order for treatment may be extended until a ruling by the court on an
application filed pursuant to this subsection.
4. The patient's attorney must be present at all
hearings and may subpoena and cross-examine witnesses and present
evidence. The patient has the right to attend all hearings, but may
choose not to attend a hearing.� The patient's attorney may waive the patient's
presence after speaking with the patient and confirming that the patient
understands the right to be present and does not desire to
attend. If the patient is unable to be present at the hearing for
medical or psychiatric reasons and the hearing cannot be conducted where the
patient is being treated or confined, or the patient cannot appear by another
reasonably feasible means, the court shall require clear and convincing
evidence that the patient is unable to be present at the hearing and on such a
finding may proceed with the hearing in the patient's absence.
5. The evidence presented by the applicant includes
the testimony of one or more witnesses acquainted with the patient during the
period of court-ordered treatment, which may be satisfied by a statement
agreed on by the parties, and the testimony of any physician who performed an
annual review of the patient, which may be satisfied by stipulating to the
admission of the examining physicians' written report prepared pursuant to
subsection B of this section. The court may waive the need for the
applicant to present the testimony of witnesses acquainted with the patient as
required by this subsection, if it finds that the need for a continued court
order for treatment has been established by clear and convincing evidence from
the other testimony and evidence presented at the hearing.
� The
court, for good cause shown, may allow the patient, the patient's attorney or
any witness to appear and present testimony in open court through the use of
telephone, videoconferencing or other audiovisual technology.
6. At a hearing held pursuant to this subsection,
the court, with notice, may impose on an existing guardian additional powers
pursuant to section 14-5312.01. If the court finds that the
patient's needs can be adequately met by an existing guardian with the
additional powers pursuant to section 14-5312.01 and that a court order
for treatment is not necessary to ensure compliance with necessary treatment,
the court may terminate the court order for treatment or decline to issue an
order continuing court-ordered treatment. The court may also order
an investigation into the need for guardianship or conservatorship, or both,
and may appoint a suitable person or agency to conduct the investigation. The
appointee may include a court-appointed guardian ad litem, a court-appointed
investigator pursuant to section 14-5308 or the public fiduciary if there
is no person willing and qualified to act in that capacity. The
court shall give notice of the appointment to the appointee within three days
after the appointment. The appointee shall submit the report of the
investigation to the court within twenty-one days. The report
shall include recommendations as to who should be guardian or conservator, or
both, and the findings and reasons for the recommendation. If the investigation
and report so indicate, the court may authorize an appropriate person to file a
petition for appointment of a guardian or conservator for the patient.
E. If a hearing is held pursuant to subsection D of
this section, the party seeking the renewal of the court order must prove all
of the following by clear and convincing evidence:
1. The patient continues to have a mental disorder
and, as a result of that disorder, has either a persistent or acute disability
or a grave disability.
2. The patient is in need of continued court-ordered
treatment.
3. The patient is either unwilling or unable to
accept treatment voluntarily.
F. After a hearing held pursuant to subsection D of
this section, the court may order the patient to be released from court-ordered
treatment or to undergo continued court-ordered treatment for a period not to
exceed the time periods prescribed in section 36-540, subsection D.
G. The director shall create and operate a program
to ensure that the examination and review of persons with grave disabilities or
persistent or acute disabilities under court order are carried out in an
effective and timely manner. The director shall adopt rules needed
to operate this program.
H. The medical director of the mental health
treatment agency is not civilly liable for any acts committed by the released
patient if the medical director
of the mental health treatment
agency
has in good faith complied with the requirements of this article.
END_STATUTE
Sec. 6. Section 36-550.09, Arizona Revised
Statutes, is amended to read:
START_STATUTE
36-550.09.
Secure behavioral health residential facilities; court
determination; findings
A. If a court finds that a patient meets the
criteria for court-ordered treatment pursuant to section 36-540,
subsection A, the court may approve the patient's placement in a secure
behavioral health residential facility that is licensed by the department
pursuant to section 36-425.06 and that is willing to accept the patient
if the patient has been determined to be seriously mentally ill and the court
finds that the patient is chronically resistant to treatment as set forth in
this section. Placement in a
licensed
secure
behavioral health residential facility for treatment is not a period of
inpatient treatment for the purposes of section 36-540, subsection F.
B. A court may determine that a person is
chronically resistant to treatment if the court finds that, within twenty-four
months before the issuance of a court order pursuant to this section, excluding
any time during this period that the person was hospitalized or incarcerated,
the person demonstrated a persistent or recurrent unwillingness or inability to
participate in or adhere to treatment for a mental disorder despite having
treatment offered, prescribed, recommended or ordered to improve the person's
condition or to prevent a relapse or harmful deterioration of the person's
condition. The court's finding shall be based on evidence that
establishes all of the following by clear and convincing evidence:
1. The person received treatment in the preceding
twenty-four months in other less-restrictive settings, including
unsecured residential treatment settings with on-site twenty-four-hour
supportive treatment and supervision by staff with behavioral health training,
and the treatment was unsuccessful or is not likely to be successful due to the
person's expressed or demonstrated unwillingness to cooperate with treatment in
other less-restrictive or unsecured residential treatment settings.
2. The person's nonadherence to or nonparticipation
in treatment over the preceding twenty-four months resulted in one or
more of the following:
(a) Serious harm to self.
(b) Serious harm or threats of serious harm to
others.
(c) Recurrent periods of homelessness resulting from
the mental disorder.
(d) Recurrent serious medical problems due to poor
self-care or failure to follow medical treatment recommendations.
(e) Recurrent arrests due to behavior resulting from
the mental disorder.
3. Any other evidence relevant to the person's
willingness or ability to participate in and adhere to treatment or the
person's need for treatment in a licensed secure residential setting to ensure
the person's compliance with court-ordered treatment.
C. A person's placement in a licensed secure
behavioral health residential facility for treatment shall be part of the
written treatment plan
that conforms to the requirements of
section 36-540.01, subsection B and that is
presented to
the court by a mental health treatment agency
and approved by
the court
as required by section 36-540, subsection C,
paragraph 2
. The court shall confirm in the order that the
person's placement in a licensed secure behavioral health residential facility
is the least restrictive environment to ensure the person's compliance with the
treatment plan.
The
mental health treatment agency that will supervise the treatment pursuant to
section 36-540, subsection E and the licensed secure behavioral health
residential facility shall coordinate the care of the patient pursuant to rules
adopted by the department or as required by the administration.
D. A person who is placed in a
licensed secure behavioral health residential facility may appear and present
testimony in open court through the use of telephone, videoconferencing or
other audiovisual technology pursuant to section 36-505, subsection B.
END_STATUTE
Sec. 7.
Retroactivity
Sections 36-501, 36-540
and 36-550.09, Arizona Revised Statutes, as amended by this act, apply
retroactively to from and after April 30, 2025.