2023 LEGISLATIVE UPDATE

Fifty-Sixth Legislature, First Regular Session Report Last Updated May 19, 2023 (on recess until June 12, 2023) Disclaimer: Since the legislature acts daily, each bill’s status listed herein could change daily. This tracking document is merely meant to advise our Arizona Psychiatric Society (APS) members of a general overview of some of the bills that have been introduced and the status of the bill as of the date listed below. The bill summaries listed herein may or may not include all aspects of the proposed legislation and subsequent amendments and do not necessarily reflect APS’s interpretation/summary of the bills or the merits of the same. For more information please reach out to admin@azpsych.org and we'll get you in contact with our Government Affairs Committee. THESE ARE BILLS ONLY (E.G. PROPOSED LAWS) BUT HAVE NOT BEEN MADE LAWS AS OF THIS DATE – UNLESS SPECIFICALLY IDENTIFIED Arizona Psychiatric Society Bill Tracking Report Priority Bills SB1018: Mental health coverage; collaborative care (Included in SB 1726/HB 2816: Health Care 2023-2024 Budget) Establishes the Collaborative Care Uptake Fund and requires the Arizona Department of Health Services (ADHS) to use Fund monies to make grants to primary care physicians who are in a medical practice with up to 50 employees to meet the initial costs of establishing and delivering behavioral health integration services through the collaborative care model. Specifies the expenses that a primary care physician that receives a grant may use the grant monies for. ADHS is required to solicit proposals from and enter into grant agreements with eligible collaborative care technical assistance center applicants to provide technical assistance to primary care physicians providing behavioral health integration services through the collaborative care model. A collaborative care technical assistance center that receives a grant is required to assist primary care physicians with a list of tasks. Appropriates $1 million from the general fund in FY2023-24 to the Fund and from the Fund to ADHS. AS PASSED SENATE Sponsor: Sen. Shope (Prime) and Sen. Shamp Status: Passed House Appropriations 15-0-0; Included in Health Care 2023-2024 Budget (SB 1726/ HB 2816) Introduced Version of Bill Amendment: Establishes the Collaborative Care Uptake Fund and directs the Department of Health Services (DHS) to award grants to outlined primary care physicians and technical assistance centers to aid primary care physicians on providing services through the collaborative care model. Appropriates $1,000,000 from the state General Fund (state GF) in FY 2024 to the Fund and from the Fund to DHS. SB1077: Jails; mental health; evaluations; treatment For the purpose of court-ordered mental health evaluations, the definitions of "evaluation agency" and "mental health treatment agency" are expanded to include a facility that is exempt from licensure as a health care institution, that possesses an accreditation from either a national commission on correctional health care or an American correctional association, and that has been approved to provide the services required. Sponsor: Sen. Shope Status: Signed SB1710 - State hospital; governing board; governance Various changes relating to the Arizona State Hospital. Establishes a 5-member Arizona State Hospital Governing Board and transfers responsibility for administering the Arizona State Hospital to the Board, from the Arizona Department of Health Services (ADHS). Session law provides for the Board to succeed to the authority, powers, duties, and responsibilities of ADHS relating to the Arizona State Hospital. The Arizona State Hospital is required to admit patients based on clinical need for treatment and is prohibited from placing any limit on admission based on a patient's county of residence. Effective January 1, 2025. AS PASSED SENATE Sponsor: Sen. David Gowan (R) Status: Awaiting COW Calendar Introduced Version of Bill Amendment: Removes the requirement that there be a legally available funded bed at ASH in order for the Director of a local mental health treatment agency assigned to supervise and administer a patient's treatment to request that the court amend the patient's order to place the patient for treatment at ASH. Other Bills of Interest HB2041 - Mental health; voluntary evaluations; payment During the process for court-ordered mental health evaluations, if a person who requested a voluntary mental health evaluation does not appear or does not complete the appointments scheduled, the provider who was to conduct the evaluation is required to immediately notify the evaluation agency provided for by the county, and the evaluation agency is required to provide pre-petition screening of the application for court-ordered mental health evaluation. When a person is given a voluntary mental health evaluation, the person is required to pay all or a portion of the established charges as the person can afford. If the person is indigent, charges cannot be made against the person. AS PASSED SENATE Sponsor: Rep. Selina Bliss (R) Status: Signed HB2043: Physician assistants; supervision; collaboration Licensed physician assistants (PAs) who have at least 6,000 hours of clinical practice certified by the Arizona Regulatory Board of Physician Assistants are no longer required to be supervised by a licensed physician, and instead are required to collaborate with or refer to the appropriate health care professional as determined by the policies of the practice setting at which the PA is employed. PAs are authorized to provide any legal medical service for which the physician assistant has been prepared by education, training, and experience and that the physician assistant is competent to perform. PAs who have less than 6,000 hours of clinical practice certified by the Board are required to work in accordance with a supervision agreement that describes the PA's scope of practice. A PA who does not practice under a supervision agreement is legally responsible for the health care services performed by the PA. Effective January 1, 2024. Sponsor: Rep. Bliss Status: Signed Introduced Version of Bill Amendment: Adds to the documentation exemption requirements that the physician assistant must have graduated from an accredited physician assistant program. Increases from 6,000 to 8,000 hours, the clinical practice hour requirement that a physician assistant must achieve before they can be exempt from supervision by a licensed physician. HB2753 - Graduate medical education; residency programs By March 1, 2024, the Arizona Area Health Education System (AAHES) is required to establish a program for qualifying community health centers and rural health clinics that supports and expands the number of primary care residency positions, provides support and technical assistance for starting or expanding primary care residency programs in rural areas and health professional shortage areas, and provides training and technical assistance to support the success of qualifying community health center and rural health clinic primary care residency programs. Appropriates $5 million from the general fund in FY2023-24 to the AAHES for these purposes. Appropriates $5 million from the general fund in FY2023-24 to the Arizona Health Care Cost Containment System (AHCCCS) Administration for the direct and indirect costs of primary care graduate medical education at qualifying community health centers and rural health clinics. Defines “primary care” as family medicine, internal medicine, pediatrics, pediatric internal medicine, psychiatry, obstetrics and gynecology, geriatrics or general surgery. Sponsor: Rep. Michele Pena (R) Cosponsors: Rep. Amish Shah (D), Rep. Patricia Contreras (D), Rep. Michael Carbone (R), Rep. Selina Bliss (R) Status: Passed Senate Appropriations Introduced Version of Bill Amendment: Adds Tribal Health Facilities to the list of clinics eligible for the program. SB1220: Alzheimer's disease state plan; appropriation (Included in SB 1726/HB 2816: Health Care 2023-2024 Budget) The Arizona Department of Health Services (ADHS) is designated as the lead agency in Arizona to address Alzheimer’s Disease and related forms of dementias. ADHS is required to develop an Alzheimer’s Disease State Plan to assess the impact of Alzheimer’s Disease and dementia on Arizona, assess the existing state services that address the needs of persons who have Alzheimer’s Disease or dementia and their family caregivers, and provide a strategic plan for state action to increase access to care, support, and treatment, improve quality of care, advance risk reduction and early detection, and ensure a coordinated statewide response. The ADHS Director is required to establish a Dementia Services Program within ADHS that meets a list of specified requirements, including facilitating the coordination and implementation of the Plan. By July 1, 2024 and every third year after, ADHS is required to review the Plan and submit an updated Plan to the Governor and the Legislature. Appropriates $300,000 from the general fund in FY2023-24 to ADHS for the Program and the implementation of the Plan. Sponsor: Sen. Thomas "T.J." Shope (R) Status: Passed House Government; Included in Health Care 2023-2024 Budget (SB 1726/ HB 2816) Dead Bills HB2157: Medical malpractice; statute of limitations Increases the statute of limitations on a cause of action for medical malpractice to five years, from two years, after the cause of action accrues. Sponsor: Rep. Diaz Status: Second Read; Assigned to Health & Human Services, Judiciary HB2467: International medical graduates; licensure (mirror bill to SB 1249) The Arizona Medical Board is required to grant a license to practice medicine in Arizona to an medical graduate who is a resident of and is licensed to practice in any of a list of ten countries if the person meets other specified requirements. AMB is required to issue a provisional license to practice medicine in Arizona to any international medical graduate who has an offer for employment at any health care provider that operates in Arizona, whose federal immigration status allows him/her to practice as a physician in the U.S., and who meets the requirements for licensure. A provisional license under these circumstances is automatically converted into a full license after three years unless AMB disciplines the licensee in that period. Effective January 1, 2024. Sponsor: Rep. Montenegro Status: Held in HHS HB2486 - Clinical research; psilocybin; grants; appropriation The Director of the Arizona Department of Health Services (ADHS) is required to provide competitive research grants for whole mushroom psilocybin phase one, phase two, and phase three clinical trials that are capable of being approved by the U.S. Food and Drug Administration to evaluate the effects of whole mushroom psilocybin on treating a list of disorders and conditions. Establishes requirements for the clinical trials that are funded under this section. Establishes a 5-member Psilocybin Research Advisory Council in ADHS to establish criteria for the clinical trials and oversee the application process for grants. These provisions self-repeal January 1, 2029. Appropriates $30 million from the general fund in FY2023-24 to ADHS for psilocybin research grants. Sponsor: Rep. Kevin Payne (R) Cosponsors: Rep. Jennifer L. Longdon (D), Rep. Stacey Travers (D), Sen. Thomas "T.J." Shope (R) Status: Passed House Military Affairs & Public Safety 15-0-0 HB2529: Scope of practice; process; repeal (mirror bill to SB 1248 which was VETOED) Repeals statute establishing a process for a health professional group seeking an increased scope of practice. HB2601 - Teen mental health; grant program Establishes the Children’s behavioral health services fund which provides funding to school districts or nonprofit organizations for mental health first aid training, youth resiliency training, substance misuse awareness training, and other programs. Sponsor: Rep. Travis Grantham (R), Toma Status: Second Read HB2716 - Appropriation; mental health services; minors Appropriates an unspecified amount (blank in original) from the general fund in FY2023-24 to the Arizona Department of Health Services for mental health services for minors. Sponsor: Rep. Melody Hernandez (D) Cosponsors: Rep. Lorena Austin (D), Rep. Stephanie Stahl Hamilton (D), Rep. Mariana Sandoval (D), Rep. Marcelino Quiñonez (D), Rep. Analise Ortiz (D), Rep. Jennifer L. Longdon (D), Rep. Lydia Hernandez (D), Rep. Consuelo Hernandez (D), Rep. Alma Hernandez (D), Rep. Oscar De Los Santos (D), Rep. Lupe Contreras (D), Rep. Andrés Cano (D), Rep. Cesar Aguilar (D) Status: Second Read Introduced Version of Bill SB1225 - Appropriations; developmental disabilities programs Appropriates $60 million from the general fund and $120 million from expenditure authority in FY2023-24 to the Arizona Department of Economic Security (ADES) for provider rate increases for services to individuals with intellectual and developmental disabilities. Appropriates $18 million from the general fund and $36 million from expenditure authority in FY2023-24 to ADES for home and community-based services for habilitation services for adults and children and habilitation services at vendor supported developmental homes, room and board at vendor supported developmental homes, and habilitation services and room and board at group homes. Appropriates $5 million from the general fund in FY2023-24 to ADES for the Arizona Early Intervention Program. Sponsor: Sen. Thomas "T.J." Shope (R) Status: Failed House Appropriations SB1248: NOW: Scope of practice; process; repeal (mirror bill to HB 2529) Repeals statute establishing a process for a health professional group seeking an increased scope of practice. Sponsor: Sen. Thomas "T.J." Shope (R) Status: VETOED SB1249: Medical licensing; study committee (International medical graduates; licensure) The Arizona Medical Board is required to grant a license to practice medicine in Arizona to an international medical graduate who is a resident of and is licensed to practice in any of a list of ten countries if the person meets other specified requirements. AMB is required to issue a provisional license to practice medicine in Arizona to any international medical graduate who has an offer for employment at any health care provider that operates in Arizona, whose federal immigration status allows him/her to practice as a physician in the U.S., and who meets the requirements for licensure. A provisional license under these circumstances is automatically converted into a full license after three years unless AMB disciplines the licensee in that period. Effective January 1, 2024. SB1282 – NOW: nurse anesthetist; appropriation S/E Amendment: A certified registered nurse anesthetist is authorized to administer anesthetics, without being under the direction of and in the presence of a physician or surgeon, in specified settings. Establishes the Student Registered Nurse Anesthetist Clinical Rotation Program in the Arizona Health Care Cost Containment System (AHCCCS) Administration to expand the capacity of preceptor training programs at healthcare institutions for nurse anesthetist students. The AHCCCS Administration is required to develop a grant program to distribute monies appropriated for the Program to licensed health care institutions to expand or create clinical training placements for nurse anesthetist students. Appropriates $200,000 from the general fund in FY2023-24 to the AHCCCS Administration for the Program. Sponsor: Sen. Janae Shamp (R) Status: FAILED Third Reading SB1285 - Obstetric services; rural communities; recommendations (S/E- licensure; international medical graduates) S/E Amendment: AMB is required to issue a provisional license to practice medicine in Arizona to any international medical graduate who has an offer for employment at any health care provider that operates in Arizona, whose federal immigration status allows him/her to practice as a physician in the U.S., and who meets the requirements for licensure. A provisional license under these circumstances is automatically converted into a full license after three years unless AMB disciplines the licensee in that period. Effective January 1, 2024. Sponsor: Sen. Janae Shamp (R) Status: Held in House Appropriations SB1457 - Psychologists; prescribing authority (S/E: firefighter health; transaction fee; fireworks) The Board of Psychologist Examiners is authorized to issue a conditional prescription certificate to licensed psychologists to allow the psychologist to prescribe psychotropic medication and any other medication approved by the U.S. Food and Drug Administration to treat mental disorders under the supervision of a physician. Establishes requirements for a psychologist to apply to the Board for a conditional prescription certificate, including completing pharmacological training from an institution of higher education approved by the Board and supervised and relevant clinical experience approved by the Board. A licensed physician is authorized to supervise a licensed psychologist who holds a conditional prescription certificate to prescribe psychotropic medication and any other medication approved by the U.S. Food and Drug Administration to treat mental disorders. The prescribing psychologist is required to maintain an ongoing collaborative relationship with the health care practitioner who oversees the patient's general medical care. Sponsor: Sen. Thomas "T.J." Shope (R) Status: Held in House Appropriations Committee Introduced Version of Bill Proposed Striker Amendment: Establishes the Firefighter Health Care Fund to provide health care services to firefighters injured, disabled or killed. Allows municipalities to impose stricter restrictions on the sale of fireworks. SB1459 - Mental illness; medication; authorization For the purpose of behavioral health services and the Arizona Health Care Cost Containment System, medications that are prescribed to address a mental disorder are not subject to prior authorization for persons who are at least 18 years of age if a list of specified conditions apply, including that the medication is prescribed to prevent or treat any of a list of qualifying mental disorders, the medication is a covered benefit, and the prescription does not exceed labeled dosages approved by the U.S. Food and Drug Administration. Qualifying mental disorders include bipolar disorder, obsessive-compulsive disorder, paranoid and other psychotic disorders, schizoaffective disorders, and schizophrenia. Sponsor: Sen. Thomas "T.J." Shope (R) Status: Second Read SB1661 - Behavioral health treatment facilities; notification When a patient is admitted for initial evaluation, a behavioral health residential facility is required to notify the patient's family or next of kin as promptly as possible. A person cannot be transported to a behavioral health residential facility by representatives of the facility unless the person is sober or is referred by an approved provider of a Tribal health care program. Establishes penalties for violations. Sponsor: Sen. Theresa Hatathlie (D) Status: Discussion Only- No vote